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<regulation prefix="Regulation" num=".05" citation="COMAR 10.47.02.05" title_num="10" subtitle_num="47" chapter_num="02" heading="Intensive Outpatient Services Level II.1 and Partial Hospitalization Services Level II.5.">
  <paragraph num="A.">
    <text>Program Description. A program shall provide structured outpatient evaluation and treatment to patients who require programming:</text>
    <paragraph num="(1)">
      <text>From 9 to 20 hours weekly for adult intensive outpatient services;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>From 6 to 20 hours weekly for adolescent intensive outpatient services, based on the adolescents' developmental and clinical needs; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>From 20 to 35 hours weekly for adult and adolescent partial hospitalization services.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Patients who are appropriate for this level of treatment shall meet the current edition of the American Society of Addiction Medicine Patient Placement Criteria for either Level II.1 or Level II.5, or its equivalent as approved by the Administration.</text>
  </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 patient to alcohol and drug counselor ratio may not exceed 15 patients 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 1 week 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 5 working days of the comprehensive assessment and updated every 30 days;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Case management services;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>At least one group counseling session a week;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>At least one individual session every 2 weeks;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Family services, which may include an assessment for family 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. A designated clinical staff person shall:</text>
    <paragraph num="(1)">
      <text>Write a patient progress note at the end of each week that services are provided; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Place the progress note in the patient's record.</text>
    </paragraph>
  </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 services with medical consultations available:</text>
      <paragraph num="(a)">
        <text>Within 24 hours of a request for service by telephone for intensive outpatient services;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Within 72 hours of a request for service in person for intensive outpatient services;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Within 8 hours of a request for service by telephone for partial hospitalization services; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Within 48 hours of a request for service in person for partial hospitalization services;</text>
      </paragraph>
    </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 with psychiatric consultations available:</text>
      <paragraph num="(a)">
        <text>Within 24 hours of a request for service by telephone for intensive outpatient services;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Within 72 hours of a request for service in person for intensive outpatient services;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Within 8 hours of a request for service by telephone for partial hospitalization services; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Within 48 hours of a request for service in person for partial hospitalization services;</text>
      </paragraph>
    </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>