Header:
CODE OF MARYLAND REGULATIONS
TITLE 10. DEPARTMENT OF HEALTH AND MENTAL HYGIENE
SUBTITLE 47. ALCOHOL AND DRUG ABUSE ADMINISTRATION
CHAPTER 01. REQUIREMENTS
Date:
08/31/2009
Document:
.31 Non-Residential Intermediate Care Program.
A. Scope of Service. The non-residential intermediate care program shall be designed to provide for the detoxification, when appropriate, and rehabilitation of alcoholics by placing them in an organized therapeutic environment in which they may receive medical services, counseling, vocational rehabilitation or work therapy.
B. Plan for Service.
(1) The non-residential intermediate care program shall have a written plan for services describing both its treatment philosophy and objectives relating to the provision of care to individuals with problems associated with alcohol abuse or alcoholism. The plan shall include the following comments:
(a) A statement describing and justifying the primary diagnostic and treatment modalities utilized within the program.
(b) A statement of organizational objectives consistent with the program's philosophy.
(c) A description of the criteria used to measure progress toward the attainment of program objectives.
(d) A schedule of individual and group motivational counseling sessions, alcohol education programs, family counseling services, personal growth experiences, health and nutritional education programs and exposure to Alcoholics Anonymous programs.
(e) A written rationale for the proposed program staffing.
(f) A written agreement between the program and a physician describing the minimum hours per week the physician will be available to clients as well as the physician, physician's assistant or nurse practitioner's on call availability. This agreement shall identify a back-up physician and indicate the means by which the services shall be obtained.
(2) The plan for services shall provide a schedule of therapeutic activities which shall be sufficient to insure that non-residential intermediate care program clients shall receive a minimum of 4 hours of therapeutic activity at least 5 days per week.
(3) The non-residential intermediate care program shall have a written plan describing its organization which shall include a description of:
(a) The interrelationship of the non-residential intermediate care program and any other service provided by the facility;
(b) An organizational chart showing the relationship between and the function of all program staff and administrators.
(4) The non-residential intermediate care program shall maintain documentation demonstrating that the program's governing authority, executive director, and clinical and administrative staff, have annually updated and approved the program's plan for services and organizational plan.
(5) The non-residential intermediate care program shall maintain documentation verifying that each administrative and clinical staff member of these programs have reviewed a copy of the plan for services as part of their orientation process.
C. Minimum Physical Facility Requirements.
(1) Non-residential intermediate care programs shall provide space for private counseling sessions and group activities.
(2) The program shall be designed, located, constructed and equipped so as to promote the effective operation of its programs and to protect the health and safety of its clients, staff and equipment.
(3) The program shall have a documented evacuation plan in case of fire or other disaster.
(4) The non-residential intermediate care program shall make reasonable provisions to accommodate handicapped individuals in accordance with State and federal law.
D. Staffing. The amount of staff required for a non-residential intermediate care program will vary with the complexity of the services provided and the number of clients enrolled in the program. The following standards establish minimum staffing patterns for a non-residential intermediate care program:
(1) One physician, physician's assistant or nurse practitioner shall provide consultation services on an as-needed basis; and
(2) One full-time (35 or more hours per week) certified alcoholism counselor or a person who has a level of training and experience equivalent to that required for certification as an alcoholism counselor, for every ten clients enrolled in the program.
E. Intake. Non-residential intermediate care facilities shall adhere to standards applicable to intake in this chapter under Regulation .30E.
F. Treatment Plan. The non-residential intermediate care program shall adhere to the standards applicable to treatment plan in this chapter under Regulation .30F.
G. Family Care Services. The non-residential intermediate care program shall adhere to the standards applicable to family services in this chapter under Regulation .30G.
H. Medication Control. The non-residential intermediate care program shall adhere to the standards applicable to the medication control in the chapter under Regulation .30H.
I. Dietary Services.
(1) Every non-residential intermediate care program shall have a written plan describing the organization and delivery of dietary services if applicable. The plan shall insure that these services are provided in compliance with appropriate local, State and federal regulations.
(2) In a non-residential intermediate care program, meals may or may not be provided for clients. If meals are provided, then the program shall comply with standards for dietary services as indicated under Regulation .30I of this chapter.
J. Cooperation with Outside Service Providers. Program staff of the non-residential intermediate care program shall cooperate with community service providers and groups such as Alcoholics Anonymous, Al-Anon and Alateen to insure that appropriate services are available to clients. When appropriate, the program shall enter into qualified service organization agreements in accordance with federal regulations.
K. Services to Adolescents.
(1) Non-residential intermediate care programs which provide treatment services to primary clients, age 12--17 inclusive, shall adhere to all the requirements in this regulation under Sec. A--J.
(2) A written treatment protocol shall be established and maintained that provides for the special developmental needs of adolescents and emphasizes the use of family counseling procedures.
(3) Activities and identified treatment needs for adolescents shall be fully documented in the client's treatment plan progress notes and aftercare plan.
(4) Admission criteria for persons between 12 and 17 years old shall allow for admission if primary diagnosis is drug abuse.
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