Sec. 10.21.26.12. Transition and Discharge

A. Discharge Policy. The program director shall:

(1) Collaborate with the Administration's ASO to:

(a) Arrange for discharge from the program when services are no longer authorized by the Administration's ASO; and

(b) Make recommendations for referral for alternative services for an individual for whom the program's services are not appropriate; and

(2) Maintain clearly written policies and procedures for:

(a) Transition services;

(b) Collaborative discharge from the program; and

(c) Making recommendations for discharge and referral for alternative services for an individual for whom the program's services are not appropriate.

B. Transition. The treatment coordinator shall:

(1) Collaborate with the Administration's ASO to provide interim services and assure appropriate referrals for authorization for case management and other service providers before discharge; and

(2) With proper consent and while the individual is still in the RCS program, contact the providers who have been authorized to provide the services designated in the discharge summary.

C. Collaborative Discharge. When the Administration's ASO, in consultation with the treatment coordinator, determines that services are no longer medically necessary, the rehabilitation coordinator shall:

(1) Prepare a discharge plan based on an assessment of the individual's current service needs and mutually agreed upon goals, in collaboration with:

(a) The individual, and, for a child, the primary caretaker; and

(b) With proper consent:

(i) Family or significant others designated by the individual; and

(ii) When feasible, other treatment and service providers;

(2) When needed, make appropriate recommendations to the Administration's ASO for treatment, rehabilitation, and community supports; and

(3) Complete a discharge summary in accordance with COMAR 10.21.17.07D(3).

D. Individual's Discontinuation of Services. When an individual discontinues services before a planned, collaborative discharge as described in §C of this regulation, the treatment coordinator shall:

(1) When possible, give the individual information about appropriate alternate services;

(2) If authorized by the Administration's ASO, provide appropriate outreach to encourage the individual to access appropriate services;

(3) With proper consent, provide notice of the discontinuation to:

(a) The emergency contact named by the individual at the time of admission;

(b) When feasible, other service providers, including the individual's somatic care provider, when known; and

(c) When needed, the CSA and the Administration's ASO, for referral for appropriate alternative services; and

(4) Complete a discharge summary in accordance with COMAR 10.21.17.07D(3).

E. Program's Recommendation to Discontinue Services. If, in consultation with the program director, the treatment coordinator recommends discharging an individual who does not comply with the program's rules or for whom the program's services are not appropriate, the program director shall:

(1) Provide written notice of the intention to discharge from services and recommend referral for alternative services:

(a) To the individual and, for a child, the parent or guardian and, if other than the parent or guardian, the primary caretaker;

(b) With proper consent to:

(i) The emergency contact named by the individual at the time of admission;

(ii) When feasible, other service providers; and

(iii) When needed, the CSA and the Administration's ASO, for referral for appropriate alternative services;

(c) That includes:

(i) The effective date of the action;

(ii) The reason for the action; and

(iii) When possible, a discharge plan; and

(2) Complete a discharge summary in accordance with COMAR 10.21.17.07D(3).