D.C. Mun. Regs. r. 22-A2513

Current through Register Vol. 71, No. 25, June 21, 2024

Rule 22-A2513 - HEALTH HOME STAFFING REQUIREMENTS

2513.1

Health Homes shall have the following staff:

(a) Health Home Director;

(b) Nurse Care Manager(s); and

(c) Primary Care Liaison.

2513.2

The Health Home Director shall be responsible for managing the CSA's Health Home program. The Health Home Director shall have a Master's level education in a health-related field. There shall be a point five (.5) Full Time Equivalent staff person for every Health Home Team of three hundred (300) consumers.

2513.3

The Nurse Care Manager shall be an Advanced Practice Registered Nurse (APRN) or Registered Nurse (RN) with relevant experience and expertise in care of physical health care. The Nurse Care Manager shall lead and/or manage team-based assessment, care plan development and care plan implementation activities. The Health Home provider shall ensure one (1) full-time Nurse Care Manager per one hundred and fifty (150) enrolled Health Home consumers.

2513.4

The Primary Care Liaison shall be staffed with a licensed clinician or combination of clinicians based on the needs of the individual Health Home consumer. The Primary Care Liaison shall have experience in the care and treatment of the serious mentally ill and be a Medical Doctor, APRN, Nutritionist, Licensed Independent Clinical Social Worker, Licensed Professional Counselor, Physician

Assistant or Registered Nurse. A provider may use a combination of these staff to meet the full time equivalent (FTE) requirement. The Primary Care Liaison shall be licensed in the District of Columbia. The Health Home provider shall ensure one (1) full-time Primary Care Liaison per five hundred (500) Health Home enrollees. The responsibilities of the Primary Care Liaison shall include the following:

(a) Provide medical consultation to the Health Home team;

(b) Coordinate care with external medical and behavioral health providers; and

(c) Assist with developing effective Health Home comprehensive care management and coordination of care protocols involving community and hospital medical providers.

2513.5

All Health Homes shall provide Health Home services in accordance with their Human Care Agreement (HCA) with the Department.

2513.6

All Health Homes providers shall obtain a National Provider Identification (NPI) number for themselves and all personnel performing Health Homes services through the provider. All providers shall register themseles and all personnel performing Health Home services with the Department of Health Care Finance's designated information system prior to billing for services.

2513.7 Deleted.

2513.8 Deleted.

D.C. Mun. Regs. r. 22-A2513

Final Rulemaking published at 63 DCR 849 (1/22/2016); amended by Final Rulemaking published at 66 DCR 5625 (5/3/2019); amended by Final Rulemaking published at 69 DCR 13495 (11/4/2022)