<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".10" citation="COMAR 10.21.17.10" title_num="10" subtitle_num="21" chapter_num="17" heading="Discharge from Services.">
  <paragraph num="A.">
    <text>When an individual has attained the goals identified in the individual's service plan, the individual's program coordinator shall begin the process for discharge planning.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Discharge Policy. The program shall have and maintain written policies and procedures, which may be contained in one document, that include:</text>
    <paragraph num="(1)">
      <text>The process for all types of discharge from the program, including:</text>
      <paragraph num="(a)">
        <text>Collaborative discharge;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The individual's discontinuation of services;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The program's recommendation to discontinue services; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The ASO's determination to discontinue authorization for services; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The individual's right to appeal.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Discharge Plan.</text>
    <paragraph num="(1)">
      <text>The individual's program coordinator and the individual, if appropriate, shall develop a discharge plan that:</text>
      <paragraph num="(a)">
        <text>Is based on an assessment of the individual's current status, service needs, and mutually agreed upon goal attainment;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Includes:</text>
        <paragraph num="(i)">
          <text>A brief description of the recommendations for continued treatment, if any;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Referrals for continuing services; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Information about how the individual can re-access services when needed; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>With proper consent, is developed in collaboration with family or others designated by the individual, and other treatment, rehabilitation, and service providers.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The individual's program coordinator shall provide the individual with a copy of the discharge plan as soon as possible, but in no event, not later than the date of discharge.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Discharge Summary. Within 10 working days after an individual is discharged from a program, a staff person responsible for coordinating services to the individual shall complete and sign a discharge summary that includes, at a minimum, the:</text>
    <paragraph num="(1)">
      <text>Reason for admission;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Reason for discharge;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Services provided, including the frequency and duration of services;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Progress that was made;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Diagnosis at the time of discharge, if appropriate;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Current medications, if any;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Continuing service recommendations and summary of the transition process; and</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Extent of the individual's involvement in the discharge plan.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Program's Recommendation to Discontinue Services.</text>
    <paragraph num="(1)">
      <text>If, in consultation with the program director, the program coordinator recommends discontinuing services for an individual for whom, because of the individual's actions, the program's services are not effective, or the individual's clinical needs exceed the program's ability to secure the safety and welfare of the individual or others, the program director shall provide written notice of the intention to discontinue services and recommend referral for alternative services.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Except in the case of imminent danger, the program director shall provide the notice at least 30 calendar days before discontinuing services.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The program director shall assure that the notice is sent to the individual and, with proper consent, to:</text>
      <paragraph num="(a)">
        <text>Family or others designated by the individual; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>If appropriate, the CSA and the Administration's ASO, for referral for alternative services.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>The notice shall include:</text>
      <paragraph num="(a)">
        <text>The effective date of the action;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The reason for the action; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A discharge plan.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>If an individual presents as a danger to self or to others, the program director shall make necessary arrangements to try to protect the individual, others, or both, and link the individual with the appropriate level of care.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>ASO's Determination to Discontinue Authorization for Services. If the Administration's ASO determines that services are no longer medically necessary, the program coordinator shall follow the provision for discharge outlined in §C of this regulation.</text>
  </paragraph>
</regulation>