1. A. Staff Support. The program director shall ensure:

   1. (1) That sufficient staff are on duty at all times to relate to the expected clinical needs of the individuals in the residence; and

   2. (2) At a minimum:

      1. (a) The provision of at least one on-site, awake staff for every four individuals receiving RCS or, if a child is in the residence, one staff for every three individuals;
      2. (b) The availability, based upon clinical acuity and the request of on-duty staff, of at least one other staff member to arrive at the RCS program within 1 hour of a request; and
      3. (c) That the program has the capacity for 1:1 coverage, and provides 1:1 coverage when clinically indicated.

2. B. Psychiatric Evaluation and Intervention. The program director shall assure that a psychiatrist:

   1. (1) Is available on call, 24 hours per day, 7 days per week;

   2. (2) Within 24 hours of an individual's admission:

      1. (a) Conducts a face-to-face evaluation;

      2. (b) Either:

         1. (i) Formulates and documents a psychiatric diagnosis and the rationale for the diagnosis; or
         2. (ii) Affirms the psychiatric diagnosis formulated under Regulation .06A(4) of this chapter; and
      3. (c) Through participation in the ITP, prescribes treatment interventions; and
   3. (3) If the individual presents a danger to self, indicates appropriate staff coverage and precautions.

3. C. Treatment and Support Services.

   1. (1) The program director shall ensure that a mental health professional:

      1. (a) Provides regular supervision of all treatment staff; and

      2. (b) Each day, either:

         1. (i) Monitors, face-to-face, an individual's condition and documents significant changes; or
         2. (ii) Consults with staff regarding the clinical needs of an individual.

   2. (2) The program director shall assign a treatment coordinator who shall assure that the individual receives:

      1. (a) Care or treatment recommended under Regulation .07A of this chapter; and
      2. (b) The services under Regulation .09C(1)(c) — (e) of this chapter.

   3. (3) Medication Services.

      1. (a) Monitoring. When required by the individual's ITP, a member of the treatment team credentialed and privileged to do so shall provide medication monitoring, as outlined in Regulation .09C(2)(a) of this chapter.
      2. (b) Administration. The program director shall assure that an individual authorized under Health Occupations Article, Annotated Code of Maryland, is available to administer medication in a case where medication administration is required by an individual's ITP.

Authority: Health-General Article, §§10-901 and 10-902, Annotated Code of Maryland

Effective date: December 28, 1998 (25:26 Md. R. 1926)

Regulation .02B amended as an emergency provision effective June 1, 2007 (34:13 Md. R. 1149); amended permanently effective August 13, 2007 (34:16 Md. R. 1432)

Regulation .03C amended as an emergency provision effective June 1, 2007 (34:13 Md. R. 1149); amended permanently effective August 13, 2007 (34:16 Md. R. 1432)