Sec. 10.21.29.07. Rehabilitation and Support Services Provided

A. PRP services may only be provided to a minor if identified in the minor's IRP and referred for PRP services by:

(1) A licensed mental health professional who is providing inpatient, residential treatment center, or outpatient mental health services to the minor; and

(2) Staff who have been privileged by the program to provide the services.

B. Rehabilitation Activities. The program director shall ensure that the program provides rehabilitation activities directed toward the development or restoration of skills including:

(1) Age-appropriate self care skills, including:

(a) Personal hygiene;

(b) Grooming;

(c) Nutrition;

(d) Dietary planning;

(e) Food preparation; and

(f) Self-administration of medication;

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

(3) Independent living skills, including:

(a) Maintenance of the minor's living environment;

(b) Community awareness;

(c) Mobility skills;

(d) Money management; and

(e) Accessing available entitlements;

(4) Activities that support the minor's cultural interests;

(5) Conflict resolution;

(6) Anger management;

(7) Interactive skills with peers and authority figures;

(8) Maintaining personal living space;

(9) Maintaining age-appropriate boundaries;

(10) Maintaining personal safety in a social environment; and

(11) Time management, including constructive use of structured and unstructured time.

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:

(a) Support the individual's self-administration, as appropriate, 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. Promotion of Illness Self Management.

(1) As is age appropriate, staff shall provide education and information regarding mental illness.

(2) The program director shall ensure that the minor's rehabilitation coordinator collaborates with the minor to identify effective strategies to assist the minor to manage the minor's illness.

(3) The strategies identified under §D(2) shall include, at a minimum, the minor's identification of:

(a) Potential problematic symptoms;

(b) Warning signs of relapse;

(c) Helpful interventions; and

(d) Other individuals the minor identifies to resolve the situation in order for the minor to remain in service or to seek treatment.

(4) The minor's illness self management strategies shall be documented and may be incorporated in the minor's IRP, ITP, mental health advance directive, or any combination of them.

(5) 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 minor.

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

(1) On-call and emergency response services are available by a licensed mental health professional to an individual who has been admitted to the PRP:

(a) Face-to-face during the hours that the PRP is open; and

(b) By telephone, on an on-call basis, 24 hours per day, 7 days per week, during the hours the PRP is not open:

(i) Through the PRP; or

(ii) Through an agreement with another mental health crisis service provider;

(2) PRP staff provide to a minor:

(a) Intensive support and assistance, as authorized, including but not limited to:

(i) Providing one-to-one staff support for the minor, if necessary;

(ii) Escorting the minor while accessing needed assistance or services; and

(iii) Obtaining input from the mental health professional who is providing outpatient mental health services to the minor;

(b) Information regarding needed services; and

(c) If necessary, referral for appropriate health care.

F. If emergency care is necessary, all relevant staff shall:

(1) Have access to the names, addresses, and telephone numbers of providers, including the hospital, that are designated to provide emergency care and treatment to the minors served; and

(2) Be appropriately trained to link minors to emergency care, as needed.

G. Linkage with a Minor in a Psychiatric Inpatient Facility, Residential Treatment Center (RTC), or Detention Center.

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

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