Chapter 04. Additional Requirements for Accreditation-Based Licenses for Specific Residential Community-Based Behavioral Health Services
Regulation .01 Scope.LinkCopy Citation
This chapter sets forth descriptions of, criteria for, and licensing requirements for, three specific programs that provide residential community-based behavioral health services. These programs shall comply with COMAR 10.63.01—.02, 10.63.04, and 10.63.06. Residential Rehabilitation Programs shall also comply with COMAR 10.63.03.09.
Regulation .02 Covered Programs.LinkCopy Citation
This chapter applies to the following programs:
A.
Group Homes for Adults with Mental Illness;
B.
Residential Crisis Services (RCS) program; and
C.
Residential Rehabilitation Program (RRP).
Regulation .03 Group Homes for Adults with Mental Illness.LinkCopy Citation
A.
In order to be licensed under this subtitle, a group home for adults with mental illness shall:
(1)
Meet the definition in Health-General Article, §10-514 (b), (d), and (e), Annotated Code of Maryland;
(2)
Provide a home-like, supportive residential environment:
(a)
In a small group home, which provides services for more than 3, but not more than 8 individuals with a mental health disorder; or
(b)
In a large group home for more than 8, but not more than 16 individuals with a mental health disorder; and
(3)
Meet the site requirements set out in Regulation .07 of this chapter verified through an annual site inspection conducted by the CSA or LBHA.
B.
A group home for adults with mental illness may not provide services for individuals with a primary diagnosis of developmental disability, as defined in Health-General Article, §7-101, Annotated Code of Maryland.
Regulation .04 Residential Crisis Services (RCS).LinkCopy Citation
In order to be licensed under this subtitle, a residential crisis services program:
A.
Shall provide short-term mental health treatment and support services in a structured environment for individuals who require 24-hour supervision due to a psychiatric crisis;
B.
Shall be designed to:
(1)
Prevent psychiatric inpatient admission;
(2)
Shorten the length of inpatient stay;
(3)
Effectively use general hospital emergency departments; and
(4)
Provide an alternative to psychiatric inpatient admission;
C.
Shall have staff who are on-site 24 hours per day, 7 days per week, whenever an individual is on-site receiving services;
D.
For adults, shall meet the site requirements set out in Regulation .07 of this chapter verified through an annual site inspection conducted by the CSA or LBHA; and
E.
For individuals younger than 21 years old, may offer services in an appropriately licensed therapeutic program, as appropriate.
Regulation .05 Residential Rehabilitation Program (RRP).LinkCopy Citation
In order to be licensed under this subtitle, a residential rehabilitation program (RRP) shall:
A.
Serve individuals with a mental disorder;
B.
Be operated by a licensed PRP-A;
C.
Lease or own the RRP sites;
D.
Be approved by BHA for RRP funding;
E.
Provide a home-like, supportive residential environment;
F.
Provide services for no more than 3 individuals per RRP site, unless also licensed as a group home as provided in Regulation .03 of this chapter;
G.
Promote the individual’s ability to engage and participate in appropriate community activities;
H.
Enable the individual to develop the daily living skills needed for independent functioning;
I.
Have:
(1)
On-site staffing, as needed to meet the needs of the individuals served; and
(2)
Staff that are available on call, 24 hours per day, 7 days per week;
J.
Meet the site requirements as set out in Regulation .07 of this chapter, verified through an annual site inspection conducted by the CSA or LBHA, as appropriate;
K.
Have a written policy regarding the development of and process for implementation of a managed intervention plan (MIP) for an individual receiving residential services who may be at risk of an unplanned discharge, which:
(1)
Is developed in collaboration with the individual, treatment team members, and CSA or LBHA, as appropriate; and
(2)
Includes a description of additional individualized services and supports that may be needed, and identification of temporary residential alternatives, if any; and
L.
If an MIP is executed, develop a transition plan that:
(1)
Is created in collaboration with the individual, treatment team members, CSA or LBHA, as appropriate, and ASO; and
(2)
Includes the elements outlined in §K(2) of this regulation.
Regulation .06 Application Requirements for a Residence to be Operated by a Program.LinkCopy Citation
A program seeking a license under this subtitle for a residential site shall submit to the CSA or LBHA a completed application that:
A.
Is on the form required by the Administration with all required documents attached; and
B.
Includes documentation that the residence:
(1)
Is owned or leased by the applicant; or
(2)
Will be owned or leased by the applicant; and
(3)
Is located in a building that will have continuous fire, liability, and hazard insurance coverage.
Regulation .07 Residential Site Requirements.LinkCopy Citation
A program licensed to provide community-based behavioral health residential services under this chapter shall ensure that:
A.
All areas of a residence, including storage areas:
(1)
Are safe;
(2)
Clean; and
(3)
Free of hazards and clutter;
B.
A residence has:
(1)
No housing code or zoning violations;
(2)
Working smoke alarms or smoke detectors that meet local fire codes for residential dwellings;
(3)
Hot and cold running water:
(4)
Adequate light, heat, and ventilation; and
(5)
Sufficient, appropriate, and functional furnishings, equipment, supplies, and utensils comparable to those found in the residences of nondisabled individuals;
C.
Each resident:
(1)
Has the resources to purchase or has access to food;
(2)
Has the resources to acquire an adequate supply of soap, towels, and toilet tissue;
(3)
Who self-administers medication, has access to a secure storage area for the resident’s medications;
(4)
Has access to a secure storage area for funds and valuables;
(5)
Has access to transportation;
(6)
Has access to a telephone in the residence; and
(7)
To the extent possible, may use personal possessions and preferences in furnishing and decorating the resident’s space.
D.
The following emergency procedures are followed:
(1)
Posted near the telephone are telephone numbers for the:
(a)
Fire department, police, ambulance, and poison control center; and
(b)
Program’s on-call staff; and
(2)
An emergency evacuation procedure that is explained to and practiced by residents within 10 days after entering residence and, at a minimum, every 3 months after that;
E.
Each bedroom has:
(1)
A minimum of 70 square feet for a single bedroom and a minimum of 120 square feet for a double bedroom;
(2)
An interior door, except for an efficiency apartment;
(3)
Closet space in or convenient to each bedroom for each individual using the bedroom;
(4)
Coverings for each window, for privacy;
(5)
A bed with a clean mattress and pillow for each resident using the bedroom;
(6)
At least two sets of bed linens per resident; and
(7)
Not more than two residents using the bedroom;
F.
Each toilet and bathing area has:
(1)
A minimum of one full bathroom for every four residents; and
(2)
At least one toilet, one basin, and one tub or shower connected to hot and cold water;
(3)
Easy access and conveniently located, not more than one floor level from living, dining, and sleeping rooms; and
(4)
Privacy for the individual using it; and
G.
The program has a written relocation plan for each site that:
(1)
Specifies where residents may live temporarily if the CSA or LBHA determines that conditions in the approved residence pose an imminent risk to the health, safety, or welfare of a resident;
(2)
Is approved by the CSA or LBHA, as appropriate; and
(3)
Is updated annually.
Chapter annotations
Authority: Health-General Article, §§7.5-204, 8-402, 8-404, and 10-901, Annotated Code of Maryland
History: Effective date: July 1, 2016 (43:10 Md. R. 585)
History: Regulation .03 amended effective February 27, 2017 (44:4 Md. R. 255)