D.C. Mun. Regs. r. 22-A3711

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

Rule 22-A3711 - AUTHORIZATION OF AND REFERRALS TO SUD SUPPORTED EMPLOYMENT SERVICES

3711.1

Providers of Level Opioid Treatment Program, Level 1, Level 2.1 and Level 2.5 shall assess all clients eighteen (18) years of age and older for interest in and potential eligibility for SUD Supported Employment services as part of:

(a) Developing or updating the client's SUD person-centered plan of care; or

(b) Upon request by the client, family member, advocates, or other service providers.

3711.2

If a client is interested in SUD Supported Employment services, the SUD provider shall, in a manner specified by the Department, collect and submit the following information to the Department for review:

(a) The client's current comprehensive diagnostic assessment that documents the client's interest in employment; and

(b) The client's current SUD person-centered Plan of Care.

3711.3

To determine eligibility for SUD Supported Employment Services, the Department shall:

(a) Review the client's current comprehensive diagnostic assessment and person-centered Plan of Care; and

(b) Conduct an independent needs-based assessment in accordance with § 3710.1(g).

3711.4

Within three (3) business days after the receipt of the client's SUD Supported Employment referral from the SUD provider, the Department shall contact the client to schedule an appointment for the independent needs-based assessment. The Department shall conduct the independent needs-based assessment within ten (10) business days after the receipt of the referral, unless the consumer is unavailable for all available times within ten (10) days of the referral. The Department may close the referral if the client does not respond to the Department's scheduling efforts.

3711.5

The Department shall complete the independent needs-based assessment face-to-face or through telehealth as permitted by Title 29 DCMR § 910 using the Department-specified approved independent needs-based assessment tool.

3711.6

Qualified practitioners eligible to administer the independent needs-based assessments must be:

(a) Permitted to screen, assess and diagnose consumers in accordance with Title 22-A DCMR § 6339.13;

(b) Appropriately licensed in the District of Columbia or the jurisdiction where the services are delivered; and

(c) Practicing within the scope of their license.

3711.7

The Department shall complete an independent needs-based assessment annually for each client receiving Supported Employment services.

3711.8

The Department shall notify the client and their SUD provider of the SUD Supported Employment services authorization determination within three (3) business days after the administration of the independent needs-based assessment. Medicaid beneficiaries are entitled to Notice and Appeal rights pursuant to Title 29 DCMR § 9508 in cases of intended adverse action, such as an action to deny, discontinue, terminate, or change the manner or form of Medicaid-funded Supported Employment services. The Department shall provide local-only beneficiaries the same Notice and Appeal rights as those provided to Medicaid beneficiaries in Title 29 DCMR § 9508.

3711.9

The Department, SUD providers and SUD Supported Employment providers shall not deny or deem clients ineligible for SUD Supported Employment services on the basis of the client's receipt of SSI/SSDI, criminal and/or substance use history, current employment status, or physical impairments.

3711.10

If the Department authorizes the provision of SUD Supported Employment services, the Department shall within five (5) business days of authorization refer the client to the SUD Supported Employment provider of the client's choosing. The referral shall be in writing and include the following information:

(a) The client's SUD provider treatment team contact information;

(b) Contact information for the client, including emergency contact information; and

(c) The client's current SUD person-centered Plan of Care.

3711.11

The SUD Supported Employment provider, upon receipt of the referral, shall engage the client within three (3) business days.

3711.12

The SUD Supported Employment provider must have a Wait List Policy to track and manage timely access to services. The SUD Supported Employment provider must immediately notify the Department if it is unable to accept new clients.

3711.13

Department authorization of SUD Supported Employment services shall not exceed three-hundred sixty-five (365) calendar days. The SUD Supported Employment provider must notify the client's SUD provider to request a continuation of services at least forty-five (45) calendar days before the expiration of the authorization. Within five (5) business days after the request, the SUD provider shall provide the Department with the client's most recent person-centered Plan of Care and comprehensive diagnostic assessment, and request that the Department conduct an independent needs-based assessment to determine the client's continued eligibility for Supported Employment services. Upon receipt of the request, the Department shall conduct an independent needs-based assessment pursuant to the procedure described in §§ 3711.4 - 3711.8.

3711.14

SUD and/or Supported Employment providers shall reassess clients receiving Supported Employment services and review the SUD person-centered Plan of Care any time there is a significant change in the client's condition or situation that affects the progress toward the Supported Employment-related goals of the Plan of Care, including but not limited to a change in level of care, hospitalization, or incarceration.

D.C. Mun. Regs. r. 22-A3711

Final Rulemaking published at 67 DCR 10775 (9/4/2020); amended by Final Rulemaking published at 69 DCR 11733 (9/30/2022); amended by Final Rulemaking published at 70 DCR 16660 (12/29/2023)