COMAR 10.21.11

Chapter 11 Purchase of Residential Therapeutic Care for Children

This chapter establishes eligibility requirements for providers of residential therapeutic services for emotionally or behaviorally disordered children who wish to accept placements from the Maryland Department of Health (Mental Hygiene Administration). Providers must hold a license from the Department of Human Services, Juvenile Services, or Maryland Department of Health (including under COMAR 10.21.07 for therapeutic group homes), have rates established through the Negotiated Rates Process, and deliver core services including 24-hour residential supervision, case management, crisis intervention, and linkage to community resources. Providers must also offer individualized additional services based on clinical assessment, including appropriate levels of supervision up to secure settings for authorized placements.

Code of Maryland Regulations

Chapter 11 Purchase of Residential Therapeutic Care for Children

Administrative History

Effective date:

Regulations 
.01
 — 
.03
 adopted as an emergency provision effective October 13, 1992 (19:22 Md. R. 1980); adopted permanently effective March 29, 1993 (20:1 Md. R. 27)

Authority

Health-General Article, §10-902, Annotated Code of Maryland

.01 Scope.

This chapter outlines the requirements that a provider of residential therapeutic services to emotionally or behaviorally disordered children shall meet to be eligible to accept children placed by the Mental Hygiene Administration.

.02 Definitions.

A.
 In this chapter, the following terms have the meaning indicated.

B.
 Terms Defined.

(1)
 “Direct supervision” means that a provider staff member maintains continuous visual contact with the child.

(2)
 “Family of origin” means the child's parent, guardian, or primary caretaker.

(3)
 “Least restrictive setting” means the treatment program or facility in which needed services are delivered in the environment that least limits the child being served.

(4)
 “Oversight” means that a provider staff member approves and is aware of the child's activities.

(5)
 “Primary caretaker” means the adult individual who carries responsibility for the welfare of a child where the child resides.

(6)
 “Secure setting” means a treatment program or facility that is locked to prevent a child from leaving without staff permission.

.03 Provider Requirements.

A provider of residential therapeutic services may not be eligible to accept children placed by the Maryland Department of Health unless the provider:

A.
 Is licensed by the Department of:

(1)
 Human Services, under the provisions of 
COMAR 07.02.23
 or 
07.02.13
;

(2)
 Juvenile Services, under the provisions of COMAR 16.06.01; or

(3)
 Maryland Department of Health , under the provisions of 
COMAR 10.21.07
;

B.
 Has rates that are established by the Negotiated Rates Process of the Rates Management Unit, Social Services Administration of the Department of Human Services as authorized under the provisions of COMAR 21.14.01.04B(2);

C.
 Provides the following core services:

(1)
 Care and 24-hour supervision in a residential setting;

(2)
 Direct provision of food and clothing;

(3)
 Social work or case management services;

(4)
 Recreational activities;

(5)
 Access and linkage to appropriate community resources, including but not limited to:

(a)
 Medical care;

(b)
 Dental care;

(c)
 Mental health treatment;

(d)
 Education; and

(e)
 Social services; and

(6)
 Crisis intervention planning;

D.
 Provides the additional services that, based on a documented clinical assessment, are required by the child who is being referred, including but not limited to:

(1)
 A location as close as possible to the child's family of origin;

(2)
 The least restrictive setting appropriate to the child's needs; and

(3)
 As appropriate to the child's needs, a level of supervision that provides:

(a)
 Opportunity for off-site activities, with oversight by provider staff; or

(b)
 For a placement that is authorized by the State Coordinating Council for Residential Placement of Handicapped Children or a local coordinating council, as authorized under Article 49D, §§13 — 19, Annotated Code of Maryland:

(i)
 Structured, on-site activities, with direct supervision by provider staff, and 24-hour awake staff; or

(ii)
 The level of supervision described in 
§D(3)(b)(i) of this regulation
 in a secure setting; and

E.
 Is in compliance with all applicable laws and regulations, including but not limited to laws and regulations governing patient rights, as set forth in Health-General Article, §§10-701 — 10-707, Annotated Code of Maryland.