Md. Code Regs. 10.21.02.02

Current through Register Vol. 51, No. 12, June 14, 2024

Section 10.21.02.02 - General Provisions

A. Program Approval. Psychiatric day treatment services which are under the auspices of a psychiatric unit located in a licensed psychiatric hospital or under the auspices of a psychiatric unit of a licensed acute general hospital shall be reviewed and approved by the Mental Hygiene Administration on the basis of these regulations. Free-standing psychiatric day treatment services and those under the auspices of a community mental health program shall also be reviewed and approved by the Mental Hygiene Administration on the basis of these regulations.

B. Standards for Psychiatric Day Treatment Services.

(1) The daily treatment program shall provide intensive treatment following a treatment plan developed by a multi-disciplinary staff team on the basis of an evaluation of the patient's needs. A variety of psychiatric modes shall be available, including psychopharmacological treatment, occupational therapy, activity therapy, and other necessary medical, psychological, and social services.

(2) There shall be an acceptable plan and procedure which fix responsibility for the care and treatment of the patient if an emergency occurs during the patient's stay within the day treatment service.

(3) The treatment center shall have an agreement with at least one licensed general or psychiatric hospital to provide inpatient services as needed.

(4) The day treatment program shall assure continuity of care by developing appropriate mechanisms for referral to outpatient services if the patient does not have a private therapist and to necessary support and residential services, developing written agreements whenever feasible. When patients continue in treatment with a therapist who is not a member of the day treatment program team, the program shall have an agreement with the therapist which clearly delineates relative treatment responsibilities of the day treatment team and the other therapist.

(5) A registered nurse shall be on the premises throughout the treatment day.

(6) Within 4 working days of admission, every patient shall have an individual treatment plan, developed collaboratively by a multi-disciplinary team, which clearly defines expectations and means of accomplishing the goals of the plan. The treatment plan shall be signed by the psychiatrist responsible for its development. The names of the other members of the mental health treatment team involved in the development of the plan shall be listed adjacent to the signature of the psychiatrist. The treatment plan shall describe the patient's problems and probable diagnosis, state the short- and long-term goals of treatment, and delineate the modalities, including medications, to be used to accomplish these goals. The treatment plan shall record any physical condition which can affect the treatment plan.

(7) There shall be a utilization review committee which shall include at least one qualified person who has no financial or other direct interest, past or present, in the treatment of the patient or the operation of the program. In addition to its other duties, the committee shall review the treatment plans for patients whose expected length of stay exceeds 30 full treatment days.

(8) Programs for children, adolescents, and adults shall be separate, although some activities may be shared with mutual benefit.

(9) Each day treatment program shall describe in writing its mechanisms for quality assurance, including systematic case review and program evaluation, and shall define the composition and responsibilities of the utilization review committee.

C. Capacity of Psychiatric Day Treatment Center. The number of persons treated at any one time in each psychiatric day treatment center shall be limited according to the premises, staff, and equipment as set forth in Regulation .10 of this chapter.

Md. Code Regs. 10.21.02.02