Sec. 10.21.26.05. Eligibility, Referral, Screening, and Admission

A. Eligibility and Referral.

(1) An individual is eligible for RCS if:

(a) The individual:

(i) Is a participant, as described in COMAR 10.21.25.01D(2), in the public mental health system;

(ii) Has a diagnosis that is listed in COMAR 10.09.70.02;

(iii) Due to acute symptomatology related to the individual's psychiatric condition, has impaired ability to function within the individual's community living situation and is in need of RCS to avoid inpatient psychiatric admission or to shorten the length of inpatient stay;

(iv) For clinical reasons, requires a temporary separation from the individual's current living situation;

(v) Has stated a willingness to comply with program rules, or, for a child, a parent or guardian has stated a willingness to comply with program rules;

(vi) Expects, with staff support, to be able to comply with treatment recommendations; and

(vii) Is able, with staff support, to care for physical needs and basic personal hygiene; and

(b) The services are preauthorized, as needed, by the Administration's administrative services organization (ASO) according to the provisions of COMAR 10.21.17.02-1A.

(2) An individual is not eligible for RCS if the individual:

(a) Has a sole diagnosis of substance abuse, mental retardation, or dementia;

(b) Is in need of immediate involuntary inpatient psychiatric admission;

(c) As determined by an individual authorized under Health Occupations Article, Annotated Code of Maryland, to make medical determinations, is medically unstable; or

(d) Does not meet the eligibility criteria under §A(1)(a) of this regulation.

(3) An RCS program may not exclude an individual solely because the individual:

(a) Does not participate in other treatment or rehabilitation programs; or

(b) Is homeless.

B. Screening Assessment.

(1) If an individual who is authorized for services has not, before the individual's entry into the RCS program, been evaluated face-to-face by a physician who documents the elements included in this section, an appropriately privileged mental health professional, in collaboration with the individual, shall conduct a screening assessment to:

(a) Assess the individual's needs and willingness to participate in RCS;

(b) Document:

(i) The diagnosis, if any, provided by the referral source; and

(ii) If applicable, medications that are prescribed for the individual;

(c) In consultation with the individual and, if any, the referral source, outline a preliminary plan for the RCS services to be provided if the individual enters RCS services, including, at a minimum, the level and type of staff support required for the individual's first 48 hours in the program, and, when appropriate, enhanced support such as:

(i) 24-hour, on-site;

(ii) 24-hour, on-site, awake; or

(iii) One-to-one; and

(d) Inform the individual of the rules of the program and the process and procedure for discharge, including situations as outlined under Regulation .12E of this chapter.

(2) If, following the assessment under §B(1) of this regulation, the RCS program director determines that the program's services are not appropriate for an individual who has been referred, the program director shall promptly:

(a) Inform the individual and, if the individual is a child, the parent or guardian, of the determination and the reason;

(b) With proper consent, notify the family or significant others designated by the individual of the determination and of any recommendations for other services; and

(c) Notify the CSA and the Administration's ASO for appropriate alternative referral.

C. Admission. Unless an individual has been re-referred to the Administration's ASO under the provisions of §B(2)(c) of this regulation, an RCS program shall initiate services to an individual if:

(1) The individual accepts the rules of the RCS program; and

(2) When the individual referred for RCS is a child, the parent or guardian signs an agreement with the provider to accept the child for placement upon discharge from RCS.