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<regulation prefix="Regulation" num=".05" citation="COMAR 10.21.27.05" title_num="10" subtitle_num="21" chapter_num="27" heading="Referral, Eligibility, Screening, and Acceptance for Respite Services.">
  <paragraph num="A.">
    <text>Referral. An individual or the individual's caregiver may request respite care services, or an agency providing mental health treatment or support services to an individual may refer the individual for respite care services.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Eligibility.</text>
    <paragraph num="(1)">
      <text>An individual is eligible to receive respite care if:</text>
      <paragraph num="(a)">
        <text>The individual is a participant, as described in COMAR 10.21.25.01D(2), in the public mental health system;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The individual has a diagnosis that is listed in COMAR 10.09.70.02;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The individual is:</text>
        <paragraph num="(i)">
          <text>An adult who has serious and persistent mental illness and who lives independently or in a family-like setting, or in a residential rehabilitation program (RRP) under the provisions of COMAR 10.21.22; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A child who has a serious emotional disturbance and who lives with a parent, guardian, or other primary caretaker in a family-like home, or in a foster home under the provisions of COMAR 07.02.11 or 07.02.21; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(d)">
        <text>The services are preauthorized, as needed, by the Administration's administrative services organization (ASO) according to the provisions of COMAR 10.21.17.02-1A.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>An individual is not eligible to receive respite care if the individual is a resident of a therapeutic group home (TGH) licensed under COMAR 10.21.07 or a facility licensed under Health-General Article, Title 19, Annotated Code of Maryland.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Screening. Upon receipt of a referral for respite care, the program director shall ensure that respite care staff:</text>
    <paragraph num="(1)">
      <text>Conduct a screening assessment with the:</text>
      <paragraph num="(a)">
        <text>Individual for whom respite care services are requested;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The caregiver or significant other, if any; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Referral source, if any;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Evaluate whether the respite care is needed:</text>
      <paragraph num="(a)">
        <text>At a specific future time;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Immediately; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Intermittently;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Outline, in consultation with the individual and the caregiver, a preliminary plan, including the schedule for respite care, for the services to be provided in accordance with this chapter;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Based on consultation with the individual and, if any, the referral source, document:</text>
      <paragraph num="(a)">
        <text>The expected duration of the respite care;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The frequency, level, and type of staff contacts needed, such as staff availability:</text>
        <paragraph num="(i)">
          <text>At a minimum, on call, 24 hours per day, 7 days per week; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>On site for up to 24 hours per day, 7 days per week; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>If applicable, medications that are prescribed for the individual; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>Inform the individual and the caregiver of the rules for the respite care episode.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Acceptance. Upon acceptance of an individual for respite care, staff assigned by the program director, in consultation with the individual and the caregiver, shall:</text>
    <paragraph num="(1)">
      <text>Perform an assessment of:</text>
      <paragraph num="(a)">
        <text>The individual's and the caregiver's strengths and needs; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Interventions needed by the individual during respite;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>In order to ensure continuity of care, document information regarding, at a minimum, the individual's participation in:</text>
      <paragraph num="(a)">
        <text>Outpatient mental health treatment;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Psychiatric rehabilitation;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>School;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Work; or</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Other scheduled activities;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Taking into consideration the needs under §§C(4) and D(2) of this regulation, formulate an initial plan for respite services, including the:</text>
      <paragraph num="(a)">
        <text>Schedule for providing respite care;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Location;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Level of staff support;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Schedule of the individual's activities during respite; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Needed interventions to facilitate the individual's remaining in or returning to the living situation.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>