D.C. Mun. Regs. r. 22-A3002

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

Rule 22-A3002 - CERTIFICATION PROCESS

3002.1

Subject to the initial transition period in § 3000.3, FSMHC providers shall be certified in accordance with the requirements of this Section.

3002.2

Each applicant seeking certification as an FSMHC shall submit a certification application in the format required by the Department.

3002.3

The Department shall review the certification application upon receipt to determine if it is complete. If a certification application is incomplete, the Department shall return the incomplete certification application to the applicant. An incomplete certification application shall not be regarded as a certification application. The Department shall deny any application that contains false representations or documents and the applicant shall be barred from resubmitting an application for twelve (12) months.

3002.4

Following the Department's review and acceptance of the documentation contained in the certification application, the Department shall determine whether the applicant's services and activities meet the certification standards described in this chapter. The Department shall schedule and conduct an on-site survey of the applicant's services to determine whether the applicant satisfies all certification standards.

3002.5

An FSMHC seeking recertification shall submit a recertification application at least ninety (90) calendar days prior to the termination of its current certification. An FSMHC that timely submits a renewal application may continue to provide FSMHC services until the Department takes action to renew or deny renewal of certification.

3002.6

The Department may also conduct an on-site survey at the time of certification renewal, or at any other time during the period of certification.

3002.7

Upon request, the Department shall be provided access to all FSMHC records, including but not limited to consumer records, claims and billing records, and FSMHC employee records, to verify compliance with certification standards, and may conduct interviews with FSMHC staff. All FSMHCs shall cooperate with the Department's certification and compliance reviews.

3002.8

Certification as an FSMHC shall be for one (1) calendar year for new applicants, and two (2) calendar years for existing providers seeking renewal. Certification shall start from the date of issuance of certification by the Department, subject to the FSMHC's continuous compliance with these certification standards. Certification shall remain in effect until it expires, is renewed, or is revoked pursuant to § 3003. The Certification shall specify the effective date of the certification and the date the certification expires.

3002.9

A Certification is not transferable from one organization to another.

3002.10

An applicant or FSMHC that fails to comply with these Department certification standards may receive a Statement of Deficiencies (SOD) from the Department. The SOD shall describe the areas of non-compliance, identify actions needed to bring operations into compliance, and establish a timeframe for the provider's submission of a written Corrective Action Plan (CAP). The Department may, at its discretion, proceed directly to denial or decertification without issuing an SOD when the deficiencies relate to the health or safety of consumers, or constitute a material misrepresentation, fraud, or abuse.

3002.11

When the Department issues a SOD, the applicant or FSMHC shall submit a CAP. The CAP shall describe the actions to be taken and specify a timeframe for correcting the areas of non-compliance. The CAP shall be submitted to the Department no later than (10) business days from the date of receipt of the Department's SOD.

3002.12

The Department shall notify the applicant or FSMHC whether the applicant or FSMHC's CAP is accepted within ten (10) business days after receipt. Failure to comply with the CAP shall be grounds for denial or decertification.

3002.13

The Department may issue certification after it verifies that the applicant or FSMHC has complied with its CAP and meets all the certification standards.

3002.14

These rules do not create any rights or entitlements. Certification as an FSMHC depends upon the Director's assessment of the need for additional providers(s) and availability of funds. No certifications shall be issued during the period of time that the Department has imposed a moratorium via published notice in the D.C. Register.

3002.15

The Director may deny or revoke certification if the applicant or FSMHC fails to comply with any certification standard, or if the FSMHC fails to maintain a provider agreement with DHCF.

3002.16

Certification shall be considered terminated and invalid if the FSMHC fails to apply for renewal of certification with a complete application ninety (90) calendar days prior to the expiration date of the current certification, voluntarily relinquishes certification or goes out of business.

3002.17

The FSMHC shall notify the Department within forty-eight (48) hours of any changes in its operation that affect the FSMHC's continued compliance with these certification standards, including changes in:

(a) Ownership or control;

(b) Services;

(c) Key clinical staff, e.g., psychiatrist, therapists, or the FSMHC Clinical Administrator; and

(d) Any affiliation and referral arrangements.

3002.18

Each certification application shall contain the following information:

(a) A list of the services to be provided, target population for its services and potential referral sources;

(b) Identification of the psychiatrist(s) who will provide clinical and administrative direction, and provide direct services;

(c) Personnel documentation including:

(1) Staff roster that includes for each individual the name, position, license/degree, full or part time status, and the services provided. Roster must include a full time Clinical Administrator, although one or more persons may share part time duties to equal full-time coverage.

(2) A signed contract for each clinical staff member, or a letter signed by each clinician that attests to his/her intention to become an employee with the organization. Documents must include the time frame of the commitment and the scope of service and responsibilities that will be expected as a condition of employment.

(3) Completed background checks on all personnel to ensure none of the individuals employed by, or affiliated with, the administration or governing board or body, if any, are excluded from participation in federal reimbursements or as a District contractor.

(4) Completed criminal background checks as outlined in D.C. Official Code § 44-551 and Title 22-B Chapter 47 for all unlicensed individuals employed or contracted with the FSMHC.

(5) Completed child protection registry check for all staff.

(6) A copy of the current license and resume for each licensed practitioner and a copy of the resume(s) for the designated fulltime equivalent Clinical Administrator(s).

(d) A program manual that contains all policies listed in § 3006;

(e) An organizational chart that clearly indicates all clinical and administrative positions within the FSMHC.

(1) If the FSMHC is contained within a larger parent organization, the chart must clearly show how the FSMHC program fits administratively and clinically into the larger organizational structure; and

(2) The chart shall clearly define the agency structure, staff responsibilities, lines of authority, and clinical process flow.

(f) A job description for the psychiatrist(s) that includes a description of how the psychiatrist(s) will provide clinical and administrative direction for all services provided by the FSMHC.

D.C. Mun. Regs. r. 22-A3002

Final Rulemaking published at 67 DCR 11929 (10/16/2020)