D.C. Mun. Regs. tit. 22, r. 22-A3499
The following terms in this chapter have the meaning ascribed in this section:
Advanced Practice Registered Nurse ("APRN") -A person licensed as an advanced practice registered nurse in accordance with applicable laws and regulations of the District or jurisdiction where services are delivered.
Assertive Community Treatment team ("ACT team") - A mobile interdisciplinary team of qualified practitioners and other staff involved in providing ACT to a consumer.
Authorized - MHRS services that are prior authorized or reauthorized by the Department, in accordance with these standards.
Behavioral Concern - A behavioral and emotional reaction of childhood and adolescence that can range from normal to severe responses and can be categorized as troubling, disruptive, or threatening. Behavioral concerns can have varying ranges of manifestations by children that include but are not limited to poor concentration, changes in social interactions, sadness, poor academic performance, high levels of irritability, acting out aggressively, expressing anger inappropriately, and engaging in a variety of antisocial and destructive acts, including violence towards people and animals, destruction of property, lying, stealing, truancy, and running away from home.
Certified Addiction Counselor ("CAC") -A person certified as a Certified Addiction Counselor I or II in accordance with applicable laws and regulations of the District or jurisdiction where services are delivered.
Certification - The written authorization from the Department rendering an entity eligible to provide MHRS. The Department grants certification to community-based organizations that submit an approved certification application and satisfy the certification standards.
Certification Application - The application and supporting materials prepared and submitted to the Department by a community-based organization requesting a new certification or renewal of an existing certification to provide MHRS.
Certification Standards - The minimum requirements established by the Department in this chapter that a provider shall satisfy to obtain and maintain certification to provide MHRS and receive reimbursement from the District for MHRS.
Certified Peer Specialist -An individual who has completed the Peer Specialists Certification Program requirements and is approved to deliver Peer Support Services within the District's public behavioral health network.
Certified Recovery Coach -An individual with any DBH-approved recovery coach certification.
Child and Family Services Agency ("CFSA") - The District agency responsible for the coordination of foster care, adoption, and child welfare services and services to protect children against abuse or neglect.
Child-Parent Psychotherapy or CPP Fidelity Audit - A process by which the implementation of CPP, in accordance with the established standards and guiding principles, are annually evaluated.
Clinical Care Coordination - Coordination of care between the behavioral health clinician and the clinical personnel of an external provider (e.g., primary care, another behavioral health provider, payors, behavioral health authority, hospital).
Collateral Contact - A contact by a qualified practitioner or credentialed staff with any person other than the consumer.
Community Based Intervention Team ("CBI team") - The interdisciplinary team of qualified practitioners and other staff involved in providing CBI to a consumer.
Consumer - A person eligible to receive MHRS as set forth in this chapter.
Core Services - The following six (6) categories of MHRS: Diagnostic Assessment, Medication/Somatic Treatment, Counseling, Community Support, Crisis/Emergency Services, and Clinical Care Coordination.
Core Services Agency ("CSA") - A Department-certified community-based MHRS provider that has entered into a Human Care Agreement with the Department to provide specified MHRS.
Corrective Action Plan ("CAP") - A written plan prepared by either an applicant for certification or the certified MHRS provider describing the actions that the provider intends to take to correct or abate the violations described in an SOD issued by the Department.
CPP Fidelity Standards - The six (6) established interconnected standards of fidelity, as set forth by the developers of CCP.
CPP-FV Fidelity Standards - The six established interconnected standards of fidelity, as set forth by the developers of CCP-FV.
Credentialed Staff -Non-licensed staff or staff who are not qualified practitioners that are credentialed by the MHRS provider to perform certain MHRS or components of MHRS under the clinical supervision of an appropriate qualified practitioner.
Crisis Support Services - Mental health services that support the consumer through a crisis, such as meeting with the consumer in the community or an emergency department to help calm the consumer; implementing the crisis plan developed for the consumer; assisting the consumer to reach an emergency department; and providing pertinent mental health information about a consumer to an emergency department to assist in addressing a crisis.
Cultural and Linguistic Competence -The ability of an MHRS provider to deliver mental health services and mental health supports in a manner that effectively responds to the languages, values, and practices present in the various cultures of the MHRS provider's consumers.
Cultural Responsiveness- Understanding and appropriately including and responding to the combination of cultural variables and the full range of dimensions of diversity that an individual brings to interactions.
Department ("DBH") - The Department of Behavioral Health, the successor in interest to the Department of Mental Health and the Addiction and Prevention Recovery Administration.
Department of Health Care Finance ("DHCF") - The District's Medicaid authority.
Department of Youth Rehabilitation Services ("DYRS") - The District agency responsible for providing security, supervision, and residential and community support services for committed and detained juvenile offenders and juvenile persons in need of supervision.
Diagnostic Assessment Report -The report prepared by an independently licensed qualified practitioner that summarizes the results of the Diagnostic Assessment service and includes recommendations for service delivery. The Diagnostic Assessment report is used to initiate the Plan of Care.
Director - The Director of the Department of Behavioral Health.
District of Columbia ("District") - The government of the District of Columbia.
Economic Security Administration ("ESA") - The unit within the District of Columbia Department of Human Services that determines eligibility for medical assistance programs for District residents.
Electronic Health Record ("EHR")- An electronic record of patient health information from one (1) or more encounters in any care delivery setting and meeting the requirement of a designated record set under 45 C.F.R. §§ 164.501.
Enrollment - Process by which the Department adds a consumer to the MHRS system of care and assigns them to a provider after ascertaining their eligibility.
Evidence-Based Practice -A process that brings together the best available research, professional expertise, and input from consumers to identify and deliver services that have been demonstrated to achieve positive outcomes for individuals. Evidence-based programs and practices (EBPPs) are specific techniques and intervention models that have shown to have positive effects on outcomes through rigorous evaluations.
Functional Family Therapy - An evidence-based proprietary therapeutic service for children, youth, and their families to prevent children and youth who are already involved or at risk of becoming involved with the juvenile justice system from further penetrating the system.
Governing Authority - The designated individuals or governing body legally responsible for conducting the affairs of the MHRS provider.
Grievance - A description by any individual of his or her dissatisfaction with an MHRS provider, including the denial or abuse of any consumer right or protection provided by applicable Federal and District laws and regulations.
Human Care Agreement ("HCA") - A written agreement entered into by the certified MHRS provider and the Department which establishes a contractual relationship between the parties.
ICD-10 - The 10th Revision of the International Classification of Diseases and Related Health Problems.
Independent Living Program - A residential program licensed by the District in accordance with Title 29 DCMR Chapter 63, Licensing of Independent Living Programs for Adolescents and Young Adults.
Intensive Home and Community-Based Services or IHCBS -An intensive model of treatment adopted by the Department to prevent the utilization of out-of-home treatment resources by emotionally disturbed children and youth. IHCBS is the modality adopted for CBI Levels II and III.
Licensed Independent Clinical Social Worker ("LICSW") - A person licensed as an independent clinical social worker in accordance with applicable laws and regulations of the District or jurisdiction where services are delivered.
Licensed Independent Social Worker ("LISW") - A person licensed as a licensed independent social worker in accordance with applicable laws and regulations of the District or jurisdiction where services are delivered.
Licensed Marriage and Family Therapist ("LMFT") -A person licensed as a licensed marriage and family therapist under laws and regulations of the District or jurisdiction where services are delivered.
Licensed Graduate Professional Counselor ("LGPC") - A person licensed as a licensed graduate professional counselor in accordance with applicable laws and regulations of the District or jurisdiction where services are delivered.
Licensed Graduate Social Worker ("LGSW") -A person licensed as a licensed graduate social worker in accordance with applicable laws and regulations of the District or jurisdiction where services are delivered.
Licensed Practical Nurse ("LPN") - A person licensed as a practical nurse in accordance with applicable laws and regulations of the District or jurisdiction where services are delivered.
Licensed Professional Counselor ("LPC") - A person licensed as a licensed professional counselor in accordance with applicable laws and regulations of the District or jurisdiction where services are delivered.
Long-Term Placement Option - A permanent caregiver or permanent home. A group home or other residential placement is not a long-term placement option.
Medicaid - The medical assistance program approved by federal Centers for Medicare and Medicaid Services and administered by the Department of Health Care Finance, which enables the District to receive Federal financial assistance for its medical assistance program and other purposes as permitted by law.
Medical Necessity (or medically necessary) - Health care services or products that a prudent provider would provide to a client for the purpose of preventing, diagnosing, or treating an illness, injury, disease, or its symptoms in a manner that is:
Member - A consumer who has joined a Psychosocial Rehabilitation Clubhouse.
Mental Health Rehabilitation Services ("MHRS") - Mental health rehabilitative services provided by a certified MHRS provider to consumers in accordance with the District of Columbia State Medicaid Plan, the Department Memorandum of Understanding with the Department of Health Care Finance and this chapter.
Mental Illness - A substantial disorder of thought, mood, perception, orientation, or memory that grossly impairs judgment, behavior, capacity to recognize reality, or ability to meet the ordinary demands of life.
MHRS Provider -An organization certified by the Department to provide MHRS. MHRS provider are CSAs, sub-providers, and specialty providers.
Mobile Crisis Response Team - A team of mental health clinicians who provide face-to-face and telephone support to children and families in crisis.
Multisystemic Therapy ("MST") - An intensive model of treatment based on empirical data and evidence-based interventions that target specific behaviors with individualized behavioral interventions.
Natural Settings - The consumer's home; the consumer's residence, school, or workplace; or other locations in the community the consumer frequents, such as community centers, homeless shelters, street locations, or other public facilities. Natural settings do not include inpatient hospitals.
Natural Support - A non-professional person (including but not limited to a family member, friend, or employer) who supports a consumer in their treatment and recovery as outlined in the consumer's person-centered Plan of Care.
Organizational On boarding - The mechanism through which new employees acquire the necessary knowledge, skills, and behaviors to become effective performers. It begins with recruitment and includes a series of events, one of which is employee orientation, which helps new employees understand performance expectations and contribute to the success of the organization.
Out-of-home therapeutic resource - A psychiatric hospital or psychiatric residential treatment facility.
Permanent Caregiver - A natural or adoptive family or foster home that has cared for the consumer for at least six (6) consecutive months within the twelve (12) month period immediately preceding the referral for CBI. A group home or other residential placement is not a permanent caregiver.
Physician Assistant - A person licensed as a physician assistant in accordance with applicable laws and regulations of the District or jurisdiction where services are delivered.
Plan of Care (formerly called the Individual Plan of Care / Individual Recovery Plan) - The Plan of Care refers to what the DBH formerly called the IPC/IRP, and encompasses the provision of services to all consumers regardless of age.
Prior Authorization - Approval by the Department in advance for the initiation of an MHRS to a consumer.
Provisional Accreditation- A preliminary, conditional, or limited temporary accreditation from the Commission on Accreditation of Rehabilitation Facilities, The Joint Commission, or the Council on Accreditation.
Psychiatric residential treatment facility - Shall have the meaning ascribed in 42 CFR Subpart G, Section 483.352.
Psychiatrist - A person who is:
Psychologist - A person licensed as a psychology in accordance with applicable laws and regulations of the District or jurisdiction where services are delivered.
Psychology Associate - A person registered as a psychology associate in accordance with applicable laws and regulations of the District or jurisdiction where services are delivered.
Psychosocial Rehabilitation Clubhouse ("Clubhouse") - MHRS specialty service that assists individuals with behavioral health diagnoses to develop social networking, independent living, budgeting, self-care, and other skills that will assist them to live in the community and to prepare for securing and retaining employment. A Clubhouse shall operate in accordance with established standards coordinated by Clubhouse International and the standards set forth in 22-A DCMR Chapter 39.
Qualified Practitioner - A Qualified Practitioner is a behavioral health clinician appropriately licensed, certified, or registered in the District with Department of Health or in the jurisdiction where services are delivered. Pursuant to service specific MHRS standards a qualified practitioner may practice MHRS within the scope of their license, certification, or registration, and any applicable supervision requirements.
Referral - A recommendation to seek or request services or evaluation between a CSA and a sub-provider or specialty provider in order to assess or meet the needs of consumers.
Registered Nurse ("RN") - A person licensed as a registered nurse in accordance with applicable laws and regulations of the District or jurisdiction where services are delivered.
Residential Placement - A psychiatric residential treatment center, group home, independent living program, or other residence where children or youth are temporarily receiving services. A permanent home is not a residential placement.
Service specific standards -The certification standards described in §§3418 through 3430, which set forth the specific requirements applicable to each MHRS.
Specialty Provider - An MHRS provider certified by the Department to provide specialty services either directly or through contract.
Specialty Services - Assertive Community Treatment, Child-Parent Psychotherapy, Community Based Intervention, Functional Family Therapy, Psychosocial Rehabilitation Clubhouse, Intensive Day Treatment, Rehabilitation Day Services, Trauma-Focused Cognitive-Behavioral Therapy, Trauma Recovery and Empowerment Model, and Trauma Systems Therapy.
Statement of Deficiencies ("SOD") - A written statement of non-compliance issued by the Department, which describes the areas in which an applicant for certification or the certified provider fails to comply with the certification standards.
Subcontractor - A licensed independent practitioner qualified to provide mental health services in the District or in the jurisdiction in services are provided. A subcontractor may provide one (1) or more core service(s) under contract with a CSA. A subcontractor may also provide specialty service(s) under contract with a specialty provider.
Sub-provider - A community-based organization certified by the Department to provide one (1) or more core services.
Supported Employment Services - Evidence-based Mental Health Supported Employment program designed for MHRS consumers for whom competitive employment has been interrupted or is intermittent as a result of a severe mental illness. Services assist consumers in obtaining and maintaining permanent part-time or full- time employment in a competitive setting. Mental Health Supported Employment service providers shall be certified and deliver services to eligible consumers according to standards set forth in 22-A DCMR Chapter 37.
TF-CBT Practice Session Checklist - An instrument used to track whether supervisors and therapists are implementing TF-CBT in accordance with the established model.
Triaging - Prioritizing the level of crisis services required by a consumer, based upon the assessed needs of the consumer.
Urgent need - A situation where, due to a mental illness, there is no immediate risk to life, health, or property, but if the situation is not addressed promptly may turn into an emergency situation. An emergency situation is where a consumer is an immediate risk to life, health, or property due to a mental illness.
D.C. Mun. Regs. tit. 22, r. 22-A3499