EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0121*
HOUSE BILL 121
J1, J3 3lr0450
(PRE–FILED) CF SB 8
By: Delegate Charkoudian
Requested: September 26, 2022
Introduced and read first time: January 11, 2023
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Mental Health – Treatment Plans for Individuals in Facilities – Requirements 2
FOR the purpose of requiring that a plan of treatment for an individual with a mental 3
disorder admitted to a certain health care facility include a certain discharge goal 4
and an estimate of the probable length of inpatient stay the individual requires 5
before transfer to a certain setting; requiring certain facility staff to review and 6
reassess a plan of treatment within certain time periods; establishing certain rights 7
and requirements relating to the participation of certain family members and other 8
individuals in the development, review, and reassessment of a plan of treatment; 9
establishing an appeals process for individuals admitted to a State facility relating 10
to the review and reassessment of a plan of treatment; requiring a certain health 11
care facility to take certain actions if the facility is unable to address certain needs 12
under a plan of treatment; and generally relating to treatment plans for individuals 13
with mental disorders admitted to health care facilities. 14
BY repealing and reenacting, with amendments, 15
Article – Health – General 16
Section 10–706 17
Annotated Code of Maryland 18
(2019 Replacement Volume and 2022 Supplement) 19
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 20
That the Laws of Maryland read as follows: 21
Article – Health – General 22
10–706. 23
(a) (1) Except as provided by paragraph (2) of this subsection, promptly after 24
admission of an individual, a facility shall make and periodically update a written plan of 25 2 HOUSE BILL 121
treatment for the individual in the facility, in accordance with the provisions of this 1
subtitle. 2
(2) Promptly after admission of an individual to a psychosocial center, the 3
center shall make and periodically update a written plan of rehabilitation for the individual 4
in the facility, in accordance with the provisions of this subtitle. 5
(b) The Director shall adopt rules and regulations under this section that include: 6
(1) [A] SUBJECT TO SUBSECTION (D) OF THIS SECTION , A description 7
of the nature and content of plans of treatment; and 8
(2) [Appropriate] SUBJECT TO SUBSECTION (E) OF THIS SECTION , 9
APPROPRIATE time periods for the development, implementation, and review of each plan. 10
(c) An individual shall: 11
(1) Participate, in a manner appropriate to the individual’s condition, in 12
the development and periodic updating of the plan of treatment; and 13
(2) Be told, in appropriate terms and language, of: 14
(i) The content and objectives of the plan of treatment; 15
(ii) The nature and significant possible adverse effects of 16
recommended treatments; 17
(iii) The name, title, and role of personnel directly responsible for 18
carrying out the treatment for the individual; and 19
(iv) When appropriate, other available alternative treatments, 20
services, or providers of mental health services. 21
(D) A PLAN OF TREATMENT SHALL INCLUDE : 22
(1) A LONG–RANGE DISCHARGE GOAL ; AND 23
(2) AN ESTIMATE OF THE PR OBABLE LENGTH OF INP ATIENT STAY 24
THE INDIVIDUAL REQUIRES BEFORE TRANSFER TO A LESS RESTRICTIVE OR 25
INTENSIVE TREATMENT SETTING. 26
(E) FACILITY STAFF WHO WORK DIRECTLY WI TH AND PROVIDE TREAT MENT 27
TO AN INDIVIDUAL SHALL REVIEW AND REASSESS THE PLAN OF TREATMEN T FOR 28
THE INDIVIDUAL TO DETERMIN E THE INDIVIDUAL ’S PROGRESS AND ANY NEED FOR 29
ADJUSTMENTS TO THE P LAN NOT LESS THAN: 30
HOUSE BILL 121 3
(1) ONCE EVERY 15 DAYS FOR THE FIRST 2 MONTHS AFTER 1
ADMISSION OF THE IND IVIDUAL TO THE FACIL ITY; AND 2
(2) ONCE EVERY 60 DAYS FOR THE REMAINDER OF THE INPATIENT 3
STAY OF THE INDIVIDU AL IN THE FACILITY. 4
(F) (1) ON THE ADMISSION OF AN INDIVIDUAL TO A FACILITY AND AT 5
EACH REVIEW AND REAS SESSMENT OF THE I NDIVIDUAL’S PLAN OF TREATMENT , THE 6
FACILITY SHALL ASK THE INDIVIDUAL WHETHER THE INDIVIDU AL CONSENTS TO 7
THE INCLUSION OF FAMILY MEMBERS OR ANY OTHER INDIVIDUAL S IN THE 8
DEVELOPMENT , REVIEW, AND REASSESSMENT OF THE PLAN OF TREATMEN T OF THE 9
INDIVIDUAL. 10
(2) IF AN INDIVIDUAL AGRE ES TO HAVE FAMILY MEMBERS OR OTHER 11
INDIVIDUALS PARTICIPATE IN THE DEVELOPMENT , REVIEW, AND REASSESSMENT OF 12
THE INDIVIDUAL’S PLAN OF TREATMENT , THE FACILITY SHALL : 13
(I) INCLUDE THE FAMILY MEMBERS AND OTHER INDIVIDUALS 14
AUTHORIZED BY THE INDIVIDUAL IN: 15
1. EACH STAGE OF THE DEVELOPMENT OF THE PLAN OF 16
TREATMENT ; 17
2. ANY REVIEW AND RE ASSESSMENT OF THE PLAN OF 18
TREATMENT ; AND 19
3. ANY MEETING OF FACILITY STAFF THAT HAS A 20
PURPOSE OF DEVELOPIN G, REVIEWING, OR REASSESSING THE P LAN OF 21
TREATMENT ; AND 22
(II) PROVIDE NOTICE TO THE FAMILY MEMBERS AND OTHER 23
INDIVIDUALS OF A TRE ATMENT TEAM MEETING : 24
1. AT LEAST 7 DAYS IN ADVANCE OF T HE MEETING; OR 25
2. IF THE TREATMENT TEAM MEETING IS BEING HEL D 26
DUE TO AN EMERGENCY , AS SOON AS THE MEETI NG IS SCHEDULED . 27
(3) THE INDIVIDUAL MAY WI THDRAW THE CONSENT GIVEN UNDER 28
PARAGRAPH (1) OF THIS SUBSECTION AT ANY TIME ORALLY OR IN WRITING . 29
(G) (1) IF AN INDIVIDUAL ADMITTED TO A FACILI TY OR ANY FAMILY 30
MEMBER OR OTHER INDIVIDUAL AUTHORIZED BY THE IN DIVIDUAL TO PARTICIP ATE 31 4 HOUSE BILL 121
IN THE REVIEW AND REASSESSMENT OF THE PLAN OF TREATMENT FO R THE 1
INDIVIDUAL UNDER SUBSECTION (F) OF THIS SECTION BELIEVES THAT THE PL AN OF 2
TREATMENT IS NOT MEE TING THE NEEDS OF TH E INDIVIDUAL, THE INDIVIDUAL , 3
FAMILY MEMBER , OR OTHER AUTHORIZED INDIVIDUA L HAS THE RIGHT TO REQUEST 4
THAT THE FACILITY REVIEW AND REASSESS THE PLAN OF TREATMENT . 5
(2) ON RECEIPT OF A REQUE ST UNDER PARAGRAPH (1) OF THIS 6
SUBSECTION, THE FACILITY STAFF W HO WORK DIRECTLY WIT H AND PROVIDE 7
TREATMENT TO THE IND IVIDUAL SHALL CONDUCT A REVIEW AND REASSESSMENT 8
OF THE PLAN OF TREATMENT THAT INCLUDES A WRITTEN EXPLANATIO N OF HOW 9
ALL ISSUES R AISED IN THE REQUEST WERE CONSIDERED IN THE REVIEW AND 10
REASSESSMENT OF THE PLAN OF TREATMENT . 11
(3) IF THE FACILITY DOES NOT MAKE ANY CH ANGES TO THE PLAN OF 12
TREATMENT FOR THE INDIVIDUAL , THE FACILITY SHALL: 13
(I) PROVIDE A DETAILED WRITTEN E XPLANATION FOR THE 14
DECISION TO THE INDIVIDUAL AN D ANY FAMILY MEMBER AND INDIVIDUAL 15
AUTHORIZED BY THE IN DIVIDUAL TO PARTICIP ATE IN THE REVIEW AN D 16
REASSESSMENT OF THE PLAN OF TREATMENT ; AND 17
(II) INCLUDE THE EXPLANATION IN THE MEDICAL RECOR DS OF 18
THE INDIVIDUAL . 19
(H) (1) AN INDIVIDUAL ADMITTED TO A STATE FACILITY MAY REQUEST 20
AN ADMINISTRATIVE HE ARING FOR A RECONSID ERATION OF THE REVIE W AND 21
REASSESSMENT COMPLETED UNDER SUBSECTION (G) OF THIS SECTION BY FILING A 22
REQUEST FOR HEARING WITH THE CHIEF EXECU TIVE OFFICER OF THE STATE 23
FACILITY OR THE CHIEF EXECUTIVE OFFICE R’S DESIGNEE WITHIN 7 DAYS AFTER 24
RECEIPT OF THE WRITT EN EXPLANATION OF TH E REVIEW AND REASSES SMENT. 25
(2) WITHIN 72 HOURS AFTER RECEIPT OF A REQUEST FOR A 26
HEARING, THE CHIEF EXECUTIVE OFFICER OF THE STATE FACILITY OR THE CHIE F 27
EXECUTIVE OFFICER ’S DESIGNEE SHALL FOR WARD THE REQUEST TO THE OFFICE 28
OF ADMINISTRATIVE HEARINGS. 29
(3) SUBJECT TO PARAGRAPH (5) OF THIS SUBSECTION, THE OFFICE 30
OF ADMINISTRATIVE HEARINGS SHALL CONDUC T A HEARING AND ISSU E A DECISION 31
WITHIN 15 CALENDAR DAYS AFTER THE RECEIPT OF THE REQUEST FORWARDED 32
UNDER PARAGRAPH (2) OF THIS SUBSECTION . 33
(4) THE INDIVIDUAL ADMITTED TO A STATE FACILITY IS ENTITLED TO 34
BE REPRESENTED BY CO UNSEL AT THE ADMINISTRATIVE HEARING. 35 HOUSE BILL 121 5
(5) THE ADMINISTRATIVE HE ARING MAY BE POSTPON ED BY 1
AGREEMENT OF THE PAR TIES OR FOR GOOD CAU SE SHOWN. 2
(6) THE ADMINISTRATIVE LA W JUDGE SHALL CONDUC T A DE NOVO 3
HEARING TO DETERMINE WHETHER THE PLAN OF TREATMEN T IS MEETING THE 4
NEEDS OF THE INDIVID UAL. 5
(7) AT THE HEARING , THE INDIVIDUAL REPRE SENTING THE STATE 6
FACILITY: 7
(I) MAY INTRODUCE THE WRI TTEN EXPLANATION RELATING 8
TO THE PLAN OF TREATMEN T AS EVIDENCE; AND 9
(II) SHALL PROVE, BY CLEAR AND CONVINC ING EVIDENCE , 10
THAT THE PLAN OF TRE ATMENT IS MEETING TH E NEEDS OF THE INDIV IDUAL. 11
(8) (I) THE ADMINISTRATIVE LA W JUDGE SHALL STATE ON THE 12
RECORD THE FINDINGS OF FACT AND CONCLUSI ONS OF LAW. 13
(II) THE ADMINISTRATIVE LA W JUDGE SHALL DETERMINE 14
THAT: 15
1. BY CLEAR AND CONVINCI NG EVIDENCE, THE PLAN OF 16
TREATMENT IS MEETING THE NEEDS OF THE IND IVIDUAL; OR 17
2. THE PLAN OF TREATMENT IS NOT MEETING THE 18
NEEDS OF THE INDIVID UAL. 19
(III) IF THE ADMINISTRATIVE LAW JUDGE DETERMINES THAT 20
THE PLAN OF TREATMEN T IS NOT MEETING THE NEEDS OF THE INDIVID UAL, THE 21
ADMINISTRATIVE LAW J UDGE SHALL ORDER THE STATE FACILITY TO MAKE 22
ARRANGEMENTS FOR THE INDIVIDUAL TO RECEIV E NECESSARY TREATMEN T, WHICH 23
MAY INCLUDE TREATMENT FROM ANOTHER FACILIT Y OR ANOTHER HEALTH CARE 24
PROVIDER OUTSIDE THE STATE FACILITY. 25
(9) THE DETERMINATION OF THE ADMINISTRATIVE L AW JUDGE IS A 26
FINAL DECISION FOR T HE PURPOSE OF JUDICI AL REVIEW OF A FINAL DECISION 27
UNDER THE ADMINISTRATIVE PROCEDURE ACT. 28
(I) (1) WITHIN 14 CALENDAR DAYS AFTER THE ADMINISTRATIVE L AW 29
JUDGE ISSUES A DECISION UNDER SUBSECTION (H) OF THIS SECTION , THE 30
INDIVIDUAL OR THE STATE FACILITY MAY APPEAL THE DECISION TO THE CIRCUIT 31 6 HOUSE BILL 121
COURT ON THE RECORD FROM THE HEARING CON DUCTED BY THE OFFICE OF 1
ADMINISTRATIVE HEARINGS. 2
(2) THE SCOPE OF REVIEW S HALL BE AS A CONTEST ED CASE UNDER 3
THE ADMINISTRATIVE PROCEDURE ACT. 4
(3) (I) REVIEW SHALL BE ON TH E RECORD MADE BEFORE THE 5
OFFICE OF ADMINISTRATIVE HEARINGS, UNLESS EITHER PARTY TO THE APPEAL 6
REQUESTS TRANSCRIPTI ON OF THE TAPE. 7
(II) A REQUEST FOR TRANSCRI PTION OF THE TAPE SH ALL BE 8
MADE AT THE TIME THE APPEAL IS FILED. 9
(III) 1. THE OFFICE OF ADMINISTRATIVE HEARINGS SHALL 10
PREPARE THE TRANSCRI PTION BEFORE THE APPEAL HEARING . 11
2. THE PARTY REQUESTING THE T RANSCRIPTION SHALL 12
BEAR THE COST OF TRA NSCRIPTION. 13
(4) THE CIRCUIT COURT SHA LL HEAR AND ISSUE A DECISION ON AN 14
APPEAL WITHIN 30 CALENDAR DAYS AFTER THE DATE THE APPEAL WAS FILED. 15
(J) IF A FACILITY IS UNABLE TO PROVIDE THE TREATMEN T NECESSARY TO 16
ADDRESS THE REHABILI TATION NEEDS OF AN INDIVIDUAL UNDER A PLAN OF 17
TREATMENT FOR THE INDIVIDUAL , THE FACILITY SHALL : 18
(1) MAKE ARRANGEMENTS FOR THE INDIVIDUAL TO RE CEIVE 19
NECESSARY TREATMENT FROM ANOTH ER FACILITY OR OTHER HEALTH CARE 20
PROVIDER OUTSIDE THE FACILITY; AND 21
(2) ENSURE THAT TREATMENT FOR THE INDIV IDUAL IS 22
COORDINA TED BETWEEN THE FACI LITY AND THE OTHER FACILITY OR HEALTH C ARE 23
PROVIDER. 24
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 25
October 1, 2023. 26