This chapter sets forth: Additional requirements that a program shall meet to be certified to offer the correctional levels of care; and Requirement exemptions for a program certified as a correctional level of care, which shall meet the requirements of COMAR 10.47.01 and 10.47.04. Correctional levels are exempt from the following requirements of COMAR 10.47.01: COMAR 10.47.01.03C(2)(h), if the correctional facility's requirements are more stringent; COMAR 10.47.01.04A(1)(a) and (b); COMAR 10.47.01.04E(2); COMAR 10.47.01.07A(1)(e); and COMAR 10.47.01.09. In this chapter, terms have the meanings stated in COMAR 10.47.01.02. Program Description. The program shall provide evaluation and treatment to patients who require services for less than 9 hours weekly in a correctional facility. Inmates receiving treatment may be housed throughout the correctional facility. Inmates who are appropriate for this level of treatment shall: 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, for the 30 days before incarceration; and Have a physical and emotional status that allows the inmate to function in the inmate's usual environment. Staffing. Services shall be provided by appropriately credentialed staff as described in COMAR 10.47.01.06. Program Services. A program shall provide the following services: An assessment as described in COMAR 10.47.01.04 within 30 days of admission; An individualized treatment plan as described in COMAR 10.47.01.04 with a treatment plan update completed every 90 days in accordance with the following: The alcohol and drug counselor and patient shall complete and sign the initial treatment plan within 10 working days of the comprehensive assessment; or If the alcohol and drug counselor is unable to develop a treatment plan within the required time, the clinical director or the clinical supervisor shall: Determine the reason for a delay in development of a treatment plan; Document the reason in the patient's record; and Direct an appropriate clinical staff person to develop a treatment plan within 7 working days of the clinical director or clinical supervisor's documentation of the delay; Case management services; and Group or individual counseling sessions. Documentation. The clinical staff person providing the service shall: Write a patient progress note after each counseling session; and Place the note in the patient's record. Referral Services. The program shall have available through referral the following at the time of the patient's release from the institution: Medical examinations; Services through the Division of Rehabilitation Services; Vocational assistance; Mental health services; Substance abuse treatment programs; Legal assistance; and Social services. Program Description. A program shall provide structured evaluation and treatment to patients who require services from 9 to 20 hours weekly in a correctional facility. Inmates receiving treatment may be housed throughout the institution. Inmates who are appropriate for this level of treatment shall: Meet the current edition of the American Society of Addiction Medicine Patient Placement Criteria for Level II.1, or its equivalent as approved by the Administration, for the 30 days before incarceration; and Have a physical and emotional status that allows the inmate to function in the inmate's usual environment. Staffing. Services shall be provided by appropriately credentialed staff as described in COMAR 10.47.01.06. Program Services. A program shall provide the following services: An assessment as described in COMAR 10.47.01.04 within 30 days of admission; An individualized treatment plan as described in COMAR 10.47.01.04 with a treatment plan update completed every 30 days in accordance with the following: The alcohol and drug counselor and patient shall complete and sign the initial treatment plan within 10 working days of the comprehensive assessment; or If the alcohol and drug counselor is unable to develop a treatment plan within the required time, the clinical director or the clinical supervisor shall: Determine the reason for a delay in development of a treatment plan; Document the reason in the patient's record; and Direct an appropriate clinical staff person to develop a treatment plan within 3 working days of the clinical director's or clinical supervisor's documentation of the delay; Case management services; At least one group counseling session a week; and At least one individual session every 2 weeks. Documentation. A designated clinical staff person shall: Write a patient progress note at the end of each week that services are provided; and Place the progress note in the patient's record. Referral Services. The program shall have available through referral the following at the time of the patient's release from the institution: Medical services; Services through the Division of Rehabilitation Services; Vocational assistance; Mental health services; Substance abuse treatment programs; Legal assistance; and Social services. Program Description. A program shall provide structured evaluation and treatment to patients who require programming from 20 to 35 hours weekly in a correctional facility. Inmates receiving treatment may be housed together in a separate unit. Inmates who are appropriate for this level of treatment shall: Meet the current edition of the American Society of Addiction Medicine Patient Placement Criteria for Level II.5, or its equivalent as approved by the Administration, for the 30 days before incarceration; and Have a physical and emotional status that allows the inmate to function in the inmate's usual environment. Staffing. Services shall be provided by appropriately credentialed staff as described in COMAR 10.47.01.06. Program Services. A program shall provide the following services: An assessment as described in COMAR 10.47.01.04 within 30 days of admission; An individualized treatment plan as described in COMAR 10.47.01.04 with a treatment plan update completed every 30 days in accordance with the following: The alcohol and drug counselor and patient shall complete and sign the initial treatment plan within 10 working days of the comprehensive assessment; or If the alcohol and drug counselor is unable to develop a treatment plan within the required time, the clinical director or the clinical supervisor shall: Determine the reason for a delay in development of a treatment plan; Document the reason in the patient's record; and Direct an appropriate clinical staff person to develop a treatment plan within 3 working days of the clinical director's or clinical supervisor's documentation of the delay; Case management services; At least one group counseling session a week; and At least one individual session every 2 weeks. Documentation. A designated clinical staff person shall: Write a patient progress note at the end of each week that services are provided; and Place the progress note in the patient's record. Referral Services. The program shall have available through referral the following at the time of the patient's release from the institution: Medical services; Services through the Division of Rehabilitation Services; Vocational assistance; Mental health services; Substance abuse treatment programs; Legal assistance; and Social services. Program Description. A program shall offer treatment services at least 5 hours a week directed toward preventing relapse, applying recovery skills, promoting personal responsibility, and reintegration into the community. Inmates receiving this level of treatment shall be housed: Together in a prerelease center or a correctional halfway house; and Separately from inmates not receiving this level of treatment. Inmates who are appropriate for this level of treatment shall: 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, for the 30 days before incarceration; and Be capable of self care but not ready to return to independent living. Staffing. Services shall be provided by appropriately credentialed staff as described in COMAR 10.47.01.06. A correctional Level III.1 program shall employ: One individual as clinical supervisor, who may also be the program's administrator; and At least one staff member to be on duty at all times. Staff may not dispense medications. Program Services. A correctional Level III.1 program shall provide the following services: An assessment as described in COMAR 10.47.01.04 within 30 days of admission; An individualized treatment plan as described in COMAR 10.47.01.04 with a treatment plan update completed every 60 days in accordance with the following: The alcohol and drug counselor and patient shall complete and sign the initial treatment plan within 10 working days of the comprehensive assessment; or If the alcohol and drug counselor is unable to develop a treatment plan within the required time, the clinical director or the clinical supervisor shall: Determine the reason for a delay in development of a treatment plan; Document the reason in the patient's record; and Direct an appropriate clinical staff person to develop a treatment plan within 7 working days of the clinical director's or clinical supervisor's documentation of the delay; Periodic group counseling that focuses on relapse prevention; Case management services; Individual counseling, at least monthly; and Leisure and recreational activities. Documentation. The clinical staff person providing the service shall: Write a patient progress note after each counseling session; and Place the note in the patient's record. Referral Services. The program shall have available through referral the following at the time of the patient's release from the institution: Medical examinations; Services through the Division of Rehabilitation Services; Vocational assistance; Mental health services; Legal assistance; Substance abuse treatment programs; Social services; and Education. Program Description. A correctional Level III.5 program: Shall provide a highly structured environment in combination with moderate to high intensity treatment and ancillary services to support and promote recovery; Shall be characterized by its reliance on the treatment community as a therapeutic agent; and May not allow a structure whereby inmates have authority over one another. Inmates who are appropriate for this level of treatment shall: Meet the current edition of the American Society of Addiction Medicine Patient Placement Criteria for Level III.5, or its equivalent as approved by the Administration, for the 30 days before incarceration; and Be housed separately from inmates not receiving this level of treatment. Staffing. Services shall be provided by appropriately credentialed staff as described in COMAR 10.47.01.06. A program shall have sufficient medical services to: Provide initial diagnostic work-up; Provide identification of medical and surgical problems for referral; and Handle medical emergencies when necessary. Program Services. A program shall provide the following services: An assessment as described in COMAR 10.47.01.04 within 2 days of admission; An individualized treatment plan as described in COMAR 10.47.01.04 with a treatment plan update every 30 days in accordance with the following: The alcohol and drug counselor and patient shall complete and sign the initial treatment plan within 10 working days of the comprehensive assessment; or If the alcohol and drug counselor is unable to develop a treatment plan within the required time, the clinical director or the clinical supervisor shall: Determine the reason for a delay in development of a treatment plan; Document the reason in the patient's record; and Direct an appropriate clinical staff person to develop a treatment plan within 2 working days of the clinical director's or clinical supervisor's documentation of the delay; and A minimum of 36 hours of therapeutic activities a week, including but not limited to: One individual counseling session a week; Group counseling; Alcohol and drug education; Career counseling; and Nutrition education. Documentation. A designated clinical staff person shall write a patient progress note at the end of each week that services are provided and place the progress note in the patient's record. Referral Services. At the time of the patient's release from the institution, the program shall have available through referral the following: Medical care; Services through the Division of Rehabilitation Services; Vocational assistance; Mental health services; Substance abuse treatment programs; Legal assistance; and Social services. Health-General Article, §§8-401 — 8-405 and 19-308, Annotated Code of Maryland Effective date: COMAR 10.47.03, Certification Requirements, recodified to be COMAR 10.47.04 and new chapter, Specific Program Requirements for Correctional Levels of Care, adopted as an emergency provision effective April 1, 2008 (35:9 Md. R. 894); adopted permanently effective May 5, 2008 (35:9 Md. R. 898)