<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 10.47.02.04" title_num="10" subtitle_num="47" chapter_num="02" heading="Outpatient Services Level I.">
  <paragraph num="A.">
    <text>Program Description. The program shall provide outpatient evaluation and treatment to patients who require services for less than 9 hours weekly for adults and 6 hours weekly for adolescents.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Patients who are appropriate for this level of treatment shall:</text>
    <paragraph num="(1)">
      <text>Meet the current edition of the American Society of Addiction Medicine Patient Placement Criteria for Level I, or its equivalent as approved by the Administration; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Have a physical and emotional status that allows them to function in their usual environment.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Staffing.</text>
    <paragraph num="(1)">
      <text>Services shall be provided by appropriately credentialed staff as described in COMAR 10.47.01.06.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The adult patient to alcohol and drug counselor ratio may not exceed 30 adult patients weekly to one full-time alcohol and drug counselor.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The child and adolescent patient to alcohol and drug counselor ratio may not exceed 25 adolescent patients weekly to one full-time alcohol and drug counselor.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Program Services. A program shall provide the following services:</text>
    <paragraph num="(1)">
      <text>An assessment as described in COMAR 10.47.01.04 within 2 weeks of admission;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>An individualized treatment plan as described in COMAR 10.47.01.04 completed and signed by the alcohol and drug counselor and patient within 7 working days of the comprehensive assessment and updated every 90 days;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Case management services;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Group or individual counseling sessions;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Family services that shall include an assessment for family treatment needs and, as clinically appropriate:</text>
      <paragraph num="(a)">
        <text>Alcohol and drug education; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Family counseling.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Documentation. The clinical staff providing the service shall write a patient progress note after each counseling session and shall place the note in the patient's record.</text>
  </paragraph>
  <paragraph num="F.">
    <text>Referral Services. The program shall offer the following services or maintain a listing of agency referral agreements for the following services:</text>
    <paragraph num="(1)">
      <text>Medical examinations;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Services through the Division of Rehabilitation Services;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Vocational assistance;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Mental health services;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Substance abuse treatment programs;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Legal assistance; and</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Social services.</text>
    </paragraph>
  </paragraph>
</regulation>