info@east20thwellness.com
(443) 320-2706
1114 E 20th Street, Baltimore, MD 21218

Residential Medium-Intensity Addictions Treatment (ASAM Level 3.3)

Structured, 24-Hour Residential Care with Enhanced Therapeutic Support

Residential Medium-Intensity Treatment Services

1114 E 20th Street LLC provides Residential Medium-Intensity Addictions Treatment (ASAM Level 3.3) for adults who require a highly structured, supportive residential environment combined with moderate-intensity therapeutic services to address substance use disorders and related functional impairments.

This level of care is appropriate for individuals who are capable of self-care and clinically stable, yet are not ready to return to independent or family living without a controlled environment and consistent therapeutic engagement. Residential Medium-Intensity treatment offers a balance of 24-hour residential care, daily structure, and increased therapeutic hours, allowing participants to stabilize, build recovery skills, and prepare for reintegration into the community.

Population Served

The Residential Medium-Intensity (ASAM Level 3.3) program serves adults age 18 and older who reside in Maryland and meet ASAM Level 3.3 criteria.

Participants appropriate for this program are individuals who:

  • Have a moderate or severe substance use disorder
  • Are able to perform activities of daily living
  • Are medically and psychiatrically stable
  • Require a controlled, structured residential environment to remain engaged in treatment
  • Are not yet able to safely return to independent or family living

This level of care is particularly appropriate for individuals whose substance use disorder has resulted in cognitive impairments, physical or mental disabilities, or functional limitations that interfere with success in less structured treatment settings.

Entry Criteria (ASAM Level 3.3)

Individuals admitted to Residential Medium-Intensity services must demonstrate motivation for treatment and meet ASAM Level 3.3 medical necessity criteria, which may include:

  • A diagnosis of moderate or severe substance use disorder
  • No active withdrawal symptoms, or withdrawal needs that can be safely managed within a Level 3.3 setting
  • Biomedical conditions, if present, that are stable and do not require skilled nursing care
  • Cognitive impairments related to prolonged substance use
  • Physical or mental disabilities resulting from substance-related disorders
  • Limited recognition of relapse triggers or limited insight into continued substance use
  • Continued substance use posing imminent danger or harm to self or others without 24-hour monitoring
  • A recovery environment or social network that poses a high risk of neglect, abuse, or continued substance use

Residential Setting

Residential Medium-Intensity services are provided in a community-based residential environment, rather than a hospital or institutional setting.

Services may occur in:

  • Residential facilities
  • Office-based settings
  • Community-based locations
  • In-home environments, when clinically appropriate

Services are NOT provided in:

  • Hospital medical units
  • Nursing homes
  • Adult medical daycare centers
  • Emergency rooms (when included in a hospital rate)

24/7 Residential Care & Intake

This program operates as a true residential program, meaning participants live on-site and receive 24-hour care, supervision, and monitoring.

Intake and admissions are available 24/7

Residential support services are available at all times to ensure:

Safety and structure
Crisis response
Support with daily living needs

Program Schedule & Daily Structure

While residential care is continuous, therapeutic and clinical services are delivered during scheduled service hours to support consistency and engagement.

Clinical & Program Service Hours

Monday – Friday

8:00 AM – 5:00 PM

During these hours, participants engage in a structured daily schedule that includes therapeutic activities, recovery-focused services, and individualized support.

After-Hours & Weekend Services

Residential care and monitoring remain available 24 hours a day, including evenings, nights, and weekends.

After-hours services are available for:

  • Crisis intervention
  • Scheduled appointments
  • Residential support needs

Therapeutic Intensity & Frequency of Services

Residential Medium-Intensity (ASAM Level 3.3) treatment provides a higher level of therapeutic engagement than low-intensity residential care.

Participants receive: Between 20 and 35 hours of therapeutic activities per week

Services delivered in accordance with COMAR 10.09.06

Interventions focused on:

Relapse prevention
Recovery skill development
Emotional regulation
Coping strategies
Functional skill building
Preparation for community reintegration

A minimum of five (5) hours per week is specifically directed toward relapse prevention, application of recovery skills, and community reintegration.

Meals & Medication Support

To promote stability, wellness, and adherence to treatment, the program provides structured meals and medication support.

Meals and medication support are provided daily at:

7:00 AM
12:00 PM
5:00 PM

Medication support includes assistance with self-administration and coordination with prescribing providers, when appropriate and permitted.

Length & Frequency of Stay

Residential Medium-Intensity services are authorized based on medical necessity and individual treatment needs.

  • Up to two non-consecutive residential stays per rolling calendar year
  • Up to 30 days per stay
  • Continued stay is subject to authorization and ASAM criteria

Exceptions may apply for court-ordered specialty populations, including:

  • Health-General §8-507
  • Title 3 commitments

Services Provided

Residential Medium-Intensity services are designed to support stabilization and recovery through structured treatment and ancillary supports.

Individual substance use counseling
Group therapy and therapeutic activities
Peer recovery support services
Relapse prevention education
Coping skills and emotional regulation training
Life skills development
Case management and care coordination
Opioid Treatment Services

All services are rendered by authorized clinical professionals in accordance with the Maryland Health Occupations Article.

Transition & Discharge Planning

Discharge and transition planning begins at admission and continues throughout all phases of treatment.

A participant is ready for discharge or transition when:

  • Individual treatment goals are achieved
  • Recovery supports are established
  • Referrals to ongoing services are completed, when appropriate

Transition planning focuses on continuity of care and long-term recovery success.

Philosophy of the Program

The Residential Medium-Intensity program is designed to assist individuals in developing and maintaining coping skills that support adjustment and integration into their living environments and communities.

Services are designed to:

  • Support recovery, health, and well-being
  • Enhance quality of life
  • Reduce symptoms and unmet needs
  • Build resilience
  • Restore and improve functioning
  • Support community integration

Clients—and when appropriate, family members—are empowered to make informed decisions about care.

Program Goals

The overall goal of Residential Medium-Intensity treatment is to increase quality of life through specialized addiction treatment services, while reducing the need for higher levels of care.

Areas of focus may include:

Recovery and relapse prevention
Education and vocational development
Parenting and family relationships
Emotional regulation and coping skills
Anger management
Grief and loss
Spirituality, when desired

Specific objectives include:

  • Improving mood and affect in daily living
  • Improving social, family, and community integration
  • Reducing the likelihood of hospitalization or higher levels of care

Payment, Insurance & Referrals

Services are available to individuals with:

  • Maryland Medicaid
  • Certain dually eligible Medicare coverage
  • Uninsured individuals who qualify

Assistance with Medicaid application and temporary coverage may be available.

We accept referrals from:

Self-referrals and walk-ins
Community stakeholders
Healthcare providers
Courts and governmental agencies

Take the Next Step Toward Recovery

For individuals who need increased structure, more therapeutic engagement, and a supportive residential environment, Residential Medium-Intensity Addictions Treatment (ASAM Level 3.3) may be the right level of care.

Call Now — (443) 320-2706

1114 E 20th Street LLC is committed to providing structured, compassionate care that supports recovery and community reintegration.