<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".03" citation="COMAR 10.21.05.03" title_num="10" subtitle_num="21" chapter_num="05" heading="Content and Nature of Aftercare Plans.">
  <paragraph num="A.">
    <text>Staff designated by the CEO to assist individuals in aftercare planning shall, as soon as possible after acceptance, in collaboration with the individual:</text>
    <paragraph num="(1)">
      <text>Initiate the aftercare planning process;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>With proper consent, involve in the aftercare planning process:</text>
      <paragraph num="(a)">
        <text>Community-based service providers;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Family members;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Others who have a personal interest in the individual; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Third-party payors, including Medical Assistance, the Administration's ASO, or private insurance carriers, if involved, for authorization of outpatient services;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Assist in applying for benefits to which the individual may be entitled and document the outcome of the benefits application process in the individual's record.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Before discharge or release, designated staff shall:</text>
    <paragraph num="(1)">
      <text>Provide notification of the discharge or release:</text>
      <paragraph num="(a)">
        <text>With proper consent, to:</text>
        <paragraph num="(i)">
          <text>The individual's next-of-kin;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>As appropriate, the core service agency (CSA);</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Community-based treatment and support services providers rendering services before the individual's inpatient admission; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Third-party payors, including Medical Assistance, the Administration's ASO, or private insurance carriers, if involved, for authorization of outpatient services; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>If the individual is a minor, to the parent or guardian; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Assist the individual to participate in the aftercare plan by:</text>
      <paragraph num="(a)">
        <text>Explaining to the individual the benefits of:</text>
        <paragraph num="(i)">
          <text>The aftercare plan;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Community-based treatment and support services; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The involvement of family or others who have a personal interest in the individual;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Encouraging the individual to consent to the aftercare plan; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Arranging appointments for the individual with appropriate community programs.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>In collaboration with community programs and government agencies that have agreed to provide aftercare services to the individual after discharge or release, designated staff shall prepare a written aftercare plan that includes:</text>
    <paragraph num="(1)">
      <text>The individual's:</text>
      <paragraph num="(a)">
        <text>Name;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Date of birth; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Address and telephone number upon discharge or release;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>For a minor or an individual under guardianship, the name, address, and telephone number of the custodial adult or guardian;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>If the individual will reside in program-arranged housing, the name, address, telephone number, and contact person of the placement agency;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The date and type of admission and discharge or release;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>The scheduled court date, if any;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>The diagnoses, including existing psychiatric, somatic, and dental diagnoses, and level of functional assessment;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>The type of treatment initiated;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>The name, address, and telephone number of the primary care provider;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Medication information, including the:</text>
      <paragraph num="(a)">
        <text>Medication prescribed;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Dosage schedules;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Amount of each medication given to the individual upon discharge or release; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Information necessary to help the individual to obtain the prescribed medication in the community;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>The most recent laboratory results, including therapeutic drug levels;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>If applicable, a description of:</text>
      <paragraph num="(a)">
        <text>Allergies, including medication allergies;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Nutritional requirements; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Active somatic problems requiring continued attention;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(12)">
      <text>Information on the individual's medical insurance coverage, including the:</text>
      <paragraph num="(a)">
        <text>Company;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Policy number;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Name of the policy holder; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Preauthorization information, if given, for services to be initiated upon discharge or release;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(13)">
      <text>Entitlements, if any, and status;</text>
    </paragraph>
    <paragraph num="(14)">
      <text>The plan for continuing treatment, including but not limited to:</text>
      <paragraph num="(a)">
        <text>Outpatient mental health treatment services;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Somatic care;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Psychiatric rehabilitation and support services;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>When appropriate, substance abuse services; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Case management;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(15)">
      <text>A list of additional referrals indicated, such as:</text>
      <paragraph num="(a)">
        <text>Public social services;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Legal aid;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Educational services;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Housing services;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Vocational services;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Peer support services; and</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Available crisis services; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(16)">
      <text>Any identifying information required by the Administration's ASO.</text>
    </paragraph>
  </paragraph>
</regulation>