Staffing and Clinical Oversight

Residential High-Intensity Addictions Treatment (ASAM Level 3.5) at Hope on the Hill Recovery is delivered by a highly structured, multidisciplinary treatment team designed to support individuals with severe substance use disorders who require intensive therapeutic engagement, continuous residential supervision, and appropriate medical and psychiatric oversight.

The staffing model for ASAM Level 3.5 at 626 Denison Street builds upon the staffing foundations of Residential Low-Intensity (ASAM 3.1) and Residential Medium-Intensity (ASAM 3.3) services, with enhanced clinical intensity and medical involvement to meet the needs of individuals requiring the highest level of residential care outside of a hospital setting. 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 & Facility Oversight

Facility Director / Program Director

The Residential High-Intensity program is overseen by a Facility Director who is on-site a minimum of 20 hours per week. The Facility Director is responsible for overall program operations, regulatory compliance, quality assurance, and coordination of residential and clinical services to ensure a safe, structured, and therapeutic environment.

Medical Oversight & Clinical Support

ASAM Level 3.5 services include sufficient medical coverage to address the complex needs of individuals with severe substance use disorders. Medical services are structured to provide initial diagnostic evaluations, identify medical and surgical issues requiring referral, and respond to medical concerns and emergencies. A physician, nurse practitioner, or physician assistant is on-site a minimum of 1 hour per week, with additional availability as needed to support medical oversight and emergency response.

Psychiatric Services

Because individuals in Residential High-Intensity treatment often present with co-occurring mental health symptoms or complex behavioral needs, psychiatric consultation is incorporated into the program. A psychiatrist or psychiatric nurse practitioner is available a minimum of 1 hour per week to provide psychiatric assessment, consultation, and coordination of behavioral health care.

Clinical & Therapeutic Services Team

Direct therapeutic services in the ASAM Level 3.5 program are delivered by an on-site multidisciplinary treatment team experienced in high-intensity residential addiction treatment. The Clinical Supervisor provides oversight of therapeutic services, supervises counselors and peer support staff, ensures adherence to treatment plans, and maintains clinical quality and compliance. A licensed mental health clinician provides individual counseling, group therapy, clinical assessments, treatment planning, and discharge planning appropriate for a high-intensity residential population. Certified SUD counselors deliver individual and group substance use disorder treatment under direct supervision, with services focusing on relapse prevention, behavioral change, recovery skill application, and engagement in the therapeutic community.

Peer Recovery Support & Aftercare Coordination

Peer Recovery Support Specialists play a central role in Residential High-Intensity treatment and are integrated throughout the therapeutic community. They provide daily recovery-oriented support and encouragement, assist participants with engagement, accountability, and motivation, support the development of recovery-focused routines and behaviors, coordinate aftercare services in collaboration with licensed providers, connect with peer support resources, and ensure continuity of care following discharge.

Residential & Overnight Supervision

Because ASAM Level 3.5 is a 24-hour residential program, trained residential staff are present at all times to ensure safety, structure, and immediate response to resident needs. At least one staff member is on duty overnight between 11:00 PM and 7:00 AM, trained in crisis intervention and certified in cardiopulmonary resuscitation (CPR). Overnight staff provide monitoring, safety assurance, and emergency response as needed.

A High-Intensity, Team-Based Model of Care

Residential High-Intensity (ASAM Level 3.5) treatment at Hope on the Hill Recovery relies on a team-based approach in which clinical, medical, psychiatric, peer, and residential services work together as a cohesive therapeutic community. This model supports delivery of a minimum of 36 hours of therapeutic activities per week, continuous engagement in the treatment process, structured accountability and behavioral change, safe and effective care delivery, and coordinated transition and aftercare planning. By combining strong clinical leadership, medical and psychiatric oversight, peer recovery support, and 24-hour residential supervision, we provide a comprehensive high-intensity residential treatment environment at 626 Denison Street designed to support stabilization, recovery, and long-term success.