<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".09" citation="COMAR 10.21.07.09" title_num="10" subtitle_num="21" chapter_num="07" heading="Eligibility, Application, and Admission.">
  <paragraph num="A.">
    <text>Eligibility.</text>
    <paragraph num="(1)">
      <text>A child is eligible for admission to a TGH if:</text>
      <paragraph num="(a)">
        <text>The child:</text>
        <paragraph num="(i)">
          <text>Has a mental disorder;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Is or should be receiving treatment for the mental disorder;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Because of the mental disorder, requires residential services not available in the home;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Needs 24-hour supervision in a structured private group home;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Has the ability to understand and states, in writing, a willingness to comply with the rules and regulations of the TGH; and</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Has the ability to act appropriately under emergency conditions; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>There is no less restrictive form of treatment that is consistent with the welfare and safety of the child.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>A TGH may not admit or retain as a resident a child if the child:</text>
      <paragraph num="(a)">
        <text>Has a primary diagnosis of alcoholism, drug addiction, or severe brain damage;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Shows current violent or antisocial behavior; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Has cognitive deficits that severely limit the child's ability to benefit from the treatment modalities provided.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Application for Admission. An applicant to a TGH shall use an application form which outlines the following requirements:</text>
    <paragraph num="(1)">
      <text>Identifying data, including but not limited to:</text>
      <paragraph num="(a)">
        <text>Name, date of birth, sex, legal domicile, and current residence of the child;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Names, addresses, and telephone numbers of persons or agencies having legal care or custody of the child; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Documentation of the child's custody status, including, if relevant, documentation of agreements regarding responsibility for financial support and health care;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Authorization to release information signed by the child's parent or guardian;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Based on a comprehensive mental health assessment by an individual authorized, under Health Occupations Article, Annotated Code of Maryland, to formulate a psychiatric diagnosis, a statement including:</text>
      <paragraph num="(a)">
        <text>The psychiatric diagnosis and the rationale for the diagnosis;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>An explanation of why the child would benefit from the treatment and related services provided in and by a TGH;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The treatment goals for the child, if TGH placement occurs;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Any history of violence or trauma, and the potential for current violent behavior; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Documentation that the child meets the eligibility criteria outlined in §A of this regulation;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>A recent history of the child's:</text>
      <paragraph num="(a)">
        <text>Mental health treatment, including relevant psychiatric and psychological evaluations;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Family status;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Education, including documentation of a handicapping condition, if any; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Involvement, if any, with community agencies;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>Relevant medical records; and</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Unless the child has a guardian that is a State agency, a written and signed statement that, at the time of application for admission, the child's parent or guardian:</text>
      <paragraph num="(a)">
        <text>Agrees to the placement;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Agrees to the rules and regulations of the TGH; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Enters into an agreement regarding the responsibility for payment for the child's medical and mental health care.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>If, under §B(3) of this regulation, the child has a history of violent behavior, TGH staff shall be permitted to plan and collaborate with the clinical referral source to develop a treatment plan which addresses the current potential for violent behavior.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Admissions Procedures.</text>
    <paragraph num="(1)">
      <text>An applicant for admission of a child to a TGH shall:</text>
      <paragraph num="(a)">
        <text>Submit an application for admission, as described in §B of this regulation, to the TGH chief executive officer; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Forward copies of the application to the Administration and the CSA, if the jurisdiction in which the child's parent or guardian resides is served by a CSA.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>On receipt of an application for admission to the TGH, the TGH chief executive officer, in collaboration with appropriate TGH mental health professional staff, may conduct a pre-admission interview with:</text>
      <paragraph num="(a)">
        <text>The applicant for admission to a TGH;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>If other than the applicant, the:</text>
        <paragraph num="(i)">
          <text>Child;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Child's parent or guardian; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Referring agency; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>As appropriate, past or current providers of the following services:</text>
        <paragraph num="(i)">
          <text>Educational;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Social; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Mental health treatment.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Within 2 weeks of receipt of an application for admission, the TGH chief executive officer shall:</text>
      <paragraph num="(a)">
        <text>In consultation with clinical and residential staff at the TGH and based on the eligibility criteria outlined under §A of this regulation, determine whether the TGH is the appropriate setting for the child;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Notify the applicant of the determination;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>If the determination is that the TGH is not appropriate for the child, notify the applicant of:</text>
        <paragraph num="(i)">
          <text>The reason for the determination; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A recommendation regarding the appropriate level of care; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(d)">
        <text>Notify the appropriate CSA director and the Administration of the determination.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>If the TGH chief executive officer approves the application for admission, the chief executive officer shall give to the applicant written notice of:</text>
      <paragraph num="(a)">
        <text>If a bed is available, the date of admission to the TGH; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>If a bed is not available within the following 21 days:</text>
        <paragraph num="(i)">
          <text>The child's position on the TGH's waiting list;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The process for reviewing the child's waiting list status; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Information about appropriate placement alternatives.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>