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<chapter num="06" heading="Admission to Regional Institutes for Children and Adolescents" title_num="10" subtitle_num="21">
  <regulation prefix="Regulation" num=".01" heading="Scope.">
    <text>This chapter establishes procedures and standards for residential admission to the Regional Institutes for Children and Adolescents (RICAs). The RICAs are mental health facilities licensed and operated by the Maryland Department of Health for the residential treatment of severely emotionally disturbed children and adolescents.</text>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Definitions.">
    <paragraph num="A.">
      <text>The following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Administration” means the Maryland Department of Health.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Applicant” means a child or adolescent who is the subject of an application for admission to a RICA.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Director” means the Director of the Maryland Department of Health.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“Mental disorder” means a behavioral or emotional illness that results from a psychiatric or neurological disorder and is referenced in Health-General Article, §10-620(e)(1), Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>“Resident” means a child or adolescent who is admitted to a RICA for residential treatment.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>“Residential treatment” means a program of active psychiatric treatment that is provided on a residential basis, under the direction of a psychiatrist, and in conformity with an individualized treatment plan.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>“RICA” means a Regional Institute for Children and Adolescents.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Application for Admission.">
    <paragraph num="A.">
      <text>On referral by a public or private agency or mental health professional, application for admission to a RICA may be made by:</text>
      <paragraph num="(1)">
        <text>The parent or guardian of a child or adolescent under 18 years old;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>An adolescent, if the adolescent is 16 years old or older; or</text>
      </paragraph>
      <paragraph num="(3)">
        <text>A State or county agency that has custody of a child or adolescent, with the signed consent of the parent or guardian or in accordance with a court order.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>The admission application shall be on a form prescribed by the Administration and shall include:</text>
      <paragraph num="(1)">
        <text>The name, date of birth, sex, legal domicile, and present residence of the applicant;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>A statement based on clinical evaluation by a mental health professional that the applicant has a long term and severe mental disorder and is in need of residential treatment; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>A recent history of the applicant's psychiatric or psychological treatment, educational or special educational services, and involvement with community agencies.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Available medical records and psychiatric or psychological evaluations describing the applicant's mental disorder and need for residential treatment shall be attached to the admission application.</text>
    </paragraph>
    <paragraph num="D.">
      <text>The referring agency or mental health professional shall be responsible for assuring that appropriate written consent is obtained so as to permit that all required completed application materials may be sent to the RICA.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Admission Procedures.">
    <paragraph num="A.">
      <text>Each RICA shall maintain an admission team which consists of a physician, mental health and educational professionals and other persons, as appropriate. The RICA admission team shall determine whether the applicant meets the admission standards set forth in Regulation .05 of this chapter, within 10 working days of receipt of the completed application.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The applicant and referring agency or mental health professional shall be notified by the RICA admission team as to whether the applicant meets the admission criteria.</text>
    </paragraph>
    <paragraph num="C.">
      <text>If the admission team determines that the admission criteria are met, a pre-admission interview shall be scheduled by the RICA at the earliest convenient date for all parties involved.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Admission Criteria.">
    <paragraph num="A.">
      <text>A child or adolescent may be admitted to a RICA if the:</text>
      <paragraph num="(1)">
        <text>Individual has a long-term and severe mental disorder;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Individual has treatment needs that cannot be met through available community-based programs;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Residential treatment provided by the RICA can reasonably be expected to improve the individual's condition or prevent further regression so that the individual can return to the community.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>The child or adolescent shall be between 12 and 17 years old at the time of admission. The RICA admission team may waive the age limit in appropriate cases.</text>
    </paragraph>
    <paragraph num="C.">
      <text>A RICA may not admit a child or adolescent who has:</text>
      <paragraph num="(1)">
        <text>A primary diagnosis of alcoholism, drug addiction, or severe brain damage; or</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Cognitive deficits which severely limit the individual's ability to use the treatment modalities provided.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>A child or adolescent who otherwise meets the admission standards may not be denied residential treatment solely because the individual resides outside the regular catchment area served by the RICA, as established by the Director. The Director shall take into consideration the ratio of residential treatment beds to population base and proximity to the program when establishing the catchment areas, and shall review and revise the catchment areas, as appropriate, every 5 years beginning in 1990. Priority for admission shall be given to applicants living in the catchment area served by the RICA.</text>
    </paragraph>
    <paragraph num="E.">
      <text>If a child or adolescent meets the admission standards but the RICA is occupied to its licensed capacity, priority on the waiting list for admission shall be given to those individuals who have the most severe mental disorders as exhibited by level of dysfunctions.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Resident Rights.">
    <paragraph num="A.">
      <text>Residents shall be accorded the rights enumerated in the Health-General Article, §§10-701 through 10-709, Annotated Code of Maryland, and shall be informed of these rights upon admission.</text>
    </paragraph>
    <paragraph num="B.">
      <text>An individualized treatment plan shall be developed and implemented for each resident in accordance with Health-General Article, §10-706, Annotated Code of Maryland, and COMAR 10.21.03.</text>
    </paragraph>
    <paragraph num="C.">
      <text>An educational program shall be provided for each resident based on educational needs and shall include, when appropriate, an individualized educational program in accordance with COMAR 13A.05.01.</text>
    </paragraph>
    <paragraph num="D.">
      <text>An aftercare plan shall be developed for each resident before release from a RICA in cooperation with the referring agency or professional, parent, or guardian or other appropriate agencies in accordance with the Health-General Article, §§10-709 and 10-809, Annotated Code of Maryland.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".07" heading="Court Evaluation Unit.">
    <paragraph num="A.">
      <text>A RICA may establish a separate unit for short term evaluation of children and adolescents referred by a Juvenile Court.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Admission from the court evaluation unit to the regular residential treatment program shall be in accordance with the procedures and standards set forth in Regulations .04 and .05 of this chapter.</text>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Health-General Article, §§2-104, 10-204, 10-401, 10-406, 10-407, 10-602, 10-609, and 10-610, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: July 1, 1985 (12:9 Md. R. 811)</annotation>
  </annotations>
</chapter>