<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".08" citation="COMAR 10.21.07.08" title_num="10" subtitle_num="21" chapter_num="07" heading="TGH Program Model.">
  <paragraph num="A.">
    <text>A TGH provides therapeutic living services:</text>
    <paragraph num="(1)">
      <text>For at least four but not more than eight children;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>By providing access to a combination of developmental, diagnostic, and therapeutic mental health services;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>When possible, in the child's community of origin; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>In a home-like environment.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The chief executive officer of a TGH shall assure that a TGH:</text>
    <paragraph num="(1)">
      <text>Provides to each child in the TGH mental health care and treatment:</text>
      <paragraph num="(a)">
        <text>That can reasonably be expected to benefit the child; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>By an adequate staff or, under agreement, by a provider of mental health services;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Has sufficient staff to provide adequate supervision to the children in the TGH, including 24-hour supervision for each resident not participating in a program outside the TGH; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Coordinates treatment in the TGH with the appropriate public or nonpublic educational program.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The chief executive officer of the TGH shall assure that services are:</text>
    <paragraph num="(1)">
      <text>Appropriate to the cultural and psychosocial developmental needs of the child;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Provided by staff who:</text>
      <paragraph num="(a)">
        <text>As determined by the program, are appropriately credentialed and privileged; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Organize and manage the therapeutic milieu to:</text>
        <paragraph num="(i)">
          <text>Foster clinically appropriate social, cognitive, emotional, and physical growth;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Handle aggression in a nonpunitive manner that promotes growth and learning;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Reinforce the child's ability to function with peers in a social environment;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Model and provide opportunities for children to behave in age-appropriate ways, such as assuming responsibility for carrying out routine activities, exhibiting independence and initiative in planning their own activities, getting along with others, and demonstrating age-appropriate social skills;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Facilitate the child's awareness of appropriate behavior in a predictable, constructive, and timely manner; and</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Help children to make choices and to negotiate disagreements among themselves, rather than resolving conflicts for them;</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Provided in an environment that is:</text>
      <paragraph num="(a)">
        <text>Consistent with existing standards of program design; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Organized consistent with the learning styles and developmental needs of the child; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Designed to foster positive relationships between the child and the child's parents or guardians and, if other than a parent, the child's primary caretaker, and the anticipated post-placement caretaker.</text>
    </paragraph>
  </paragraph>
</regulation>