D.C. Mun. Regs. r. 22-A3858
A Supported Rehabilitative Residence (SRR) shall provide on-site rehabilitative services in addition to meeting the minimum MHCRF requirements for a homelike environment, staffing, and resident care set forth in §§ 3800, 3850 and 3852.
An SRR shall be appropriate for a maximum of eight (8) adults (unless a higher number is specifically authorized pursuant to § 3800.5) with a principal diagnosis of serious and persistent mental illness who require twenty-four (24) hour supervision and on-site rehabilitation and who may require specialized services on-site.
Each person seeking residential placement in an SRR shall have a principal diagnosis of mental illness, be in need of twenty-four (24) hour staff supervision to assist with ADLs, meals, lodging, and recreation, and shall also require on-site rehabilitation. Residents may remain in the residence, work, or participate in a structured day program or other daily activity. Attendance at a day program shall not be mandatory for persons seeking placement in an SRR.
Specialized services, such as medication administration, limited or intermittent nursing care, or physical therapy, shall be provided as necessary on a scheduled basis as established in the resident's IRP. These services shall be provided by appropriate and qualified:
An SRR shall maintain a staff to resident ratio of at least one (1) to eight (8), twenty-four (24) hours per day, and at least two (2) staff persons for every five (5) to eight (8) residents during periods of peak activity as provided in §§ 3858.6 and 3858.7. If there are four (4) or fewer residents, a second staff person is not required, except as provided in § 3858.8.
An SRR shall determine the hours of peak activity based upon the hours that meals are served and when most residents are home and awake. At a minimum, the following are peak hours for purposes of complying with this section and receipt of the per diem payments: 6:00 a.m. to 9:00 a.m. and 5:00 p.m. to 8:00 p.m.
The Department may approve a written MHCRF staffing plan with different peak hours upon a showing that the MHCRF is providing adequate staffing coverage based upon the residents' individual schedules. The SRR shall maintain a record of any changes in the peak activity hours and work schedules and the reason for the changes.
An SRR shall provide awake supervision a minimum of sixteen (16) hours a day and shall provide awake supervision twenty-four (24) hours a day when required to adequately address the needs of one or more residents experiencing a period of destabilization or residents who require twenty-four (24) hour awake supervision on an ongoing basis in order to be maintained within the SRR and in the community.
An SRR shall have the capacity to provide one-to-one support to residents on a periodic basis, as needed, to care for and safeguard the resident and other residents of the facility.
In addition to the general staff requirements in this chapter, staff shall be responsible for providing rehabilitative services, therapeutic support, management, and re-direction consistent with the resident's IRP. Staff shall provide a consistent and therapeutic environment where through daily contact and interaction the resident's needs and progress are assessed.
Rehabilitation in an SRR shall be coordinated under the direction of the resident's designated clinical treatment team in conjunction with the Residence Director and facility staff.
There shall be an assigned Residence Director who shall provide or arrange for supervision and coordination of rehabilitative and other required services at the SRR to ensure that each resident's health, safety, and welfare are protected.
The resident's clinical treatment team and the facility's Residence Director, in conjunction with the Department shall determine whether a person is appropriately placed in an SRR.
The Residence Director and staff at an SRR shall also meet any additional qualifications or higher staff-to-resident ratios required pursuant to a current contract between the MHCRF and the Department for SRR services.
D.C. Mun. Regs. r. 22-A3858