# COMAR Title 10 — Maryland Department of Health

## Subtitle 47 — Alcohol and Drug Abuse Administration

### Chapter 02 — Specific Program Requirements

#### Regulation .06 Residential Service — Clinically Managed Low Intensity Treatment Level III.1.

*COMAR 10.47.02.06*

A. Program Description. Clinically managed low intensity treatment programs shall offer treatment services at least 5 hours a week directed toward preventing relapse, applying recovery skills, promoting personal responsibility, and reintegration.

B. Patients who are appropriate for this level of treatment shall:

  (1) Meet the current edition of the American Society of Addiction Medicine Patient Placement Criteria for Level III.1, or its equivalent as approved by the Administration; and

  (2) Be capable of self-care but not ready to return to family or independent living.

C. Staffing.

  (1) Services shall be provided by appropriately credentialed staff as described in COMAR 10.47.01.06.

  (2) A clinically managed low intensity treatment program shall employ:

    (a) One individual as clinical supervisor who may also be the program's administrator;

    (b) Another individual as house manager;

    (c) At least one staff member to be on duty at all times; and

    (d) At least one staff member who is certified in cardiopulmonary resuscitation, and who has been trained in crisis intervention to be on duty between 11 p.m. and 7 a.m.

  (3) The patient to alcohol and drug counselor ratio may not exceed 15 patients to one full-time alcohol and drug counselor.

  (4) Staff may not dispense medications.

D. Program Services. A clinically managed low intensity treatment program shall provide the following services:

  (1) An assessment as described in COMAR 10.47.01.04 within 2 weeks of admission;

  (2) 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 60 days;

  (3) Periodic group counseling that focuses on relapse prevention;

  (4) Case management services;

  (5) Individual counseling, at least monthly; and

  (6) Leisure and recreational activities.

E. 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.

F. Referral Services. The program shall offer the following services or maintain a listing of agency referral agreements for the following services:

  (1) Physical examinations as determined by medical condition, within a reasonable time;

  (2) Services through the Division of Rehabilitation Services;

  (3) Vocational assistance;

  (4) Mental health services, which shall include:

    (a) Medication monitoring for patients who are admitted on or are prescribed psychotropic medications; and

    (b) Services appropriate to the severity and urgency of the patient's mental condition;

  (5) Legal assistance;

  (6) Substance abuse treatment programs;

  (7) Social services;

  (8) Family services; and

  (9) Education.