.20 Mobile Crisis Team Programs.

A. Definition.

(1) In this regulation, the following term has the meaning indicated.

(2) Term Defined. “Program” means the site and service combination which is recognized through licensure to offer an organized system of activities performed for the benefit of persons served.

B. In order to be licensed under this subtitle, a mobile crisis team within a mobile crisis team program shall:

(1) Meet the requirements of COMAR 10.63.01, 10.63.02, and 10.63.06 and this regulation;

(2) Provide, 24 hours per day, 7 days per week, 365 days per year, professional intervention for children or adults whose behaviors are consistent with experiencing:

(a) A mental health crisis;

(b) A substance use disorder crisis; or

(c) Both §B(2)(a) and (b) of this regulation;

(3) Meet the requirements defined in Health-General Article, Title 10, Subtitle 14, Annotated Code of Maryland;

(4) Be pre-approved by the Department or its designee to participate in the public behavioral health system to receive funding through the Department; and

(5) Respond to urgent symptoms or behaviors that are disrupting an individual’s behavioral health functioning.

C. Mobile crisis team response may also include engaging law-enforcement where the addition of a law enforcement presence provides additional safety measures, when indicated, for all individuals involved in the mobile crisis intervention.

D. Mobile Crisis Team Program Services. A mobile crisis team program shall provide the following services:

(1) In-person, community-based professional and peer intervention services which shall:

(a) Be age and culturally appropriate, and explained in terms understandable to the individual;

(b) Be designed to:

(i) De-escalate an individual’s behavioral health crisis;

(ii) Evaluate the nature of the crisis;

(iii) Stabilize the individual to the pre-crisis level of functioning; and

(iv) Maintain continuity of care by coordinating access to various treatment and support services;

(c) Be deployed to the location of an individual in crisis;

(d) Address immediate dynamics that may be contributing to the crisis;

(e) Include a response initiated by a mobile crisis team within an average of 60 to 120 minutes of determining an individual is in need of crisis intervention;

(f) Use evidence-based tools to screen, assess, stabilize, and refer persons, as clinically indicated;

(g) Be provided by a mobile crisis team that is nearest to the location of the individual in crisis; and

(h) Be provided under the documented supervision of a licensed mental health professional approved by the appropriate board to supervise.

(2) Crisis Intervention Services. A mobile crisis team program shall provide medically necessary crisis intervention services, inclusive of the following:

(a) Triage and screening to determine the level of risk faced by the individual in crisis and assess the most appropriate response;

(b) An immediate assessment conducted by a licensed mental health professional to determine the services necessary to stabilize the crisis for the individual;

(c) A plan for de-escalation and resolution of the crisis, including in-person interventions for immediate de-escalation of presenting behavioral symptoms;

(d) Brief therapeutic and skill-building interventions and therapeutic counseling techniques specific to the crisis that aims to lower risks and resolve the crisis so that a higher level of care is not needed;

(e) Case management and care coordination services, which may include referrals to other services as well as follow-up contacts;

(f) Engaging peer and natural and family support when appropriate;

(g) A safety crisis plan, which shall aim to keep an individual in crisis and their environment safe and may include the distribution of opioid overdose reversal drugs, lethal means counseling, and other evidence-based interventions;

(h) Stabilization services to ensure the individual’s safety and connection to needed resources to reduce the behavioral symptoms leading to crisis; and

(i) Follow-up screening and assessment for ongoing risk when indicated by the needs of persons served, in-person, via phone, or via telehealth following the initial crisis intervention.

(3) Follow-up services, provided in-person, via phone, or via telehealth, which shall include, but are not limited to:

(a) Referral and linkage with other service providers; and

(b) Ongoing coordination to meet identified resource needs.

E. Mobile Crisis Team Program Staffing. A mobile crisis team program shall include at least one licensed mental health professional available at all times, either via telehealth or face-to-face, who is:

(1) Licensed at the independent practice level;

(2) Eligible to oversee the staff of the team; and

(3) Eligible to complete an emergency petition.

F. A mobile crisis team:

(1) Shall include two staff members responding in-person;

(2) Shall include a licensed mental health professional face-to-face or via telehealth; and

(3) May not include law enforcement, if present, as part of the two-person response team.

G. Mobile Crisis Team Program Staff Training Requirements.

(1) All mobile crisis team program staff shall complete required trainings approved by the Department.

(2) A mobile crisis team program shall have a training and competency plan in place that:

(a) Is reviewed annually;

(b) Is consistent with:

(i) Accreditation requirements; and

(ii) Requirements published by the Department;

(c) Defines the core competencies needed to provide reliable and high-quality care for each clinical discipline, within their scope of practice, as a staff member of a mobile crisis team; and

(d) Ensures that all staff receive competency verification following all initial and ongoing training.

(3) All mobile crisis teams shall be trained in the mobile response and stabilization services (MRSS) model.

H. Mobile Crisis Team Program Reporting Requirements. A mobile crisis team program shall provide data on outcomes and social determinants of care to the State in the format and frequency required by the Department.

I. A mobile crisis team program shall obtain pre-approval from the Department and LBHA or CSA to operate mobile crisis services in the PBHS to ensure services meet local community needs for behavioral health crisis services.