<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".09" citation="COMAR 10.21.26.09" title_num="10" subtitle_num="21" chapter_num="26" heading="Staff Support and Mental Health Services — Inpatient Admission Prevention.">
  <paragraph num="A.">
    <text>Staff Support. The program director shall assure that the program:</text>
    <paragraph num="(1)">
      <text>Has at least one staff person on duty at all times that a resident is present in the RCS facility;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Has the capacity for and, when required by an individual's ITP, provides 24-hour awake staff support;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Has the capacity for 1:4 coverage and, when required by an individual's ITP, provides 1:4 coverage; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>If the program serves children, provides at least one staff member for every three children.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Psychiatric Evaluation and Intervention. The program director shall assure that a psychiatrist provides evaluation and prescribed needed treatment interventions, either:</text>
    <paragraph num="(1)">
      <text>By consultation with the psychiatrist who is currently treating the individual; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Through a written agreement with a provider of mental health treatment, who will provide face-to-face evaluation by a psychiatrist before the development of the ITP.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Treatment and Support Services.</text>
    <paragraph num="(1)">
      <text>The program director shall assign to each individual who is receiving RCS a treatment coordinator who shall assure that the individual receives:</text>
      <paragraph num="(a)">
        <text>The care or treatment recommended under Regulation .07A of this chapter;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Monitoring of the individual's condition;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Supportive counseling focused on:</text>
        <paragraph num="(i)">
          <text>Assessment and definition of problems;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Planning and goal setting;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Development of effective problem-solving techniques; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Evaluation of progress;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(d)">
        <text>Assistance in accessing community resources, including case management, that are essential to meeting the individual's identified needs; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Transition services and discharge planning.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Medication Services.</text>
      <paragraph num="(a)">
        <text>Monitoring. A member of the treatment team privileged to do so shall provide the following medication monitoring services:</text>
        <paragraph num="(i)">
          <text>Supporting the individual's self-administration of medications, including both prescribed and over-the-counter medications;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>To the extent possible, monitoring compliance with instructions appearing on the label or a more recent physician's order;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Reading the label to assure that each container of medication is clearly labeled with the individual's name, the contents, directions for use, and expiration date;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Assuring that each individual has secure, appropriate, and accessible space in which to store medications;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Observing and documenting medications taken and any apparent reactions to the medication, and, either verbally or in writing and in a timely fashion, communicating to the prescribing authority problems that possibly may be related to the medication; and</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Reinforcing education on the role and effects of medication in symptom management.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Administration. If an individual's ITP requires that RCS staff administer medication, only an individual authorized to do so under Health Occupations Article, Annotated Code of Maryland, may administer medication.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>