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<chapter num="11" heading="Purchase of Residential Therapeutic Care for Children" title_num="10" subtitle_num="21">
  <regulation prefix="Regulation" num=".01" heading="Scope.">
    <text>This chapter outlines the requirements that a provider of residential therapeutic services to emotionally or behaviorally disordered children shall meet to be eligible to accept children placed by the Mental Hygiene Administration.</text>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meaning indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Direct supervision” means that a provider staff member maintains continuous visual contact with the child.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Family of origin” means the child's parent, guardian, or primary caretaker.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Least restrictive setting” means the treatment program or facility in which needed services are delivered in the environment that least limits the child being served.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“Oversight” means that a provider staff member approves and is aware of the child's activities.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>“Primary caretaker” means the adult individual who carries responsibility for the welfare of a child where the child resides.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>“Secure setting” means a treatment program or facility that is locked to prevent a child from leaving without staff permission.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Provider Requirements.">
    <text>A provider of residential therapeutic services may not be eligible to accept children placed by the Maryland Department of Health unless the provider:</text>
    <paragraph num="A.">
      <text>Is licensed by the Department of:</text>
      <paragraph num="(1)">
        <text>Human Services, under the provisions of COMAR 07.02.23 or 07.02.13;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Juvenile Services, under the provisions of COMAR 16.06.01; or</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Maryland Department of Health , under the provisions of COMAR 10.21.07;</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Has rates that are established by the Negotiated Rates Process of the Rates Management Unit, Social Services Administration of the Department of Human Services as authorized under the provisions of COMAR 21.14.01.04B(2);</text>
    </paragraph>
    <paragraph num="C.">
      <text>Provides the following core services:</text>
      <paragraph num="(1)">
        <text>Care and 24-hour supervision in a residential setting;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Direct provision of food and clothing;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Social work or case management services;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Recreational activities;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Access and linkage to appropriate community resources, including but not limited to:</text>
        <paragraph num="(a)">
          <text>Medical care;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Dental care;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Mental health treatment;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Education; and</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Social services; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(6)">
        <text>Crisis intervention planning;</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>Provides the additional services that, based on a documented clinical assessment, are required by the child who is being referred, including but not limited to:</text>
      <paragraph num="(1)">
        <text>A location as close as possible to the child's family of origin;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The least restrictive setting appropriate to the child's needs; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>As appropriate to the child's needs, a level of supervision that provides:</text>
        <paragraph num="(a)">
          <text>Opportunity for off-site activities, with oversight by provider staff; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>For a placement that is authorized by the State Coordinating Council for Residential Placement of Handicapped Children or a local coordinating council, as authorized under Article 49D, §§13 — 19, Annotated Code of Maryland:</text>
          <paragraph num="(i)">
            <text>Structured, on-site activities, with direct supervision by provider staff, and 24-hour awake staff; or</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>The level of supervision described in §D(3)(b)(i) of this regulation in a secure setting; and</text>
          </paragraph>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="E.">
      <text>Is in compliance with all applicable laws and regulations, including but not limited to laws and regulations governing patient rights, as set forth in Health-General Article, §§10-701 — 10-707, Annotated Code of Maryland.</text>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Health-General Article, §10-902, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date:</annotation>
    <annotation type="History" subtype="Administrative History">Regulations .01 — .03 adopted as an emergency provision effective October 13, 1992 (19:22 Md. R. 1980); adopted permanently effective March 29, 1993 (20:1 Md. R. 27)</annotation>
  </annotations>
</chapter>