1. A. Initial Hearing.

   1. (1) When an individual is confined on observation status in an inpatient facility on the basis of application and certificates for IVA, inpatient facility staff shall:

      1. (a) Schedule a hearing to take place within 10 days of the individual's initial confinement in the inpatient facility;
      2. (b) Notify the OAH and the OPD that the hearing has been scheduled; and
      3. (c) Give the Notice of Status and Rights in accordance with Regulation .05 of this chapter, and Notice of Hearing in accordance with Regulation .06 of this chapter.

   2. (2) The ALJ may postpone the hearing for good cause or by agreement of the parties, and the postponement shall be:

      1. (a) For not more than 7 days;
      2. (b) On the record; and
      3. (c) One time only.

2. B. Change of Status Hearing.

   1. (1) An inpatient facility that accepts individuals who are referred for IVA may initiate the procedure outlined in this section to change the admission status of an individual when, in the clinical judgment of the individual's treating physician, the individual meets the requirements for IVA outlined in Health-General Article, §10-617, Annotated Code of Maryland, and Regulation .04C(4)(c) of this chapter, and the individual is:

      1. (a) Admitted voluntarily pursuant to Health-General Article, §10-609, Annotated Code of Maryland, and the individual requests discharge or otherwise demonstrates that the individual is unwilling or unable to continue to agree to voluntary treatment;

      2. (b) A minor who is admitted on the basis of an application for voluntary admission of a minor signed by the parent or guardian, pursuant to Health-General Article, §10-610, Annotated Code of Maryland, and the:

         1. (i) Parent or guardian requests release of the minor; or
         2. (ii) Minor has been admitted to a State inpatient facility, and the minor is in need of care or treatment for longer than 20 days; or
      3. (c) Admitted on the basis of a court order pursuant to Health-General Article, §12-104 or 12-110, Annotated Code of Maryland, and the Office of the State's Attorney or the court has agreed to dismiss, nolle prosequi, or stet the charges.

   2. (2) Two physicians or one physician and one psychologist shall evaluate the individual and, if the individual meets the requirements for IVA outlined in Health-General Article, §10-617, Annotated Code of Maryland, and Regulation .04C(4)(c) of this chapter, shall submit an application for IVA of the individual in accordance with the provisions of Regulation .03 of this chapter and complete certificates for IVA in accordance with the provisions of Regulation .04 of this chapter:

      1. (a) Within 3 days of the request for discharge, if the individual was admitted on the basis of a formal, written application for voluntary admission;
      2. (b) Before 4 p.m. on the day of the request for discharge, if the individual was admitted voluntarily on the basis of an informal request;
      3. (c) Before the expiration of the 20-day maximum stay, if the individual is a minor who was admitted to a State inpatient facility on the basis of an application for voluntary admission signed by the parent or guardian; and
      4. (d) By the close of business of the next working day following official notification that the charges have been dismissed, nolle prossed, or stetted.

   3. (3) Following completion of the application and certificates for IVA under §B(2) of this regulation, staff at the inpatient facility shall:

      1. (a) Schedule a hearing to take place within 10 days of the completion of application and certificates for IVA in accordance with §B(2) of this regulation;
      2. (b) Notify the OAH and the OPD that the hearing has been scheduled;
      3. (c) Give the Notice of Status and Rights in accordance with Regulation .05 of this chapter, and Notice of Hearing pursuant to Regulation .06 of this chapter; and

      4. (d) If the individual is 65 years old or older and is in a State inpatient facility or Veterans' Administration hospital, and during the individual's current stay in the State facility or Veterans' Administration hospital the individual has not been approved for IVA by the GES:

         1. (i) Notify the GES in the county of the individual's last residence that application and certificates for IVA have been completed; and
         2. (ii) Document that the GES team has determined that there is no available, less restrictive form of care or treatment that is adequate for the needs of the individual.

   4. (4) If an inpatient facility does not accept individuals who are referred for IVA, and an individual is admitted voluntarily, pursuant to Health-General Article, §10-609, Annotated Code of Maryland, if the individual requests to be discharged from the inpatient facility or otherwise demonstrates that the individual is unwilling or unable to continue to agree to voluntary treatment, before discharging the individual, staff at the inpatient facility:

      1. (a) May initiate the procedure outlined in §B(2) of this regulation and arrange to refer the individual to an inpatient facility that accepts individuals who are referred for IVA; and
      2. (b) Shall assure that a hearing shall be held at the receiving inpatient facility within 10 days of completion of application and certificates for IVA in accordance with §B(2) of this regulation.

3. C. Semiannual Hearing.

   1. (1) Facility staff shall schedule a hearing for the purpose of determining whether an individual continues to meet the requirements for IVA outlined in Health-General Article, §10-617, Annotated Code of Maryland, and Regulation .04C(4)(c)(i) — (v) of this chapter:

      1. (a) Not sooner than 5 months or later than 6 months from the date that the individual is involuntarily admitted to an inpatient facility following an IVA hearing in accordance with §A or B of this regulation; and
      2. (b) Semiannually after that.

   2. (2) At least 7 days before the date a semiannual hearing is scheduled to take place:

      1. (a) Two physicians or one physician and one psychologist or one physician and one psychiatric nurse practitioner shall complete certificates for IVA in accordance with the provisions of Regulation .04 of this chapter;
      2. (b) Staff at the inpatient facility shall give the Notice of Status and Rights in accordance with Regulation .05 of this chapter, and Notice of Hearing pursuant to Regulation .06 of this chapter;
      3. (c) Staff at the inpatient facility shall notify the OAH and the OPD that a hearing has been scheduled; and

      4. (d) If the individual is 65 years old or older and is in a State inpatient facility or Veterans' Administration hospital, and during the individual's current stay in the State inpatient facility or Veterans' Administration hospital the individual has not been approved for IVA by the GES, State inpatient facility or Veterans' Administration hospital staff shall:

         1. (i) Notify the GES in the county of the individual's last residence that certificates for IVA have been completed; and
         2. (ii) Document that the GES team has determined that there is no available, less restrictive form of care or treatment that is adequate for the needs of the individual.
   3. (3) A parent or guardian of a minor individual may not execute an application for voluntary admission of the minor at the time that a semiannual hearing is scheduled for the minor.

Authority: Health-General Article, §§7.5-204 — 7.5-205, 10-603, 10-615 — 10-616, 10-619 and 10-806(d)(3), Annotated Code of Maryland

Effective date: December 5, 1970

Amended effective October 1, 1973

Chapter revised effective October 12, 1981 (8:20 Md. R. 1635)

Annotation: COMAR 10.21.01.04B and .07E cited in Attorney General Opinion No. 86-031 (May 12, 1986)

Regulations .01 — .10 repealed and new Regulations .01 — .11 adopted effective September 28, 1992 (19:19 Md. R. 1708)

Regulation .02 amended effective September 13, 1993 (20:18 Md. R. 1430)

Regulation .02B amended effective March 28, 2016 (43:6 Md. R. 409); January 2, 2017 (43:26 Md. R. 1445)

Regulation .04 amended effective March 28, 2016 (43:6 Md. R. 409)

Regulation .04B amended effective January 2, 2017 (43:26 Md. R. 1445)

Regulation .08C amended effective March 28, 2016 (43:6 Md. R. 409)

Regulation .09 amended effective September 13, 1993 (20:18 Md. R. 1430)

Regulation .10 amended effective March 28, 2016 (43:6 Md. R. 409)