Code of Maryland Regulations (Last Updated: April 6, 2021) |
Title 10. Maryland Department of Health |
Part 3. |
Subtitle 21. MENTAL HYGIENE REGULATIONS |
Chapter 10.21.26. Community Mental Health Programs—Residential Crisis Services |
Sec. 10.21.26.04. Program Model
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A. A provider of RCS shall assure that services are:
(1) Therapeutic;
(2) Provided by staff who, as determined by the program, are appropriately credentialed and privileged;
(3) Available:
(a) 24 hours per day, 7 days per week;
(b) On a short-term basis, as needed to resolve an immediate crisis; and
(c) At a location in the community, unless given a written exemption from the core service agency (CSA).
B. A provider of RCS shall assure that services are adequate to support one or more of the following levels of service:
(1) Inpatient admission prevention, which provides:
(a) Services to an individual who, based on the individual's history, as evaluated by a physician or a mental health professional, has a mental disorder and, without RCS, is at risk for inpatient admission or cannot be discharged from an inpatient facility; and
(b) Staff adequate to support the services under §B(1)(a) of this regulation, as outlined under Regulations .08 and .09 of this chapter;
(2) Inpatient admission alternative, which provides:
(a) Services to an individual who, based on an evaluation by a physician or a mental health professional, has a mental disorder, presents a danger to self or others, and would, without RCS, be admitted to or could not be discharged from an inpatient facility; and
(b) Staff adequate to support the services under §B(2)(a) of this regulation, as outlined under Regulations .08 and .10 of this chapter, including access to a psychiatrist 24 hours per day, 7 days per week; or
(3) Treatment foster care, which provides:
(a) Services to an individual who, based on an evaluation by a physician or mental health professional, has a mental disorder, and is in need of a high level of treatment intervention in a family setting; and
(b) Staff adequate to support services under §B(3)(a) of this regulation, as outlined under Regulations .08 and .11 of this chapter.
C. A provider of RCS shall assure that services are designed to:
(1) Avert or shorten the length of inpatient admissions;
(2) Defuse a current crisis, evaluate the nature of the crisis, stabilize the individual to the pre-crisis level of functioning, and intervene to reduce the likelihood of crisis recurrence;
(3) Assist the individual and members of the individual's natural support system to recognize and take preventive action to resolve situations that lead to crisis;
(4) Provide counseling, training, and support for crisis prevention, identification, and intervention for individuals and, if appropriate, their families;
(5) Link individuals with services and supports in the community including, but not limited to, financial, educational, social, medical, and mental health resources that will enable the individual to:
(a) Return to the individual's previous living situation; or
(b) Secure an alternative living situation; and
(6) Offer a home-like environment that provides goal-directed services to facilitate safe discharge from residential crisis services.
D. A provider of RCS shall assure that services are coordinated with, when appropriate:
(1) An individual's custodial agents;
(2) Designated psychiatric emergency facilities;
(3) Psychiatric inpatient facilities;
(4) Psychiatric rehabilitation programs;
(5) Outpatient mental health clinics;
(6) Somatic care providers;
(7) Schools;
(8) Other agencies involved with the individual, including, but not limited to:
(a) Local departments of social services;
(b) Department of Juvenile Services;
(c) The local education authority;
(d) The local coordinating council (LCC);
(e) The local management board; and
(f) Criminal justice agencies; and
(9) Other public and private providers of mental health services to an individual.