Current through Register Vol. 51, No. 19, September 20, 2024
A. Upon a
properly executed application executed in accordance with Regulation .03 of
this chapter and certificates for IVA and all required attachments in
accordance with Regulation .04 of this chapter, an inpatient facility that
accepts individuals who are referred for IVA may take an individual into
confinement on observation status.
B. GES Evaluation. If an individual is an
emergency evaluee, and the individual is 65 years old or older, on the first
working day after the individual is taken into confinement on observation
status, staff at a State inpatient facility or Veterans' Administration
hospital shall:
(1) Notify the GES team in
the county where the individual resides; and
(2) Document whether the GES grants clearance
for the involuntary admission of the individual.
C. Examination.
(1) A psychiatrist shall examine an
individual if the individual remains confined on observation status in an
inpatient facility within 24 hours of the initial confinement.
(2) If a physician who examines an individual
confined on observation status determines that the individual does not meet the
requirements for IVA outlined in Health-General Article, §10-617,
Annotated Code of Maryland, and Regulation .04C(4)(c) of this chapter, the
physician shall:
(a) If the individual meets
the requirements for voluntary admission, offer the individual an application
for voluntary admission; or
(b)
Immediately release the individual, following:
(i) Notification to the parent or guardian
that the individual is being released, if the individual is a minor or is a
disabled adult who is under guardianship of the parent or guardian under the
provisions of Estates and Trusts Article, §13-708, Annotated
Code of Maryland, and
(ii)
Preparation of a written aftercare plan in accordance with Health-General
Article, §10-809, Annotated Code of Maryland.
D. Medical Records.
(1) An inpatient facility shall maintain the
medical records for individuals who are confined on observation status separate
from the inpatient medical records of the facility.
(2) The inpatient facility may not disclose
an individual's observation status medical record in any way that would
indicate that the individual had been present in the inpatient facility,
except:
(a) For the sole purposes of:
(i) Providing notice of admission status and
rights and notice of hearing to the individual's parent, guardian, or next of
kin, in accordance with Regulations .05 and .06 of this chapter,
(ii) Calling witnesses to testify at the
individual's IVA hearing, and
(iii)
Fulfilling the provisions of Health-General Article, Title 4, Subtitle 3,
Annotated Code of Maryland; or
(b) Upon the authorization of the
individual.
(3) Staff at
the inpatient facility where an individual is confined may use prior
observation status medical records, as necessary, to provide for the proper
care or treatment of the individual.
E. Rights. An individual who is confined on
observation status in an inpatient facility shall be entitled to the rights
granted in accordance with Health-General Article, Title 10, Subtitle 7, and
Title 4, Subtitle 3, Annotated Code of Maryland.
F. An individual taken into an inpatient
facility in accordance with §A of this regulation shall remain confined on
observation status until the individual is:
(1) Voluntarily admitted to the inpatient
facility in accordance with the provisions of Health-General Article,
§10-609 or 10-610, Annotated Code of Maryland, and if the individual is:
(a) A minor, a parent or guardian who is not
a representative of a State agency signs an application for voluntary admission
of a minor, in accordance with Health-General Article, §10-610, Annotated
Code of Maryland,
(b) A minor who
is confined in a State inpatient facility, a parent or guardian has not
previously executed an application for voluntary admission of a minor during
the minor individual's current confinement in the State inpatient facility,
and
(c) Not a disabled adult who is
under guardianship of the person under the provisions of Estates and Trusts
Article, §13-708, Annotated
Code of Maryland;
(2)
Released by a physician of the inpatient facility before the scheduled IVA
hearing pursuant to §C(2)(b) of this regulation;
(3) Admitted to the inpatient facility by an
ALJ following an IVA hearing in accordance with Health-General Article,
§10-632, Annotated Code of Maryland, and Regulation .09G of this chapter;
or
(4) Released from the inpatient
facility by an ALJ following an IVA hearing in accordance with Health-General
Article, §10-632, Annotated Code of Maryland, and Regulation .09G of this
chapter.
G. Discharge of
an Individual on Observation Status and Referral for Direct IVA at Another
Inpatient Facility. An inpatient facility may refer for IVA to another
inpatient facility an individual who is confined on observation status only if
the receiving inpatient facility agrees to have the hearing held within 10 days
of the individual's initial confinement in the discharging inpatient facility
on the basis of application and certificates for IVA.
H. Payment or Reimbursement for Care or
Treatment. Payment or reimbursement for care or treatment of an individual who
is confined on observation status in, or who is involuntarily admitted to, an
inpatient facility shall be in accordance with the provisions of Health-General
Article, Title 16, Subtitle 2, Annotated Code of Maryland.
