Staffing and Clinical Oversight

The staffing model for ASAM Level 3.3 builds upon the staffing requirements of Residential Low-Intensity (ASAM 3.1) and includes additional medical, nursing, and psychiatric resources to meet the needs of individuals with more complex clinical and functional challenges. All services are provided by licensed, certified, or otherwise authorized professionals in accordance with the Maryland Health Occupations Article and applicable COMAR regulations.

Program Leadership & Oversight

A part-time Facility Director is on-site a minimum of 20 hours per week and provides overall oversight of the residential program, ensuring that services are delivered in compliance with Maryland regulations, ASAM standards, and program policies.

Clinical Supervisor / Clinical Director

The Clinical Supervisor provides oversight of all therapeutic services, including supervision of counselors and peer support staff, coordination of treatment planning, and ongoing review of clinical progress. This role ensures that services remain individualized, appropriate to the ASAM Level 3.3 population, and aligned with treatment goals.

Counseling & Therapeutic Services Staff

Licensed mental health clinicians provide individual counseling, group therapy, clinical assessments, treatment planning, and discharge planning tailored to the needs of individuals receiving medium-intensity residential services. Certified substance use disorder counselors deliver individual and group treatment under approved clinical supervision, focusing on recovery skill development, relapse prevention, and functional improvement.

Peer Recovery Support Services

Peer Recovery Support Specialists provide daily recovery-oriented support and encouragement, assistance with goal setting and accountability, modeling of recovery-focused behaviors, support with engagement in treatment and daily routines, connection to community-based recovery resources, and aftercare supports. Peer services are coordinated with clinical treatment and transition planning.

Medical, Nursing & Psychiatric Services

ASAM Level 3.3 includes access to medical and psychiatric services appropriate for individuals with moderate to severe substance use disorders. Physician coverage is a minimum of 4 hours per week (physician, nurse practitioner, or physician assistant on-site with additional on-call availability). Psychiatric services are a minimum of 3 hours per week (psychiatrist or psychiatric nurse practitioner). Nursing services are provided 40 hours per week (RN or LPN on-site to support medical monitoring, medication coordination, and health-related needs).

Residential & Overnight Support Staff

House managers and residential support staff provide continuous residential supervision, support daily routines, reinforce program expectations, and assist residents outside of scheduled clinical service hours. At least one staff member is on duty overnight (11:00 PM – 7:00 AM), trained in crisis intervention and certified in CPR, responsible for resident safety, monitoring, and emergency response.

A Coordinated, Team-Based Model of Care

The ASAM Level 3.3 program uses a team-based approach that integrates residential, clinical, medical, nursing, and peer recovery services. This coordinated model supports individualized treatment planning, continuous communication among service providers, safe and supportive 24-hour care, effective discharge and aftercare planning, and alignment with each participant's recovery goals and functional needs.