Sec. 10.21.21.07. Rehabilitation and Support Services Provided

A. Rehabilitation and support services may only be provided:

(1) To an individual consistent with the individual's IRP or ITRP; and

(2) By staff who have been determined competent by the program to provide the services.

B. Rehabilitation and Recovery Activities. The program director shall ensure that the program provides rehabilitation activities directed toward the individual's recovery and the improvement or restoration of skills, including:

(1) Self-care skills, including personal hygiene, grooming, nutrition, dietary planning, food preparation, and self-administration of medication;

(2) Social skills, including community integration activities, developing natural supports, and developing linkages with and supporting the individual's participation in community activities;

(3) Independent living skills, including:

(a) Skills necessary for housing stability;

(b) Community awareness;

(c) Mobility and transportation skills;

(d) Money management;

(e) Accessing available entitlements and resources;

(f) Supporting the individual to obtain and retain employment; and

(g) Wellness self-management; and

(4) Activities that support the individual's cultural interests.

C. Medication Services.

(1) Administration.

(a) An individual licensed to administer medication under Health Occupations Article, Annotated Code of Maryland, may do so.

(b) A licensed practical nurse or a registered nurse may delegate the administration of medication only according to the provisions of COMAR 10.27.11.

(2) Monitoring. A PRP staff member shall provide the following services for psychiatric and somatic medications:

(a) Support the individual's self-administration of prescribed medication;

(b) Read the medication label to ensure that each container of medication is clearly labeled with the individual's name, the contents, directions for use, and expiration date;

(c) To the extent possible, monitor compliance with instructions appearing on the medication label;

(d) Ensure that each individual has secure, appropriate, and accessible space in which to store medications;

(e) Observe and document any apparent reactions to medication and, either verbally or in writing and in a timely fashion, communicate to the prescribing authority any problems that possibly may be related to the medication; and

(f) Reinforce, with the individual, education on the role and effects of medication in symptom management.

D. Health Promotion and Training. PRP staff shall encourage health promotion activities, such as proper nutrition and exercise.

E. Promotion of Individual Wellness Self Management and Recovery.

(1) Staff shall:

(a) Provide education and information regarding mental illness and recovery; and

(b) Support the individual to identify effective strategies to assist the individual to manage the individual's wellness.

(2) The strategies shall include, at a minimum, the individual's identification of:

(a) Potential challenging symptoms;

(b) Warning signs of relapse;

(c) Helpful interventions; and

(d) Other people the individual identifies to support the individual's recovery.

(3) The individual's wellness self-management strategies shall be documented and may be incorporated in the individual's IRP, Residential Rehabilitation Program Managed Intervention Plan, as outlined in Regulation .08 of this chapter, mental health advance directive, or any combination of these items.

(4) The strategies shall be reviewed at the time of the IRP review and may be revised or revoked at any time at the request of the individual.

F. On-Call and Emergency Response. The program director shall assure that:

(1) On-call and crisis intervention services are available 24 hours per day, 7 days per week, by telephone, to an individual who has been admitted to the PRP; and

(2) All relevant staff shall assist the individual to access, as appropriate, the OMHC, mobile crisis, residential crisis services, hospitals, and other service providers that are designated to provide crisis and emergency care and treatment.

G. Linkage with an Individual in a Psychiatric Inpatient Facility or Detention Center.

(1) If an individual who is enrolled in a program is admitted to a psychiatric inpatient facility or detention center, the rehabilitation coordinator shall make reasonable efforts to maintain ongoing communication with the individual and the individual's inpatient treatment team.

(2) To the degree permitted by the setting, PRP staff serving the individual shall participate in aftercare or release planning from that setting.