Current through Register Vol. 51, No. 19, September 20, 2024
A. PRP services may only be provided to a
minor if identified in the minor's IRP and referred for PRP services by:
(1) A licensed mental health professional who
is providing inpatient, residential treatment center, or outpatient mental
health services to the minor; and
(2) Staff who have been privileged by the
program to provide the services.
B. Rehabilitation Activities. The program
director shall ensure that the program provides rehabilitation activities
directed toward the development or restoration of skills including:
(1) Age-appropriate self care skills,
including:
(a) Personal hygiene;
(b) Grooming;
(c) Nutrition;
(d) Dietary planning;
(e) Food preparation; and
(f) Self-administration of
medication;
(2) Social
skills, including community integration activities, developing natural
supports, and developing linkages with and supporting the minor's participation
in community activities;
(3)
Independent living skills, including:
(a)
Maintenance of the minor's living environment;
(b) Community awareness;
(c) Mobility skills;
(d) Money management; and
(e) Accessing available
entitlements;
(4)
Activities that support the minor's cultural interests;
(5) Conflict resolution;
(6) Anger management;
(7) Interactive skills with peers and
authority figures;
(8) Maintaining
personal living space;
(9)
Maintaining age-appropriate boundaries;
(10) Maintaining personal safety in a social
environment; and
(11) Time
management, including constructive use of structured and unstructured
time.
C. Medication
Services.
(1) Administration.
(a) An individual licensed to administer
medication under Health Occupations Article, Annotated Code of Maryland, may do
so.
(b) A licensed practical nurse
or a registered nurse may delegate the administration of medication only
according to the provisions of COMAR 10.27.11.
(2) Monitoring. A PRP staff member shall
provide the following services:
(a) Support
the individual's self-administration, as appropriate, of prescribed
medication;
(b) Read the medication
label to ensure that each container of medication is clearly labeled with the
individual's name, the contents, directions for use, and expiration
date;
(c) To the extent possible,
monitor compliance with instructions appearing on the medication
label;
(d) Ensure that each
individual has secure, appropriate, and accessible space in which to store
medications;
(e) Observe and
document any apparent reactions to medication and, either verbally or in
writing and in a timely fashion, communicate to the prescribing authority any
problems that possibly may be related to the medication; and
(f) Reinforce, with the individual, education
on the role and effects of medication in symptom management.
D. Promotion of Illness
Self Management.
(1) As is age appropriate,
staff shall provide education and information regarding mental
illness.
(2) The program director
shall ensure that the minor's rehabilitation coordinator collaborates with the
minor to identify effective strategies to assist the minor to manage the
minor's illness.
(3) The strategies
identified under §D(2) shall include, at a minimum, the minor's
identification of:
(a) Potential problematic
symptoms;
(b) Warning signs of
relapse;
(c) Helpful interventions;
and
(d) Other individuals the minor
identifies to resolve the situation in order for the minor to remain in service
or to seek treatment.
(4) The minor's illness self management
strategies shall be documented and may be incorporated in the minor's IRP, ITP,
mental health advance directive, or any combination of them.
(5) The strategies shall be reviewed at the
time of the IRP review and may be revised or revoked at any time at the request
of the minor.
E. On-Call
and Emergency Response. The program director shall assure that:
(1) On-call and emergency response services
are available by a licensed mental health professional to an individual who has
been admitted to the PRP:
(a) Face-to-face
during the hours that the PRP is open; and
(b) By telephone, on an on-call basis, 24
hours per day, 7 days per week, during the hours the PRP is not open:
(i) Through the PRP; or
(ii) Through an agreement with another mental
health crisis service provider;
(2) PRP staff provide to a minor:
(a) Intensive support and assistance, as
authorized, including but not limited to:
(i)
Providing one-to-one staff support for the minor, if necessary;
(ii) Escorting the minor while accessing
needed assistance or services; and
(iii) Obtaining input from the mental health
professional who is providing outpatient mental health services to the
minor;
(b) Information
regarding needed services; and
(c)
If necessary, referral for appropriate health care.
F. If emergency care is necessary,
all relevant staff shall:
(1) Have access to
the names, addresses, and telephone numbers of providers, including the
hospital, that are designated to provide emergency care and treatment to the
minors served; and
(2) Be
appropriately trained to link minors to emergency care, as needed.
G. Linkage with a Minor in a
Psychiatric Inpatient Facility, Residential Treatment Center (RTC), or
Detention Center.
(1) If a minor who is
enrolled in a program is admitted to a psychiatric inpatient facility, RTC, or
detention center, the rehabilitation coordinator shall make reasonable efforts
to maintain ongoing communication with the minor and the minor's inpatient
treatment team.
(2) To the degree
permitted by the setting, PRP staff serving the minor shall participate in
aftercare or release planning from that setting.