<section article="ghg" article_name="Health - General" number="10-101" title_number="10" title_name="Mental Health Law" subtitle_number="1" subtitle_name="Definitions; General Provisions"> <level label="a"> <text>In this title the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Administration” means the Behavioral Health Administration.</text> </level> <level label="c"> <level label="1"> <text>“Admission” means the process by which an individual is accepted as a resident in:</text> <level label="i"> <text>An inpatient facility; or</text> </level> <level label="ii"> <text>A Veterans’ Administration hospital in this State that provides care or treatment for individuals who have mental disorders.</text> </level> </level> <level label="2"> <text>“Admission” includes the physical act of the individual entering the facility or Veterans’ Administration hospital.</text> </level> </level> <level label="d"> <text>“Behavioral health care” includes prevention, screening, early intervention, treatment, recovery, support, wraparound, and rehabilitation services for individuals with substance–related disorders, addictive disorders, mental disorders, or a combination of these disorders.</text> </level> <level label="e"> <text>“Core service agency” means the designated county or multicounty authority that is responsible for planning, managing, and monitoring publicly funded mental health services.</text> </level> <level label="f"> <text>“Director” means the Director of the Behavioral Health Administration.</text> </level> <level label="g"> <level label="1"> <text>Except as otherwise provided in this title, “facility” means any public or private clinic, hospital, or other institution that provides or purports to provide treatment or other services for individuals who have mental disorders.</text> </level> <level label="2"> <text>“Facility” does not include a Veterans’ Administration hospital.</text> </level> </level> <level label="h"> <text>“Local behavioral health authority” means the designated county or multicounty authority that is responsible for planning, managing, and monitoring publicly funded mental health, substance–related disorder, and addictive disorder services.</text> </level> <level label="i"> <level label="1"> <text>“Mental disorder” means a behavioral or emotional illness that results from a psychiatric disorder.</text> </level> <level label="2"> <text>“Mental disorder” includes a mental illness that so substantially impairs the mental or emotional functioning of an individual as to make care or treatment necessary or advisable for the welfare of the individual or for the safety of the person or property of another.</text> </level> <level label="3"> <text>“Mental disorder” does not include an intellectual disability.</text> </level> </level> <level label="j"> <text>“State Advisory Council” means the Behavioral Health Advisory Council.</text> </level> <level label="k"> <text>“State facility” means a facility that is owned or operated by the Department.</text> </level> <level label="l"> <text>“Treatment” means any professional care or attention that is given in a facility, private therapeutic group home for children and adolescents, or Veterans’ Administration hospital to improve or to prevent the worsening of a mental disorder.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-102" title_number="10" title_name="Mental Health Law" subtitle_number="1" subtitle_name="Definitions; General Provisions"> <text>It is the policy of this State:</text> <level label="1"> <text>To the best of its ability, to foster and preserve the mental health of its citizens; and</text> </level> <level label="2"> <text>To that end, to provide without partiality care and treatment to citizens who have mental disorders.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-103" title_number="10" title_name="Mental Health Law" subtitle_number="1" subtitle_name="Definitions; General Provisions"> <text>This title shall be construed in a manner consistent with the policy stated in this subtitle.</text> </section> <section article="ghg" article_name="Health - General" number="10-104" title_number="10" title_name="Mental Health Law" subtitle_number="1" subtitle_name="Definitions; General Provisions"> <text>Notwithstanding any other provision of law, this title applies to a person who is licensed under Title 19 of this article if the person provides care or treatment to individuals who have mental disorders.</text> </section> <section article="ghg" article_name="Health - General" number="10-205" title_number="10" title_name="Mental Health Law" subtitle_number="2" subtitle_name="Mental Health Plans and Services"> <level label="a"> <text>The Administration may administer a program of nonresidential services for individuals who have mental disorders or have conditions that may lead to mental disorders:</text> <level label="1"> <text>To develop, extend, and improve services for finding these individuals; and</text> </level> <level label="2"> <text>To provide facilities for diagnosis and treatment of nonresidential cases.</text> </level> </level> <level label="b"> <text>The Administration may:</text> <level label="1"> <text>Prepare plans for the program;</text> </level> <level label="2"> <text>Adopt necessary rules and regulations to carry out these plans;</text> </level> <level label="3"> <text>In accordance with these plans, receive and spend any available funds;</text> </level> <level label="4"> <text>Coordinate and supervise the provision of program services that the Administration does not provide directly; and</text> </level> <level label="5"> <text>Cooperate with the federal government and with all other public or private agencies in:</text> <level label="i"> <text>Developing, extending, and improving the services; and</text> </level> <level label="ii"> <text>Carrying out the plans.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-206" title_number="10" title_name="Mental Health Law" subtitle_number="2" subtitle_name="Mental Health Plans and Services"> <level label="a"> <text>The Secretary shall revise periodically the State comprehensive mental health plan.</text> </level> <level label="b"> <text>The State comprehensive mental health plan shall:</text> <level label="1"> <text>Include an inventory of the mental health resources in this State;</text> </level> <level label="2"> <text>Set out the needs of the various areas for services, including community-based services in accordance with the findings and recommendations of the plan described in § 10-207 of this subtitle;</text> </level> <level label="3"> <text>Establish priorities of the different services needed; and</text> </level> <level label="4"> <text>Include any other matter that the Secretary thinks should be covered.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-207" title_number="10" title_name="Mental Health Law" subtitle_number="2" subtitle_name="Mental Health Plans and Services"> <level label="a"> <text>By January 1, 1992, within existing resources, the Director shall update the current Mental Hygiene Administration 3–year plan for mental health, which was submitted to the federal government in response to § 1925 of the Public Health Service Act, in order to plan for those individuals who:</text> <level label="1"> <text>Have a serious mental disorder as defined in the plan; and</text> </level> <level label="2"> <text>Are not receiving the appropriate array of community–based services described in the “total need” section of the 3–year mental health plan that expired on June 30, 1991.</text> </level> </level> <level label="b"> <level label="1"> <text>On or after October 1, 1993, within existing resources and in concert with local core service agencies or local behavioral health authorities, the Director shall prepare a comprehensive mental health plan which identifies the needs of all individuals who have a serious mental disorder and who are targeted for services in the “Comprehensive Mental Health Services Plan” submitted by the State to the federal government in accordance with § 1925 of the Public Health Service Act.</text> </level> <level label="2"> <text>The comprehensive mental health plan shall:</text> <level label="i"> <text>Include annual strategic projections, through the year 2000, of resources needed;</text> </level> <level label="ii"> <text>Plan for those individuals who have a serious mental disorder, including those who are presently not being served by the public mental health system, those who are homeless, and those children, adults, and elderly individuals living without services in the community with their families or on their own who are at risk of further institutionalization;</text> </level> <level label="iii"> <text>Plan for individuals who have a serious mental disorder and who are presently residing in a State facility, nursing home, or jail who could appropriately be served in the community if the proper community–based services were available to them;</text> </level> <level label="iv"> <text>Plan for individuals who have a serious mental disorder and who are unable or unwilling to obtain community–based services from existing State–supported programs or from the private sector and assess their need for additional, flexible, individualized, or otherwise more appropriate services;</text> </level> <level label="v"> <text>Plan for the extent of need for the development of additional community–based housing and related support services;</text> </level> <level label="vi"> <text>Plan for the extent of the need for additional community–based support services, including rehabilitation, clinical treatment, case management, crisis and emergency services, mobile treatment, in–home intervention services, school–based, after–school services, respite and family support services, and vocational services in order to implement the orderly transfer of institutionalized individuals who can live in the community and to serve those individuals presently in the community who are now underserved or unserved and at risk of institutionalization;</text> </level> <level label="vii"> <text>Evaluate the role of existing State hospitals and plan for the reallocation to the community of any funds saved through hospital downsizing, consolidation, or closure; and</text> </level> <level label="viii"> <text>Be consistent with the goal of providing comprehensive, coordinated community–based housing and support services for every individual who has a serious mental disorder and who is appropriate for and in need of such services.</text> </level> </level> </level> <level label="c"> <text>The Director shall, in concert with local core service agencies or local behavioral health authorities, implement each plan to the extent that resources are available.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-208" title_number="10" title_name="Mental Health Law" subtitle_number="2" subtitle_name="Mental Health Plans and Services"> <level label="a"> <level label="1"> <text>There is a continuing, nonlapsing Mental Health Community–Based Services Fund.</text> </level> <level label="2"> <text>The purpose of the Mental Health Community–Based Services Fund is to ensure that funds realized from the sale or lease of Behavioral Health Administration facilities as the result of downsizing, consolidation, or closure are used to provide community–based services.</text> </level> </level> <level label="b"> <text>Notwithstanding any other provision of law, if any Behavioral Health Administration facility is downsized, consolidated, or closed, all State property associated with the facility that is not transferred to another governmental entity shall be sold or leased at fair market value, and the net proceeds of the sale or lease shall be deposited into the Mental Health Community–Based Services Fund.</text> </level> <level label="c"> <level label="1"> <text>If a facility operated by the Behavioral Health Administration is downsized, consolidated, or closed such that the net resident population declines or if a facility is closed or consolidated and bed capacity levels remained unchanged:</text> <level label="i"> <text>State general funds may be appropriated as necessary, in advance, to assist in the downsizing;</text> </level> <level label="ii"> <text>Any funds in the Mental Health Community–Based Services Fund:</text> <level label="1"> <text>May not supplant resources for existing community services; and</text> </level> <level label="2"> <text>Shall be used to meet the needs of individuals leaving facilities to enter community–based services; and</text> </level> </level> <level label="iii"> <text>Any funds remaining after meeting the needs of individuals identified in subparagraph (ii)2 of this paragraph shall be used to increase the availability of:</text> <level label="1"> <text>Affordable housing and employment opportunities for individuals with mental illness; and</text> </level> <level label="2"> <text>Community mental health services designed to promote recovery and community integration, including development of the Maryland Mental Health Crisis Response System established under Subtitle 14 of this title.</text> </level> </level> </level> <level label="2"> <text>Funds in the Mental Health Community–Based Services Fund shall be spent in accordance with a plan developed by the Behavioral Health Administration in consultation with consumers, family members, providers, and mental health advocates.</text> </level> </level> <level label="d"> <text>On or before January 1 of each year, the Secretary shall prepare a report to be submitted to the General Assembly and the Department of Legislative Services on the Mental Health Community–Based Services Fund.</text> </level> <level label="e"> <text>Any unspent portions of the Mental Health Community–Based Services Fund and any interest earned on money in the Waiting List Equity Fund may not be transferred or revert to the General Fund of the State but shall remain in the Mental Health Community–Based Services Fund to be used for the purposes specified in this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-308" title_number="10" title_name="Mental Health Law" subtitle_number="3" subtitle_name="Advisory Bodies"> <level label="a"> <text>Except as otherwise provided in subsections (c) and (d) of this section, the governing body of each county shall establish a mental health advisory committee.</text> </level> <level label="b"> <text>The purpose of a mental health advisory committee shall be to serve as advocate for a comprehensive mental health system for persons of all ages.</text> </level> <level label="c"> <text>The governing bodies of two or more counties may establish, by agreement, an intercounty mental health advisory committee if:</text> <level label="1"> <text>The population of one of the counties is too small to warrant the establishment of a mental health advisory committee for that county; and</text> </level> <level label="2"> <text>The Director consents.</text> </level> </level> <level label="d"> <text>The governing body of a county may establish a joint mental health and addictions advisory committee.</text> </level> <level label="e"> <text>In Howard County, if a quasi–public authority is established under Subtitle 12 of this title, the governing body may designate the authority as the mental health advisory committee for the county.</text> </level> <level label="f"> <text>In Baltimore City, the governing body may designate Behavioral Health Systems Baltimore the local behavioral health authority for Baltimore City under Subtitle 12 of this title, as the mental health advisory committee for Baltimore City.</text> </level> <level label="g"> <text>In Anne Arundel County, the governing body may designate Anne Arundel County Mental Health Agency, Inc., the core service agency or local behavioral health authority for Anne Arundel County under Subtitle 12 of this title, as the mental health advisory committee for Anne Arundel County.</text> </level> <level label="h"> <text>In Washington County, the governing body may designate Washington County Mental Health Authority, Inc., the core service agency for Washington County under Subtitle 12 of this title, as the mental health advisory committee for Washington County.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-309" title_number="10" title_name="Mental Health Law" subtitle_number="3" subtitle_name="Advisory Bodies"> <level label="a"> <level label="1"> <text>The mental health advisory committee of each county shall consist of:</text> <level label="i"> <text>As nonvoting ex officio members, the following individuals or their designees:</text> <level label="1"> <text>The health officer for the county;</text> </level> <level label="2"> <text>A representative of a State inpatient facility that serves that county, appointed as provided in paragraph (2) of this subsection;</text> </level> <level label="3"> <text>The county mental health director;</text> </level> <level label="4"> <text>The director of the core service agency or local behavioral health authority, if any; and</text> </level> <level label="5"> <text>In jurisdictions with designated State inpatient beds located in local general hospitals, a representative from that facility; and</text> </level> </level> <level label="ii"> <text>As voting members, appointed by the governing body of the county and representative of the county’s major socio–economic and ethnic groups:</text> <level label="1"> <text>At least 5, but not more than 7, representatives selected from among the following groups or agencies:</text> </level> <level label="A"> <text>The governing body;</text> </level> <level label="B"> <text>The county department of education;</text> </level> <level label="C"> <text>The local department of social services;</text> </level> <level label="D"> <text>The practicing physicians;</text> </level> <level label="E"> <text>Mental health professionals who are not physicians;</text> </level> <level label="F"> <text>The clergy;</text> </level> <level label="G"> <text>The legal profession;</text> </level> <level label="H"> <text>A local law enforcement agency;</text> </level> <level label="I"> <text>A local general hospital that contains an inpatient psychiatric unit;</text> </level> <level label="J"> <text>The Department of Aging;</text> </level> <level label="K"> <text>The Department of Juvenile Services;</text> </level> <level label="L"> <text>The local alcohol and drug abuse agency; and</text> </level> <level label="M"> <text>A local community rehabilitation or housing program; and</text> </level> <level label="2"> <text>At least 5 individuals selected from among the following groups or organizations and appointed as provided in paragraph (3) of this subsection:</text> </level> <level label="A"> <text>At least 2 individuals who are currently receiving or who have in the past received mental health services;</text> </level> <level label="B"> <text>Parents or other relatives of adults with mental disorders;</text> </level> <level label="C"> <text>Parents or other relatives of children or adolescents with emotional, behavioral, or mental disorders the onset of which occurred during childhood or adolescence;</text> </level> <level label="D"> <text>The local mental health association, if any;</text> </level> <level label="E"> <text>An individual with experience with mental health care for veterans or individuals serving in the military; and</text> </level> <level label="F"> <text>A member of the general public.</text> </level> </level> </level> <level label="2"> <text>If more than one State inpatient facility serves a county, a representative from at least 1 of the facilities shall be appointed by the Director.</text> </level> <level label="3"> <text>At least one–half of the voting members shall be appointed from among the individuals listed in paragraph (1)(ii)2A through C of this subsection.</text> </level> <level label="4"> <text>Notwithstanding paragraphs (1) through (3) of this subsection, if the governing body of Baltimore City or Anne Arundel County designates a core service agency or local behavioral health authority as the mental health advisory committee, the mental health advisory committee shall consist of the governing body of the core service agency or local behavioral health authority.</text> </level> </level> <level label="b"> <text>If an intercounty advisory committee is established, the governing body of each participating county shall appoint at least 4 members of the committee.</text> </level> <level label="c"> <text>Notwithstanding subsection (a)(1)(ii) of this section, if the governing body of a county establishes a joint mental health and addictions advisory committee, the governing body may appoint any additional members as necessary to advise and advocate about addictions issues.</text> </level> <level label="d"> <level label="1"> <text>The term of an appointed member is 3 years and begins on July 1.</text> </level> <level label="2"> <text>The terms of one–third of the appointed members of each county advisory committee or intercounty advisory committee end each year.</text> </level> <level label="3"> <text>At the end of a term, a member may continue to serve until a successor is appointed and qualifies.</text> </level> <level label="4"> <text>A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.</text> </level> <level label="5"> <text>A member who serves 2 consecutive full 3–year terms may not be reappointed for 2 years after completion of those terms.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-310" title_number="10" title_name="Mental Health Law" subtitle_number="3" subtitle_name="Advisory Bodies"> <level label="a"> <text>From among its members, each county advisory committee and each intercounty advisory committee shall elect annually a chairperson and other officers that the committee finds necessary.</text> </level> <level label="b"> <text>A member may not serve as chairperson for more than 2 consecutive years.</text> </level> <level label="c"> <text>The manner of election of officers shall be as each county advisory committee or intercounty advisory committee determines.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-311" title_number="10" title_name="Mental Health Law" subtitle_number="3" subtitle_name="Advisory Bodies"> <level label="a"> <text>Each county advisory committee and intercounty advisory committee shall have no fewer than 6 meetings per year at the times and places that the committee determines.</text> </level> <level label="b"> <text>Except in Montgomery County, staff services for each county advisory committee or intercounty advisory committee shall be provided by the health officer for the appropriate county.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-312" title_number="10" title_name="Mental Health Law" subtitle_number="3" subtitle_name="Advisory Bodies"> <level label="a"> <text>Each county advisory committee and each intercounty advisory committee may:</text> <level label="1"> <text>Create subcommittees; and</text> </level> <level label="2"> <text>Have additional individuals participate as needed.</text> </level> </level> <level label="b"> <text>Each county advisory committee and intercounty advisory committee shall:</text> <level label="1"> <text>Monitor, review and evaluate the allocation and adequacy of publicly funded mental health services within the county through means such as conducting or participating in site visits;</text> </level> <level label="2"> <text>Determine the needs of the county mental health system, including quality of services, gaps in the system, and interagency coordination;</text> </level> <level label="3"> <text>Participate in the development of the local mental health plan and local mental health budget;</text> </level> <level label="4"> <level label="i"> <text>Prepare and disseminate an annual report to the following:</text> <level label="1"> <text>The health officer;</text> </level> <level label="2"> <text>In Montgomery County, the director of the Montgomery County Department of Health and Human Services;</text> </level> <level label="3"> <text>The county mental health director;</text> </level> <level label="4"> <text>The governing body of the appropriate county;</text> </level> <level label="5"> <text>The director of the local core service agency or local behavioral health authority, if any;</text> </level> <level label="6"> <text>The regional mental health director;</text> </level> <level label="7"> <text>The Director;</text> </level> <level label="8"> <text>The Secretary; and</text> </level> <level label="9"> <text>The Behavioral Health Advisory Council; and</text> </level> </level> <level label="ii"> <text>Include in the annual report, at a minimum, the following:</text> <level label="1"> <text>A description of the progress of the county mental health system;</text> </level> <level label="2"> <text>Recommendations on actions needed to improve the system;</text> </level> <level label="3"> <text>Recommendations on priorities for allocation of funds; and</text> </level> <level label="4"> <text>In accordance with those priorities and after consideration of financial resources, recommendations on appropriate allocation of funds;</text> </level> </level> </level> <level label="5"> <text>Review and comment upon the annual core service agency or county mental health plan and preliminary budget, prior to submission of the budget to the State; and</text> </level> <level label="6"> <text>Review and comment upon the annual fiscal report.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-401" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <text>The Director shall supervise generally the operation of all State facilities.</text> </section> <section article="ghg" article_name="Health - General" number="10-404" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <text>In Part II of this subtitle, “Board” means a citizens’ advisory board for a State facility.</text> </section> <section article="ghg" article_name="Health - General" number="10-405" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <text>Part II of this subtitle does not apply to the Maryland Psychiatric Research Center.</text> </section> <section article="ghg" article_name="Health - General" number="10-406" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <level label="a"> <text>The following State facilities shall be maintained under the direction of the Administration:</text> <level label="1"> <text>Clifton T. Perkins Hospital Center;</text> </level> <level label="2"> <text>Eastern Shore Hospital Center;</text> </level> <level label="3"> <text>Regional Institutes for Children and Adolescents — Baltimore and Rockville;</text> </level> <level label="4"> <text>Springfield Hospital Center;</text> </level> <level label="5"> <text>Spring Grove Hospital Center; and</text> </level> <level label="6"> <text>Thomas B. Finan Hospital Center.</text> </level> </level> <level label="b"> <text>As a facility is built or transferred to the Administration, the facility may be made a State facility.</text> </level> <level label="c"> <level label="1"> <text>By January 1, 1985, the Department shall adopt rules and regulations for admission to all Regional Institutes for Children and Adolescents in cooperation with representatives from the advisory committees of the Regional Institutes for Children and Adolescents, the mental health advisory committees in each region, the local education agencies, and the Mental Health Association of Maryland.</text> </level> <level label="2"> <text>In determining these rules and regulations, the Department shall provide that no bona fide candidate for admission may be rejected solely because of residence outside the regular catchment area served by the institution.</text> </level> <level label="3"> <text>In determining these rules and regulations, the Department shall provide that candidates for admission who reside in the regular catchment area served by the institution shall be granted priority in admissions to the institution.</text> </level> </level> <level label="d"> <level label="1"> <text>Beginning in fiscal year 2007, the Department may not bill a local board of education for any services provided by the State at a regional institute for children and adolescents.</text> </level> <level label="2"> <text>Notwithstanding paragraph (1) of this subsection:</text> <level label="i"> <text>Beginning in fiscal year 2007, the Department shall continue to provide the same scope of services at regional institutes for children and adolescents that were provided as of January 1, 2005; and</text> </level> <level label="ii"> <text>A local board of education may make a contribution toward the cost of services provided by the State at a regional institute for children and adolescents.</text> </level> </level> </level> <level label="e"> <level label="1"> <text>Before a regional institute for children and adolescents may be closed, the Department shall submit a report to the Governor and, in accordance with § 2–1257 of the State Government Article, the Senate Finance Committee, the Senate Budget and Taxation Committee, the House Health and Government Operations Committee, and the House Appropriations Committee, justifying the closure.</text> </level> <level label="2"> <text>The report shall address:</text> <level label="i"> <text>The reasons for the closure;</text> </level> <level label="ii"> <text>The plan for serving the regional institute for children and adolescents target population after the closure;</text> </level> <level label="iii"> <text>The budgetary savings anticipated from the closure compared to the costs associated with serving the regional institute for children and adolescents target population in other settings;</text> </level> <level label="iv"> <text>The plan for assisting State employees displaced by the closure in finding other employment; and</text> </level> <level label="v"> <text>The plan for the regional institute for children and adolescents facility.</text> </level> </level> <level label="3"> <text>The committees shall have 60 days to review and comment on the report.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-406.1" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <level label="a"> <text>The Regional Institutes for Children and Adolescents in Baltimore and Montgomery counties shall be comparable:</text> <level label="1"> <text>In programs by January 1, 1992; and</text> </level> <level label="2"> <text>In facilities by July 1, 1994.</text> </level> </level> <level label="b"> <text>The facilities and programs of an institute may not be reduced to achieve comparability.</text> </level> <level label="c"> <text>In no event shall the level of State funding provided or number of positions authorized to any Regional Institute for Children and Adolescents be reduced in order to attain comparability.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-407" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <text>The Director shall set standards for admission to a State facility.</text> </section> <section article="ghg" article_name="Health - General" number="10-408" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <level label="a"> <text>With the advice of the Director, the Secretary shall appoint an administrative head for each State facility.</text> </level> <level label="b"> <text>Each administrative head shall have the qualifications that the Secretary sets for administrative heads.</text> </level> <level label="c"> <text>The Director may remove an administrative head for incompetence or misconduct.</text> </level> <level label="d"> <text>In addition to any other power or duty that the Director or Secretary delegates, the administrative head of a State facility shall:</text> <level label="1"> <text>Supervise generally the State facility;</text> </level> <level label="2"> <text>In accordance with the provisions of the State Personnel and Pensions Article, appoint a staff for the State facility as needed and as provided in the State budget; and</text> </level> <level label="3"> <text>Report to the Director as the Director requires.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-409" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <text>The administrative head of the Eastern Shore Hospital Center shall:</text> <level label="1"> <text>Advertise for and receive bids for a contract to provide laundry services; and</text> </level> <level label="2"> <text>Contract for the services with the low bidder unless the administrative head finds that the bidder would not fulfill the contract satisfactorily.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-410" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <text>There is a citizens’ advisory board for each State facility.</text> </section> <section article="ghg" article_name="Health - General" number="10-411" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <level label="a"> <level label="1"> <level label="i"> <text>Except for the Eastern Shore Hospital Center, the Spring Grove Hospital Center, and the Clifton T. Perkins Hospital Center, each Board consists of 7 members appointed by the Governor.</text> </level> <level label="ii"> <text>The Board for the Eastern Shore Hospital Center consists of 11 members appointed by the Governor.</text> </level> <level label="iii"> <text>The Board for the Spring Grove Hospital Center consists of 9 members appointed by the Governor.</text> </level> <level label="iv"> <text>The Board for the Clifton T. Perkins Hospital Center consists of 9 members appointed by the Governor.</text> </level> </level> <level label="2"> <text>The Board for each State facility shall reflect adequately the composition of the community that the State facility serves.</text> </level> <level label="3"> <text>Of the members of the Board for a State facility:</text> <level label="i"> <text>At least 2 shall be parents or other relatives of residents or former residents of a State facility; and</text> </level> <level label="ii"> <text>Each of the others shall be individuals who:</text> <level label="1"> <text>Are known for their interest in civic and public affairs; and</text> </level> <level label="2"> <text>Have expressed an interest in the care of individuals who have a mental disorder or generally in mental health endeavors.</text> </level> </level> </level> <level label="4"> <text>The Governor shall appoint the members from a list of qualified individuals submitted to the Governor by the Secretary.</text> </level> </level> <level label="b"> <text>Each member of a Board shall be a citizen of this State.</text> </level> <level label="c"> <level label="1"> <text>The term of a member is 4 years.</text> </level> <level label="2"> <level label="i"> <text>Except for the Board for the Clifton T. Perkins Hospital Center, the terms of members are staggered as required for members of each Board on July 1, 1982. For the Board for the Clifton T. Perkins Hospital Center, the terms of the members are staggered as required for the members on the Board on October 1, 1994.</text> </level> <level label="ii"> <text>Except for the Boards for the Eastern Shore Hospital Center, the Spring Grove Hospital Center, and the Clifton T. Perkins Hospital Center, the terms of those members end as follows:</text> <level label="1"> <text>1 in 1983;</text> </level> <level label="2"> <text>4 in 1984;</text> </level> <level label="3"> <text>1 in 1985; and</text> </level> <level label="4"> <text>1 in 1986.</text> </level> </level> <level label="iii"> <text>The terms of the members of the Board for the Eastern Shore Hospital Center end as follows:</text> <level label="1"> <text>2 in 1983;</text> </level> <level label="2"> <text>5 in 1984;</text> </level> <level label="3"> <text>2 in 1985; and</text> </level> <level label="4"> <text>2 in 1986.</text> </level> </level> <level label="iv"> <text>The terms of the members of the Board for the Spring Grove Hospital Center end as follows:</text> <level label="1"> <text>1 in 1986;</text> </level> <level label="2"> <text>1 in 1987;</text> </level> <level label="3"> <text>4 in 1988; and</text> </level> <level label="4"> <text>3 in 1989.</text> </level> </level> <level label="v"> <text>The terms of the members of the Board for the Clifton T. Perkins Hospital Center end as follows:</text> <level label="1"> <text>1 in 1996;</text> </level> <level label="2"> <text>5 in 1997; and</text> </level> <level label="3"> <text>3 in 1998.</text> </level> </level> </level> <level label="3"> <text>At the end of a term, a member continues to serve until a successor is appointed and qualifies.</text> </level> <level label="4"> <text>A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.</text> </level> <level label="5"> <level label="i"> <text>Except as provided in subparagraph (ii) of this paragraph, a member who serves 2 consecutive full 4–year terms may not be reappointed for 4 years after completion of those terms.</text> </level> <level label="ii"> <text>An initial member of a Board who serves 3 consecutive full 4–year terms may not be reappointed for 4 years after completion of those terms.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-412" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <level label="a"> <text>From among its members, each Board shall elect a chairman and other officers that the Board considers necessary.</text> </level> <level label="b"> <text>The manner of election of officers and their terms of office shall be as the Board determines.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-413" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <level label="a"> <text>Each Board shall meet at least 4 times a year, at the times and places that it determines.</text> </level> <level label="b"> <text>A member of a Board may not receive compensation.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-414" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <level label="a"> <text>Each Board may adopt rules and regulations for the conduct of its meetings.</text> </level> <level label="b"> <level label="1"> <text>Each Board serves in an advisory capacity.</text> </level> <level label="2"> <text>Each Board shall:</text> <level label="i"> <text>Submit to the Secretary an annual report on:</text> <level label="1"> <text>The needs of individuals who have a mental disorder; and</text> </level> <level label="2"> <text>The extent to which its State facility meets these needs;</text> </level> </level> <level label="ii"> <text>Advise the administrative head of the State facility on its goals, programs, physical plant, and policies;</text> </level> <level label="iii"> <text>Help in evaluating the degree to which these goals are achieved;</text> </level> <level label="iv"> <text>Review and make recommendations about the annual budget of the State facility;</text> </level> <level label="v"> <text>Assume leadership in developing community understanding of the needs of those who have a mental disorder; and</text> </level> <level label="vi"> <text>Carry out any other responsibility that the administrative head of the State facility requests.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-415" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <level label="a"> <level label="1"> <text>In this subsection, “facility” means:</text> <level label="i"> <text>The Clifton T. Perkins Hospital Center;</text> </level> <level label="ii"> <text>The Eastern Shore Hospital Center;</text> </level> <level label="iii"> <text>The Regional Institutes for Children and Adolescents – Baltimore and Rockville;</text> </level> <level label="iv"> <text>The Springfield Hospital Center;</text> </level> <level label="v"> <text>The Spring Grove Hospital Center;</text> </level> <level label="vi"> <text>The Thomas B. Finan Hospital Center; or</text> </level> <level label="vii"> <text>The Office of Health Care Quality.</text> </level> </level> <level label="2"> <level label="i"> <text>The pay scale for a “Physician Clinical Specialist” position in a facility shall be the same as a “Psychiatrist Clinical” position in a facility.</text> </level> <level label="ii"> <text>The pay scale for a “Physician Clinical Staff” position in a facility shall be the same as a “Psychiatrist Clinical Graduate” position in a facility.</text> </level> </level> <level label="3"> <text>In a fiscal year in which an upward adjustment to the pay scale is made for initial appointments to a “Registered Nurse” position in a facility, the “Registered Nurse Charge”, “Registered Nurse Supervisor”, and “Registered Nurse Manager” positions in the same facility shall receive an upward adjustment to their pay scales in an amount at least equal to the adjustment for the employees in a “Registered Nurse” position who report to employees in the “Registered Nurse Charge”, “Registered Nurse Supervisor”, and “Registered Nurse Manager” positions at the facility.</text> </level> </level> <level label="b"> <level label="1"> <text>In a fiscal year in which an upward adjustment to the pay scale is made for initial appointments to a “Registered Nurse Perkins” position at the Clifton T. Perkins Hospital Center, the “Registered Nurse Charge Perkins”, “Registered Nurse Supervisor Perkins”, “Registered Nurse Manager Perkins”, “Assistant Director of Nursing Perkins”, and “Director of Nursing Perkins” positions at the Clifton T. Perkins Hospital Center shall receive an upward adjustment to their pay scales in an amount at least equal to the adjustment for the employees in a “Registered Nurse Perkins” position who report to employees in the “Registered Nurse Charge Perkins”, “Registered Nurse Supervisor Perkins”, “Registered Nurse Manager Perkins”, “Assistant Director of Nursing Perkins”, and “Director of Nursing Perkins” positions.</text> </level> <level label="2"> <level label="i"> <text>This paragraph applies only to employees of the Clifton T. Perkins Hospital Center who are:</text> <level label="1"> <text>Employed in a “Security Attendant” position; and</text> </level> <level label="2"> <text>Required as a condition of employment to complete a correctional training course approved by the Correctional Training Commission under Title 8, Subtitle 2 of the Correctional Services Article.</text> </level> </level> <level label="ii"> <text>The pay scale for a “Security Attendant” position shall be at least equal to the pay scale for a correctional officer employed by the Department of Public Safety and Correctional Services.</text> </level> </level> </level> <level label="c"> <text>In a fiscal year in which an upward adjustment to the pay scale is made for initial appointments to a “Health Facility Surveyor Nurse I” position in the Office of Health Care Quality, the “Health Facility Surveyor Nurse I” and “Health Facility Surveyor Nurse II” positions in the Office of Health Care Quality shall receive an upward adjustment to their pay scales in an amount equal to the adjustment for the “Health Facility Surveyor Nurse I” position.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-417" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <level label="a"> <text>In Part III of this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Center” means the Maryland Psychiatric Research Center.</text> </level> <level label="c"> <text>“Department of Psychiatry” means the Department of Psychiatry of the University of Maryland School of Medicine.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-418" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <text>There is a Maryland Psychiatric Research Center in the Department.</text> </section> <section article="ghg" article_name="Health - General" number="10-419" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <text>There is an Executive Board for the Center.</text> </section> <section article="ghg" article_name="Health - General" number="10-420" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <text>The Executive Board consists of the following 5 ex officio members:</text> <level label="1"> <text>The Superintendent of the Center.</text> </level> <level label="2"> <text>The Director of Research and Evaluation of the Department.</text> </level> <level label="3"> <text>The Director of the Behavioral Health Administration.</text> </level> <level label="4"> <text>The Chairman of the Department of Psychiatry.</text> </level> <level label="5"> <text>The Dean of the University of Maryland School of Medicine.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-421" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <level label="a"> <text>From among its members, the Executive Board shall elect a chairman.</text> </level> <level label="b"> <text>The manner of election of officers and their terms of office shall be as the Executive Board determines.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-422" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <text>The Executive Board of the Center shall develop policy for the operations of the Center, including policies on the assignments and responsibilities of the scientific employees and technical employees of the Center.</text> </section> <section article="ghg" article_name="Health - General" number="10-423" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <level label="a"> <text>By joint action, the Director and the Chairman of the Department of Psychiatry shall appoint a superintendent of the Center and may remove the Superintendent.</text> </level> <level label="b"> <text>The Executive Board of the Center shall appoint individuals to scientific positions and technical positions at the Center and may remove these individuals.</text> </level> <level label="c"> <level label="1"> <text>The Superintendent of the Center and each individual in a scientific position or technical position shall be in the management service or special appointments in the State Personnel Management System.</text> </level> <level label="2"> <text>The remaining administrative employees and all clerical employees shall be in the skilled service in the State Personnel Management System.</text> </level> <level label="3"> <text>The Executive Board shall determine the status of each position at the Center.</text> </level> </level> <level label="d"> <text>All positions at the Center shall be assigned to the University of Maryland School of Medicine.</text> </level> <level label="e"> <text>Each employee of the Center whom the Executive Board designates as performing scientific duties or technical duties shall be appointed to a faculty position in the Department of Psychiatry.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-424" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <text>The Center shall:</text> <level label="1"> <text>Be maintained as a State facility for psychiatric research;</text> </level> <level label="2"> <text>Direct its programs toward prevention, discovery of causes, and treatment of mental disorders and allied conditions; and</text> </level> <level label="3"> <text>Perform the research programs under the written agreements that the Department and the Department of Psychiatry make.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-425" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <text>Research programs shall be carried out under the general supervision and direction of the Department of Psychiatry, but subject to the policies of the Executive Board of the Center.</text> </section> <section article="ghg" article_name="Health - General" number="10-426" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <text>There is a technical review committee in the Center.</text> </section> <section article="ghg" article_name="Health - General" number="10-427" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <level label="a"> <text>The technical review committee consists of the following 11 members:</text> <level label="1"> <text>As ex officio members:</text> <level label="i"> <text>The Superintendent of the Center; and</text> </level> <level label="ii"> <text>The Chairman of the Department of Psychiatry;</text> </level> </level> <level label="2"> <text>3 psychologists;</text> </level> <level label="3"> <text>3 physicians who are licensed to practice medicine in this State and devote a substantial amount of professional time to the practice of psychiatry; and</text> </level> <level label="4"> <text>3 citizens of this State chosen by the Executive Board of the Center from individuals who are interested in and concerned about the care of individuals who have a mental disorder and about research directed toward the prevention, discovery of causes, and treatment of mental disorders and allied conditions.</text> </level> </level> <level label="b"> <text>Of the 3 psychologists and 3 physicians:</text> <level label="1"> <text>1 shall be chosen by the Executive Board of the Center from the University of Maryland School of Medicine;</text> </level> <level label="2"> <text>2 shall be chosen by the Executive Board of the Center from the Johns Hopkins University School of Medicine; and</text> </level> <level label="3"> <text>3 shall be chosen by the Executive Board of the Center from other affiliations, including private practitioners.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-428" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <level label="a"> <text>From among its members, the technical review committee shall elect a chairman.</text> </level> <level label="b"> <text>The manner of election of officers and their terms of office shall be as the technical review committee determines.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-429" title_number="10" title_name="Mental Health Law" subtitle_number="4" subtitle_name="State Facilities"> <text>The technical review committee shall:</text> <level label="1"> <text>Provide peer review over research activities at the Center;</text> </level> <level label="2"> <text>Serve in an advisory capacity to the Executive Board and the Superintendent of the Center; and</text> </level> <level label="3"> <text>Submit an annual report to the Executive Board.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-501" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <text>In Part I of this subtitle, “license” means a license issued by the Department to operate a private, inpatient facility.</text> </section> <section article="ghg" article_name="Health - General" number="10-502" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <level label="a"> <text>The Secretary shall adopt rules and regulations for licensing private, inpatient facilities.</text> </level> <level label="b"> <text>The rules and regulations shall ensure that care and treatment of individuals who have a mental disorder are provided in accordance with the policy stated in Subtitle 1 of this title.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-503" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <text>In addition to holding any other license required by law, a person shall be licensed by the Department before the person may operate a private, inpatient facility.</text> </section> <section article="ghg" article_name="Health - General" number="10-504" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <text>To qualify for a license, an applicant shall:</text> <level label="1"> <text>Have a certificate of accreditation from the Joint Commission on Accreditation of Hospitals for the private inpatient facility to be operated; or</text> </level> <level label="2"> <text>Meet the requirements that the Secretary adopts under this subtitle.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-505" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <level label="a"> <text>An applicant for a license shall submit an application on the form that the Secretary requires.</text> </level> <level label="b"> <text>The application shall provide the information that the Secretary requires.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-506" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <text>When an application for a license is filed, the Department promptly shall investigate the applicant.</text> </section> <section article="ghg" article_name="Health - General" number="10-507" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <text>The Department shall issue a license to any applicant who meets the requirements of this subtitle.</text> </section> <section article="ghg" article_name="Health - General" number="10-508" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <text>A license authorizes the licensee to operate a private facility while the license is effective.</text> </section> <section article="ghg" article_name="Health - General" number="10-509" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <level label="a"> <level label="1"> <text>Except as provided in paragraph (2) of this subsection, the Department shall inspect each private, inpatient facility at least once every 6 months and at any other time that the Department considers necessary.</text> </level> <level label="2"> <text>A facility that is accredited by the Joint Commission on Accreditation of Hospitals shall be inspected under § 19-308(b) of this article.</text> </level> </level> <level label="b"> <text>The Department shall keep a report of each inspection.</text> </level> <level label="c"> <text>The Department shall bring any deficiencies to the attention of the management of the private, inpatient facility.</text> </level> <level label="d"> <text>Complaint investigations of private inpatient facilities and psychiatric units of private acute general hospitals shall be performed in accordance with the provisions of § 19-309 of this article.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-510" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <level label="a"> <text>The Department shall deny a license to any applicant or suspend or revoke a license if the applicant or licensee fails to comply with the applicable laws, rules, or regulations of this State.</text> </level> <level label="b"> <text>Except as otherwise provided in the Administrative Procedure Act, before the Department takes any action under this section, the Department shall give the applicant or licensee notice and an opportunity for a hearing.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-511" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <text>Any person aggrieved by a final decision of the Department in a contested case, as defined in the Administrative Procedure Act, may petition for judicial review as allowed by the Administrative Procedure Act.</text> </section> <section article="ghg" article_name="Health - General" number="10-514" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <level label="a"> <text>In Part II of this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Large private group home” means a private group home that admits at least 10 but not more than 16 individuals.</text> </level> <level label="c"> <text>“License” means a license issued by the Secretary to operate a private group home.</text> </level> <level label="d"> <level label="1"> <text>“Private group home” means a residence in which individuals who have been or are under treatment for a mental disorder may be provided care or treatment in a homelike environment.</text> </level> <level label="2"> <text>“Private group home” does not include:</text> <level label="i"> <text>Any facility that is owned by or leased to this State or any public agency;</text> </level> <level label="ii"> <text>Any facility that is regulated by the Department of Juvenile Services;</text> </level> <level label="iii"> <text>Any facility that is regulated by the Developmental Disabilities Administration;</text> </level> <level label="iv"> <text>Any facility that is organized wholly or partly to make a profit; or</text> </level> <level label="v"> <text>A foster home that is the domicile of the foster parent.</text> </level> </level> </level> <level label="e"> <text>“Small private group home” means a private group home that admits at least 4 but not more than 9 individuals.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-516" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <level label="a"> <text>A private group home shall be licensed in accordance with Title 7.5 of this article.</text> </level> <level label="b"> <text>The Secretary shall adopt rules and regulations for establishing, licensing, and operating private group homes.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-518" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <level label="a"> <text>A small private group home:</text> <level label="1"> <text>Is deemed conclusively a single–family dwelling; and</text> </level> <level label="2"> <text>Is permitted to locate in all residential zones.</text> </level> </level> <level label="b"> <text>A large private group home is deemed conclusively a multifamily dwelling and is permitted to locate in zones of similar density.</text> </level> <level label="c"> <text>A private group home is not subject to any special exception, conditional use permit, or procedure that differs from that required for a single–family dwelling or a multifamily dwelling of similar density in the same zone.</text> </level> <level label="d"> <text>A general zoning ordinance that conflicts with the provisions of this section is superseded by this section to the extent of the conflict.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-519" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <level label="a"> <text>An applicant for a license shall submit an application to the Secretary on the form that the Secretary requires.</text> </level> <level label="b"> <text>The application shall:</text> <level label="1"> <text>Be signed and verified by the applicant; and</text> </level> <level label="2"> <text>Contain:</text> <level label="i"> <text>The name and address of the applicant;</text> </level> <level label="ii"> <text>The street address of the property on which the private group home is to be located or, if it has no street address, a description that identifies the property;</text> </level> <level label="iii"> <text>If the applicant does not own the property, the name of the owner;</text> </level> <level label="iv"> <text>A statement that the applicant will comply with the laws, rules, and regulations that relate to establishing and operating the private group home;</text> </level> <level label="v"> <text>A statement that the applicant has sufficient financial resources to establish and operate the private group home or that those resources are available to the applicant; and</text> </level> <level label="vi"> <text>A description of the proposed program.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-524" title_number="10" title_name="Mental Health Law" subtitle_number="5" subtitle_name="Private Facilities"> <text>Any person aggrieved by a final decision of the Secretary in a contested case, as defined in the Administrative Procedure Act, may petition for judicial review as allowed by the Administrative Procedure Act to the circuit court for the county where the private group home is located or planned.</text> </section> <section article="ghg" article_name="Health - General" number="10-601" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Clinical social worker” means an individual who is licensed under Title 19 of the Health Occupations Article to practice clinical social work.</text> </level> <level label="c"> <text>“Danger to the life or safety of the individual or of others” means there is, as a result of a mental disorder, a substantial risk, based on conduct that is recent and relevant to the danger that the individual may present and in consideration of the individual’s current condition and, if available, recent personal, medical, and psychiatric history, that the individual will:</text> <level label="1"> <text>Cause serious bodily harm to the individual or another individual; or</text> </level> <level label="2"> <text>Be unable, except for reasons of indigence, to provide for the individual’s basic needs, including food, clothing, shelter, medical care, self–protection, or safety, to such a degree as to create a substantial risk of serious bodily harm, serious illness, or death in the near future.</text> </level> </level> <level label="d"> <text>“Electronic record” means a document communicated, received, or stored by electronic means.</text> </level> <level label="e"> <text>“Licensed clinical marriage and family therapist” means an individual who is licensed under Title 17, Subtitle 3A of the Health Occupations Article to practice clinical marriage and family therapy.</text> </level> <level label="f"> <text>“Licensed clinical professional counselor” means an individual who is licensed under Title 17, Subtitle 3A of the Health Occupations Article to practice clinical professional counseling.</text> </level> <level label="g"> <text>“Physician” means an individual who is licensed under Title 14 of the Health Occupations Article to practice medicine in this State.</text> </level> <level label="h"> <text>“Physician assistant” means an individual who is licensed under Title 15 of the Health Occupations Article to practice as a physician assistant.</text> </level> <level label="i"> <text>“Psychiatric nurse practitioner” means an individual who is:</text> <level label="1"> <text>Licensed as a registered nurse and certified as a nurse practitioner under Title 8 of the Health Occupations Article; and</text> </level> <level label="2"> <text>Practicing in the State as a certified registered nurse practitioner–psychiatric mental health.</text> </level> </level> <level label="j"> <text>“Psychologist” means an individual who is licensed under Title 18 of the Health Occupations Article to practice psychology.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-602" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <text>A facility or a Veterans’ Administration hospital may admit an individual, as provided in this subtitle.</text> </section> <section article="ghg" article_name="Health - General" number="10-603" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>This section does not apply to an individual who is:</text> <level label="1"> <text>Transferred from a facility of another state to a State facility under the Interstate Compact on Mental Health; or</text> </level> <level label="2"> <text>Admitted after an emergency evaluation under Part IV of this subtitle.</text> </level> </level> <level label="b"> <text>In addition to the other requirements of this subtitle, a State facility or a Veterans’ Administration hospital may admit an individual who is 65 years old or older only if a geriatric evaluation team determines that there is no available, less restrictive form of care or treatment that is adequate for the needs of the individual.</text> </level> <level label="c"> <level label="1"> <text>Each geriatric evaluation shall be done by the geriatric evaluation team of a county health department.</text> </level> <level label="2"> <text>Each geriatric evaluation team consists of the individuals whom the Secretary designates from multiple disciplines.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-605" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>Within 10 days after admission of an individual to a facility under this title, the facility shall submit to the Department an admission report on the individual.</text> </level> <level label="b"> <text>The report shall:</text> <level label="1"> <text>Be on the form that the Department requires; and</text> </level> <level label="2"> <text>Contain the information that the Department requires.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-608" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <text>A veteran may be admitted voluntarily to a Veterans’ Administration hospital without regard to this part.</text> </section> <section article="ghg" article_name="Health - General" number="10-609" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>Except as provided in § 10–611 of this subtitle, application for voluntary admission of an individual to a facility may be made under this section by the individual, if the individual is 16 years old or older.</text> </level> <level label="b"> <text>The applicant shall:</text> <level label="1"> <text>Submit a formal, written application that contains the personal information and is on the form required by the Administration; or</text> </level> <level label="2"> <text>Informally request admission.</text> </level> </level> <level label="c"> <text>A facility may not admit an individual under this section unless:</text> <level label="1"> <text>The individual has a mental disorder;</text> </level> <level label="2"> <text>The mental disorder is susceptible to care or treatment;</text> </level> <level label="3"> <text>The individual understands the nature of the request for admission;</text> </level> <level label="4"> <text>The individual is able to give continuous assent to retention by the facility; and</text> </level> <level label="5"> <text>The individual is able to ask for release.</text> </level> </level> <level label="d"> <level label="1"> <text>In addition to the limitations in subsection (c) of this section, a State facility may not admit an individual who is 65 years old or older unless a geriatric evaluation team determines that there is no available, less restrictive form of care or treatment that is adequate for the needs of the individual.</text> </level> <level label="2"> <text>If admission is denied because of the determination of the geriatric evaluation team, the team shall:</text> <level label="i"> <text>Inform the individual; and</text> </level> <level label="ii"> <text>Help the individual obtain the less restrictive form of care or treatment that the geriatric evaluation team finds would be adequate for the needs of the individual.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-610" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>On behalf of a minor, a parent or guardian of the person of the minor may apply, under this section, for admission of the minor to:</text> <level label="1"> <text>Any facility that is not a State facility; or</text> </level> <level label="2"> <text>The following State facilities:</text> <level label="i"> <text>A regional institute for children and adolescents; and</text> </level> <level label="ii"> <text>The child or adolescent unit of a State facility.</text> </level> </level> </level> <level label="b"> <text>The applicant shall submit a formal, written application that contains the personal information and is on the form required by the Administration.</text> </level> <level label="c"> <text>A facility may not admit an individual under this section unless:</text> <level label="1"> <text>The individual has a mental disorder;</text> </level> <level label="2"> <text>The mental disorder is susceptible to care or treatment;</text> </level> <level label="3"> <text>The applicant understands the nature of a request for admission; and</text> </level> <level label="4"> <text>Assent to the admission has been given:</text> <level label="i"> <text>By the admitting physician of the facility; or</text> </level> <level label="ii"> <text>For a child or adolescent unit of a State facility, by:</text> <level label="1"> <text>1 physician and 1 psychologist;</text> </level> <level label="2"> <text>2 physicians;</text> </level> <level label="3"> <text>1 physician and 1 psychiatric nurse practitioner;</text> </level> <level label="4"> <text>1 physician and 1 licensed certified social worker–clinical; or</text> </level> <level label="5"> <text>1 physician and 1 licensed clinical professional counselor.</text> </level> </level> </level> </level> <level label="d"> <text>An admission under this section to a child or adolescent unit of a State facility may not exceed 20 days.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-611" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Disabled person” has the meaning stated in § 13–101 of the Estates and Trusts Article.</text> </level> <level label="3"> <text>“Guardian of the person” means a guardian of the person of a disabled person appointed under Title 13, Subtitle 7, Part II of the Estates and Trusts Article.</text> </level> <level label="4"> <text>“Mental disorder” has the meaning stated in § 10–620 of this subtitle.</text> </level> </level> <level label="b"> <text>A disabled person may apply for voluntary admission of the disabled person if:</text> <level label="1"> <text>The disabled person submits a formal, written application that contains the disabled person’s personal information and is on the form required by the Administration; and</text> </level> <level label="2"> <text>In accordance with subsections (c) through (e) of this section, either a physician and a psychologist, two physicians, a physician and a psychiatric nurse practitioner, or a physician and a physician assistant certify that:</text> <level label="i"> <text>The disabled person has the capacity to execute an application for voluntary admission; and</text> </level> <level label="ii"> <text>The disabled person understands both the criteria for voluntary admission set forth under this section and the procedure for requesting discharge from the facility.</text> </level> </level> </level> <level label="c"> <level label="1"> <text>A certificate for voluntary admission of a disabled person under subsection (b) of this section shall:</text> <level label="i"> <text>Be based on the personal examination of the physician, psychologist, psychiatric nurse practitioner, or physician assistant who signs the certificate; and</text> </level> <level label="ii"> <text>Be in the form that the Secretary of Health adopts, by rule or regulation.</text> </level> </level> <level label="2"> <text>The rules and regulations shall require the form to include an opinion that:</text> <level label="i"> <text>The disabled person has a mental disorder;</text> </level> <level label="ii"> <text>The mental disorder is susceptible to care or treatment;</text> </level> <level label="iii"> <text>The disabled person understands the nature of the request for admission; and</text> </level> <level label="iv"> <text>The disabled person is able to give continuous assent to retention by the facility.</text> </level> </level> </level> <level label="d"> <text>A certificate may not be used for admission if the examination on which the certificate is made was conducted more than 1 week before the certificate is signed.</text> </level> <level label="e"> <text>A certificate may not be used for an admission if the physician, psychologist, psychiatric nurse practitioner, or physician assistant who signed the certificate:</text> <level label="1"> <text>Has a financial interest, through ownership or compensation, in a proprietary facility and admission to that proprietary facility is sought for the disabled person whose status is being certified; or</text> </level> <level label="2"> <text>Is related, by blood or marriage, to the disabled person or the guardian of the person of the disabled person.</text> </level> </level> <level label="f"> <text>A facility may not admit a disabled person under this section unless:</text> <level label="1"> <text>As certified in accordance with subsection (c) of this section, the disabled person satisfies the criteria under subsection (b)(2) of this section; and</text> </level> <level label="2"> <text>The disabled person is able to ask for release.</text> </level> </level> <level label="g"> <level label="1"> <text>In addition to the limitations in subsection (f) of this section, a State facility may not admit a disabled person who is 65 years old or older unless a geriatric evaluation team determines that there is no available less restrictive form of care or treatment that is adequate for the needs of the disabled person.</text> </level> <level label="2"> <text>If admission is denied because of the determination of the geriatric evaluation team, the team shall:</text> <level label="i"> <text>Inform the disabled person and the guardian of the person of the disabled person of the denial; and</text> </level> <level label="ii"> <text>Help the disabled person to obtain the less restrictive form of care or treatment that the geriatric evaluation team finds would be adequate for the needs of the individual.</text> </level> </level> </level> <level label="h"> <text>The facility shall notify the guardian of the person of a disabled person admitted to the facility under this section:</text> <level label="1"> <text>That the disabled person has been admitted to the facility; and</text> </level> <level label="2"> <text>If the disabled person requests to be discharged from a facility to which the disabled person was voluntarily admitted.</text> </level> </level> <level label="i"> <text>If at any time a facility reasonably believes that the disabled person no longer meets the criteria for voluntary admission under this section, the facility shall discharge the disabled person unless:</text> <level label="1"> <text>The admission status of the disabled person has been changed to an involuntary admission in accordance with Part III of this subtitle; and</text> </level> <level label="2"> <text>An involuntary commitment proceeding is held.</text> </level> </level> <level label="j"> <text>The execution by a disabled person of an application for voluntary admission under this section does not:</text> <level label="1"> <text>Diminish the rights, duties, or responsibilities conferred on the guardian of the person under § 13–708 of the Estates and Trusts Article; or</text> </level> <level label="2"> <text>Confer any additional power or authority on the guardian of the person, including the power or authority to commit the disabled person to a mental facility, that a court has not otherwise conferred on the guardian of the person under § 13–708 of the Estates and Trusts Article.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-613" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <text>In this part, “involuntary admission” includes every admission of a minor to a State facility unless the admission is a voluntary admission authorized under Part II of this subtitle.</text> </section> <section article="ghg" article_name="Health - General" number="10-614" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>Except as provided in subsection (b) of this section, application for involuntary admission of an individual to a facility or Veterans’ Administration hospital may be made under this part by any person who has a legitimate interest in the welfare of the individual.</text> </level> <level label="b"> <text>If the Administration agrees to pay the appropriate expenses, application for involuntary admission to a facility of an incarcerated individual in an institution under the Division of Correction or the Patuxent Institution may be made under this part by the Division or the Patuxent Institution.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-615" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <text>Each application for involuntary admission to a facility or Veterans’ Administration hospital under this part shall:</text> <level label="1"> <text>Be in writing;</text> </level> <level label="2"> <text>Be dated;</text> </level> <level label="3"> <text>Be on the form required by:</text> <level label="i"> <text>The Administration, in the case of a facility; or</text> </level> <level label="ii"> <text>The Veterans’ Administration hospital, in the case of a Veterans’ Administration hospital;</text> </level> </level> <level label="4"> <text>State the relationship of the applicant to the individual for whom admission is sought;</text> </level> <level label="5"> <text>Be signed by the applicant;</text> </level> <level label="6"> <text>Be accompanied by the certificates of:</text> <level label="i"> <text>1 physician and 1 psychologist;</text> </level> <level label="ii"> <text>2 physicians;</text> </level> <level label="iii"> <text>1 physician and 1 psychiatric nurse practitioner;</text> </level> <level label="iv"> <text>1 physician and 1 licensed certified social worker–clinical; or</text> </level> <level label="v"> <text>1 physician and 1 licensed clinical professional counselor; and</text> </level> </level> <level label="7"> <text>Contain any other information that the Administration requires.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-616" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <level label="1"> <text>A certificate for involuntary admission of an individual under this part shall:</text> <level label="i"> <text>Be based on the personal examination of the physician, psychologist, psychiatric nurse practitioner, licensed certified social worker–clinical, or licensed clinical professional counselor who signs the certificate; and</text> </level> <level label="ii"> <text>Be in the form that the Secretary adopts, by rule or regulation.</text> </level> </level> <level label="2"> <text>The rules and regulations shall require the form to include:</text> <level label="i"> <text>A diagnosis of a mental disorder of the individual;</text> </level> <level label="ii"> <text>An opinion that the individual needs inpatient care or treatment; and</text> </level> <level label="iii"> <text>An opinion that admission to a facility or Veterans’ Administration hospital is needed for the protection of the individual or another.</text> </level> </level> </level> <level label="b"> <text>A certificate may not be used for admission if the examination on which the certificate is made was done:</text> <level label="1"> <text>More than 1 week before the certificate is signed; or</text> </level> <level label="2"> <text>More than 30 days before the facility or the Veterans’ Administration hospital receives the application for admission.</text> </level> </level> <level label="c"> <text>A certificate may not be used for an admission if the physician, psychologist, psychiatric nurse practitioner, licensed certified social worker–clinical, or licensed clinical professional counselor who signed the certificate:</text> <level label="1"> <text>Has a financial interest, through ownership or compensation, in a proprietary facility and admission to that proprietary facility is sought for the individual whose status is being certified; or</text> </level> <level label="2"> <text>Is related, by blood or marriage, to the individual or to the applicant.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-617" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>A facility or Veterans’ Administration hospital may not admit the individual under this part unless:</text> <level label="1"> <text>The individual has a mental disorder;</text> </level> <level label="2"> <text>The individual needs inpatient care or treatment;</text> </level> <level label="3"> <text>The individual presents a danger to the life or safety of the individual or of others;</text> </level> <level label="4"> <text>The individual is unable or unwilling to be admitted voluntarily; and</text> </level> <level label="5"> <text>There is no available, less restrictive form of intervention that is consistent with the welfare and safety of the individual.</text> </level> </level> <level label="b"> <level label="1"> <text>In addition to the limitations in subsection (a) of this section, a State facility may not admit an individual who is 65 years old or older unless a geriatric evaluation team determines that there is no available, less restrictive form of care or treatment that is adequate for the needs of the individual.</text> </level> <level label="2"> <text>If admission is denied because of the determination of the geriatric evaluation team, the team shall:</text> <level label="i"> <text>Inform the applicant; and</text> </level> <level label="ii"> <text>Help the applicant obtain the less restrictive form of care or treatment that the team finds would be adequate for the needs of the individual.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-618" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>A person who applies for involuntary admission of an individual shall have the immunity from liability described under § 5–623(b) of the Courts Article.</text> </level> <level label="b"> <text>A facility or Veterans’ Administration hospital that acts in compliance with the provisions of this part shall have the immunity from liability described under § 5–623(c) of the Courts Article.</text> </level> <level label="c"> <text>An agent or employee of a facility or Veterans’ Administration hospital who acts in compliance with the provisions of this part shall have the immunity from liability described under § 5–623(d) of the Courts Article.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-619" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <text>Within 12 hours of notification by a physician, licensed psychologist, psychiatric nurse practitioner, licensed certified social worker–clinical, or licensed clinical professional counselor who has certified an individual under this part, a facility operated by the Maryland Department of Health shall receive and evaluate the individual certified for involuntary admission if:</text> <level label="1"> <text>The individual’s involuntary admission is not limited by § 10–617 of this subtitle;</text> </level> <level label="2"> <text>An application for admission has been completed;</text> </level> <level label="3"> <text>A certifying physician, psychologist, psychiatric nurse practitioner, licensed certified social worker–clinical, or licensed clinical professional counselor is unable to place the individual in a facility not operated by the Department; and</text> </level> <level label="4"> <text>The Department is unable to provide for the placement of the person other than in a facility operated by the Department.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-620" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>In Part IV of this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Court” means a district or circuit court of this State.</text> </level> <level label="c"> <text>“Emergency evaluee” means an individual for whom an emergency evaluation is sought or made under Part IV of this subtitle.</text> </level> <level label="d"> <level label="1"> <text>“Emergency facility” means a facility that the Department designates, in writing, as an emergency facility.</text> </level> <level label="2"> <text>“Emergency facility” includes a licensed general hospital that has an emergency room, unless the Department, after consultation with the health officer, exempts the hospital.</text> </level> </level> <level label="e"> <text>“Emergency facility personnel” means a physician, physician assistant, nurse practitioner, or other advanced practice professional employed or under contract with the emergency facility.</text> </level> <level label="f"> <level label="1"> <text>“Mental disorder” means the behavioral or other symptoms that indicate:</text> <level label="i"> <text>To a lay petitioner who is submitting an emergency petition, a clear disturbance in the mental functioning of another individual; and</text> </level> <level label="ii"> <text>To the following health professionals doing an examination, at least one mental disorder that is described in the version of the American Psychiatric Association’s “Diagnostic and Statistical Manual – Mental Disorders” that is current at the time of the examination:</text> <level label="1"> <text>Physician;</text> </level> <level label="2"> <text>Psychologist;</text> </level> <level label="3"> <text>Clinical social worker;</text> </level> <level label="4"> <text>Licensed clinical professional counselor;</text> </level> <level label="5"> <text>Clinical nurse specialist in psychiatric and mental health nursing (APRN/PMH);</text> </level> <level label="6"> <text>Psychiatric nurse practitioner (CRNP–PMH);</text> </level> <level label="7"> <text>Physician assistant; or</text> </level> <level label="8"> <text>Licensed clinical marriage and family therapist.</text> </level> </level> </level> <level label="2"> <text>“Mental disorder” does not include intellectual disability.</text> </level> </level> <level label="g"> <text>“Peace officer” means a sheriff, a deputy sheriff, a State police officer, a county police officer, a municipal or other local police officer, or a Secret Service agent who is a sworn special agent of the United States Secret Service or Department of Homeland Security authorized to exercise powers delegated under 18 U.S.C. § 3056.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-621" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>At least once a year, the Department shall:</text> <level label="1"> <text>Publish a list of emergency facilities and their addresses; and</text> </level> <level label="2"> <text>Give the list to each health department, judge of a court, sheriff’s office, police station, local behavioral health authority, and Secret Service office in this State.</text> </level> </level> <level label="b"> <text>The list published under subsection (a)(1) of this section may include:</text> <level label="1"> <text>Comprehensive crisis response centers;</text> </level> <level label="2"> <text>Crisis stabilization centers;</text> </level> <level label="3"> <text>Crisis treatment centers established under § 7.5–207 of this article; and</text> </level> <level label="4"> <text>Outpatient mental health clinics.</text> </level> </level> <level label="c"> <text>Before including a facility under subsection (b) of this section in the list of emergency facilities, the Department shall consult with stakeholders to develop a model program structure that ensures that a program wishing to serve as an emergency facility:</text> <level label="1"> <text>Is adequately staffed to provide 24–hour emergency petition services;</text> </level> <level label="2"> <text>Provides the necessary services required for an emergency petition;</text> </level> <level label="3"> <text>Has written procedures in place that provide for involuntary admissions, through an emergency petition, including to a licensed hospital, as necessary;</text> </level> <level label="4"> <text>Provides additional support to respect the due process rights of patients received through the emergency petition process; and</text> </level> <level label="5"> <text>Complies with additional procedures as otherwise determined by the Department.</text> </level> </level> <level label="d"> <text>On or before September 30 each year, the Department shall report to the General Assembly, in accordance with § 2–1257 of the State Government Article, on:</text> <level label="1"> <text>The number of facilities that have sought to be designated an emergency facility;</text> </level> <level label="2"> <text>The number of the facilities reported under item (1) of this subsection that have attempted to meet the model facility standards developed under subsection (c) of this section;</text> </level> <level label="3"> <text>The progress of the facilities reported under item (2) of this subsection toward meeting the model facility standards;</text> </level> <level label="4"> <text>The development of collaborative models between State, local, and private entities; and</text> </level> <level label="5"> <text>Whether the Department, in consultation with stakeholders, has determined that any changes to the model facility standards are necessary.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-622" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>A petition for emergency evaluation of an individual may be made under this section only if the petitioner has reason to believe that the individual:</text> <level label="1"> <text>Has a mental disorder; and</text> </level> <level label="2"> <text>Presents a danger to the life or safety of the individual or of others.</text> </level> </level> <level label="b"> <level label="1"> <text>The petition for emergency evaluation of an individual may be made by:</text> <level label="i"> <text>A physician, psychologist, physician assistant, clinical social worker, licensed clinical professional counselor, clinical nurse specialist in psychiatric and mental health nursing, psychiatric nurse practitioner, licensed clinical marriage and family therapist, or health officer or designee of a health officer who has examined the individual;</text> </level> <level label="ii"> <text>A peace officer who personally has observed the individual or the individual’s behavior; or</text> </level> <level label="iii"> <text>Any other interested person.</text> </level> </level> <level label="2"> <text>An individual who makes a petition for emergency evaluation under paragraph (1)(i) or (ii) of this subsection may base the petition on:</text> <level label="i"> <text>The examination or observation; or</text> </level> <level label="ii"> <text>Other information obtained that is pertinent to the factors giving rise to the petition.</text> </level> </level> </level> <level label="c"> <level label="1"> <text>A petition under this section shall:</text> <level label="i"> <text>Be signed and verified by the petitioner;</text> </level> <level label="ii"> <text>State the petitioner’s:</text> <level label="1"> <text>Name;</text> </level> <level label="2"> <text>Address; and</text> </level> <level label="3"> <text>Home and work telephone numbers;</text> </level> </level> <level label="iii"> <text>State the emergency evaluee’s:</text> <level label="1"> <text>Name; and</text> </level> <level label="2"> <text>Description;</text> </level> </level> <level label="iv"> <text>State the following information, if available:</text> <level label="1"> <text>The address of the emergency evaluee; and</text> </level> <level label="2"> <text>The name and address of the spouse or a child, parent, or other relative of the emergency evaluee or any other individual who is interested in the emergency evaluee;</text> </level> </level> <level label="v"> <text>If the individual who makes the petition for emergency evaluation is an individual authorized to do so under subsection (b)(1)(i) of this section, contain the license number of the individual;</text> </level> <level label="vi"> <text>Contain a description of the behavior and statements of the emergency evaluee or any other information that led the petitioner to believe that the emergency evaluee has a mental disorder and that the individual presents a danger to the life or safety of the individual or of others; and</text> </level> <level label="vii"> <text>Contain any other facts that support the need for an emergency evaluation.</text> </level> </level> <level label="2"> <text>The petition form shall contain a notice that the petitioner:</text> <level label="i"> <text>May be required to appear before a court; and</text> </level> <level label="ii"> <text>Makes the statements under penalties of perjury.</text> </level> </level> </level> <level label="d"> <level label="1"> <text>A petitioner who is a physician, psychologist, physician assistant, clinical social worker, licensed clinical professional counselor, clinical nurse specialist in psychiatric and mental health nursing, psychiatric nurse practitioner, licensed clinical marriage and family therapist, health officer, or designee of a health officer shall give the petition to a peace officer.</text> </level> <level label="2"> <text>The peace officer shall explain to the petitioner:</text> <level label="i"> <text>The serious nature of the petition; and</text> </level> <level label="ii"> <text>The meaning and content of the petition.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-623" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>If the petitioner under Part IV of this subtitle is not a physician, psychologist, physician assistant, clinical social worker, licensed clinical professional counselor, clinical nurse specialist in psychiatric and mental health nursing, psychiatric nurse practitioner, licensed clinical marriage and family therapist, health officer or designee of a health officer, or peace officer, the petitioner shall present the petition to the court for immediate review.</text> </level> <level label="b"> <text>After review of the petition, the court shall endorse the petition if the court finds probable cause to believe that the emergency evaluee has shown the symptoms of a mental disorder and that the individual presents a danger to the life or safety of the individual or of others.</text> </level> <level label="c"> <text>If the court does not find probable cause, the court shall indicate that fact on the petition, and no further action may be taken under the petition.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-624" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <level label="1"> <text>A peace officer shall take an emergency evaluee to the nearest emergency facility if the peace officer has a petition under Part IV of this subtitle that:</text> <level label="i"> <text>Has been endorsed by a court within the last 5 days; or</text> </level> <level label="ii"> <text>Is signed and submitted by a physician, psychologist, physician assistant, clinical social worker, licensed clinical professional counselor, clinical nurse specialist in psychiatric and mental health nursing, psychiatric nurse practitioner, licensed clinical marriage and family therapist, health officer or designee of a health officer, or peace officer.</text> </level> </level> <level label="2"> <text>The petition required under paragraph (1) of this subsection may be:</text> <level label="i"> <text>In the form of an electronic record; and</text> </level> <level label="ii"> <text>Transmitted and received electronically.</text> </level> </level> <level label="3"> <text>To the extent practicable, a peace officer shall notify the emergency facility in advance that the peace officer is bringing an emergency evaluee to the emergency facility.</text> </level> <level label="4"> <text>After a peace officer brings the emergency evaluee to an emergency facility, the peace officer need not stay unless, because the emergency evaluee is violent, emergency facility personnel ask the supervisor of the peace officer to have the peace officer stay.</text> </level> <level label="5"> <text>A peace officer shall stay until the supervisor responds to the request for assistance. If the emergency evaluee is violent, the supervisor shall allow the peace officer to stay.</text> </level> <level label="6"> <text>If emergency facility personnel ask that a peace officer stay, a physician shall examine the emergency evaluee as promptly as possible.</text> </level> </level> <level label="b"> <level label="1"> <text>If the petition is executed properly, the emergency facility shall accept the emergency evaluee.</text> </level> <level label="2"> <text>The petition required under paragraph (1) of this subsection may be:</text> <level label="i"> <text>In the form of an electronic record; and</text> </level> <level label="ii"> <text>Transmitted and received electronically.</text> </level> </level> <level label="3"> <text>Within 6 hours after an emergency evaluee is brought to an emergency facility, a physician shall examine the emergency evaluee, to determine whether the emergency evaluee meets the requirements for involuntary admission.</text> </level> <level label="4"> <text>Promptly after the examination, the emergency evaluee shall be released unless the emergency evaluee:</text> <level label="i"> <text>Asks for voluntary admission; or</text> </level> <level label="ii"> <text>Meets the requirements for involuntary admission.</text> </level> </level> <level label="5"> <text>An emergency evaluee may not be kept at an emergency facility for more than 30 hours.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-625" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>If an emergency evaluee meets the requirements for an involuntary admission and is unable or unwilling to agree to a voluntary admission under this subtitle, the examining physician shall take the steps needed for involuntary admission of the emergency evaluee to an appropriate facility, which may be a general hospital with a licensed inpatient psychiatric unit.</text> </level> <level label="b"> <level label="1"> <text>If the examining physician is unable to have the emergency evaluee admitted to a facility, the physician shall notify the Department.</text> </level> <level label="2"> <text>Within 6 hours after notification, the Department shall provide for admission of the emergency evaluee to an appropriate facility.</text> </level> </level> <level label="c"> <level label="1"> <text>Within 30 hours after the emergency facility completes an application for the involuntary admission of an emergency evaluee, the emergency facility shall notify the Mental Health Division in the Office of the Public Defender, by e–mail or facsimile, of the completion of the application.</text> </level> <level label="2"> <text>The notice required under paragraph (1) of this subsection shall include any legal documents relating to the acceptance of the emergency evaluee into the emergency facility, including the emergency petition, application for involuntary admission, and certification for involuntary admission.</text> </level> <level label="3"> <text>The notice required under paragraph (1) of this subsection does not apply to a patient who agrees to voluntary admission.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-626" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>A court may order, at any time, an emergency evaluation under Part IV of this subtitle of an individual who has been arrested, if the court finds probable cause to believe that the individual has a mental disorder and the individual presents a danger to the life or safety of the individual or of others.</text> </level> <level label="b"> <text>The court order for an emergency evaluation shall state the grounds.</text> </level> <level label="c"> <text>Unless the court directs otherwise, an individual who is taken to an emergency facility under this section shall stay in the custody of the peace officer until the individual either is admitted to an appropriate facility or returned to the court or an appropriate jail.</text> </level> <level label="d"> <text>If an individual was detained lawfully before the court ordered an emergency evaluation under this section and the individual does not meet the requirements for involuntary admission under this subtitle:</text> <level label="1"> <text>The examining physician shall send a brief report of the evaluation to the court; and</text> </level> <level label="2"> <text>The peace officer shall:</text> <level label="i"> <text>Return to the court the individual, the court order, and the report of the examining physician; or</text> </level> <level label="ii"> <text>If the court is not in session, take the individual to an appropriate jail and, before the end of the next day that the court is in session, return to the court the individual and the report of the examining physician.</text> </level> </level> </level> <level label="e"> <text>A court order under this section is a detainer against an individual until:</text> <level label="1"> <text>The charges against the individual are dismissed, nol prossed, or stetted; or</text> </level> <level label="2"> <text>The individual appears in court.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-627" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <text>On the first work day after admission of an emergency evaluee who is 65 years old or older, the geriatric evaluation team in the county where the emergency evaluee resides shall be informed.</text> </section> <section article="ghg" article_name="Health - General" number="10-628" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <level label="1"> <text>If an emergency evaluee cannot pay or does not have insurance that covers the charges for emergency services, an initial consultant examination by a physician, physician assistant, or nurse practitioner, and transportation to an emergency facility and, for an involuntary admission of the emergency evaluee, to the admitting facility, the Department shall pay the appropriate party the actual cost or a reasonable rate for this service, whichever is lower, except that hospitals shall be paid at rates approved by the Health Services Cost Review Commission.</text> </level> <level label="2"> <text>The reasonable rate for the services provided under an emergency petition shall be calculated by using a methodology established by regulation and reasonably related to the actual cost.</text> </level> </level> <level label="b"> <text>With respect to emergency admissions, the Department shall be subrogated against any insurance coverage available to the patient for charges relating to emergency service, initial consultant examination by a physician or nurse practitioner, and transportation to an emergency facility under Part IV of this subtitle.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-629" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>Any petitioner who submits or completes a petition under Part IV of this subtitle shall have the immunity from liability described under § 5-624(b) of the Courts and Judicial Proceedings Article.</text> </level> <level label="b"> <text>Any peace officer who acts as a custodian of an emergency evaluee shall have the immunity from liability described under § 5-624(c) of the Courts and Judicial Proceedings Article.</text> </level> <level label="c"> <text>An emergency facility that acts in compliance with the provisions of Part IV of this subtitle shall have the immunity from liability described under § 5-624(d) of the Courts and Judicial Proceedings Article.</text> </level> <level label="d"> <text>An agent or employee of an emergency facility who acts in compliance with the provisions of Part IV of this subtitle shall have the immunity from liability described under § 5-624(e) of the Courts and Judicial Proceedings Article.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-630" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>All court records relating to a petition for an emergency evaluation made under this subtitle are confidential and the contents may not be divulged, by subpoena or otherwise, except by order of the court on good cause shown.</text> </level> <level label="b"> <text>Except for a court record sealed under subsection (d) of this section, this section does not prohibit review of a court record relating to a petition by:</text> <level label="1"> <text>Personnel of the court;</text> </level> <level label="2"> <text>The petitioner;</text> </level> <level label="3"> <text>The emergency evaluee or counsel for the emergency evaluee;</text> </level> <level label="4"> <text>Authorized personnel of the Department;</text> </level> <level label="5"> <text>Authorized personnel of the local core service agency or local behavioral health authority;</text> </level> <level label="6"> <text>A law enforcement agency; or</text> </level> <level label="7"> <text>A person authorized by a court order on good cause shown.</text> </level> </level> <level label="c"> <text>A petition for an emergency evaluation:</text> <level label="1"> <text>Shall be considered a mental health record under Title 4 of this article; and</text> </level> <level label="2"> <text>May be released by a health care provider, as defined in § 4–301 of this article, only as permitted by law.</text> </level> </level> <level label="d"> <level label="1"> <text>An emergency evaluee who was a minor when a petition for emergency evaluation was made or sought concerning the emergency evaluee under this part may file a motion with the court at any time requesting that any court records relating to the petition be sealed.</text> </level> <level label="2"> <text>The court shall have a copy of the motion filed under this subsection served on the petitioner at the address stated for the petitioner in the petition for emergency evaluation.</text> </level> <level label="3"> <text>The court may order court records relating to the petition for emergency evaluation that is the subject of the motion sealed for good cause shown.</text> </level> <level label="4"> <level label="i"> <text>The petitioner may file an objection to a motion filed under this subsection.</text> </level> <level label="ii"> <text>If no objection is filed, the court may grant the motion without a hearing.</text> </level> <level label="iii"> <text>If the petitioner files an objection to the motion within 30 days after a copy of the motion is served on the petitioner, the court shall hold a hearing.</text> </level> <level label="iv"> <text>The court may hold a hearing on its own initiative.</text> </level> </level> <level label="5"> <text>If sealed, the court records relating to the petition for emergency evaluation that is the subject of the motion may not be opened, for any purpose, except by order of the court for good cause shown.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-631" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>The Administration shall prepare and provide each facility with standard forms that provide, in clear and simple words, at least the following information:</text> <level label="1"> <text>Notice of the admission of the individual;</text> </level> <level label="2"> <text>The right of the individual to consult with a lawyer that the individual chooses;</text> </level> <level label="3"> <text>The availability of the services of the legal aid bureaus, lawyer referral services, and other agencies that exist for the referral of individuals who need legal counsel;</text> </level> <level label="4"> <text>The right of the individual to call or write a lawyer or a referral agency or to have someone do so on behalf of the individual; and</text> </level> <level label="5"> <text>In substance:</text> <level label="i"> <text>Those provisions of this subtitle under which the individual is admitted;</text> </level> <level label="ii"> <text>The provisions of this section; and</text> </level> <level label="iii"> <text>The provisions of Subtitle 7 of this title.</text> </level> </level> </level> <level label="b"> <level label="1"> <text>Within 12 hours after initial confinement of an individual to any facility or a Veterans’ Administration hospital, the form provided for in this section shall be read and given to the individual.</text> </level> <level label="2"> <text>If the individual does not understand the notice required by this section and its legal effect, the notice also shall be given to:</text> <level label="i"> <text>The parent, guardian, or next of kin of the individual;</text> </level> <level label="ii"> <text>The applicant for an involuntary admission of the individual; and</text> </level> <level label="iii"> <text>Any other individual who has a significant interest in the status of the individual.</text> </level> </level> <level label="3"> <text>In any event, if possible, notice of the admission shall be given to the parent, guardian, or next of kin of the individual.</text> </level> <level label="4"> <text>Notice of the admission of a minor shall be given as promptly as possible.</text> </level> <level label="5"> <text>Within 24 hours after the admission of the individual, notice of the admission shall be given to the Mental Health Division in the Office of the Public Defender.</text> </level> </level> <level label="c"> <text>The form shall be read in English or, if the individual does not understand English, in the language or manner best calculated to inform the individual of the applicable provisions of the law.</text> </level> <level label="d"> <text>The facility shall keep in the individual’s records a copy of the form and a certification of the administrative head of the facility as to the compliance with this section.</text> </level> <level label="e"> <text>Notice under this section shall be given again to an individual when:</text> <level label="1"> <text>A new application is made under this subtitle for a voluntary admission; and</text> </level> <level label="2"> <text>New certificates are made under this subtitle for an involuntary admission.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-632" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <level label="a"> <text>Any individual proposed for involuntary admission under Part III of this subtitle shall be afforded a hearing to determine whether the individual is to be admitted to a facility or a Veterans’ Administration hospital as an involuntary patient or released without being admitted.</text> </level> <level label="b"> <text>The hearing shall be conducted within 10 days of the date of the initial confinement of the individual.</text> </level> <level label="c"> <level label="1"> <text>The hearing may be postponed for good cause for no more than 7 days, and the reasons for the postponement shall be on the record.</text> </level> <level label="2"> <text>A decision shall be made within the time period provided in paragraph (1) of this subsection.</text> </level> </level> <level label="d"> <text>The Secretary shall:</text> <level label="1"> <text>Adopt rules and regulations on hearing procedures; and</text> </level> <level label="2"> <text>Designate an impartial hearing officer to conduct the hearings.</text> </level> </level> <level label="e"> <text>The hearing officer shall:</text> <level label="1"> <text>Consider all the evidence and testimony of record; and</text> </level> <level label="2"> <text>Order the release of the individual from the facility unless the record demonstrates by clear and convincing evidence that at the time of the hearing each of the following elements exist as to the individual whose involuntary admission is sought:</text> <level label="i"> <text>The individual has a mental disorder;</text> </level> <level label="ii"> <text>The individual needs in–patient care or treatment;</text> </level> <level label="iii"> <text>The individual presents a danger to the life or safety of the individual or of others;</text> </level> <level label="iv"> <text>The individual is unable or unwilling to be voluntarily admitted to the facility;</text> </level> <level label="v"> <text>There is no available less restrictive form of intervention that is consistent with the welfare and safety of the individual; and</text> </level> <level label="vi"> <text>If the individual is 65 years old or older and is to be admitted to a State facility, the individual has been evaluated by a geriatric evaluation team and no less restrictive form of care or treatment was determined by the team to be appropriate.</text> </level> </level> </level> <level label="f"> <text>A hearing officer may not order the release of an individual who meets the requirements for involuntary admission under subsection (e)(2) of this section on the grounds that a health care provider or an emergency or other facility did not comply with disclosure or notice requirements under § 10–625(c) or § 10–631(b)(5) of this subtitle, § 10–803(b)(2) of this title, or § 4–306(c) or § 4–307(l) of this article.</text> </level> <level label="g"> <text>The hearing officer may not order the release of an individual who meets the requirements for involuntary admission under subsection (e)(2) of this section on the grounds that the individual was kept at an emergency facility for more than 30 hours in violation of § 10–624(b)(4) of this subtitle.</text> </level> <level label="h"> <text>The parent, guardian, or next of kin of an individual involuntarily admitted under this subtitle:</text> <level label="1"> <text>Shall be given notice of the hearing on the admission; and</text> </level> <level label="2"> <text>May testify at the hearing.</text> </level> </level> <level label="i"> <text>If a hearing officer enters an order for involuntary commitment under Part III of this subtitle and the hearing officer determines that the individual cannot safely possess a firearm based on credible evidence of dangerousness to others, the hearing officer shall order the individual who is subject to the involuntary commitment to:</text> <level label="1"> <text>Surrender to law enforcement authorities any firearms in the individual’s possession; and</text> </level> <level label="2"> <text>Refrain from possessing a firearm unless the individual is granted relief from firearms disqualification in accordance with § 5–133.3 of the Public Safety Article.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-633" title_number="10" title_name="Mental Health Law" subtitle_number="6" subtitle_name="Admission Provisions"> <text>The determination of a hearing officer on an involuntary admission under this subtitle is a final decision of the Department for the purpose of judicial review of a final decision under the Administrative Procedure Act.</text> </section> <section article="ghg" article_name="Health - General" number="10-6A-01" effective_note="EFFECTIVE UNTIL JUNE 30, 2030 PER CHAPTERS 703 AND 704 OF 2024" title_number="10" title_name="Mental Health Law" subtitle_number="6A" subtitle_name="Assisted Outpatient Treatment Programs"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Assisted outpatient treatment” means a specific regimen of outpatient treatment for a serious and persistent mental illness to which an individual is ordered by the court to adhere.</text> </level> <level label="c"> <text>“Care coordination team” means a multidisciplinary team under the oversight of a local behavioral health authority, core service agency, or the Department.</text> </level> <level label="d"> <text>“Harm to others” means an act or attempt at or credible threat of serious violent behavior toward others.</text> </level> <level label="e"> <text>“Harm to the individual” means self–harming behavior or an attempt at suicide.</text> </level> <level label="f"> <text>“Hospital” has the meaning stated in § 19–301 of this article.</text> </level> <level label="g"> <text>“Program” means an assisted outpatient treatment program.</text> </level> <level label="h"> <text>“Serious and persistent mental illness” means a mental illness that is severe in degree and persistent in duration, that causes a substantially diminished level of functioning in the primary aspects of daily living and an inability to meet the ordinary demands of life, and that may lead to an inability to maintain independent functioning in the community without intensive treatment and support.</text> </level> <level label="i"> <text>“Treatment plan” means a plan developed by a care coordination team that:</text> <level label="1"> <text>Incorporates all outpatient treatment services that are determined to be essential and available for the maintenance of an individual’s health and safety; and</text> </level> <level label="2"> <text>Includes, at a minimum:</text> <level label="i"> <text>Services of a treating psychiatrist;</text> </level> <level label="ii"> <text>Case management;</text> </level> <level label="iii"> <text>Services of a certified peer recovery specialist; and</text> </level> <level label="iv"> <text>If clinically appropriate, assertive community treatment services.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-6A-02" effective_note="EFFECTIVE UNTIL JUNE 30, 2030 PER CHAPTERS 703 AND 704 OF 2024" title_number="10" title_name="Mental Health Law" subtitle_number="6A" subtitle_name="Assisted Outpatient Treatment Programs"> <level label="a"> <text>The issuance of an assisted outpatient treatment order against a respondent under this subtitle may not be:</text> <level label="1"> <text>The basis for the involuntary admission of the respondent to a facility under this title; or</text> </level> <level label="2"> <text>Used as evidence of incompetency of the respondent.</text> </level> </level> <level label="b"> <text>This subtitle may not be construed to abridge or modify any civil right of the respondent, including:</text> <level label="1"> <text>Any civil service ranking or appointment;</text> </level> <level label="2"> <text>The right to apply for voluntary admission to a facility under § 10–609 of this title; and</text> </level> <level label="3"> <text>Any right relating to a license, permit, certification, privilege, or benefit under any law.</text> </level> </level> <level label="c"> <text>Any right normally afforded to an individual in a civil or criminal matter shall apply.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-6A-03" effective_note="EFFECTIVE UNTIL JUNE 30, 2030 PER CHAPTERS 703 AND 704 OF 2024" title_number="10" title_name="Mental Health Law" subtitle_number="6A" subtitle_name="Assisted Outpatient Treatment Programs"> <level label="a"> <level label="1"> <text>On or before July 1, 2026, a county may establish an assisted outpatient treatment program in accordance with this subtitle.</text> </level> <level label="2"> <text>A county may partner with another county to establish an assisted outpatient treatment program.</text> </level> </level> <level label="b"> <text>An assisted outpatient treatment program established under subsection (a) of this section shall be approved and overseen by the county’s local behavioral health authority or core service agency.</text> </level> <level label="c"> <level label="1"> <text>On or before July 1, 2026, the Department shall establish an assisted outpatient treatment program in any county that does not opt to establish an assisted outpatient treatment program.</text> </level> <level label="2"> <text>A county in which the Department is required to establish an assisted outpatient treatment program shall reimburse the Department:</text> <level label="i"> <text>Except as provided in paragraph (3) of this subsection, for fiscal year 2028, for 25% of the State share of associated costs;</text> </level> <level label="ii"> <text>For fiscal year 2029, for 50% of the State share of associated costs;</text> </level> <level label="iii"> <text>For fiscal year 2030, for 75% of the State share of associated costs; and</text> </level> <level label="iv"> <text>For fiscal year 2031, for 100% of the State share of associated costs.</text> </level> </level> <level label="3"> <level label="i"> <text>On or before August 31, 2026, the Department shall provide to each county the number of assisted outpatient treatment program participants in the county and the estimated annual cost to provide treatment to those participants.</text> </level> <level label="ii"> <text>For fiscal year 2028, the obligation to provide 25% of the State share of associated costs shall be waived for any county that provides a report to the Department on or before January 1, 2027, on the cost–benefit analysis of the implementation of the assisted outpatient treatment program on the county budget and operations.</text> </level> </level> </level> <level label="d"> <level label="1"> <text>A care coordination team operating under an assisted outpatient treatment program shall consist of, at a minimum:</text> <level label="i"> <text>A psychiatrist;</text> </level> <level label="ii"> <text>A case manager;</text> </level> <level label="iii"> <text>A certified peer recovery specialist;</text> </level> <level label="iv"> <text>Other treating providers as clinically appropriate, such as an assertive community treatment team and a provider familiar with the health needs of veterans; and</text> </level> <level label="v"> <text>Any other individuals required by the Department in regulation.</text> </level> </level> <level label="2"> <text>The Department shall establish clinical and operational standards for assisted outpatient treatment programs and care coordination teams established under this section.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-6A-04" effective_note="EFFECTIVE UNTIL JUNE 30, 2030 PER CHAPTERS 703 AND 704 OF 2024" title_number="10" title_name="Mental Health Law" subtitle_number="6A" subtitle_name="Assisted Outpatient Treatment Programs"> <level label="a"> <text>A petition for assisted outpatient treatment may be made under this subtitle by the director of a mental health program receiving State funding under Subtitle 9, Part I of this title, or by any individual at least 18 years old who has a legitimate interest in the welfare of the respondent.</text> </level> <level label="b"> <text>The petition for assisted outpatient treatment shall be in writing, signed by the petitioner, and state:</text> <level label="1"> <text>The petitioner’s name, address, and relationship, if any, to the respondent;</text> </level> <level label="2"> <text>The name and any known address of the respondent;</text> </level> <level label="3"> <text>That the petitioner has reason to believe the respondent meets the criteria for assisted outpatient treatment in § 10–6A–05 of this subtitle; and</text> </level> <level label="4"> <text>For each criterion for assisted outpatient treatment in § 10–6A–05 of this subtitle, the specific allegations of fact that support the petitioner’s belief that the respondent meets the criterion.</text> </level> </level> <level label="c"> <text>The petition for assisted outpatient treatment shall be accompanied by an affidavit or affirmation of a psychiatrist, stating that the psychiatrist is willing and able to testify at the hearing on the petition and has:</text> <level label="1"> <text>Examined the respondent within 30 days before the date of the petition; and</text> </level> <level label="2"> <text>Concluded that the respondent meets the criteria for assisted outpatient treatment in § 10–6A–05 of this subtitle.</text> </level> </level> <level label="d"> <level label="1"> <text>A petition for assisted outpatient treatment shall be filed in the circuit court for the county in which the respondent resides or in the county of the last known residence of the respondent.</text> </level> <level label="2"> <text>On the filing of a petition under paragraph (1) of this subsection, the circuit court shall notify the following of the filing of the petition:</text> <level label="i"> <text>The respondent;</text> </level> <level label="ii"> <text>The Mental Health Division in the Office of the Public Defender;</text> </level> <level label="iii"> <text>As applicable, the local behavioral health authority, the county’s core service agency, or the Department;</text> </level> <level label="iv"> <text>The county attorney; and</text> </level> <level label="v"> <text>If applicable and known, the respondent’s guardian and health care agent.</text> </level> </level> </level> <level label="e"> <text>A petition filed under this subtitle shall be held under seal and may not be published on Maryland Judiciary Case Search.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-6A-05" effective_note="EFFECTIVE UNTIL JUNE 30, 2030 PER CHAPTERS 703 AND 704 OF 2024" title_number="10" title_name="Mental Health Law" subtitle_number="6A" subtitle_name="Assisted Outpatient Treatment Programs"> <level label="a"> <text>The court may order the respondent to receive assisted outpatient treatment on a finding by clear and convincing evidence that:</text> <level label="1"> <text>The respondent is at least 18 years old;</text> </level> <level label="2"> <text>The respondent has a serious and persistent mental illness;</text> </level> <level label="3"> <text>The respondent has demonstrated a lack of adherence with treatment for the serious and persistent mental illness that has:</text> <level label="i"> <text>At least twice within the 36–month period immediately preceding the filing of the petition, been a significant factor in necessitating inpatient admission to a psychiatric hospital for at least 48 hours or receipt of psychiatric services in a correctional facility; or</text> </level> <level label="ii"> <text>At least once within the 36–month period immediately preceding the filing of the petition, resulted in an act of serious violent behavior toward self or others, or patterns or threats of, or attempts at, serious physical harm to self or others;</text> </level> </level> <level label="4"> <text>In view of the respondent’s treatment history and behavior at the time the petition is filed, the respondent is in need of assisted outpatient treatment in order to prevent a relapse or deterioration that would create a substantial risk of serious harm to the individual or harm to others;</text> </level> <level label="5"> <text>The respondent is unlikely to adequately adhere to outpatient treatment on a voluntary basis, as demonstrated by the respondent’s history of treatment nonadherence in the 36–month period immediately preceding the filing of the petition that is not due to financial, transportation, or language issues in the immediately preceding 36–month period; and</text> </level> <level label="6"> <text>In consideration of items (1) through (5) of this subsection, assisted outpatient treatment is the least restrictive alternative appropriate to maintain the health and safety of the respondent.</text> </level> </level> <level label="b"> <text>Time that the respondent spent hospitalized or incarcerated may not be included when calculating the time period under subsection (a)(3)(i) or (ii) of this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-6A-06" effective_note="EFFECTIVE UNTIL JUNE 30, 2030 PER CHAPTERS 703 AND 704 OF 2024" title_number="10" title_name="Mental Health Law" subtitle_number="6A" subtitle_name="Assisted Outpatient Treatment Programs"> <level label="a"> <level label="1"> <text>After the filing of the petition with the court under § 10–6A–04 of this subtitle, but not later than the date of the psychiatrist’s testimony required under § 10–6A–07 of this subtitle, the care coordination team shall develop a treatment plan and provide a copy in writing to:</text> <level label="i"> <text>The respondent;</text> </level> <level label="ii"> <text>The respondent’s attorney; and</text> </level> <level label="iii"> <text>If applicable and known, the respondent’s guardian and health care agent.</text> </level> </level> <level label="2"> <text>A treatment plan developed by the care coordination team shall be:</text> <level label="i"> <text>Recovery–oriented; and</text> </level> <level label="ii"> <text>Consistent with evidence–based and evolving best practices in the treatment of serious and persistent mental illness.</text> </level> </level> <level label="3"> <text>For each service listed in the treatment plan, a community–based provider that has agreed to provide the service to the respondent shall be identified to provide the service.</text> </level> <level label="4"> <text>A treatment plan may include medication.</text> </level> </level> <level label="b"> <level label="1"> <text>The care coordination team shall give the respondent, the respondent’s guardian, the respondent’s health care agent, and any individual designated by the respondent a reasonable opportunity to participate in the development of the treatment plan.</text> </level> <level label="2"> <text>If the respondent has executed a mental health advance directive, the care coordination team shall honor any directions included in the advance directive in the development of the treatment plan in accordance with §§ 5–602(a)(2) and 5–611(a) and (b) of this article.</text> </level> <level label="3"> <level label="i"> <text>The respondent shall have an opportunity to voluntarily agree to the treatment plan.</text> </level> <level label="ii"> <text>If the respondent voluntarily agrees to the treatment plan, the care coordination team shall:</text> <level label="1"> <text>Notify the court that the parties are dismissing the case in accordance with Maryland Rule 2–506; and</text> </level> <level label="2"> <text>File a stipulated agreement that includes the treatment plan.</text> </level> </level> </level> <level label="4"> <text>The care coordination team shall provide to the respondent, the county attorney, and the Office of the Public Defender the treatment plan and the providers that are included in the treatment plan.</text> </level> <level label="5"> <text>If the care coordination team changes the treatment plan or the providers included in the treatment plan before the hearing conducted under § 10–6A–07 of this subtitle, the care coordination team shall promptly notify the following of the change and the justification of the change:</text> <level label="i"> <text>The respondent;</text> </level> <level label="ii"> <text>The respondent’s attorney;</text> </level> <level label="iii"> <text>The county attorney; and</text> </level> <level label="iv"> <text>If applicable and known, the respondent’s guardian and health care agent.</text> </level> </level> <level label="6"> <text>The care coordination team shall assist in connecting the respondent to services that would help the respondent be successful in adhering to a treatment plan, including, if needed, transportation, housing, accessibility services, and other services that would address the health–related social needs of the respondent.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-6A-07" effective_note="EFFECTIVE UNTIL JUNE 30, 2030 PER CHAPTERS 703 AND 704 OF 2024" title_number="10" title_name="Mental Health Law" subtitle_number="6A" subtitle_name="Assisted Outpatient Treatment Programs"> <level label="a"> <level label="1"> <text>On receipt of a petition for assisted outpatient treatment that meets the requirements of § 10–6A–04 of this subtitle, the court shall schedule the date for a hearing.</text> </level> <level label="2"> <text>The court may grant a continuance or postponement only for good cause shown.</text> </level> <level label="3"> <text>A hearing shall be scheduled only if the respondent has not agreed to enter voluntary treatment.</text> </level> </level> <level label="b"> <level label="1"> <text>The respondent shall be entitled to be represented by counsel of the respondent’s choice at the hearing and at all stages of the proceedings.</text> </level> <level label="2"> <text>If the respondent is unable to afford an attorney, or is unable to obtain an attorney due to the respondent’s mental illness, representation shall be provided in accordance with §§ 16–204 and 16–208 of the Criminal Procedure Article.</text> </level> <level label="3"> <text>All rules of civil procedure shall apply to cases filed under this subtitle.</text> </level> <level label="4"> <text>Respondents may not be required to give testimony at hearings under this subtitle.</text> </level> <level label="5"> <text>Participation in assisted outpatient treatment may not be used against a respondent in a subsequent legal matter that carries negative collateral consequences.</text> </level> </level> <level label="c"> <text>At the hearing, the respondent shall be given an opportunity to present evidence, to call witnesses on the respondent’s behalf, and to cross–examine adverse witnesses.</text> </level> <level label="d"> <level label="1"> <text>The petitioner’s presentation of evidence shall include the testimony of a psychiatrist whose most recent examination of the respondent occurred within 30 days before the date of the petition.</text> </level> <level label="2"> <text>The psychiatrist shall state the facts and clinical determinations providing the basis for the psychiatrist’s opinion that the respondent meets each of the criteria for assisted outpatient treatment in § 10–6A–05 of this subtitle.</text> </level> </level> <level label="e"> <level label="1"> <text>The petitioner’s presentation of evidence shall include the testimony of a psychiatrist to explain the treatment plan, who:</text> <level label="i"> <text>May be but need not be the examining psychiatrist who testified under subsection (d) of this section; and</text> </level> <level label="ii"> <text>Has met with the respondent or has made a good faith effort to meet with the respondent, is familiar with the relevant history, to the extent practicable, and has examined the treatment plan.</text> </level> </level> <level label="2"> <text>For each category of proposed treatment, the psychiatrist shall state the clinical basis for the determination that the treatment is essential to the maintenance of the respondent’s health or safety.</text> </level> <level label="3"> <text>The psychiatrist shall testify as to the participation, if any, of the respondent in the development of the treatment plan.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-6A-08" effective_note="EFFECTIVE UNTIL JUNE 30, 2030 PER CHAPTERS 703 AND 704 OF 2024" title_number="10" title_name="Mental Health Law" subtitle_number="6A" subtitle_name="Assisted Outpatient Treatment Programs"> <level label="a"> <text>If, after hearing all relevant evidence, the court does not find by clear and convincing evidence that the respondent meets the criteria for assisted outpatient treatment, the court shall deny the petition.</text> </level> <level label="b"> <level label="1"> <text>If, after hearing all relevant evidence, the court finds by clear and convincing evidence that the respondent meets the criteria for assisted outpatient treatment, the court shall order the respondent to comply with assisted outpatient treatment for a period not to exceed 1 year.</text> </level> <level label="2"> <text>The order of the court shall incorporate a treatment plan that:</text> <level label="i"> <text>Is limited in scope to the elements included in the treatment plan presented to the court under § 10–6A–06 of this subtitle; and</text> </level> <level label="ii"> <text>Includes only those elements that the court finds by clear and convincing evidence to be essential to the maintenance of the respondent’s health or safety.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-6A-09" effective_note="EFFECTIVE UNTIL JUNE 30, 2030 PER CHAPTERS 703 AND 704 OF 2024" title_number="10" title_name="Mental Health Law" subtitle_number="6A" subtitle_name="Assisted Outpatient Treatment Programs"> <level label="a"> <text>In this section, “material change” means an addition or a deletion of a category of services to or from the treatment plan.</text> </level> <level label="b"> <text>At any time during the period of an order for assisted outpatient treatment, a petitioner, a care coordination team member, or a respondent may move that the court stay, vacate, or modify the order.</text> </level> <level label="c"> <text>A respondent under an order under this subtitle is not required to comply with a material change to the treatment plan unless the material change is explicitly authorized in advance by the terms of the order or incorporated by the court on a finding by clear and convincing evidence that the material change is essential to the maintenance of the respondent’s health or safety.</text> </level> <level label="d"> <level label="1"> <text>Subject to paragraph (2) of this subsection, not later than 30 days after receiving a motion, and any timely responses to the motion, for a material change to the incorporated treatment plan, the court shall issue a ruling on the motion and any timely responses to the motion.</text> </level> <level label="2"> <text>If the respondent informs the court that the respondent agrees to the proposed material change, the court may incorporate the material change into the treatment plan.</text> </level> </level> <level label="e"> <text>A respondent under an assisted outpatient treatment order is required to comply with nonmaterial changes to the treatment plan without further action by the court.</text> </level> <level label="f"> <level label="1"> <text>This section may not be construed to require a treating psychiatrist to delay changes to the respondent’s treatment plan as circumstances may immediately require.</text> </level> <level label="2"> <text>If a treating psychiatrist makes a change to a treatment plan due to immediate necessity, a care coordination team member shall notify the following:</text> <level label="i"> <text>The respondent;</text> </level> <level label="ii"> <text>The respondent’s attorney; and</text> </level> <level label="iii"> <text>If applicable and known, the respondent’s guardian and health care agent.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-6A-10" effective_note="EFFECTIVE UNTIL JUNE 30, 2030 PER CHAPTERS 703 AND 704 OF 2024" title_number="10" title_name="Mental Health Law" subtitle_number="6A" subtitle_name="Assisted Outpatient Treatment Programs"> <level label="a"> <text>If the care coordination team has knowledge of a petition for emergency evaluation that was filed for the respondent, a care coordination team member shall notify the court in writing of the reasons for and findings of the evaluation.</text> </level> <level label="b"> <text>In response to the notice or at any time during the period of the assisted outpatient treatment order and on its own motion, the court may convene the parties for a conference to review the progress of the respondent.</text> </level> <level label="c"> <text>To the extent practicable, if a petition for emergency evaluation of the respondent is filed or if the respondent is the subject of other court involvement, the petitioner shall notify the respondent’s care coordination team of the petition or other court involvement.</text> </level> <level label="d"> <text>Failure to comply with an order of assisted outpatient treatment is not grounds for a finding of contempt of court or for involuntary admission under this title.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-6A-11" effective_note="EFFECTIVE UNTIL JUNE 30, 2030 PER CHAPTERS 703 AND 704 OF 2024" title_number="10" title_name="Mental Health Law" subtitle_number="6A" subtitle_name="Assisted Outpatient Treatment Programs"> <text>Within 30 days before the expiration of an order of assisted outpatient treatment, the respondent’s care coordination team shall provide the respondent with a plan for continued treatment, if considered necessary. </text> </section> <section article="ghg" article_name="Health - General" number="10-6A-12" effective_note="EFFECTIVE UNTIL JUNE 30, 2030 PER CHAPTERS 703 AND 704 OF 2024" title_number="10" title_name="Mental Health Law" subtitle_number="6A" subtitle_name="Assisted Outpatient Treatment Programs"> <level label="a"> <text>On or before December 1 each year, the Administration shall submit to the General Assembly, in accordance with § 2–1257 of the State Government Article, a report on each program established under this subtitle that includes:</text> <level label="1"> <text>The number of individuals who were ordered to receive assisted outpatient treatment during the immediately preceding 12–month period;</text> </level> <level label="2"> <text>For each individual ordered to receive an assisted outpatient treatment during the immediately preceding 12–month period, the de–identified data on the following for the 12–month period immediately preceding the assisted outpatient treatment order and the most recent 12–month period following the assisted outpatient treatment order:</text> <level label="i"> <text>Incidences of hospitalizations, including the number of days spent hospitalized;</text> </level> <level label="ii"> <text>Arrests; and</text> </level> <level label="iii"> <text>Number of days spent incarcerated;</text> </level> </level> <level label="3"> <text>Program statistics for the immediately preceding 12–month period, including:</text> <level label="i"> <text>The number of petitions filed;</text> </level> <level label="ii"> <text>The number of respondents under an order for assisted outpatient treatment, including those under order by stipulated agreement;</text> </level> <level label="iii"> <text>The number of voluntary agreements made by respondents to comply with a treatment plan;</text> </level> <level label="iv"> <text>De–identified demographic data for assisted outpatient treatment program recipients, including, to the extent available:</text> <level label="1"> <text>Average age;</text> </level> <level label="2"> <text>Living situation at the time of the issuance of the assisted outpatient treatment order;</text> </level> <level label="3"> <text>Living situation at the time of the expiration of the assisted outpatient treatment order;</text> </level> <level label="4"> <text>Gender;</text> </level> <level label="5"> <text>Marital status;</text> </level> <level label="6"> <text>Race and ethnicity;</text> </level> <level label="7"> <text>Religion;</text> </level> <level label="8"> <text>Familial status;</text> </level> <level label="9"> <text>National origin;</text> </level> <level label="10"> <text>Sexual orientation;</text> </level> <level label="11"> <text>Gender identity; and</text> </level> <level label="12"> <text>Disability;</text> </level> </level> <level label="v"> <text>De–identified information on diagnoses of assisted outpatient treatment recipients;</text> </level> <level label="vi"> <text>De–identified results from the use of a clinically validated symptom tool to assess responsiveness of respondents to treatment; and</text> </level> <level label="vii"> <text>De–identified results of a survey of the satisfaction of respondents under an order for assisted outpatient treatment;</text> </level> </level> <level label="4"> <text>Any information the Department has about system–wide impacts of assisted outpatient treatment ordered under this subtitle, including any information from hospitals, local detention centers, and counties; and</text> </level> <level label="5"> <text>Information about the costs incurred by the Department, the Administration, and any county that establishes an assisted treatment program under this subtitle, including costs for:</text> <level label="i"> <text>Attorneys;</text> </level> <level label="ii"> <text>Expert witnesses; and</text> </level> <level label="iii"> <text>The provision of services provided under an assisted outpatient treatment order.</text> </level> </level> </level> <level label="b"> <text>Each county shall provide information to the Administration that the Administration determines is necessary for the purpose of complying with subsection (a) of this section.</text> </level> <level label="c"> <text>This section may not be construed to prohibit or prevent the collection of additional data, including additional demographic information or other data necessary for program evaluation or improvement, as requested by the General Assembly or the Executive Branch of State government.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-701" title_number="10" title_name="Mental Health Law" subtitle_number="7" subtitle_name="Rights of Mentally Ill Individuals in Facilities"> <level label="a"> <level label="1"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="2"> <level label="i"> <text>“Advocate” means a person who provides support and guidance to an individual in a facility.</text> </level> <level label="ii"> <text>“Advocate” includes a family member or friend.</text> </level> <level label="iii"> <text>“Advocate” does not include an attorney acting in the capacity of legal counsel to an individual in a facility during the treatment planning and discharge planning process.</text> </level> </level> <level label="3"> <text>“Facility” does not include an acute general care hospital that does not have a separately identified inpatient psychiatric service.</text> </level> <level label="4"> <level label="i"> <text>“Mental abuse” means any persistent course of conduct resulting in or maliciously intended to produce emotional harm.</text> </level> <level label="ii"> <text>“Mental abuse” does not include the performance of an accepted clinical procedure.</text> </level> </level> <level label="5"> <level label="i"> <text>“Prone restraint” means restricting the free movement of all or a portion of an individual’s body through the use of physical force or mechanical devices while the individual is in a prone position.</text> </level> <level label="ii"> <text>“Prone restraint” does not include a technique for transitioning an individual to a restraint position that involves momentarily placing the individual face down.</text> </level> </level> <level label="6"> <text>“State facility” means an inpatient facility that is maintained under the direction of the Behavioral Health Administration.</text> </level> <level label="7"> <text>“Trauma–informed care” means mental health treatment that includes:</text> <level label="i"> <text>An appreciation for the high prevalence of trauma experienced by individuals receiving mental health services;</text> </level> <level label="ii"> <text>An understanding of the neurological, biological, psychological, and social effects of trauma and violence, including sexual abuse and exploitation, on an individual; and</text> </level> <level label="iii"> <text>An understanding of the environment, practices, and treatments that may need to be modified to address trauma issues.</text> </level> </level> </level> <level label="b"> <text>It is the policy of this State that each individual with a mental disorder who receives any service in a facility has, in addition to any other rights, the rights provided in this subtitle.</text> </level> <level label="c"> <text>Each individual in a facility shall:</text> <level label="1"> <text>Receive appropriate humane treatment and services in a manner that restricts the individual’s personal liberty within a facility only to the extent necessary and consistent with the individual’s treatment needs and applicable legal requirements;</text> </level> <level label="2"> <text>Receive treatment in accordance with the applicable individualized plan of rehabilitation or the individualized treatment plan provided for in § 10–706 of this subtitle;</text> </level> <level label="3"> <text>Be free from restraints or seclusions except for restraints or seclusions that are:</text> <level label="i"> <text>Used only during an emergency in which the behavior of the individual places the individual or others at serious threat of violence or injury; and</text> </level> <level label="ii"> <level label="1"> <text>Ordered by a physician in writing; or</text> </level> <level label="2"> <text>Directed by a registered nurse if a physician’s order is obtained within 2 hours of the action;</text> </level> </level> </level> <level label="4"> <text>Be free from prone restraint;</text> </level> <level label="5"> <text>Be free from restraint that:</text> <level label="i"> <text>Applies pressure to the individual’s back;</text> </level> <level label="ii"> <text>Obstructs the airway of the individual or impairs the individual’s ability to breathe;</text> </level> <level label="iii"> <text>Obstructs a staff member’s view of the individual’s face; or</text> </level> <level label="iv"> <text>Restricts the individual’s ability to communicate distress;</text> </level> </level> <level label="6"> <text>Be free from mental abuse;</text> </level> <level label="7"> <text>Be protected from harm or abuse as provided in this subtitle;</text> </level> <level label="8"> <text>Except as provided in subsection (e) of this section, and subject to subsection (k) of this section, have the right to an advocate of the individual’s choice to participate in the treatment planning and discharge planning process; and</text> </level> <level label="9"> <text>Subject to the provisions of § 10–708 of this subtitle, if the individual has an advance directive for mental health services provided for in § 5–602.1 of this article, receive treatment in accordance with the preferences in the advance directive.</text> </level> </level> <level label="d"> <text>A State facility shall ensure that:</text> <level label="1"> <text>All clinical, direct care, and other designated staff with regular patient interaction receive training in trauma–informed care and demonstrate competency in providing trauma–informed care services within 3 months of being hired and on an annual basis;</text> </level> <level label="2"> <text>Any policy or practice followed by the facility is reviewed and revised to conform with trauma–informed care principles; and</text> </level> <level label="3"> <text>The physical environment of the facility is assessed at least annually and modified if the modifications:</text> <level label="i"> <text>Are necessary to ensure conformity with trauma–informed care principles; and</text> </level> <level label="ii"> <text>Can be funded through the State’s operating budget or capital budget.</text> </level> </level> </level> <level label="e"> <text>Notwithstanding the provisions of subsection (c)(8) of this section, a facility may prohibit an advocate from participating in the treatment planning or discharge planning process for an individual if:</text> <level label="1"> <level label="i"> <text>The individual is a minor or an adult under guardianship in accordance with § 13–705 of the Estates and Trusts Article; and</text> </level> <level label="ii"> <text>The parent of the minor or the legal guardian of the individual has requested that the advocate not participate; or</text> </level> </level> <level label="2"> <text>The advocate has engaged in behavior that:</text> <level label="i"> <text>Is disruptive to the individual, other patients, or staff at the facility; or</text> </level> <level label="ii"> <text>Poses a threat to the safety of the individual, other patients, or staff at the facility.</text> </level> </level> </level> <level label="f"> <text>A facility shall:</text> <level label="1"> <text>Have a written policy specifying the method used to ensure that an individual whose primary language or method of communication is nonverbal is able to effectively communicate distress during a physical restraint or hold; and</text> </level> <level label="2"> <text>Ensure that all staff at the facility who are authorized to participate in a physical restraint or hold of individuals are trained in the method specified in the written policy required under item (1) of this subsection.</text> </level> </level> <level label="g"> <text>Subject to the provisions of §§ 4–301 through 4–309 of this article, the records of each individual in a facility are confidential.</text> </level> <level label="h"> <level label="1"> <text>Notwithstanding any other provision of law, when the State designated protection and advocacy agency has received and documented a request for an investigation of a possible violation of the rights of an individual in a facility that is owned and operated by the Department or under contract to the Department to provide mental health services in the community under this subtitle, the executive director of the protection and advocacy agency or the executive director’s designee:</text> <level label="i"> <text>Before pursuing any investigation:</text> <level label="1"> <text>Shall interview the individual whose rights have been allegedly violated; and</text> </level> <level label="2"> <text>Shall attempt to obtain written consent from the individual; and</text> </level> </level> <level label="ii"> <text>If the individual is unable to give written consent but does not object to the investigation:</text> <level label="1"> <text>Shall document this fact; and</text> </level> <level label="2"> <text>Shall request, in writing, access to the individual’s records from the Director of the Behavioral Health Administration.</text> </level> </level> </level> <level label="2"> <text>On receipt of the request for access to the individual’s records, the Director of the Behavioral Health Administration shall authorize access to the individual’s records.</text> </level> <level label="3"> <text>After satisfying the provisions of paragraphs (1) and (2) of this subsection, the executive director of the protection and advocacy agency, or the executive director’s designee, may pursue an investigation and, as part of that investigation, shall continue to have access to the records of the individual whose rights have been allegedly violated.</text> </level> </level> <level label="i"> <level label="1"> <text>On admission to a facility, an individual shall be informed of the rights provided in this subtitle in language and terms that are appropriate to the individual’s condition and ability to understand.</text> </level> <level label="2"> <text>A facility shall post notices in locations accessible to the individual and to visitors describing the rights provided in this subtitle in language and terms that may be readily understood.</text> </level> </level> <level label="j"> <text>A facility shall implement an impartial, timely complaint procedure that affords an individual the ability to exercise the rights provided in this subtitle.</text> </level> <level label="k"> <text>This section may not be construed to:</text> <level label="1"> <text>Grant the advocate of an individual legal authority that the advocate does not otherwise have under law to make decisions on behalf of the individual regarding treatment or discharge;</text> </level> <level label="2"> <text>Grant the advocate access to the medical records of the individual or other confidential information that the advocate does not otherwise have access to under law; or</text> </level> <level label="3"> <text>Limit the legal authority that an attorney or other person otherwise has under law to participate in the treatment planning and discharge planning process or to otherwise act on behalf of an individual in a facility.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-702" title_number="10" title_name="Mental Health Law" subtitle_number="7" subtitle_name="Rights of Mentally Ill Individuals in Facilities"> <level label="a"> <level label="1"> <text>Subject to any reasonable limitation that a facility imposes, each individual in the facility shall have access, at all reasonable hours, to writing instruments, stationery, and postage and may use them to write to anyone.</text> </level> <level label="2"> <text>The correspondence of the individual shall be sent to the addressee without delay, and except under the direction of the addressee, without being opened.</text> </level> </level> <level label="b"> <text>Each individual in a facility shall have reasonable access to a telephone. However, an individual may not telephone anyone who has given the facility written notice of being unwilling to be telephoned.</text> </level> <level label="c"> <level label="1"> <text>If, for medical reasons, an individual’s access to correspondence, writing instruments, or telephones is limited, the limitation shall be:</text> <level label="i"> <text>Signed by a physician and the reasons for the limitation and the date on which the limitation expires made a permanent part of the individual’s record; and</text> </level> <level label="ii"> <text>Reviewed every 30 days if the limitation remains in effect.</text> </level> </level> <level label="2"> <text>If the attending physician believes that, because of the condition of an individual, another individual should be permitted to be present when writing instruments are used, the permission and the reasons for the permission shall be:</text> <level label="i"> <text>Signed by the attending physician;</text> </level> <level label="ii"> <text>Dated as to when the permission expires;</text> </level> <level label="iii"> <text>Made a permanent part of the individual’s record; and</text> </level> <level label="iv"> <text>Reviewed every 30 days if the permission remains in effect.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-703" title_number="10" title_name="Mental Health Law" subtitle_number="7" subtitle_name="Rights of Mentally Ill Individuals in Facilities"> <level label="a"> <text>Each individual in a facility shall be entitled to converse privately with and receive visits:</text> <level label="1"> <text>At all reasonable hours, from a lawyer that the individual chooses;</text> </level> <level label="2"> <text>At all reasonable hours, from a clergyman that the individual chooses; and</text> </level> <level label="3"> <text>During reasonable visiting hours that the facility sets, from any other visitor if the individual wishes to see the visitor.</text> </level> </level> <level label="b"> <text>If an individual refuses to see a visitor, the refusal shall be made a permanent part of the individual’s record.</text> </level> <level label="c"> <level label="1"> <text>If, for medically justified reasons, visits or private conversations are restricted, the restriction and the reasons for the restriction shall be:</text> <level label="i"> <text>Signed by a physician;</text> </level> <level label="ii"> <text>Dated as to when the restriction expires;</text> </level> <level label="iii"> <text>Made a permanent part of the individual’s record; and</text> </level> <level label="iv"> <text>Reviewed every 30 days if the restriction remains in effect.</text> </level> </level> <level label="2"> <text>Visits of an individual’s lawyer or clergyman may not be restricted during reasonable hours.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-704" title_number="10" title_name="Mental Health Law" subtitle_number="7" subtitle_name="Rights of Mentally Ill Individuals in Facilities"> <text>An individual may not be deprived of the right to vote or to receive, hold, and dispose of property solely because the individual is in a facility or a Veterans’ Administration hospital for a mental disorder.</text> </section> <section article="ghg" article_name="Health - General" number="10-705" title_number="10" title_name="Mental Health Law" subtitle_number="7" subtitle_name="Rights of Mentally Ill Individuals in Facilities"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <level label="i"> <text>“Abuse” means cruel or inhumane treatment that causes:</text> <level label="1"> <text>Any physical injury; or</text> </level> <level label="2"> <text>Any of the following kinds of sexual abuse:</text> </level> <level label="A"> <text>A sexual act, as defined in § 3–301 of the Criminal Law Article;</text> </level> <level label="B"> <text>Sexual contact, as defined in § 3–301 of the Criminal Law Article; or</text> </level> <level label="C"> <text>Vaginal intercourse, as defined in § 3–301 of the Criminal Law Article.</text> </level> </level> <level label="ii"> <text>“Abuse” does not include:</text> <level label="1"> <text>The performance of an accepted medical procedure that a physician orders in a manner that is consistent with the provisions of this subtitle; or</text> </level> <level label="2"> <text>An action taken by an employee that complies with applicable State and federal laws and applicable Department policies on the use of physical intervention.</text> </level> </level> </level> <level label="3"> <text>“Sexual harassment” means intimidation, bullying, or coercion of a sexual nature or unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature that tends to create a hostile or offensive environment.</text> </level> </level> <level label="b"> <level label="1"> <text>A person or any employee of a facility or of the Department who receives a complaint of abuse, or who observes or has reason to believe that abuse has occurred, shall promptly report the alleged abuse to:</text> <level label="i"> <text>An appropriate law enforcement agency; or</text> </level> <level label="ii"> <text>The administrative head of the facility, who promptly shall report the alleged abuse to an appropriate law enforcement agency.</text> </level> </level> <level label="2"> <text>A report:</text> <level label="i"> <text>May be oral or written; and</text> </level> <level label="ii"> <text>Shall contain as much information as the reporter is able to provide.</text> </level> </level> <level label="3"> <text>Within 24 hours after receiving the complaint, a facility that is a licensed residential treatment center, a State facility, or a hospital with a separately identified inpatient psychiatric service shall report a complaint of sexual abuse or sexual harassment of a patient receiving treatment in the residential treatment center or receiving inpatient psychiatric services to:</text> <level label="i"> <text>The Administration and the Office of Health Care Quality;</text> </level> <level label="ii"> <text>If the complaint involves a minor, the Child Protective Services unit in the Department of Human Services; and</text> </level> <level label="iii"> <text>The State designated protection and advocacy system.</text> </level> </level> <level label="4"> <text>The Administration and the Office of Health Care Quality shall collaborate to develop and implement a uniform reporting system to be used by facilities in complying with paragraph (3) of this subsection.</text> </level> </level> <level label="c"> <level label="1"> <text>The law enforcement agency shall:</text> <level label="i"> <text>Investigate thoroughly each report of an alleged abuse; and</text> </level> <level label="ii"> <text>Attempt to ensure the protection of the alleged victim.</text> </level> </level> <level label="2"> <text>The investigation shall include:</text> <level label="i"> <text>A determination of the nature, extent, and cause of the abuse, if any;</text> </level> <level label="ii"> <text>The identity of the alleged abuser; and</text> </level> <level label="iii"> <text>Any other pertinent fact or matter.</text> </level> </level> </level> <level label="d"> <text>As soon as possible, but no later than 10 working days after the completion of the investigation, the law enforcement agency shall submit a written report of its findings to the State’s Attorney, the State designated protection and advocacy system, and the administrative head of the facility.</text> </level> <level label="e"> <text>A person shall have the immunity from liability described under § 5–626 of the Courts Article for:</text> <level label="1"> <text>Making a report under this section;</text> </level> <level label="2"> <text>Participating in an investigation arising out of a report under this section; or</text> </level> <level label="3"> <text>Participating in a judicial proceeding arising out of a report under this section.</text> </level> </level> <level label="f"> <level label="1"> <text>A facility that is a licensed residential treatment center, a State facility, or a hospital with a separately identified inpatient psychiatric service shall:</text> <level label="i"> <text>Develop and implement policies and procedures on making and responding to allegations and complaints of sexual abuse or sexual harassment of patients receiving treatment in the residential treatment center or receiving inpatient psychiatric services;</text> </level> <level label="ii"> <text>Ensure that staff provide assistance to patients who have requested assistance in making complaints about sexual abuse or sexual harassment;</text> </level> <level label="iii"> <text>Develop and oversee training for staff on how to identify and prevent sexual abuse and sexual harassment, how to respond to complaints, and how to support victims in an appropriate manner; and</text> </level> <level label="iv"> <text>Develop and oversee patient education on identifying sexual abuse and sexual harassment and on reporting incidents of sexual abuse and sexual harassment.</text> </level> </level> <level label="2"> <text>The Administration shall ensure that the policies and procedures developed and implemented under paragraph (1) of this subsection are uniform for State facilities.</text> </level> </level> <level label="g"> <text>The Administration shall develop and implement a plan to secure the sleeping quarters of male and female patients at all State facilities that maximizes the use of available resources and infrastructure.</text> </level> <level label="h"> <text>Each facility that is a licensed residential treatment center, a State facility, or a hospital with a separately identified inpatient psychiatric service shall, for patients receiving treatment in the residential treatment center or receiving inpatient psychiatric services:</text> <level label="1"> <text>Use evidence–based screening tools to identify on admission a patient’s risk of being a victim of sexual or physical abuse, or being a sexual or physical abuser, and shall consider the assessment of risk in making any unit and room assignment;</text> </level> <level label="2"> <text>Adopt a written protection plan as part of a patient’s treatment plan if warranted by the patient’s risk of being a victim of sexual or physical abuse or being a sexual or physical abuser;</text> </level> <level label="3"> <text>If possible, reassign any patient accused of sexual assault promptly to another unit and ensure that any alleged victim and the alleged assailant are not housed in the same unit;</text> </level> <level label="4"> <text>Provide a patient who has a history of sexual trauma with treatment and education that is evidence–based or reflective of best practices to reduce the likelihood of the patient being the victim of repeated sexual abuse; and</text> </level> <level label="5"> <text>Ensure that designated clinical staff are trained in at least one trauma recovery modality that is considered to be a best practice.</text> </level> </level> <level label="i"> <text>The Office of Health Care Quality shall enforce this section.</text> </level> <level label="j"> <text>The Department shall adopt regulations to carry out this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-706" title_number="10" title_name="Mental Health Law" subtitle_number="7" subtitle_name="Rights of Mentally Ill Individuals in Facilities"> <level label="a"> <level label="1"> <text>Except as provided by paragraph (2) of this subsection, promptly after admission of an individual, a facility shall make and periodically update a written plan of treatment for the individual in the facility, in accordance with the provisions of this subtitle.</text> </level> <level label="2"> <text>Promptly after admission of an individual to a psychosocial center, the center shall make and periodically update a written plan of rehabilitation for the individual in the facility, in accordance with the provisions of this subtitle.</text> </level> </level> <level label="b"> <text>The Director shall adopt rules and regulations under this section that include:</text> <level label="1"> <text>Subject to subsection (d) of this section, a description of the nature and content of plans of treatment; and</text> </level> <level label="2"> <text>Subject to subsection (e) of this section, appropriate time periods for the development, implementation, and review of each plan.</text> </level> </level> <level label="c"> <text>An individual shall:</text> <level label="1"> <text>Participate, in a manner appropriate to the individual’s condition, in the development and periodic updating of the plan of treatment; and</text> </level> <level label="2"> <text>Be told, in appropriate terms and language, of:</text> <level label="i"> <text>The content and objectives of the plan of treatment;</text> </level> <level label="ii"> <text>The nature and significant possible adverse effects of recommended treatments;</text> </level> <level label="iii"> <text>The name, title, and role of personnel directly responsible for carrying out the treatment for the individual; and</text> </level> <level label="iv"> <text>When appropriate, other available alternative treatments, services, or providers of mental health services.</text> </level> </level> </level> <level label="d"> <text>A plan of treatment shall include:</text> <level label="1"> <text>A long–range discharge goal; and</text> </level> <level label="2"> <text>An estimate of the probable length of inpatient stay the individual requires before transfer to a less restrictive or intensive treatment setting.</text> </level> </level> <level label="e"> <text>Facility staff who work directly with and provide treatment to an individual shall review and reassess the plan of treatment for the individual to determine the individual’s progress and any need for adjustments to the plan not less than:</text> <level label="1"> <text>Once every 15 days for the first 2 months after admission of the individual to the facility; and</text> </level> <level label="2"> <text>Once every 60 days for the remainder of the inpatient stay of the individual in the facility.</text> </level> </level> <level label="f"> <level label="1"> <text>On the admission of an individual to a facility, the facility shall:</text> <level label="i"> <text>Ask the individual whether the individual consents to family members or any other individuals being informed of and given the opportunity to participate in meetings with the treatment team regarding the development, review, and reassessment of the plan of treatment of the individual; and</text> </level> <level label="ii"> <text>If consent is given under item (i) of this paragraph, at least every 7 days after consent is given, reconfirm the consent and provide the individual at a clinical visit with an opportunity to consent to additional individuals being informed of and given the opportunity to participate in meetings with the treatment team.</text> </level> </level> <level label="2"> <text>If an individual agrees to have family members or other individuals participate in the development, review, and reassessment of the individual’s plan of treatment, the facility shall:</text> <level label="i"> <text>Provide a schedule of routine treatment team meetings where the plan of treatment is discussed;</text> </level> <level label="ii"> <text>Establish a process for the authorized individuals to participate in treatment team meetings;</text> </level> <level label="iii"> <text>If the treatment team meeting is being held outside the regular schedule, inform the authorized individuals as soon as the meeting is scheduled; and</text> </level> <level label="iv"> <text>If the treatment team meeting is being held due to an emergency, inform the authorized individuals of the outcome of the meeting as soon as practicable.</text> </level> </level> <level label="3"> <text>The individual may withdraw the consent given under paragraph (1) of this subsection at any time orally or in writing.</text> </level> <level label="4"> <text>A treating provider may withhold information on an individual plan of treatment from a family member or other authorized individual if:</text> <level label="i"> <text>In the treating provider’s clinical judgment, the consent given under paragraph (1) of this subsection was provided through coercive means;</text> </level> <level label="ii"> <text>The treating provider believes it is in the best clinical interest of the individual; or</text> </level> <level label="iii"> <text>The individual requests that a specific piece of the plan of treatment be withheld.</text> </level> </level> </level> <level label="g"> <level label="1"> <text>If an individual admitted to a facility or any family member or other individual authorized by the individual to participate in the review and reassessment of the plan of treatment for the individual under subsection (f) of this section believes that the plan of treatment is not meeting the needs of the individual, the individual, family member, or other authorized individual has the right to request that the facility review and reassess the plan of treatment.</text> </level> <level label="2"> <text>On receipt of a request under paragraph (1) of this subsection, the facility staff who work directly with and provide treatment to the individual shall:</text> <level label="i"> <text>Conduct a review and reassessment of the plan of treatment;</text> </level> <level label="ii"> <text>Communicate the results of the review and reassessment of the plan of treatment to the patient and individual who requested the review and reassessment, including an explanation of how all issues raised in the request were considered; and</text> </level> <level label="iii"> <text>Include the request for the review and reassessment of the plan of treatment and the outcome of the review and assessment, including the explanation of the outcome, in the medical records of the individual.</text> </level> </level> <level label="3"> <text>If a State facility does not make any changes to the plan of treatment for the individual, the State facility shall provide referral information for the Resident Grievance System established under COMAR 10.21.14.</text> </level> </level> <level label="h"> <text>An individual admitted to a State facility or another individual authorized by the admitted individual may request a reconsideration of the review and reassessment completed under subsection (g) of this section by filing a grievance with the Resident Grievance System under COMAR 10.21.14.</text> </level> <level label="i"> <level label="1"> <text>An individual admitted to a State facility or another individual authorized by the admitted individual may appeal the reconsideration of the review and reassessment completed under subsection (h) of this section by filing a request with the Department’s Healthcare System’s Chief Medical Officer.</text> </level> <level label="2"> <text>The Department shall adopt regulations to establish a process for the appeal of the reconsideration of the review and reassessment under paragraph (1) of this subsection.</text> </level> </level> <level label="j"> <text>If an individual is admitted to a State facility and the State facility is unable to provide the treatment necessary to address the rehabilitation needs of an individual under a plan of treatment for the individual, the State facility shall:</text> <level label="1"> <text>Make arrangements for the individual to receive necessary treatment from another facility or other health care provider outside the State facility; and</text> </level> <level label="2"> <text>Ensure that treatment for the individual is coordinated between the State facility and the other facility or health care provider.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-707" title_number="10" title_name="Mental Health Law" subtitle_number="7" subtitle_name="Rights of Mentally Ill Individuals in Facilities"> <text>An individual in a facility has the right to refuse to participate as a subject in physically intrusive research conducted at the facility.</text> </section> <section article="ghg" article_name="Health - General" number="10-708" title_number="10" title_name="Mental Health Law" subtitle_number="7" subtitle_name="Rights of Mentally Ill Individuals in Facilities"> <level label="a"> <level label="1"> <text>In this section the following words have the meanings indicated.</text> </level> <level label="2"> <text>“Lay advisor” means an individual at a facility, who is knowledgeable about mental health practice and who assists individuals with rights complaints.</text> </level> <level label="3"> <text>“Medication” means psychiatric medication prescribed for the treatment of a mental disorder.</text> </level> <level label="4"> <text>“Panel” means a clinical review panel that determines, under the provisions of this section, whether to approve that medication be administered to an individual who objects to the medication.</text> </level> </level> <level label="b"> <text>Medication may not be administered to an individual who refuses the medication, except:</text> <level label="1"> <text>In an emergency, on the order of a physician where the individual presents a danger to the life or safety of the individual or others; or</text> </level> <level label="2"> <text>In a nonemergency, when the individual is hospitalized involuntarily or committed for treatment by order of a court and the medication is approved by a panel under the provisions of this section.</text> </level> </level> <level label="c"> <level label="1"> <text>A panel shall consist of the following individuals appointed by the chief executive officer of the facility or the chief executive officer’s designee, one of whom shall be appointed chairperson:</text> <level label="i"> <text>The clinical director of the psychiatric unit, if the clinical director is a physician, or a physician designated by the clinical director;</text> </level> <level label="ii"> <text>A psychiatrist; and</text> </level> <level label="iii"> <text>A mental health professional, other than a physician.</text> </level> </level> <level label="2"> <text>If a member of the clinical review panel also is directly responsible for implementing the individualized treatment plan for the individual under review, the chief executive officer of the facility or the chief executive officer’s designee shall designate another panel member for that specific review.</text> </level> </level> <level label="d"> <level label="1"> <text>The chief executive officer of the facility or the chief executive officer’s designee shall give the individual and the lay advisor written notice at least 24 hours prior to convening a panel.</text> </level> <level label="2"> <text>Except in an emergency under subsection (b)(1) of this section, medication or medications being refused may not be administered to an individual prior to the decision of the panel.</text> </level> </level> <level label="e"> <level label="1"> <text>The notice under subsection (d)(1) of this section shall include the following information:</text> <level label="i"> <text>The date, time, and location that the panel will convene;</text> </level> <level label="ii"> <text>The purpose of the panel; and</text> </level> <level label="iii"> <text>A complete description of the rights of an individual under paragraph (2) of this subsection.</text> </level> </level> <level label="2"> <text>At a panel, an individual has the following rights:</text> <level label="i"> <text>To attend the meeting of the panel, excluding the discussion conducted to arrive at a decision;</text> </level> <level label="ii"> <text>To present information, including witnesses;</text> </level> <level label="iii"> <text>To ask questions of any person presenting information to the panel;</text> </level> <level label="iv"> <text>To request assistance from a lay advisor; and</text> </level> <level label="v"> <text>To be informed of:</text> <level label="1"> <text>The name, address, and telephone number of the lay advisor;</text> </level> <level label="2"> <text>The individual’s diagnosis; and</text> </level> <level label="3"> <text>An explanation of the clinical need for the medication or medications, including potential side effects, and material risks and benefits of taking or refusing the medication.</text> </level> </level> </level> <level label="3"> <text>The chairperson of the panel may:</text> <level label="i"> <text>Postpone or continue the panel for good cause, for a reasonable time; and</text> </level> <level label="ii"> <text>Take appropriate measures necessary to conduct the panel in an orderly manner.</text> </level> </level> </level> <level label="f"> <text>Prior to determining whether to approve the administration of medication, the panel shall:</text> <level label="1"> <text>Review the individual’s clinical record, as appropriate;</text> </level> <level label="2"> <text>Assist the individual and the treating physician to arrive at a mutually agreeable treatment plan; and</text> </level> <level label="3"> <text>Meet for the purpose of receiving information and clinically assessing the individual’s need for medication by:</text> <level label="i"> <text>Consulting with the individual regarding the reason or reasons for refusing the medication or medications and the individual’s willingness to accept alternative treatment, including other medication;</text> </level> <level label="ii"> <text>Consulting with facility personnel who are responsible for initiating and implementing the individual’s treatment plan, including discussion of the current treatment plan and alternative modes of treatment, including medications that were considered;</text> </level> <level label="iii"> <text>Receiving information presented by the individual and other persons participating in the panel;</text> </level> <level label="iv"> <text>Providing the individual with an opportunity to ask questions of anyone presenting information to the panel; and</text> </level> <level label="v"> <text>Reviewing the potential consequences of requiring the administration of medication and of withholding the medication from the individual.</text> </level> </level> </level> <level label="g"> <text>The panel may approve the administration of medication or medications and may recommend and approve alternative medications if the panel determines that:</text> <level label="1"> <text>The medication is prescribed by a psychiatrist for the purpose of treating the individual’s mental disorder;</text> </level> <level label="2"> <text>The administration of medication represents a reasonable exercise of professional judgment; and</text> </level> <level label="3"> <text>Without the medication, the individual is at substantial risk of continued hospitalization because of:</text> <level label="i"> <text>Remaining seriously mentally ill with no significant relief of the mental illness symptoms that:</text> <level label="1"> <text>Cause the individual to be a danger to the individual or others while in the hospital;</text> </level> <level label="2"> <text>Resulted in the individual being committed to a hospital under this title or Title 3 of the Criminal Procedure Article; or</text> </level> <level label="3"> <text>Would cause the individual to be a danger to the individual or others if released from the hospital;</text> </level> </level> <level label="ii"> <text>Remaining seriously mentally ill for a significantly longer period of time with the mental illness symptoms that:</text> <level label="1"> <text>Cause the individual to be a danger to the individual or to others while in the hospital;</text> </level> <level label="2"> <text>Resulted in the individual being committed to a hospital under this title or Title 3 of the Criminal Procedure Article; or</text> </level> <level label="3"> <text>Would cause the individual to be a danger to the individual or others if released from the hospital; or</text> </level> </level> <level label="iii"> <text>Relapsing into a condition in which the individual is unable to provide for the individual’s essential human needs of health or safety.</text> </level> </level> </level> <level label="h"> <level label="1"> <text>A panel shall base its decision on its clinical assessment of the information contained in the individual’s record and information presented to the panel.</text> </level> <level label="2"> <text>A panel may meet privately to reach a decision.</text> </level> <level label="3"> <text>A panel may not approve the administration of medication where alternative treatments are available and are acceptable to both the individual and the facility personnel who are directly responsible for implementing the individual’s treatment plan.</text> </level> </level> <level label="i"> <level label="1"> <text>A panel shall document its consideration of the issues and the basis for its decision on the administration of medication or medications.</text> </level> <level label="2"> <text>A panel shall provide a written decision on the administration of medication or medications, and the decision shall be provided to the individual, the lay advisor, and the individual’s treatment team for inclusion in the individual’s medical record.</text> </level> <level label="3"> <text>If a panel approves the administration of medication, the decision shall specify:</text> <level label="i"> <text>The medication or medications approved and the dosage and frequency range;</text> </level> <level label="ii"> <text>The duration of the approval, not to exceed the maximum time provided under subsection (n) of this section; and</text> </level> <level label="iii"> <text>The reason that alternative treatments, including the medication, if any, were rejected by the panel.</text> </level> </level> <level label="4"> <text>If a panel approves the administration of medication, the decision shall contain:</text> <level label="i"> <text>Notice of the right to request a hearing under subsection (l) of this section;</text> </level> <level label="ii"> <text>The right to request representation or assistance of a lawyer or other advocate of the individual’s choice; and</text> </level> <level label="iii"> <text>The name, address, and telephone number of the designated State protection and advocacy agency and the Lawyer Referral Service.</text> </level> </level> </level> <level label="j"> <text>A panel shall convene within 9 days after an individual’s refusal of medication for a period of at least 72 hours if:</text> <level label="1"> <text>The individual was committed to a hospital under Title 3 of the Criminal Procedure Article because of a mental disorder; and</text> </level> <level label="2"> <text>The treatment plan developed under § 10–706 of this subtitle indicates that there is a substantial likelihood that, without immediate treatment, the individual will remain a danger to self or the person or property of another.</text> </level> </level> <level label="k"> <text>If a panel approves the administration of medication, the lay advisor promptly shall:</text> <level label="1"> <text>Inform the individual of the individual’s right to appeal the decision under subsection (l) of this section;</text> </level> <level label="2"> <text>Ensure that the individual has access to a telephone as provided under § 10–702(b) of this subtitle;</text> </level> <level label="3"> <text>If the individual requests a hearing, notify the chief executive officer of the facility or the chief executive officer’s designee pursuant to subsection (l)(1) of this section and give the individual written notice of the date, time, and location of the hearing; and</text> </level> <level label="4"> <text>Advise the individual of the provision for renewal of an approval under subsection (n) of this section.</text> </level> </level> <level label="l"> <level label="1"> <text>An individual may request an administrative hearing to appeal the panel’s decision by filing a request for hearing with the chief executive officer of the facility or the chief executive officer’s designee within 48 hours of receipt of the decision of the panel.</text> </level> <level label="2"> <text>Within 24 hours of receipt of a request for hearing, the chief executive officer of the facility or the chief executive officer’s designee shall forward the request to the Office of Administrative Hearings.</text> </level> <level label="3"> <text>An initial panel decision authorizing the administration of medication shall be stayed for 48 hours. If a request for hearing is filed, the stay shall remain in effect until the issuance of the administrative decision.</text> </level> <level label="4"> <text>The Office of Administrative Hearings shall conduct a hearing and issue a decision within 7 calendar days of the decision by the panel.</text> </level> <level label="5"> <text>The administrative hearing may be postponed by agreement of the parties or for good cause shown.</text> </level> <level label="6"> <text>The administrative law judge shall conduct a de novo hearing to determine if the standards and procedures in this section are met.</text> </level> <level label="7"> <text>At the hearing, the individual representing the facility:</text> <level label="i"> <text>May introduce the decision of the panel as evidence; and</text> </level> <level label="ii"> <text>Shall prove, by a preponderance of the evidence, that the standards and procedures of this section have been met.</text> </level> </level> <level label="8"> <text>The administrative law judge shall state on the record the findings of fact and conclusions of law.</text> </level> <level label="9"> <text>The determination of the administrative law judge is a final decision for the purpose of judicial review of a final decision under the Administrative Procedure Act.</text> </level> </level> <level label="m"> <level label="1"> <text>Within 14 calendar days from the decision of the administrative law judge, the individual or the facility may appeal the decision and the appeal shall be to the circuit court on the record from the hearing conducted by the Office of Administrative Hearings.</text> </level> <level label="2"> <text>The scope of review shall be as a contested case under the Administrative Procedure Act.</text> </level> <level label="3"> <level label="i"> <text>Review shall be on the audiophonic tape without the necessity of transcription of the tape, unless either party to the appeal requests transcription of the tape.</text> </level> <level label="ii"> <text>A request for transcription of the tape shall be made at the time the appeal is filed.</text> </level> <level label="iii"> <text>The Office of Administrative Hearings shall prepare the transcription prior to the appeal hearing, and the party requesting the transcription shall bear the cost of transcription.</text> </level> </level> <level label="4"> <text>The circuit court shall hear and issue a decision on an appeal within 7 calendar days from the date the appeal was filed.</text> </level> </level> <level label="n"> <level label="1"> <text>Treatment pursuant to this section may not be approved for longer than 90 days.</text> </level> <level label="2"> <level label="i"> <text>Prior to expiration of an approval period and if the individual continues to refuse medication, a panel may be convened to decide whether renewal is warranted.</text> </level> <level label="ii"> <text>Notwithstanding the provisions of paragraph (1) of this subsection, if a clinical review panel approves the renewal of the administration of medication or medications, the administration of medication or medications need not be interrupted if the individual appeals the renewal of approval.</text> </level> </level> </level> <level label="o"> <text>When medication is ordered pursuant to the approval of a panel under this section and at a minimum of every 15 days, the treating physician shall document any known benefits and side effects to the individual.</text> </level> <level label="p"> <level label="1"> <text>The Administration shall develop and conduct training on the requirements of this section to ensure compliance at all State facilities.</text> </level> <level label="2"> <text>The training is mandatory for all clinical directors and all individuals who are eligible to serve on a panel.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-709" title_number="10" title_name="Mental Health Law" subtitle_number="7" subtitle_name="Rights of Mentally Ill Individuals in Facilities"> <level label="a"> <text>In accordance with § 10-809 of this title, a facility shall prepare a written aftercare plan for an individual who has been accepted as a resident in the facility before that individual is released from the facility.</text> </level> <level label="b"> <text>The aftercare plan prepared under this section shall be offered to individuals who have been accepted as residents in a facility who are scheduled for release from a facility under this title.</text> </level> <level label="c"> <text>The Secretary shall adopt regulations governing the planning and provisions of aftercare plans including:</text> <level label="1"> <text>Procedures to obtain the consent of the individual; or</text> </level> <level label="2"> <text>Procedures to assist an individual who is unable to participate fully in aftercare planning.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-710" title_number="10" title_name="Mental Health Law" subtitle_number="7" subtitle_name="Rights of Mentally Ill Individuals in Facilities"> <level label="a"> <text>Each minor who is being cared for or treated in a residential, State facility shall be placed in a unit for minors and may not be placed in a unit where adults are placed, unless the individual plan of treatment for the minor provides otherwise.</text> </level> <level label="b"> <text>A person, on behalf of the minor, may file a petition in the circuit court for the county where the facility is located, to compel compliance with this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-711" title_number="10" title_name="Mental Health Law" subtitle_number="7" subtitle_name="Rights of Mentally Ill Individuals in Facilities"> <text>On request, the administrative head of each facility shall give to the Director or a representative of the Director:</text> <level label="1"> <text>Any information that the administrative head has about an individual in the facility;</text> </level> <level label="2"> <text>Access to the individual; and</text> </level> <level label="3"> <text>Access to any part of the facility.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-712" title_number="10" title_name="Mental Health Law" subtitle_number="7" subtitle_name="Rights of Mentally Ill Individuals in Facilities"> <level label="a"> <level label="1"> <text>Each facility shall keep complete records for each individual who is admitted to the facility under this title.</text> </level> <level label="2"> <text>The records shall contain all of the information that is required by this title or the Administration.</text> </level> </level> <level label="b"> <text>A facility shall keep the records in a separate and secure area at the facility.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-713" title_number="10" title_name="Mental Health Law" subtitle_number="7" subtitle_name="Rights of Mentally Ill Individuals in Facilities"> <level label="a"> <level label="1"> <text>In this section, “program or facility” means an inpatient or residential treatment setting, residential crisis service, group home, or residential rehabilitation program.</text> </level> <level label="2"> <text>Upon notification of the death of an individual in a State funded or operated program or facility, the administrative head of the program or facility shall report the death:</text> <level label="i"> <text>Immediately to the sheriff, police, or chief law enforcement official in the jurisdiction in which the death occurred;</text> </level> <level label="ii"> <text>Immediately to the Secretary; and</text> </level> <level label="iii"> <text>By the close of business of the next working day to:</text> <level label="1"> <text>The Director;</text> </level> <level label="2"> <text>The health officer in the jurisdiction where the death occurred; and</text> </level> <level label="3"> <text>The designated State protection and advocacy system.</text> </level> </level> </level> <level label="3"> <text>An initial report:</text> <level label="i"> <text>May be:</text> <level label="1"> <text>Oral if followed by a written report within 5 working days from the date of the death; or</text> </level> <level label="2"> <text>Written;</text> </level> </level> <level label="ii"> <text>Shall contain the following relevant information:</text> <level label="1"> <text>The name, age, and sex of the deceased;</text> </level> <level label="2"> <text>The time of discovery of the death;</text> </level> <level label="3"> <text>The deceased’s place of residence at the time of death;</text> </level> <level label="4"> <text>The location of the body at the time of discovery;</text> </level> <level label="5"> <text>The place where the body was found;</text> </level> <level label="6"> <text>The name of the person who took custody of the body;</text> </level> <level label="7"> <text>The name of the person evaluating the death, if known;</text> </level> <level label="8"> <text>Whether or not an autopsy is being performed, if known; and</text> </level> <level label="9"> <text>The name, address, and telephone number of the next of kin or legal guardian, if known; and</text> </level> </level> <level label="iii"> <text>Shall contain any other information the administrative head of the facility determines should be provided to the medical examiner and the persons listed in paragraph (2) of this subsection on the deaths occurring:</text> <level label="1"> <text>By violence;</text> </level> <level label="2"> <text>By suicide;</text> </level> <level label="3"> <text>By casualty;</text> </level> <level label="4"> <text>Suddenly, if the deceased was in apparent good health; or</text> </level> <level label="5"> <text>In any suspicious or unusual manner.</text> </level> </level> </level> <level label="4"> <text>The written report shall be available for the Director, the health officer in the jurisdiction where the death occurred, and the designated State protection and advocacy system within 5 working days from the date of the death.</text> </level> <level label="5"> <text>If the death occurred in a program or facility that operates more than one treatment program and where the deceased individual attended more than one treatment program, the facility is required to make only one report.</text> </level> <level label="6"> <text>The sheriff, police, or chief law enforcement officer shall inform the medical examiner in accordance with § 5–309(b) of this article and the medical examiner, if necessary, shall conduct an investigation in accordance with the provisions of that section.</text> </level> </level> <level label="b"> <text>If the death occurred in a nonresidential psychiatric rehabilitation program, the administrative head of the program shall report the death to the Director by the close of business of the next working day.</text> </level> <level label="c"> <level label="1"> <text>The Director shall compile annually a status report for the Secretary on patient deaths reported under this subtitle.</text> </level> <level label="2"> <text>At a minimum, the status report shall note:</text> <level label="i"> <text>The number of deaths;</text> </level> <level label="ii"> <text>The location of each death;</text> </level> <level label="iii"> <text>The cause of each death, if known; and</text> </level> <level label="iv"> <text>Other data the Secretary determines to be relevant to the status report.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-801" title_number="10" title_name="Mental Health Law" subtitle_number="8" subtitle_name="Release and Transfers"> <text>In this subtitle, “release” means a permanent, temporary, absolute, or conditional release of an individual from a residential facility or a Veterans’ Administration hospital.</text> </section> <section article="ghg" article_name="Health - General" number="10-802" title_number="10" title_name="Mental Health Law" subtitle_number="8" subtitle_name="Release and Transfers"> <text>If the Director finds that any individual is held by a facility in a manner contrary to law, the Director shall begin appropriate proceedings for release of that individual.</text> </section> <section article="ghg" article_name="Health - General" number="10-803" title_number="10" title_name="Mental Health Law" subtitle_number="8" subtitle_name="Release and Transfers"> <level label="a"> <text>An individual who is admitted voluntarily to a facility, on an informal request, may leave the facility at any time between 9 a.m. and 4 p.m., unless the admission status of the individual has been changed to an involuntary admission.</text> </level> <level label="b"> <level label="1"> <text>An individual who has been admitted voluntarily, under a formal written application, may not be held for more than 3 days after the individual asks for release, unless the admission status of the individual has been changed to an involuntary admission.</text> </level> <level label="2"> <text>If the admission status of the individual is changed from a voluntary to an involuntary admission, the facility shall notify the Mental Health Division in the Office of the Public Defender, by e–mail or facsimile, of the involuntary admission within 24 hours after the change in admission status is made.</text> </level> </level> <level label="c"> <text>A minor who has been admitted voluntarily, on the application of a parent or guardian of the minor, may not be held for more than 3 days after the applicant for the admission asks for release, unless the admission status of the minor has been changed to an involuntary admission.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-804" title_number="10" title_name="Mental Health Law" subtitle_number="8" subtitle_name="Release and Transfers"> <level label="a"> <text>Any individual who has been admitted to a facility or Veterans’ Administration hospital or any person on behalf of the individual may apply at any time to a court of competent jurisdiction for a writ of habeas corpus to determine the cause and the legality of the detention.</text> </level> <level label="b"> <text>The Director, in the name of the Administration, may make an application for a writ of habeas corpus to determine whether a facility properly admitted or properly holds an individual. The State’s Attorney for the county where the facility is located or the individual is a resident, on behalf of the Administration, shall file the application.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-805" title_number="10" title_name="Mental Health Law" subtitle_number="8" subtitle_name="Release and Transfers"> <level label="a"> <text>Subject to the limitations in this section, a petition for the release of an individual who is held under this title from the facility or a Veterans’ Administration hospital may be filed, at any time by:</text> <level label="1"> <text>The individual; or</text> </level> <level label="2"> <text>Any person who has a legitimate interest in the welfare of the individual.</text> </level> </level> <level label="b"> <text>The petition shall be filed in an equity court in the county where the individual resides or resided at the time of the admission or where the facility is located.</text> </level> <level label="c"> <level label="1"> <text>If the individual is in a public facility, the Administration shall be the respondent.</text> </level> <level label="2"> <text>If the individual is in a private facility or a Veterans’ Administration hospital, it shall be the respondent.</text> </level> </level> <level label="d"> <text>The petition shall be in the form and contain the information the Maryland Rules require.</text> </level> <level label="e"> <text>If the petitioner requests trial by jury, the trial shall be held with a jury as in a civil action at law.</text> </level> <level label="f"> <text>The trier of fact shall determine:</text> <level label="1"> <text>Whether the individual has a mental disorder; and</text> </level> <level label="2"> <text>If so, whether the individual needs inpatient medical care or treatment for the protection of the individual or another.</text> </level> </level> <level label="g"> <level label="1"> <text>If the trier of fact finds that the individual has a mental disorder and needs inpatient medical care or treatment, the court shall remand the individual to the custody of the facility or Veterans’ Administration hospital.</text> </level> <level label="2"> <text>If the trier of fact finds that the individual does not have a mental disorder or has a mental disorder, but does not need inpatient medical care or treatment, the individual shall be released from the facility or Veterans’ Administration hospital.</text> </level> </level> <level label="h"> <text>Any party may appeal from a decision on the petition as in any other civil case.</text> </level> <level label="i"> <text>Appropriate records of the proceeding under this section shall be made a permanent part of the individual’s record.</text> </level> <level label="j"> <level label="1"> <text>After a determination on the merits of a petition filed under this section, a court may not hear a later petition for the individual within 1 year after that determination, unless the petition is accompanied by a valid affidavit that the court, after review of the petition and affidavit, determines to show an improvement in the mental condition of the individual after the determination.</text> </level> <level label="2"> <text>An affidavit is not valid if executed by an individual under care or treatment in a facility or Veterans’ Administration hospital.</text> </level> <level label="3"> <text>If the matter is reopened, the petition shall be heard as provided in this section.</text> </level> <level label="4"> <text>If the affidavit does not show improvement in the individual’s mental condition, the petition shall be dismissed.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-806" title_number="10" title_name="Mental Health Law" subtitle_number="8" subtitle_name="Release and Transfers"> <level label="a"> <text>In this section, “responsible official” means:</text> <level label="1"> <text>If the individual is held in a Veterans’ Administration hospital, the chief officer of the Veterans’ Administration hospital; or</text> </level> <level label="2"> <text>If the individual is held in any other facility, the Director or the administrative head of the facility.</text> </level> </level> <level label="b"> <text>At the direction of the responsible official, an individual who has been admitted under this title shall be released from a facility or a Veterans’ Administration hospital if the individual:</text> <level label="1"> <text>Does not have a mental disorder; or</text> </level> <level label="2"> <text>Has a mental disorder but:</text> <level label="i"> <text>Does not need inpatient medical care or treatment to protect the individual or another;</text> </level> <level label="ii"> <text>Would not endanger the individual or the person or property of another; and</text> </level> <level label="iii"> <text>Would be cared for properly by the individual or by a responsible person who is able and willing to care for the individual.</text> </level> </level> </level> <level label="c"> <level label="1"> <text>At the direction of the responsible official, any individual who has been admitted under this title shall be released conditionally from a State facility within 2 weeks after the responsible official, with the written consent of the individual:</text> <level label="i"> <text>Certifies that the individual:</text> <level label="1"> <text>Would not endanger the individual or the person or property of another; and</text> </level> <level label="2"> <text>Could live in the community with appropriate assistance under the protective services program provided for in § 14–201 of the Family Law Article; and</text> </level> </level> <level label="ii"> <text>Notifies the provider of the protective services and the local department of social services in the county where the individual would live.</text> </level> </level> <level label="2"> <text>At the direction of the responsible official, any individual who has been admitted under this title may be released conditionally from a facility other than a State facility or from a Veterans’ Administration hospital, if, in the judgment of the responsible official, the individual:</text> <level label="i"> <text>Would be cared for properly by the individual or by a responsible person who is able and willing to care for the individual; and</text> </level> <level label="ii"> <text>Would not endanger the individual or the person or property of another.</text> </level> </level> <level label="3"> <text>The responsible official may set the conditions for release that the responsible official considers reasonable. The conditions may relate to:</text> <level label="i"> <text>The duration of the release; or</text> </level> <level label="ii"> <text>Care or treatment during release.</text> </level> </level> <level label="4"> <text>As resources allow, services shall be provided to individuals released from a State facility in accordance with the aftercare plan required by § 10–809 of this subtitle, as follows:</text> <level label="i"> <text>The Behavioral Health Administration shall provide community mental health services that are suitable to the needs of the individual;</text> </level> <level label="ii"> <text>The Division of Rehabilitation Services shall provide, to individuals determined to be eligible, vocational rehabilitation services and occupational placement opportunities consistent with the assessed needs and abilities of the individual; and</text> </level> <level label="iii"> <text>The Department of Human Services shall provide needed case management services and shall make arrangements for housing suitable to the needs of the individual.</text> </level> </level> <level label="5"> <text>For purposes of annual examination and execution of new admission documents, an individual released conditionally is considered to be held by the facility or Veterans’ Administration hospital from which the individual was released.</text> </level> </level> <level label="d"> <text>A facility shall release an individual who has been admitted to the facility within 1 year after the admission if, before the expiration of that 1–year period:</text> <level label="1"> <text>The individual, whether admitted on a formal, written application or on informal request, does not execute a new application for the voluntary admission;</text> </level> <level label="2"> <text>The parent or guardian does not execute a new request for the voluntary admission of the minor individual; or</text> </level> <level label="3"> <text>The physician and psychologist or 2 physicians do not execute the new certificates required for involuntary admission of the individual.</text> </level> </level> <level label="e"> <text>Each determination on any release of an individual, whether full or conditional, including a summary of the reasons for the determination, shall be made a permanent part of the individual’s record.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-807" title_number="10" title_name="Mental Health Law" subtitle_number="8" subtitle_name="Release and Transfers"> <level label="a"> <text>In this section, “public facility” means a facility under § 10–406 of this title maintained under the direction of the Administration.</text> </level> <level label="b"> <text>The Director may transfer an individual, who is admitted under Subtitle 6 of this title or committed under Title 3 of the Criminal Procedure Article, from a public facility to the Clifton T. Perkins Hospital Center, if the Director finds that:</text> <level label="1"> <text>The individual either can receive better care or treatment in or would be more likely to benefit from care or treatment at the Clifton T. Perkins Hospital Center; or</text> </level> <level label="2"> <text>The safety or welfare of other individuals would be furthered.</text> </level> </level> <level label="c"> <level label="1"> <text>Prior to transferring an individual from a public facility to the Clifton T. Perkins Hospital Center, the Director shall give the individual notice and an opportunity for a hearing before the Office of Administrative Hearings, unless the Director finds that an emergency requires the immediate transfer of the individual.</text> </level> <level label="2"> <text>If the Director determines that an emergency requires the immediate transfer of an individual, the individual may be transferred to the Clifton T. Perkins Hospital Center if the Administration:</text> <level label="i"> <text>Provides notice to the individual; and</text> </level> <level label="ii"> <text>Schedules a post transfer hearing before the Office of Administrative Hearings within 10 calendar days after the transfer.</text> </level> </level> <level label="3"> <text>A hearing requested by an individual under paragraph (1) of this subsection shall be convened at the public facility within 30 calendar days after the individual received notice of the transfer.</text> </level> </level> <level label="d"> <text>If a hearing is requested by the individual in accordance with subsection (c)(1) of this section, the hearing shall be utilized to determine whether the Administration has demonstrated by preponderance of the evidence that the criteria for transfer have been met.</text> </level> <level label="e"> <text>A decision of an administrative law judge under this section shall be the final decision of the Department for the purpose of judicial review of final decisions under Title 10, Subtitle 2 of the State Government Article.</text> </level> <level label="f"> <text>The Director may transfer any individual who is a resident of another state to a facility in that state if the Director finds that the transfer is feasible.</text> </level> <level label="g"> <level label="1"> <text>Any finding that the Director makes under this section shall be in writing and filed with the records of the individual involved.</text> </level> <level label="2"> <text>A copy of the finding and the notice to the facility to which the individual is being transferred shall be sent to the guardian or other legal representative of the individual.</text> </level> </level> <level label="h"> <text>The Director may transfer an individual between public facilities, other than the Clifton T. Perkins Hospital Center, without the consent of the individual if the Director finds that administrative or clinical reasons require a transfer of the individual from the facility.</text> </level> <level label="i"> <level label="1"> <text>In effecting a transfer of an individual from a unit in a public facility to another unit in the facility or to another public facility, the transferring facility shall provide for the transfer of all the records necessary for continuing the care of the individual on or before the date of transfer to the facility to which the individual is being transferred.</text> </level> <level label="2"> <text>This subsection is not intended to preempt the requirements of § 10–625 of this title.</text> </level> </level> <level label="j"> <text>An individual may not be transported to or from any facility unless accompanied by:</text> <level label="1"> <text>An ambulance attendant or other individual who is authorized by the facility and is of the same sex. However, the chief executive officer of the facility or that officer’s designee may designate an ambulance attendant or other person of either sex to provide transportation to an individual, if deemed appropriate; or</text> </level> <level label="2"> <text>The parent, spouse, domestic partner, adult sibling, or adult offspring of the individual.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-808" title_number="10" title_name="Mental Health Law" subtitle_number="8" subtitle_name="Release and Transfers"> <level label="a"> <text>In this section, “federal agency” means the Department of Veterans Affairs or any other agency of the United States government.</text> </level> <level label="b"> <text>Whenever the transfer of an individual to a federal agency is planned under this section, the Director or administrative head of a facility, with the consent of the individual, shall notify the parent or next of kin of the individual about the transfer. In the case of a minor child or an individual who is assigned a legal guardian, the parent of the minor child or the legal guardian of the individual shall be notified of any planned transfer.</text> </level> <level label="c"> <level label="1"> <text>The Director may transfer an individual from a facility to a Veterans’ Administration hospital in this State, if the individual is entitled to benefits in that hospital.</text> </level> <level label="2"> <text>After the transfer, the chief officer of the Veterans’ Administration hospital has all the powers and rights of the Administration as to that individual.</text> </level> </level> <level label="d"> <level label="1"> <text>If a court of competent jurisdiction of any other state commits an individual to a federal agency for care or treatment, the commitment judgment or order affects the individual, while the individual is in this State, to the extent that the judgment or order would affect the individual in the other state.</text> </level> <level label="2"> <text>The courts of the committing state have continuing jurisdiction over the committed individual to inquire into the mental condition of that individual and determine the need to continue commitment.</text> </level> <level label="3"> <text>Retention, custody, transfer, parole, and release of the committed individual are governed by the law of the committing state.</text> </level> </level> <level label="e"> <level label="1"> <text>The administrative head of a facility may transfer any individual to a federal agency for care or treatment if the federal agency certifies that facilities are available for the individual and that the individual is eligible for care or treatment.</text> </level> <level label="2"> <text>The facility shall give a proper officer of the court that ordered commitment notice of the transfer when it is made.</text> </level> <level label="3"> <text>An individual may not be transferred under this subsection if the individual is confined under a conviction of a crime or if the individual is committed under Title 12 of this article unless, after appropriate motion and hearing, the court or other authority that committed the individual orders the transfer.</text> </level> </level> <level label="f"> <text>Any individual transferred under this section is deemed to be committed to the federal agency under the original commitment.</text> </level> <level label="g"> <text>This section applies to residents and nonresidents of this State found in this State or on any federal reservation in this State.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-809" title_number="10" title_name="Mental Health Law" subtitle_number="8" subtitle_name="Release and Transfers"> <level label="a"> <text>Whenever a release of an individual from a facility is planned, the administrative head of the facility or a designee of the administrative head, with the consent of the individual, shall notify the parent or next of kin about the proposed release. In the case of a minor child or an individual who is assigned a legal guardian, the parent of the minor child or the legal guardian of the individual shall be notified of any planned release.</text> </level> <level label="b"> <level label="1"> <text>Except as otherwise provided in this section, before a facility releases an individual who has been accepted as a resident in the facility, the administrative head of the facility or a designee of the administrative head shall:</text> <level label="i"> <text>Prepare a written aftercare plan for the individual;</text> </level> <level label="ii"> <text>With the consent of the individual send the plan to the treatment program in the community that the individual chooses; and</text> </level> <level label="iii"> <text>Notify the individual of the advisability of making an advance directive for mental health services, as provided under § 5-602.1 of this article.</text> </level> </level> <level label="2"> <text>If the individual requests assistance in making an advance directive for mental health services, the facility shall assist the individual in making the advance directive or refer the individual to an appropriate community resource to assist the individual in making the advance directive.</text> </level> <level label="3"> <text>When the administrative head of the facility or the designee of the administrative head refers the individual to an appropriate community resource under paragraph (2) of this subsection, the administrative head or designee shall notify the community resource of the name of and other available nonconfidential identifying information about the individual that has been referred to the community resource and of the individual’s interest in making an advance directive for mental health services.</text> </level> <level label="4"> <text>The Department shall provide training, sample forms, and information on advance directives for mental health services to assist facilities in compliance with this section.</text> </level> </level> <level label="c"> <level label="1"> <text>In this subsection, “aftercare services” means services:</text> <level label="i"> <text>For individuals who no longer receive inpatient services for a mental disorder; and</text> </level> <level label="ii"> <text>That enhance the opportunity to maintain a mentally ill individual in the community and to assist in the prevention of homelessness.</text> </level> </level> <level label="2"> <text>“Aftercare services” include:</text> <level label="i"> <text>Medical care;</text> </level> <level label="ii"> <text>Psychiatric care;</text> </level> <level label="iii"> <text>Vocational and social rehabilitation;</text> </level> <level label="iv"> <text>Supportive housing; or</text> </level> <level label="v"> <text>Case management services.</text> </level> </level> <level label="3"> <text>The aftercare plan shall be prepared in collaboration with community programs and government agencies that are to provide aftercare services to the individual after release.</text> </level> <level label="4"> <text>The aftercare plan shall include:</text> <level label="i"> <text>Diagnoses, including existing psychiatric, somatic, and dental diagnoses;</text> </level> <level label="ii"> <text>Treatment initiated;</text> </level> <level label="iii"> <text>Medications prescribed, their dosage schedules, the amount of each medication given to the individual on release, and the information necessary to help the individual to obtain the prescribed medication in the community in accordance with the aftercare plan;</text> </level> <level label="iv"> <text>Date of release;</text> </level> <level label="v"> <text>Location of community placement;</text> </level> <level label="vi"> <text>Plan for continuing treatment; and</text> </level> <level label="vii"> <text>List of referrals indicated, including:</text> <level label="1"> <text>Public social services;</text> </level> <level label="2"> <text>Legal aid;</text> </level> <level label="3"> <text>Educational services;</text> </level> <level label="4"> <text>Vocational services; and</text> </level> <level label="5"> <text>Medical treatment other than mental health services.</text> </level> </level> </level> <level label="5"> <text>The Secretary shall periodically review selected aftercare plans and make a determination if the services included in the aftercare plans are meeting the needs of the particular individuals.</text> </level> <level label="6"> <text>The Secretary shall designate an existing employee within the Department whose primary function is to help coordinate the Department’s programs and services aimed at the prevention of homelessness to mentally ill individuals.</text> </level> </level> <level label="d"> <level label="1"> <text>If the individual does not consent to an aftercare plan, a statement to this effect signed by the individual or a parent, guardian, or other representative of the individual shall be placed in the individual’s record.</text> </level> <level label="2"> <text>With the consent of the individual, and before an individual who had been accepted as a resident in the facility is released from a facility, the staff of the facility shall assist the individual or the parent, guardian, or other representative of the individual in applying for the federal and State benefits for which the individual may be eligible.</text> </level> <level label="3"> <level label="i"> <text>The staff of the facility shall begin assisting the individual or the parent, guardian, or other representative of the individual in the application process for benefits for the individual as early as possible after the individual is accepted as a resident in the facility.</text> </level> <level label="ii"> <text>On acceptance as a resident to the facility, the facility shall provide to each individual, or the parent, guardian, or other representative of the individual, written information regarding federal and State benefits and application processes. �</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-810" title_number="10" title_name="Mental Health Law" subtitle_number="8" subtitle_name="Release and Transfers"> <text>A release under this subtitle shall be made between 9 a.m. and 4 p.m.</text> </section> <section article="ghg" article_name="Health - General" number="10-811" title_number="10" title_name="Mental Health Law" subtitle_number="8" subtitle_name="Release and Transfers"> <text>An individual who was admitted to a facility from an institution under the Division of Correction or from the Patuxent Institution and who is to be released before the expiration of the sentence to that institution shall be released to the custody of the Division or the Patuxent Institution, as the case may be.</text> </section> <section article="ghg" article_name="Health - General" number="10-812" title_number="10" title_name="Mental Health Law" subtitle_number="8" subtitle_name="Release and Transfers"> <level label="a"> <text>The Behavioral Health Administration may ask the Developmental Disabilities Administration to accept primary responsibility for an individual in or eligible for admission to a mental health residential facility, if the Behavioral Health Administration finds that the individual would be provided for more appropriately in a program for individuals with developmental disability.</text> </level> <level label="b"> <text>The Developmental Disabilities Administration shall determine whether transfer to a program for individuals with developmental disability is appropriate.</text> </level> <level label="c"> <text>A dispute over a transfer of an individual from the Behavioral Health Administration to the Developmental Disabilities Administration shall be resolved, in accordance with procedures that the Secretary sets, on request of:</text> <level label="1"> <text>The Behavioral Health Administration; or</text> </level> <level label="2"> <text>The Developmental Disabilities Administration.</text> </level> </level> <level label="d"> <text>The Director of the Behavioral Health Administration shall give an individual the opportunity for a hearing on the proposed transfer.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-813" title_number="10" title_name="Mental Health Law" subtitle_number="8" subtitle_name="Release and Transfers"> <text>The Administration shall compensate case managers or other appropriate community mental health providers for conducting initial assessments of incarcerated individuals who are:</text> <level label="1"> <text>Identified by the Department of Public Safety and Correctional Services as having a serious mental illness; and</text> </level> <level label="2"> <text>Expected to be within 3 months of release.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-901.1" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <level label="a"> <text>A community mental health services program shall submit annually financial statements and salary information in accordance with the Department’s regulations.</text> </level> <level label="b"> <text>The Administration may impose a penalty not exceeding $500 per day per violation for each day a violation occurs on a licensee that fails to comply with subsection (a) of this section.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-902" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <level label="a"> <level label="1"> <text>In accordance with the State budget and the rules and regulations that the Secretary adopts, the Secretary may make grants from or agreements for the use of State and federal funds to help public agencies or nonprofit organizations establish and operate local mental health programs to provide the following:</text> <level label="i"> <text>Inpatient services;</text> </level> <level label="ii"> <text>Outpatient services;</text> </level> <level label="iii"> <text>Partial care services, including day care services and night care services;</text> </level> <level label="iv"> <text>24–hour emergency services;</text> </level> <level label="v"> <text>Aftercare services;</text> </level> <level label="vi"> <text>Consultation services;</text> </level> <level label="vii"> <text>Education services;</text> </level> <level label="viii"> <text>Other preventive or rehabilitation services or treatment; and</text> </level> <level label="ix"> <text>Community residential programs for children and adolescents.</text> </level> </level> <level label="2"> <text>Research and training that are designed to improve or extend these services are proper items of expense.</text> </level> </level> <level label="b"> <level label="1"> <text>Services under this section shall be provided by public agencies or, under contract, by nonprofit organizations and private community-based organizations.</text> </level> <level label="2"> <text>Nothing in this section shall prohibit the Secretary from contracting with individual licensed mental health care providers, including psychiatrists, psychologists, social workers, and psychiatric nurses.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-902.1" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <level label="a"> <text>Notwithstanding any other law or regulation, the Secretary shall continue from July 1, 1998, until June 30, 1999, the transition funding option that was in effect for participating outpatient mental health clinics on July 1, 1997, as specified in the Code of Maryland Regulations 10.21.25.01F.</text> </level> <level label="b"> <text>This section may not be construed to prohibit the Secretary from increasing the rate of reimbursement under the transition funding option that was in effect for outpatient mental health clinics on July 1, 1997, as specified in the Code of Maryland Regulations 10.21.25.01F.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-903" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <level label="a"> <level label="1"> <text>The governing body of any county may apply for assistance to establish a mental health program under this part.</text> </level> <level label="2"> <text>A county shall apply by submitting annually to the Director, for approval by the Secretary, a plan and budget for the next fiscal year.</text> </level> </level> <level label="b"> <text>The governing bodies of two or more counties may apply for assistance to establish a community mental health program for the counties if:</text> <level label="1"> <text>The population of one of the counties is too small to warrant the establishment of an independent community mental health program for that county; and</text> </level> <level label="2"> <text>The Director consents.</text> </level> </level> <level label="c"> <text>A community mental health services program is not eligible for assistance under this part unless:</text> <level label="1"> <text>Its plan and budget conform to the State plan for mental health services and the priorities set under it; and</text> </level> <level label="2"> <text>The qualifications of its professional staff meet the standards that the Secretary sets.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-904" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <level label="a"> <text>Except in Montgomery County, the health officer for a county is responsible for:</text> <level label="1"> <text>The mental health services program in the county; and</text> </level> <level label="2"> <text>Supervising generally the mental health services and facilities that the county health department provides or supports.</text> </level> </level> <level label="b"> <text>The health officer for a county shall:</text> <level label="1"> <text>With the advice of the regional mental health director, revise annually the county plan for providing or contracting for services, including aftercare, and facilities and for any other matters necessary or desirable to carry out this part;</text> </level> <level label="2"> <text>Prepare annually a budget for carrying out the plan;</text> </level> <level label="3"> <text>Assure that the staff and professional services meet the standards that the Secretary adopts;</text> </level> <level label="4"> <text>Submit to the mental health advisory committee and the governing body for the county an annual report on the county program, including an account of expenditures and an estimate of anticipated needs for the next year;</text> </level> <level label="5"> <text>Facilitate the work of the county or intercounty mental health advisory committee; and</text> </level> <level label="6"> <text>Perform any other duty necessary to carry out this part.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-908" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <text>On or before January 1 each year, beginning in 2024, the Department shall report to the General Assembly, in accordance with § 2–1257 of the State Government Article, on:</text> <level label="1"> <text>The Resident Grievance System established under COMAR 10.21.14; and</text> </level> <level label="2"> <text>The grievances that were received by the Resident Grievance System related to State facilities during the immediately preceding fiscal year.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-917" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <text>The administrative head of any facility may appoint any employee as a law enforcement officer and, while the employee holds a special police commission issued by the Governor, the employee may:</text> <level label="1"> <text>Return an individual to the facility from which the individual escaped; and</text> </level> <level label="2"> <text>Be used to protect individuals or property at the facility.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-920" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <text>In this part, “private therapeutic group home” means a small private group home as defined in § 10–514(e) of this title that provides residential child care, as well as access to a range of diagnostic and therapeutic mental health services, to be identified under the requirements of § 10–924 of this subtitle, for children and adolescents who are in need of such treatments.</text> </section> <section article="ghg" article_name="Health - General" number="10-921" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <text>The Director shall:</text> <level label="1"> <text>Supervise the care and residential treatment of and the programs for children and adolescents that have mental disorders; and</text> </level> <level label="2"> <text>Provide or encourage, by consultation, cooperation, or contract, all programs needed to ensure that children and adolescents are evaluated appropriately and provided community-based residential care.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-922" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <text>The Secretary shall adopt rules and regulations that:</text> <level label="1"> <text>Ensure that a private therapeutic group home provides mental health care and treatment in accordance with this part; and</text> </level> <level label="2"> <text>Require a private therapeutic group home:</text> <level label="i"> <text>To provide treatment for each child and adolescent in the home;</text> </level> <level label="ii"> <text>To coordinate the treatment in the home with the appropriate public or nonpublic educational program conducted outside of the home; and</text> </level> <level label="iii"> <text>To provide 24–hour supervision for each child and adolescent for the time that the child and adolescent are not participating in a program conducted outside of the home.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-923" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <level label="a"> <text>Application for placement of a child or adolescent in a private therapeutic group home may be made under this section by:</text> <level label="1"> <text>An individual who is 16 years old or older;</text> </level> <level label="2"> <text>A parent or guardian on behalf of the child or adolescent;</text> </level> <level label="3"> <text>With the consent of the parent or guardian of the child or adolescent, a psychiatrist or psychologist who treats the child or adolescent;</text> </level> <level label="4"> <text>On behalf of a child or adolescent, a local department of social services that has custody or guardianship of the child or adolescent under § 3-819 of the Courts Article;</text> </level> <level label="5"> <text>The Department of Education or the local education agency with the consent of a parent or guardian;</text> </level> <level label="6"> <text>On behalf of a child or adolescent, the Department of Juvenile Services when the Department has custody or guardianship of the child or adolescent under § 3-819 of the Courts Article; or</text> </level> <level label="7"> <text>The circuit court of a county sitting as the juvenile court.</text> </level> </level> <level label="b"> <text>The applicant shall submit a formal, written application to the Director that contains the personal information and is on the form required by the Administration.</text> </level> <level label="c"> <text>A private therapeutic group home may not accept an individual under this section unless:</text> <level label="1"> <text>The individual is under the age of 18 years;</text> </level> <level label="2"> <text>The individual has a mental disorder;</text> </level> <level label="3"> <text>The individual, because of the mental disorder, requires residential services not available in the home;</text> </level> <level label="4"> <text>The individual needs 24-hour supervision in a structured private therapeutic group home;</text> </level> <level label="5"> <text>The individual is or should be receiving treatment for the mental disorder; and</text> </level> <level label="6"> <text>There is no less restrictive form of treatment that is consistent with the welfare and safety of the child or adolescent.</text> </level> </level> <level label="d"> <level label="1"> <text>Within 60 days after the Director receives an application for placement of a child or adolescent in a private therapeutic group home, the Director or the county health officer shall determine whether the child or adolescent meets the requirements for placement under this section.</text> </level> <level label="2"> <text>If the Director or county health officer determines that the child or adolescent meets the requirements under this section, the Director or county health officer shall:</text> <level label="i"> <text>Approve the application for placement in a private therapeutic group home; and</text> </level> <level label="ii"> <text>Determine the date of placement in a private therapeutic group home in accordance with the plan submitted under § 10–925 of this subtitle.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-924" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <level label="a"> <text>Each private therapeutic group home shall make and periodically update a written plan of treatment for each individual in the home, in accordance with rules and regulations that the Director adopts.</text> </level> <level label="b"> <level label="1"> <text>The Director shall adopt appropriate rules and regulations to carry out the intent of this section in accordance with current professional practices.</text> </level> <level label="2"> <text>The rules and regulations shall include:</text> <level label="i"> <text>A description of the nature and content of plans of treatment; and</text> </level> <level label="ii"> <text>Appropriate time periods for the development, implementation, and review of each plan.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-925" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <level label="a"> <text>On or before January 1, 1985, the Director shall prepare and submit a plan to the Governor, the President of the Senate, and the Speaker of the House.</text> </level> <level label="b"> <text>The plan shall include:</text> <level label="1"> <text>The number of children and adolescents in need of placement in private therapeutic group homes;</text> </level> <level label="2"> <text>The number, type, and location of private therapeutic group homes that are needed in the community for the treatment of these children and adolescents;</text> </level> <level label="3"> <text>The resources and procedures that are necessary to establish the private therapeutic group homes;</text> </level> <level label="4"> <text>The feasibility of transferring any resources of a State facility to any private therapeutic group home;</text> </level> <level label="5"> <text>The summaries of the individual plans of treatment;</text> </level> <level label="6"> <text>The schedule for the relocation of children and adolescents where plans indicate that a less restrictive placement is appropriate;</text> </level> <level label="7"> <text>A plan for establishing, developing, and maintaining a system for monitoring community services; and</text> </level> <level label="8"> <text>An evaluation by the Secretary of the feasibility of obtaining reimbursement, under Title XIX of the Social Security Act, for services to be provided to children and adolescents with mental disorders.</text> </level> </level> <level label="c"> <text>The Director shall:</text> <level label="1"> <text>Implement §§ 10–920 through 10–924 and 10–926 of this subtitle upon completion of the plan to be submitted under this section; and</text> </level> <level label="2"> <text>Review and revise periodically the plan submitted under this section.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-926" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <level label="a"> <text>At least once a year, the Director, in conjunction with a county health officer, shall evaluate each private therapeutic group home.</text> </level> <level label="b"> <level label="1"> <text>The Director, in conjunction with a county health officer shall:</text> <level label="i"> <text>Prepare a written report of each evaluation; and</text> </level> <level label="ii"> <text>Distribute a copy of this report to each private therapeutic group home.</text> </level> </level> <level label="2"> <text>The Director shall keep at least 1 copy of the report.</text> </level> <level label="3"> <text>The Secretary shall consider the report when renewing a license of any private therapeutic group home.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-929" effective_note="EFFECTIVE UNTIL JUNE 30, 2028 PER CHAPTER 867 OF 2024" title_number="10" title_name="Mental Health Law" subtitle_number="9" subtitle_name="Miscellaneous Provisions"> <level label="a"> <text>In this section, “Program” means the Language Assistance Services Pilot Program.</text> </level> <level label="b"> <text>There is a Language Assistance Services Pilot Program.</text> </level> <level label="c"> <text>The purpose of the Program is to:</text> <level label="1"> <text>Provide meaningful access to behavioral health care to children with limited English proficiency; and</text> </level> <level label="2"> <text>Establish a competitive grant process for local behavioral health authorities to provide reimbursement to behavioral health providers for language assistance services, including interpretation and translation services to:</text> <level label="i"> <text>Children with limited English proficiency accessing and receiving behavioral health services; and</text> </level> <level label="ii"> <text>Parents and legal guardians coordinating the provision of behavioral health services and making health care decisions regarding the services on behalf of a child.</text> </level> </level> </level> <level label="d"> <text>The Administration shall administer the Program.</text> </level> <level label="e"> <text>The Administration shall implement the following requirements as part of administering the Program:</text> <level label="1"> <text>A requirement that a grantee document and report:</text> <level label="i"> <text>The number of children who received language assistance services broken down by primary language spoken;</text> </level> <level label="ii"> <text>The number of parents and legal guardians who received language assistance services broken down by primary language spoken; and</text> </level> <level label="iii"> <text>The number of language assistance services that were reimbursed broken down by the type of behavioral health service provided; and</text> </level> </level> <level label="2"> <text>A requirement that, to request and receive a reimbursement from a Program grantee, a health care provider must:</text> <level label="i"> <text>Be a licensed and accredited behavioral health provider; and</text> </level> <level label="ii"> <text>Have a current, written language access plan demonstrating how the provider ensures meaningful access to its programs and activities for individuals with limited English proficiency.</text> </level> </level> </level> <level label="f"> <text>The language access plan required under subsection (e)(2)(ii) of this section shall:</text> <level label="1"> <text>Be provided to the grantee in addition to any request for reimbursement for language assistance services; and</text> </level> <level label="2"> <text>Include:</text> <level label="i"> <text>A self–assessment of the circumstances under which the provider may encounter an individual with limited English proficiency;</text> </level> <level label="ii"> <text>A self–assessment of the number or proportion of individuals with limited English proficiency from each language group in the provider’s service area to determine appropriate language assistance services;</text> </level> <level label="iii"> <text>The provider’s procedure for identifying an individual’s primary language;</text> </level> <level label="iv"> <text>The provider’s procedure for providing language assistance services, including oral and written language assistance services;</text> </level> <level label="v"> <text>The provider’s procedure for ensuring effective communication with individuals with limited English proficiency in languages encountered less frequently;</text> </level> <level label="vi"> <text>The provider’s plan for training staff on the provider’s policies and procedures; and</text> </level> <level label="vii"> <text>The provider’s procedure for providing notice of language assistance services at no cost to individuals with limited English proficiency.</text> </level> </level> </level> <level label="g"> <text>For each of fiscal years 2025 and 2026, the Governor shall include in the annual budget bill an appropriation of $120,000 to the Program.</text> </level> <level label="h"> <text>The Administration shall award, at a minimum, three grants of $30,000 each in each of fiscal years 2025 and 2026.</text> </level> <level label="i"> <text>On or before December 1, 2025, 2026, and 2027, the Administration shall submit to the Governor and, in accordance with § 2–1257 of the State Government Article, the General Assembly a report on the implementation of the Program that includes:</text> <level label="1"> <text>The total number of individuals with limited English proficiency who received language assistance services broken down by jurisdiction;</text> </level> <level label="2"> <text>The total number of children who received language assistance services broken down by primary language spoken;</text> </level> <level label="3"> <text>The total number of parents and legal guardians who received language assistance services broken down by primary language spoken;</text> </level> <level label="4"> <text>The total number of language assistance services that were reimbursed broken down by the type of behavioral health service provided; and</text> </level> <level label="5"> <text>The total amount in grant money provided to each grantee during the immediately preceding fiscal year.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-1001" title_number="10" title_name="Mental Health Law" subtitle_number="10" subtitle_name="Prohibited Acts; Penalties; Civil Liability"> <level label="a"> <text>A person may not operate a private, inpatient facility unless licensed by the Department.</text> </level> <level label="b"> <text>A person who operates a private, inpatient facility in violation of this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $10,000.</text> </level> <level label="c"> <text>An employee, officer, operator, or director of a private, inpatient facility or any other person, who knowingly participates in a violation of this section, is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000 or imprisonment not exceeding 1 year or both.</text> </level> <level label="d"> <text>In addition to any other penalties specified in this section, an individual who is admitted or held against the individual’s will by a person who is operating a private, inpatient facility without a license may recover civil damages from that person and from any other person who knowingly participates in the admission or detention.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-1002" title_number="10" title_name="Mental Health Law" subtitle_number="10" subtitle_name="Prohibited Acts; Penalties; Civil Liability"> <level label="a"> <text>A person may not:</text> <level label="1"> <text>Knowingly make a false application or certificate in connection with the admission or detention of any individual; or</text> </level> <level label="2"> <text>Detain an individual in a manner contrary to Subtitle 6 or Subtitle 8 of this title.</text> </level> </level> <level label="b"> <text>A person who violates any provision of this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000 or imprisonment not exceeding 2 years or both.</text> </level> <level label="c"> <text>In addition to any other penalties specified in this section, a person who willfully violates any provision of this section is liable for civil damages sustained by the individual who is admitted or detained unlawfully.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-1003" title_number="10" title_name="Mental Health Law" subtitle_number="10" subtitle_name="Prohibited Acts; Penalties; Civil Liability"> <level label="a"> <text>A person may not interfere knowingly with the rights of an individual under § 10-701, § 10-702, § 10-703, § 10-704, § 10-706, or § 10-707 of this title.</text> </level> <level label="b"> <text>A person who violates any provision of this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000 or imprisonment not exceeding 2 years or both.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-1004" title_number="10" title_name="Mental Health Law" subtitle_number="10" subtitle_name="Prohibited Acts; Penalties; Civil Liability"> <text>A person who fails to comply with any provision of § 10-709 of this title, as to records, is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000 or imprisonment not exceeding 2 years or both.</text> </section> <section article="ghg" article_name="Health - General" number="10-1101" title_number="10" title_name="Mental Health Law" subtitle_number="11" subtitle_name="Short Title"> <text>This title may be cited as the Maryland Mental Health Law.</text> </section> <section article="ghg" article_name="Health - General" number="10-1201" title_number="10" title_name="Mental Health Law" subtitle_number="12" subtitle_name="Core Service Agencies, Local Addictions Authorities, and Local Behavioral Health Authorities"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Core service agency” has the meaning stated in § 7.5–101 of this article.</text> </level> <level label="c"> <text>“Local addictions authority” has the meaning stated in § 7.5–101 of this article.</text> </level> <level label="d"> <text>“Local behavioral health authority” has the meaning stated in § 7.5–101 of this article.</text> </level> <level label="e"> <text>“Services to persons with mental illnesses” means the health care and community support rendered to a recipient primarily in connection with the diagnosis, evaluation, treatment, case management, rehabilitation, or supervised housing for individuals with serious mental disorders.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-1202" title_number="10" title_name="Mental Health Law" subtitle_number="12" subtitle_name="Core Service Agencies, Local Addictions Authorities, and Local Behavioral Health Authorities"> <level label="a"> <text>A core service agency, local addictions authority, or local behavioral health authority shall:</text> <level label="1"> <text>Be an agent of a county or Baltimore City government which may include a local health department;</text> </level> <level label="2"> <text>Unless an exception is requested by an individual county and is granted by the Secretary, serve a county or counties with an estimated population of over 80,000 people;</text> </level> <level label="3"> <text>Either purchase services or provide the services directly;</text> </level> <level label="4"> <text>Annually submit a program plan to the secretaries of the affected State departments for review and to the Director for approval; and</text> </level> <level label="5"> <text>Meet the standards required under this subtitle and, as needed, the rules and regulations set by the Secretary.</text> </level> </level> <level label="b"> <text>A core service agency, local addictions authority, or local behavioral health authority may not be a for–profit entity.</text> </level> <level label="c"> <text>Each core service agency, local addictions authority, or local behavioral health authority shall function under the Secretary’s authority.</text> </level> <level label="d"> <text>Once established in a jurisdiction, the core service agency, local addictions authority, or local behavioral health authority shall:</text> <level label="1"> <text>Submit, on an annual basis, a program plan to the Director for approval;</text> </level> <level label="2"> <text>Incorporate in its method of governance a mechanism for the local county mental health advisory committee, local drug and alcohol abuse council, or joint mental health and substance–related committee to serve as the advisory committee to the core service agency, local addictions authority, or local behavioral health authority and, if serving more than 1 unit of government, a method of representation serving those jurisdictions;</text> </level> <level label="3"> <text>Implement guidelines developed by the Director which establish or designate the authority of the local mental health advisory committee, local drug and alcohol abuse council, or joint mental health and substance–related committee to advise and assist in the planning and evaluation of the publicly funded mental health and substance–related disorder services;</text> </level> <level label="4"> <text>In accordance with guidelines developed by the Director, develop planning, management, and accountability mechanisms for the delivery of services including:</text> <level label="i"> <text>Case management;</text> </level> <level label="ii"> <text>Data collection which satisfies the Department’s requirements for client tracking and incorporates clear outcome measures to enable the local entity to govern itself and monitor and evaluate the system; and</text> </level> <level label="iii"> <text>A yearly summary which includes at a minimum:</text> <level label="1"> <text>Relevant financial statements; and</text> </level> <level label="2"> <text>Program evaluation reports which articulate the core service agency’s, local addictions authority’s, or local behavioral health authority’s ability to identify the outcomes of services provided for the target populations and the effects of those services on program planning for the target population;</text> </level> </level> </level> <level label="5"> <text>As an agent of county government, function in any of the following organizational structures:</text> <level label="i"> <text>A unit of county or Baltimore City government;</text> </level> <level label="ii"> <text>A local health department;</text> </level> <level label="iii"> <text>A quasi–public authority; or</text> </level> <level label="iv"> <text>A private, nonprofit corporation;</text> </level> </level> <level label="6"> <text>Be authorized to screen individuals for whom voluntary or involuntary admission is being initiated to determine whether a less restrictive alternative can be provided;</text> </level> <level label="7"> <text>Subject to the availability of funding in the State budget, be authorized to approve funding for a youth’s educational costs incurred during a residential treatment center admission made for medical or psychiatric purposes in accordance with item (6) of this subsection if the educational costs are not covered under § 8–406 of the Education Article; and</text> </level> <level label="8"> <text>Provide clear guidelines to avoid either the appearance or occurrence of conflicts of interest in the direction and operation of the core service agency, local addictions authority, or local behavioral health authority or organizations which provide mental health or substance–related services.</text> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-1202.1" title_number="10" title_name="Mental Health Law" subtitle_number="12" subtitle_name="Core Service Agencies, Local Addictions Authorities, and Local Behavioral Health Authorities"> <level label="a"> <text>This section applies only to Howard County.</text> </level> <level label="b"> <level label="1"> <text>The purpose of this section is to authorize the establishment of a quasi–public authority which may be activated by Howard County, if the county decides to designate a quasi–public authority as the core service agency or local behavioral health authority to perform the duties imposed under this subtitle.</text> </level> <level label="2"> <text>This section has no effect on any other form of core service agency or local behavioral health authority, whether it is a unit of Howard County government, a local health department, or a private, nonprofit corporation.</text> </level> </level> <level label="c"> <level label="1"> <text>If activated as a quasi–public authority by an ordinance or resolution of the governing body of Howard County, there is established a quasi–public authority in Howard County.</text> </level> <level label="2"> <text>The quasi–public authority shall:</text> <level label="i"> <text>Serve as the core service agency or local behavioral health authority for the jurisdiction; and</text> </level> <level label="ii"> <text>Be a public body, corporate and politic.</text> </level> </level> </level> <level label="d"> <text>The local ordinance activating the quasi-public authority shall include the following:</text> <level label="1"> <text>The name of the quasi-public authority;</text> </level> <level label="2"> <text>The method of appointing individuals to the authority, including whether or not appointments require approval of the chief elected official of the jurisdiction and the legislative body of the jurisdiction;</text> </level> <level label="3"> <text>The number of members of the authority;</text> </level> <level label="4"> <text>The terms of members;</text> </level> <level label="5"> <text>The duties and powers of the authority in accordance with the provisions of this subtitle; and</text> </level> <level label="6"> <text>Specific terms governing the operation of the authority, including, but not limited to financial reporting, budgetary, and personnel requirements, provided that these specific terms may not add powers to the authority which are not included under this subtitle.</text> </level> </level> <level label="e"> <text>The quasi-public authority is exempt from taxation by the State and the county.</text> </level> <level label="f"> <text>Howard County shall send to the Secretary a copy of any ordinance or resolution activating a quasi–public authority which will serve as a core service agency or local behavioral health authority.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-1203" title_number="10" title_name="Mental Health Law" subtitle_number="12" subtitle_name="Core Service Agencies, Local Addictions Authorities, and Local Behavioral Health Authorities"> <level label="a"> <text>To the extent resources are available, the Director, after consultation with the Behavioral Health Advisory Council as established in Title 7.5, Subtitle 3 of this article and federal requirements mandated under P.L. 99–660, may initiate the development of core service agencies, local addictions authorities, or local behavioral health authorities as a mechanism for community planning, management, and financing of mental health and substance–related disorder services.</text> </level> <level label="b"> <text>When core service agencies, local addictions authorities, or local behavioral health authorities are initiated, the Director shall:</text> <level label="1"> <text>Define the priority populations to be served by the core service agencies, local addictions authorities, or local behavioral health authorities;</text> </level> <level label="2"> <text>Define the essential mental health, substance–related disorder, and associated support services to be provided under the auspices of the core service agencies, local addictions authorities, or local behavioral health authorities;</text> </level> <level label="3"> <text>Define the essential administrative functions to be carried out by core service agencies, local addictions authorities, or local behavioral health authorities; and</text> </level> <level label="4"> <text>Outline the requirements for the core service agencies’, local addictions authorities’, or local behavioral health authorities’ governance structure.</text> </level> </level> <level label="c"> <text>To assure the continuing provision of appropriate services, the Director shall:</text> <level label="1"> <text>Annually review and may approve the core service agencies’, local addictions authorities’, or local behavioral health authorities’ program plan;</text> </level> <level label="2"> <text>In conjunction with the appropriate authorities, establish and maintain a funding mechanism for the core service agencies, local addictions authorities, or local behavioral health authorities which may include the allocation of funds for inpatient services;</text> </level> <level label="3"> <text>Develop a mechanism whereby any unexpended funds remaining at the end of the year may remain with the core service agencies, local addictions authorities, or local behavioral health authorities or the community providers;</text> </level> <level label="4"> <text>Establish procedures to facilitate intraagency and interagency linkages at State and local levels with the core service agencies, local addictions authorities, or local behavioral health authorities; and</text> </level> <level label="5"> <text>Establish procedures within the Behavioral Health Administration for a process regarding program, policy, or contract disputes that gives all community mental health and substance–related disorder programs regulated by the Administration the right to:</text> <level label="i"> <text>Access the mediation process established by the Administration; and</text> </level> <level label="ii"> <text>If dissatisfied with the outcome of the mediation by the Administration, request a hearing with the Office of Administrative Hearings in accordance with Title 10, Subtitle 2 of the State Government Article.</text> </level> </level> </level> <level label="d"> <text>If a core service agency, local addictions authority, or local behavioral health authority violates any provision of this subtitle, the Director may deny approval of the core service agency, local addictions authority, or local behavioral health authority and, after written notification of denial of approval, cease funding or request the return of unspent funds by the core service agency, local addictions authority, or local behavioral health authority.</text> </level> <level label="e"> <text>If a county elects to terminate its core service agency, local addictions authority, or local behavioral health authority, the county may do so upon 90 days’ written notice to the Director.</text> </level> <level label="f"> <text>The Director may not require a core service agency, local addictions authority, or local behavioral health authority to provide services the Department does not provide funding for.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-1301" title_number="10" title_name="Mental Health Law" subtitle_number="13" subtitle_name="Uniform Act for the Extradition of Persons of Unsound Mind"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>As applied to a request to return any person within the purview of this subtitle to or from the District of Columbia, the words “executive authority”, “Governor”, and “chief magistrate” respectively include the chief judge of the Superior Court of the District of Columbia and other authority.</text> </level> <level label="c"> <text>“Flee” means to depart:</text> <level label="1"> <text>Voluntarily or involuntarily from the jurisdiction of the court where the proceedings hereinafter mentioned may have been instituted and are still pending, with the effect of avoiding, impeding, or delaying the action of the court in which the proceedings may have been instituted or be pending; or</text> </level> <level label="2"> <text>From the state where one is if one is under detention by law as a person of unsound mind and subject to detention.</text> </level> </level> <level label="d"> <text>“Flight” means the act of fleeing.</text> </level> <level label="e"> <text>“State” includes a state, territory, district, and insular possession or other possession of the United States.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-1302" title_number="10" title_name="Mental Health Law" subtitle_number="13" subtitle_name="Uniform Act for the Extradition of Persons of Unsound Mind"> <level label="a"> <text>This section applies to a person alleged to be of unsound mind found in this State, who has fled from another state, in which at the time of the flight the person:</text> <level label="1"> <text>Was under detention by law in a hospital, asylum, or other institution for the insane as a person of unsound mind;</text> </level> <level label="2"> <text>Had been theretofore determined by legal proceedings to be of unsound mind, the finding being unreversed and in full force and effect, and the control of the person having been acquired by a court of competent jurisdiction of the state from which the person fled; or</text> </level> <level label="3"> <text>Was subject to detention in the other state, being then the person’s legal domicile (personal service of process having been made) based on legal proceedings there pending to have the person declared of unsound mind.</text> </level> </level> <level label="b"> <text>A person subject to this section shall, on demand of the executive authority of the state from which the person fled, be delivered up to be removed thereto.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-1303" title_number="10" title_name="Mental Health Law" subtitle_number="13" subtitle_name="Uniform Act for the Extradition of Persons of Unsound Mind"> <level label="a"> <level label="1"> <text>This subsection applies whenever the executive authority of any state:</text> <level label="i"> <text>Demands of the Governor, a fugitive within the purview of § 10-1302 of this subtitle; and</text> </level> <level label="ii"> <text>Produces a copy of the commitment, decree, or other judicial process and proceedings, certified as authentic by the governor or chief magistrate of the state whence the person so charged has fled, with an affidavit made before a proper officer showing the person to be a fugitive.</text> </level> </level> <level label="2"> <text>The Governor shall:</text> <level label="i"> <text>Cause a person subject to this subsection to be apprehended and secured, if found in this State;</text> </level> <level label="ii"> <text>Cause immediate notice of the apprehension to be given to the executive authority making a demand for the person, or to the agent of the executive authority appointed to receive the fugitive; and</text> </level> <level label="iii"> <text>Cause the fugitive to be delivered to the agent when the agent appears.</text> </level> </level> </level> <level label="b"> <text>If an agent does not appear within 30 days from the time of the apprehension, the fugitive may be discharged.</text> </level> <level label="c"> <text>All costs and expenses incurred in the apprehending, securing, maintaining, and transmitting the fugitive to the state making the demand for the fugitive shall be paid by the demanding state.</text> </level> <level label="d"> <text>Any agent so appointed who receives the fugitive into custody shall be empowered to transmit the fugitive to the state from which the fugitive has fled.</text> </level> <level label="e"> <text>On application of any person interested, the Governor may demand the return to this State of any fugitive within the purview of this subtitle.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-1304" title_number="10" title_name="Mental Health Law" subtitle_number="13" subtitle_name="Uniform Act for the Extradition of Persons of Unsound Mind"> <text>Any proceedings under this subtitle shall begin within 1 year after the flight referred to in this subtitle.</text> </section> <section article="ghg" article_name="Health - General" number="10-1305" title_number="10" title_name="Mental Health Law" subtitle_number="13" subtitle_name="Uniform Act for the Extradition of Persons of Unsound Mind"> <text>This subtitle shall be interpreted and construed to effectuate its general purpose to make uniform the laws of those states that enact it.</text> </section> <section article="ghg" article_name="Health - General" number="10-1306" title_number="10" title_name="Mental Health Law" subtitle_number="13" subtitle_name="Uniform Act for the Extradition of Persons of Unsound Mind"> <text>This subtitle is the Uniform Act for the Extradition of Persons of Unsound Mind.</text> </section> <section article="ghg" article_name="Health - General" number="10-1401" title_number="10" title_name="Mental Health Law" subtitle_number="14" subtitle_name="Maryland Behavioral Health Crisis Response System"> <level label="a"> <text>In this subtitle the following words have the meanings indicated.</text> </level> <level label="b"> <text>“Administration” means the Behavioral Health Administration.</text> </level> <level label="c"> <text>“Core service agency” has the meaning stated in § 7.5–101 of this article.</text> </level> <level label="d"> <text>“Crisis Response System” means the Maryland Behavioral Health Crisis Response System.</text> </level> <level label="e"> <text>“Family support services” has the meaning stated in § 7.5–101 of this article.</text> </level> <level label="f"> <text>“Local behavioral health authority” has the meaning stated in § 7.5–101 of this article.</text> </level> <level label="g"> <text>“Mobile crisis team” means a team established by the local behavioral health authority that:</text> <level label="1"> <text>Operates 24 hours a day and 7 days a week to provide assessments, crisis intervention, stabilization, follow–up, and referral to urgent care and to arrange appointments for individuals to obtain behavioral health services;</text> </level> <level label="2"> <text>Incorporates nationally recognized standards and best practices; and</text> </level> <level label="3"> <text>Prioritizes:</text> <level label="i"> <text>Providing connection to services and coordinating patient follow–up, including peer support and family support services after stabilization;</text> </level> <level label="ii"> <text>Serving all members of the immediate community with cultural competency and appropriate language access; and</text> </level> <level label="iii"> <text>Limiting the interaction of law enforcement with individuals in crisis.</text> </level> </level> </level> </section> <section article="ghg" article_name="Health - General" number="10-1402" title_number="10" title_name="Mental Health Law" subtitle_number="14" subtitle_name="Maryland Behavioral Health Crisis Response System"> <level label="a"> <text>There is a Maryland Behavioral Health Crisis Response System in the Behavioral Health Administration.</text> </level> <level label="b"> <text>The Crisis Response System shall:</text> <level label="1"> <text>Operate a statewide network utilizing existing resources and coordinating interjurisdictional services to develop efficient and effective crisis response systems to serve all individuals in the State, 24 hours a day and 7 days a week;</text> </level> <level label="2"> <text>Provide skilled clinical intervention to help prevent suicides, homicides, unnecessary hospitalizations, and arrests or detention, and to reduce dangerous or threatening situations involving individuals in need of behavioral health services; and</text> </level> <level label="3"> <text>Respond quickly and effectively to community crisis situations.</text> </level> </level> <level label="c"> <text>The Administration shall consult with consumers of behavioral health services, family members, and behavioral health advocates in the development of the Crisis Response System.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-1403" title_number="10" title_name="Mental Health Law" subtitle_number="14" subtitle_name="Maryland Behavioral Health Crisis Response System"> <level label="a"> <text>The Crisis Response System shall include:</text> <level label="1"> <text>A State 9–8–8 Suicide and Crisis Lifeline in each jurisdiction or region to:</text> <level label="i"> <text>Provide a single point of entry to the Crisis Response System;</text> </level> <level label="ii"> <text>Coordinate with the national 9–8–8 Suicide and Crisis Lifeline to provide the full range of services provided by the national 9–8–8 Suicide and Crisis Lifeline, including:</text> <level label="1"> <text>Supportive counseling;</text> </level> <level label="2"> <text>Suicide prevention;</text> </level> <level label="3"> <text>Crisis intervention;</text> </level> <level label="4"> <text>Referrals to additional resources; and</text> </level> <level label="5"> <text>Direct dispatch or warm hand–offs to mobile crisis response and stabilization services and other immediate services as needed;</text> </level> </level> <level label="iii"> <text>Coordinate with the local core service agency or local behavioral health authority, police, 3–1–1, 2–1–1, or other local mental health hotlines, emergency medical service personnel, and behavioral health providers; and</text> </level> <level label="iv"> <text>Provide other programs that may include:</text> <level label="1"> <text>A clinical crisis telephone line for suicide prevention and crisis intervention;</text> </level> <level label="2"> <text>A hotline for behavioral health information, referral, and assistance;</text> </level> <level label="3"> <text>Clinical crisis walk–in services, including:</text> </level> <level label="A"> <text>Triage for initial assessment;</text> </level> <level label="B"> <text>Crisis stabilization until additional services are available;</text> </level> <level label="C"> <text>Linkage to treatment services and family and peer support groups; and</text> </level> <level label="D"> <text>Linkage to other health and human services programs;</text> </level> <level label="4"> <text>Critical incident stress management teams, providing disaster behavioral health services, critical incident stress management, and an on–call system for these services;</text> </level> <level label="5"> <text>Crisis residential beds to serve as an alternative to hospitalization;</text> </level> <level label="6"> <text>A community crisis bed and hospital bed registry, including a daily tally of empty beds;</text> </level> <level label="7"> <text>Transportation coordination, ensuring transportation of patients to urgent appointments or to emergency psychiatric facilities;</text> </level> <level label="8"> <text>Mobile crisis teams;</text> </level> <level label="9"> <text>23–hour holding beds;</text> </level> <level label="10"> <text>Emergency psychiatric services;</text> </level> <level label="11"> <text>Urgent care capacity;</text> </level> <level label="12"> <text>Expanded capacity for assertive community treatment;</text> </level> <level label="13"> <text>Crisis intervention teams with capacity to respond in each jurisdiction 24 hours a day and 7 days a week; and</text> </level> <level label="14"> <text>Individualized family intervention teams;</text> </level> </level> </level> <level label="2"> <text>Community awareness promotion and training programs; and</text> </level> <level label="3"> <text>An evaluation of outcomes of services:</text> <level label="i"> <text>In each jurisdiction or region, including an evaluation of:</text> <level label="1"> <text>9–8–8 call, text, and chat volume;</text> </level> <level label="2"> <text>9–8–8 local answer rate;</text> </level> <level label="3"> <text>9–8–8 call, text, and chat resolution data, including:</text> </level> <level label="A"> <text>The proportion of crises resolved by phone;</text> </level> <level label="B"> <text>The proportion of crises resolved through mobile crisis team dispatch; and</text> </level> <level label="C"> <text>The proportion of crises resolved by transfer to 9–1–1;</text> </level> <level label="4"> <text>Mobile crisis team dispatch volume;</text> </level> <level label="5"> <text>Mobile crisis team response time;</text> </level> <level label="6"> <text>Mobile crisis team dispatch resolution data, including:</text> </level> <level label="A"> <text>The proportion of crises resolved safely in the community; and</text> </level> <level label="B"> <text>The proportion of crises resolved through transfer to a higher level of care;</text> </level> <level label="7"> <text>Crisis stabilization center usage; and</text> </level> <level label="8"> <text>Crisis stabilization center discharge data, including:</text> </level> <level label="A"> <text>The proportion of crises resolved through a discharge to home; and</text> </level> <level label="B"> <text>The proportion of crises resolved through a discharge to a higher level of care;</text> </level> </level> <level label="ii"> <text>Through data obtained from consumers and family members who have received services from the Crisis Response System collected through ongoing data collection from 9–8–8 call, text, and chat providers and other crisis providers that is reported annually; and</text> </level> <level label="iii"> <text>Through annual crisis services data collection on the involvement of law enforcement, involuntary status of clients, and diversion from higher levels of care, including hospitals.</text> </level> </level> </level> <level label="b"> <text>The data derived from the evaluation of outcomes of services required under subsection (a)(3) of this section shall be:</text> <level label="1"> <text>Collected, analyzed, and publicly reported on or before December 1 each year, beginning in 2026;</text> </level> <level label="2"> <text>Disaggregated by race, gender, age, and zip code; and</text> </level> <level label="3"> <text>Used to formulate policy recommendations with the goal of decreasing criminal detention and improving crisis diversion programs and linkages to effective community health services.</text> </level> </level> <level label="c"> <text>The Crisis Response System services shall be implemented as determined by the Administration in collaboration with the core service agency or local behavioral health authority serving each jurisdiction and community members of each jurisdiction.</text> </level> <level label="d"> <text>An advance directive for mental health services under § 5–602.1 of this article shall apply to the delivery of services under this subtitle.</text> </level> <level label="e"> <text>This subtitle may not be construed to affect petitions for emergency evaluations under § 10–622 of this title.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-1404" title_number="10" title_name="Mental Health Law" subtitle_number="14" subtitle_name="Maryland Behavioral Health Crisis Response System"> <text>The Administration shall implement the Crisis Response System, in collaboration with core service agencies or local behavioral health authorities, on a regional or jurisdictional basis as federal funding or funding from other sources becomes available.</text> </section> <section article="ghg" article_name="Health - General" number="10-1405" title_number="10" title_name="Mental Health Law" subtitle_number="14" subtitle_name="Maryland Behavioral Health Crisis Response System"> <text>The Crisis Response System providers shall contract with service providers who employ individuals who use or have used behavioral health services.</text> </section> <section article="ghg" article_name="Health - General" number="10-1501" title_number="10" title_name="Mental Health Law" subtitle_number="15" subtitle_name="Behavioral Health Workforce Investment Fund"> <text>In this subtitle, “Fund” means the Behavioral Health Workforce Investment Fund established under § 10–1502 of this subtitle.</text> </section> <section article="ghg" article_name="Health - General" number="10-1502" title_number="10" title_name="Mental Health Law" subtitle_number="15" subtitle_name="Behavioral Health Workforce Investment Fund"> <level label="a"> <text>There is a Behavioral Health Workforce Investment Fund.</text> </level> <level label="b"> <text>The purpose of the Fund is to provide reimbursement for costs associated with educating, training, certifying, recruiting, placing, and retaining behavioral health professionals and paraprofessionals.</text> </level> <level label="c"> <text>The Department shall administer the Fund.</text> </level> <level label="d"> <level label="1"> <text>The Fund is a special, nonlapsing Fund that is not subject to § 7–302 of the State Finance and Procurement Article.</text> </level> <level label="2"> <text>The State Treasurer shall hold the Fund separately, and the Comptroller shall account for the Fund.</text> </level> </level> <level label="e"> <text>The Fund shall consist of:</text> <level label="1"> <text>Money appropriated in the State budget to the Fund;</text> </level> <level label="2"> <text>Interest earnings of the Fund; and</text> </level> <level label="3"> <text>Any other money from any other source accepted for the benefit of the Fund.</text> </level> </level> <level label="f"> <text>The Fund may be used only for carrying out the purpose of the Fund.</text> </level> <level label="g"> <level label="1"> <text>The State Treasurer shall invest the money of the Fund in the same manner as other State money may be invested.</text> </level> <level label="2"> <text>Any interest earnings of the Fund shall be credited to the Fund.</text> </level> </level> <level label="h"> <text>Expenditures from the Fund may be made only in accordance with the State budget.</text> </level> <level label="i"> <text>Money expended from the Fund for carrying out the purpose of the Fund is supplemental to and is not intended to take the place of funding that otherwise would be appropriated for carrying out the purpose of the Fund.</text> </level> <level label="j"> <text>Notwithstanding any other provision of law, no part of the Fund may revert or be credited to:</text> <level label="1"> <text>The General Fund of the State; or</text> </level> <level label="2"> <text>Any other special fund of the State.</text> </level> </level> <level label="k"> <text>The Fund is subject to audit by the Office of Legislative Audits as provided in § 2–1220 of the State Government Article.</text> </level> </section> <section article="ghg" article_name="Health - General" number="10-1503" title_number="10" title_name="Mental Health Law" subtitle_number="15" subtitle_name="Behavioral Health Workforce Investment Fund"> <text>On or before December 1 each year, beginning in 2024, the Department shall submit a report to the Legislative Policy Committee, the Senate Budget and Taxation Committee, and the House Appropriations Committee, in accordance with § 2–1257 of the State Government Article, that includes:</text> <level label="1"> <text>For the immediately preceding fiscal year, the amount of funds transferred and distributed from the Fund in accordance with § 10–1502 of this subtitle;</text> </level> <level label="2"> <text>For the immediately preceding fiscal year, the number of behavioral health professionals and paraprofessionals educated, trained, recruited, certified, placed, or retained with money from the Fund, aggregated by:</text> <level label="i"> <text>The type of professional or paraprofessional;</text> </level> <level label="ii"> <text>Geographic region;</text> </level> <level label="iii"> <text>Race; and</text> </level> <level label="iv"> <text>Ethnicity;</text> </level> </level> <level label="3"> <text>The amount of any unspent funds in the Fund at the end of the immediately preceding fiscal year; and</text> </level> <level label="4"> <text>If unspent funds are identified under item (3) of this section, the reasons why the funds were not spent.</text> </level> </section>