Staffing and Clinical Oversight

Residential Medium-Intensity Addictions Treatment (ASAM Level 3.3) at Hope on the Hill Recovery is delivered by a comprehensive, multidisciplinary team that provides 24-hour residential supervision, structured therapeutic services, and appropriate medical and psychiatric oversight.

The staffing model for ASAM Level 3.3 at 626 Denison Street 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

The Residential Medium-Intensity program is supported by experienced leadership responsible for program operations, clinical quality, and regulatory compliance.

Facility Director / Program Director

A part-time Facility Director is on-site a minimum of 20 hours per week and provides overall oversight of the residential program. This role ensures that services are delivered in compliance with Maryland regulations, ASAM standards, and program policies, and that residential operations support safety, structure, and quality of care.

Clinical Supervision & Treatment Oversight

Clinical services within the ASAM Level 3.3 program are overseen by qualified clinical leadership to ensure medical necessity, treatment integrity, and coordination of care.

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

Direct therapeutic services are provided by licensed and certified professionals with experience in substance use disorder treatment and population-specific care. 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 substance use disorder treatment under approved clinical supervision, focusing on recovery skill development, relapse prevention, and functional improvement. These clinicians work collaboratively to support engagement, stability, and progress toward recovery goals.

Peer Recovery Support Services

Peer Recovery Support Specialists are an integral component of the ASAM Level 3.3 program and 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 and related conditions. Medical and psychiatric coverage is sufficient to provide initial diagnostic work-ups, identify medical or surgical issues requiring referral, and address medical concerns and respond to emergencies.

• Physician coverage: Minimum 4 hours per week; physician, nurse practitioner, or physician assistant on-site with additional on-call availability.
• Psychiatric services: Minimum 3 hours per week; psychiatrist or psychiatric nurse practitioner available.
• Nursing services: 40 hours per week; RN or LPN on-site to support medical monitoring, medication coordination, and health-related needs.

Residential & Overnight Support Staff

Because Residential Medium-Intensity treatment is a true 24-hour residential program, trained residential staff are present at all times to ensure safety, structure, and responsiveness. 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 cardiopulmonary resuscitation (CPR), and is responsible for resident safety, monitoring, and emergency response.

A Coordinated, Team-Based Model of Care

The ASAM Level 3.3 program at Hope on the Hill Recovery 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. By combining the foundational staffing of ASAM Level 3.1 with the enhanced medical and psychiatric supports required for ASAM Level 3.3, we provide a comprehensive residential treatment environment at 626 Denison Street designed to promote stability, engagement, and long-term recovery.