(a) (1) Except as provided by paragraph (2) of this subsection, promptly after admission of an individual, a facility shall make and periodically update a written plan of treatment for the individual in the facility, in accordance with the provisions of this subtitle.
(2) Promptly after admission of an individual to a psychosocial center, the center shall make and periodically update a written plan of rehabilitation for the individual in the facility, in accordance with the provisions of this subtitle.
(b) The Director shall adopt rules and regulations under this section that include:
(1) Subject to subsection (d) of this section, a description of the nature and content of plans of treatment; and
(2) Subject to subsection (e) of this section, appropriate time periods for the development, implementation, and review of each plan.
(c) An individual shall:
(1) Participate, in a manner appropriate to the individual’s condition, in the development and periodic updating of the plan of treatment; and
(2) Be told, in appropriate terms and language, of:
(i) The content and objectives of the plan of treatment;
(ii) The nature and significant possible adverse effects of recommended treatments;
(iii) The name, title, and role of personnel directly responsible for carrying out the treatment for the individual; and
(iv) When appropriate, other available alternative treatments, services, or providers of mental health services.
(d) A plan of treatment shall include:
(1) A long–range discharge goal; and
(2) An estimate of the probable length of inpatient stay the individual requires before transfer to a less restrictive or intensive treatment setting.
(e) Facility staff who work directly with and provide treatment to an individual shall review and reassess the plan of treatment for the individual to determine the individual’s progress and any need for adjustments to the plan not less than:
(1) Once every 15 days for the first 2 months after admission of the individual to the facility; and
(2) Once every 60 days for the remainder of the inpatient stay of the individual in the facility.
(f) (1) On the admission of an individual to a facility, the facility shall:
(i) Ask the individual whether the individual consents to family members or any other individuals being informed of and given the opportunity to participate in meetings with the treatment team regarding the development, review, and reassessment of the plan of treatment of the individual; and
(ii) If consent is given under item (i) of this paragraph, at least every 7 days after consent is given, reconfirm the consent and provide the individual at a clinical visit with an opportunity to consent to additional individuals being informed of and given the opportunity to participate in meetings with the treatment team.
(2) If an individual agrees to have family members or other individuals participate in the development, review, and reassessment of the individual’s plan of treatment, the facility shall:
(i) Provide a schedule of routine treatment team meetings where the plan of treatment is discussed;
(ii) Establish a process for the authorized individuals to participate in treatment team meetings;
(iii) If the treatment team meeting is being held outside the regular schedule, inform the authorized individuals as soon as the meeting is scheduled; and
(iv) If the treatment team meeting is being held due to an emergency, inform the authorized individuals of the outcome of the meeting as soon as practicable.
(3) The individual may withdraw the consent given under paragraph (1) of this subsection at any time orally or in writing.
(4) A treating provider may withhold information on an individual plan of treatment from a family member or other authorized individual if:
(i) In the treating provider’s clinical judgment, the consent given under paragraph (1) of this subsection was provided through coercive means;
(ii) The treating provider believes it is in the best clinical interest of the individual; or
(iii) The individual requests that a specific piece of the plan of treatment be withheld.
(g) (1) If an individual admitted to a facility or any family member or other individual authorized by the individual to participate in the review and reassessment of the plan of treatment for the individual under subsection (f) of this section believes that the plan of treatment is not meeting the needs of the individual, the individual, family member, or other authorized individual has the right to request that the facility review and reassess the plan of treatment.
(2) On receipt of a request under paragraph (1) of this subsection, the facility staff who work directly with and provide treatment to the individual shall:
(i) Conduct a review and reassessment of the plan of treatment;
(ii) Communicate the results of the review and reassessment of the plan of treatment to the patient and individual who requested the review and reassessment, including an explanation of how all issues raised in the request were considered; and
(iii) Include the request for the review and reassessment of the plan of treatment and the outcome of the review and assessment, including the explanation of the outcome, in the medical records of the individual.
(3) If a State facility does not make any changes to the plan of treatment for the individual, the State facility shall provide referral information for the Resident Grievance System established under COMAR 10.21.14.
(h) An individual admitted to a State facility or another individual authorized by the admitted individual may request a reconsideration of the review and reassessment completed under subsection (g) of this section by filing a grievance with the Resident Grievance System under COMAR 10.21.14.
(i) (1) An individual admitted to a State facility or another individual authorized by the admitted individual may appeal the reconsideration of the review and reassessment completed under subsection (h) of this section by filing a request with the Department’s Healthcare System’s Chief Medical Officer.
(2) The Department shall adopt regulations to establish a process for the appeal of the reconsideration of the review and reassessment under paragraph (1) of this subsection.
(j) If an individual is admitted to a State facility and the State facility is unable to provide the treatment necessary to address the rehabilitation needs of an individual under a plan of treatment for the individual, the State facility shall:
(1) Make arrangements for the individual to receive necessary treatment from another facility or other health care provider outside the State facility; and
(2) Ensure that treatment for the individual is coordinated between the State facility and the other facility or health care provider.