This chapter establishes admission procedures, criteria, and resident rights for Maryland's Regional Institutes for Children and Adolescents (RICAs), which are state-licensed mental health facilities providing residential treatment to severely emotionally disturbed children and adolescents aged 12–17. Operators must maintain an admission team, evaluate applicants within 10 working days, and ensure admitted residents meet clinical criteria including a long-term severe mental disorder that cannot be addressed through community-based programs. Facilities must develop individualized treatment and aftercare plans for each resident and inform residents of their statutory rights upon admission.
View official sourceCode of Maryland Regulations Chapter 06 Admission to Regional Institutes for Children and Adolescents Administrative History Effective date: July 1, 1985 (12:9 Md. R. 811) Authority Health-General Article, §§2-104, 10-204, 10-401, 10-406, 10-407, 10-602, 10-609, and 10-610, Annotated Code of Maryland .01 Scope. This chapter establishes procedures and standards for residential admission to the Regional Institutes for Children and Adolescents (RICAs). The RICAs are mental health facilities licensed and operated by the Maryland Department of Health for the residential treatment of severely emotionally disturbed children and adolescents. .02 Definitions. A. The following terms have the meanings indicated. B. Terms Defined. (1) “Administration” means the Maryland Department of Health. (2) “Applicant” means a child or adolescent who is the subject of an application for admission to a RICA. (3) “Director” means the Director of the Maryland Department of Health. (4) “Mental disorder” means a behavioral or emotional illness that results from a psychiatric or neurological disorder and is referenced in Health-General Article, §10-620(e)(1), Annotated Code of Maryland. (5) “Resident” means a child or adolescent who is admitted to a RICA for residential treatment. (6) “Residential treatment” means a program of active psychiatric treatment that is provided on a residential basis, under the direction of a psychiatrist, and in conformity with an individualized treatment plan. (7) “RICA” means a Regional Institute for Children and Adolescents. Cross References 13A.08.04.01A(3) .03 Application for Admission. A. On referral by a public or private agency or mental health professional, application for admission to a RICA may be made by: (1) The parent or guardian of a child or adolescent under 18 years old; (2) An adolescent, if the adolescent is 16 years old or older; or (3) A State or county agency that has custody of a child or adolescent, with the signed consent of the parent or guardian or in accordance with a court order. B. The admission application shall be on a form prescribed by the Administration and shall include: (1) The name, date of birth, sex, legal domicile, and present residence of the applicant; (2) A statement based on clinical evaluation by a mental health professional that the applicant has a long term and severe mental disorder and is in need of residential treatment; and (3) A recent history of the applicant's psychiatric or psychological treatment, educational or special educational services, and involvement with community agencies. C. Available medical records and psychiatric or psychological evaluations describing the applicant's mental disorder and need for residential treatment shall be attached to the admission application. D. The referring agency or mental health professional shall be responsible for assuring that appropriate written consent is obtained so as to permit that all required completed application materials may be sent to the RICA. .04 Admission Procedures. A. Each RICA shall maintain an admission team which consists of a physician, mental health and educational professionals and other persons, as appropriate. The RICA admission team shall determine whether the applicant meets the admission standards set forth in Regulation .05 of this chapter , within 10 working days of receipt of the completed application. B. The applicant and referring agency or mental health professional shall be notified by the RICA admission team as to whether the applicant meets the admission criteria. C. If the admission team determines that the admission criteria are met, a pre-admission interview shall be scheduled by the RICA at the earliest convenient date for all parties involved. .05 Admission Criteria. A. A child or adolescent may be admitted to a RICA if the: (1) Individual has a long-term and severe mental disorder; (2) Individual has treatment needs that cannot be met through available community-based programs; (3) Residential treatment provided by the RICA can reasonably be expected to improve the individual's condition or prevent further regression so that the individual can return to the community. B. The child or adolescent shall be between 12 and 17 years old at the time of admission. The RICA admission team may waive the age limit in appropriate cases. C. A RICA may not admit a child or adolescent who has: (1) A primary diagnosis of alcoholism, drug addiction, or severe brain damage; or (2) Cognitive deficits which severely limit the individual's ability to use the treatment modalities provided. D. A child or adolescent who otherwise meets the admission standards may not be denied residential treatment solely because the individual resides outside the regular catchment area served by the RICA, as established by the Director. The Director shall take into consideration the ratio of residential treatment beds to population base and proximity to the program when establishing the catchment areas, and shall review and revise the catchment areas, as appropriate, every 5 years beginning in 1990. Priority for admission shall be given to applicants living in the catchment area served by the RICA. E. If a child or adolescent meets the admission standards but the RICA is occupied to its licensed capacity, priority on the waiting list for admission shall be given to those individuals who have the most severe mental disorders as exhibited by level of dysfunctions. Cross References 10.21.06.04A .06 Resident Rights. A. Residents shall be accorded the rights enumerated in the Health-General Article, §§10-701 through 10-709, Annotated Code of Maryland, and shall be informed of these rights upon admission. B. An individualized treatment plan shall be developed and implemented for each resident in accordance with Health-General Article, §10-706, Annotated Code of Maryland, and COMAR 10.21.03 . C. An educational program shall be provided for each resident based on educational needs and shall include, when appropriate, an individualized educational program in accordance with COMAR 13A.05.01. D. An aftercare plan shall be developed for each resident before release from a RICA in cooperation with the referring agency or professional, parent, or guardian or other appropriate agencies in accordance with the Health-General Article, §§10-709 and 10-809, Annotated Code of Maryland. .07 Court Evaluation Unit. A. A RICA may establish a separate unit for short term evaluation of children and adolescents referred by a Juvenile Court. B. Admission from the court evaluation unit to the regular residential treatment program shall be in accordance with the procedures and standards set forth in Regulations .04 and .05 of this chapter.