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10.21.18.00.htm 10.21.18.00. Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE Subtitle 21 MENTAL HYGIENE REGULATIONS Chapter 18 Community Mental Health Programs ― Therapeutic Nursery Programs Authority: Health-General Article, §10-901 and 10-902, Annotated Code of Maryland
10.21.18.01.htm 10.21.18.01. 01 Scope.. A. This chapter applies to clinical programs that provide a combination of developmental and mental health services in a preschool setting, made accessible and available to children and the families of children who are at risk for or who are emotionally disturbed, who have behavior or adjustment problems, or both.B. The Department shall grant approval to an agency to be eligible to receive State funds for providing therapeutic nursery services if the agency mee
10.21.18.02.htm 10.21.18.02. 02 Definitions.. A. In this chapter, terms have the meanings stated in COMAR 10.21.17 and this regulation.. B. Terms Defined.. 1) "Individualized family service plan (IFSP) means the plan defined in COMAR 10.09.40.. 2) "Learning center" means a designated area of a classroom that serves children in a therapeutic nursery and that is equipped specifically for the development of a particular skill, including, but not limited to, fine motor, gross motor, and socialization.
10.21.18.03.htm 10.21.18.03. 03 Program Model.. A provider of therapeutic nursery services shall ensure that services:. A. Are appropriate to the cultural and psychosocial developmental needs of the child;. B. Are provided:. 1) For a minimum of 3 hours per day, 3 days per week at each site; and. 2) In either a free-standing program or as an integral component of a preschool program in which services are offered in a therapeutic milieu;C. Are provided by staff who:.
10.21.18.04.htm 10.21.18.04. 04 Referral and Admission.. A. Referral. A therapeutic nursery may accept a referral to the therapeutic nursery from:. 1) Education, social service, or health care agency staff;. 2) Family members; or. 3) Other interested individuals and agencies.. B. Eligibility. A child is eligible for therapeutic nursery services if the child:. 1) Has or is at risk for a mild to severe mental disorder, as defined in the current Diagnostic and Statistical Manual of Mental Disorders, or mild to
10.21.18.05.htm 10.21.18.05. 05 Evaluative Services for the Child.. A. Assessment. If a comprehensive developmental assessment has not been completed within the 90 days before admission, before the child's 6th visit, the therapeutic nursery staff shall assure the completion of an assessment, including, when appropriate, standardized measurement, that includes, at a minimum, an assessment of the following:1) Social and emotional development;. 2) Cognitive skills and deficits;. 3) Language development;.
10.21.18.06.htm 10.21.18.06. 06 Treatment and Support Services.. A. Therapies. The therapeutic nursery program shall provide the following therapies:. 1) If required by the ITP, individual therapy:. a) With the therapeutic nursery mental health professional staff;. b) With the community psychotherapist who is currently treating the child; or. c) By referral;. 2) For children in Program A, conjoint therapy involving an individual child or groups of children with their primary caretakers;3) Milieu therapy that us
10.21.18.07.htm 10.21.18.07. 07 Discharge and Transitioning.. A. Not later than the date of admission, the therapeutic nursery program shall provide a written policy statement on discharge and transition procedures to parents, legal guardians, and primary caretakers.B. To the extent practicable, parents, legal guardians, or primary caretakers as well as referring agencies or professionals, and the continuing care providers shall participate in discharge and transition planning.C. Within 15 days of disc
10.21.18.08.htm 10.21.18.08. 08 Program Staff.. A. Based on the complexity of the services provided and the number of enrollees in the therapeutic nursery, a therapeutic nursery program shall provide sufficient staff to maintain the staff-to-child ratio provided in §E of this regulation and to carry out the therapeutic goals of the therapeutic nursery.B. Therapeutic Nursery Staff. A provider of therapeutic nursery services shall ensure that the therapeutic nursery staff includes, at a minimum:
10.21.18.09.htm 10.21.18.09. 09 Policies and Procedures.. In addition to the policy and procedure requirements outlined in COMAR 10.21.17.08, a therapeutic nursery program shall adopt policies and procedures for:A. Licensure by the Department of Human Resources under COMAR 07.04.02;. B. Physical setting, furnishings, materials, and equipment, as required by Regulations .10 and .11 of this chapter;C. Health and safety, as required by Regulation .12 of this chapter; and.
10.21.18.10.htm 10.21.18.10. 10 Physical Setting.. A. Capacity.. 1) The Department shall determine the capacity of a therapeutic nursery based on:. a) Space requirements under §C(1) of this regulation;. b) Staff requirements, including the staff-to-child ratio, required under Regulation .08D of this chapter; andc) Maintenance of the therapeutic milieu described in Regulation .03B(2) of this chapter.. 2) The program director of the therapeutic nursery program shall limit the number of enrollees to th
10.21.18.11.htm 10.21.18.11. 11 Materials, Equipment, Furnishings, and Storage.. A. Materials and Equipment. In addition to any other requirements of law or regulation, the therapeutic nursery program shall:1) Provide a sufficient quantity and variety of materials and equipment for indoor and outdoor activities, according to the numbers and ages of the children enrolled, including materials and equipment for:a) Vigorous play;. b) Creative or dramatic play;. c) Socialization;.
10.21.18.12.htm 10.21.18.12. 12 Health and Safety Requirements.. The therapeutic nursery program director shall:. A. Ensure that a criminal background investigation as required under Family Law Article, §5-560―5-568, Annotated Code of Maryland, has been completed and is on file in each staff member's personnel record;B. If a child is involved in an accident or is injured while in attendance at a therapeutic nursery program:1) Notify the primary caretaker on the day that the accident or injury occurs;.
10.21.18.13.htm 10.21.18.13. 13 Transportation.. If the therapeutic nursery provides transportation, the therapeutic nursery program shall ensure that:A. Vehicles used for the transport of therapeutic nursery enrollees are in compliance with the requirements outlined in Transportation Article, Title 22, Annotated Code of Maryland;B. Each driver:. 1) Possesses a valid Class D license; and. 2) Presents the driver's record, certified by the Motor Vehicle Administration, showing not more tha
10.21.18.9999.htm 10.21.18.9999. Administrative History Effective date: January 2, 1995 (21:26 Md. R. 2187).
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