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<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>
