1. A. A TGH provides therapeutic living services:

   1. (1) For at least four but not more than eight children;
   2. (2) By providing access to a combination of developmental, diagnostic, and therapeutic mental health services;
   3. (3) When possible, in the child's community of origin; and
   4. (4) In a home-like environment.

2. B. The chief executive officer of a TGH shall assure that a TGH:

   1. (1) Provides to each child in the TGH mental health care and treatment:

      1. (a) That can reasonably be expected to benefit the child; and
      2. (b) By an adequate staff or, under agreement, by a provider of mental health services;
   2. (2) Has sufficient staff to provide adequate supervision to the children in the TGH, including 24-hour supervision for each resident not participating in a program outside the TGH; and
   3. (3) Coordinates treatment in the TGH with the appropriate public or nonpublic educational program.

3. C. The chief executive officer of the TGH shall assure that services are:

   1. (1) Appropriate to the cultural and psychosocial developmental needs of the child;

   2. (2) Provided by staff who:

      1. (a) As determined by the program, are appropriately credentialed and privileged; and

      2. (b) Organize and manage the therapeutic milieu to:

         1. (i) Foster clinically appropriate social, cognitive, emotional, and physical growth;
         2. (ii) Handle aggression in a nonpunitive manner that promotes growth and learning;
         3. (iii) Reinforce the child's ability to function with peers in a social environment;
         4. (iv) Model and provide opportunities for children to behave in age-appropriate ways, such as assuming responsibility for carrying out routine activities, exhibiting independence and initiative in planning their own activities, getting along with others, and demonstrating age-appropriate social skills;
         5. (v) Facilitate the child's awareness of appropriate behavior in a predictable, constructive, and timely manner; and
         6. (vi) Help children to make choices and to negotiate disagreements among themselves, rather than resolving conflicts for them;

   3. (3) Provided in an environment that is:

      1. (a) Consistent with existing standards of program design; and
      2. (b) Organized consistent with the learning styles and developmental needs of the child; and
   4. (4) Designed to foster positive relationships between the child and the child's parents or guardians and, if other than a parent, the child's primary caretaker, and the anticipated post-placement caretaker.

Authority: Health-General Article, §§10-501 — 10-524, 10-701 — 10-714, 10-901, 10-920 — 10-926, 16-101 — 16-303; Article 49D, §4;
Annotated Code of Maryland

Effective date: January 13, 1986 (13:1 Md. R. 16)

Regulation .01 amended effective February 15, 1993 (20:3 Md. R. 259)

Regulation .02B amended effective February 15, 1993 (20:3 Md. R. 259)

Regulation .03 amended effective February 15, 1993 (20:3 Md. R. 259)

Regulation .05 amended effective February 15, 1993 (20:3 Md. R. 259)

Regulation .09A amended effective February 15, 1993 (20:3 Md. R. 259)

Regulation .14 amended effective February 15, 1993 (20:3 Md. R. 259)

Regulations .01 — .14 repealed and new Regulations .01 — .17 adopted effective November 27, 2000 (27:23 Md. R. 2147)

Regulation .02 amended effective April 29, 2013 (40:8 Md. R. 723)

Regulation .03 amended effective April 29, 2013 (40:8 Md. R. 723)

Regulation .04 amended effective April 29, 2013 (40:8 Md. R. 723)

Regulation .05B amended effective April 29, 2013 (40:8 Md. R. 723)

Regulation .06 amended effective April 29, 2013 (40:8 Md. R. 723)

Regulation .07A amended effective April 29, 2013 (40:8 Md. R. 723)

Regulation .09 amended effective April 29, 2013 (40:8 Md. R. 723)

Regulation .11E amended effective April 29, 2013 (40:8 Md. R. 723)

Regulation .12F amended effective April 29, 2013 (40:8 Md. R. 723)

Regulation .13 amended effective April 29, 2013 (40:8 Md. R. 723)

Regulation .14B, C amended effective April 29, 2013 (40:8 Md. R. 723)

Regulation .14G adopted effective April 29, 2013 (40:8 Md. R. 723)