Sec. 10.21.20.05. Eligibility, Screening, Enrollment, and Orientation

A. Eligibility.

(1) An individual is eligible for services through the public mental health system (PMHS) if the services are preauthorized, if required, by the Administration's administrative services organization (ASO), according to the provisions of COMAR 10.21.17.03A.

(2) In addition to those individuals described in §A(1) of this regulation, an OMHC may provide services to other individuals who wish to contract privately for services.

(3) If an OMHC provides services to an individual described in §A(2) of this regulation, an OMHC may not seek reimbursement by the PMHS for providing services to that individual.

B. Screening Assessment.

(1) An OMHC licensed mental health professional, in collaboration with the individual referred, shall conduct a screening assessment to assess the individual's goals for recovery, strengths, available resources, and treatment needs:

(a) Within 5 working days of receipt of a referral from an inpatient facility for OMHC services; or

(b) By the date established under §B(2) of this regulation for all other referrals.

(2) For referrals that are not from an inpatient facility, the program director shall:

(a) In collaboration with the medical director, establish a procedure to review clinical acuity as described by the referral source;

(b) Based on the review of clinical acuity described in §B(2)(a) of this regulation, establish the date for a screening assessment; and

(c) Inform the individual of:

(i) The date established for the screening assessment; or

(ii) If, due to program capacity, there will be a delay in the screening assessment, a tentative time frame for services.

(3) If, following the screening assessment under §B(1) of this regulation, the OMHC program director, or licensed mental health professional designated by the program director, determines that the OMHC's services are not appropriate for an individual referred, the OMHC shall advise the individual and, if appropriate, notify the ASO and CSA.

C. Enrollment. Unless an individual has been determined to be clinically inappropriate for services under the provisions of §B(3) of this regulation, an OMHC shall:

(1) Initiate evaluation and treatment services for an individual who has been referred from an inpatient facility, within 5 working days of the screening assessment conducted under §B(1) of this regulation; or

(2) For all other referrals screened under §B(2) of this regulation, the program director shall:

(a) In collaboration with the medical director, establish a procedure to review clinical acuity as described by the referral source;

(b) Assign priority for OMHC services based on clinical acuity;

(c) Inform the individual of:

(i) The estimated date evaluation and treatment services may be initiated; and

(ii) If, due to program capacity, there will be a delay in the initiation of treatment services, alternative services that are available.

D. Orientation. The program director shall ensure that an individual who has been enrolled in the OMHC, or if the individual is a minor, the minor's parent or guardian, receives an orientation as outlined in COMAR 10.21.17.04B.