D.C. Mun. Regs. r. 22-A8024

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

Rule 22-A8024 - BEHAVIORAL HEALTH STABILIZATION PROGRAMS: GENERAL REQUIREMENTS

8024.1

All behavioral health stabilization programs shall, at a minimum, assess individuals during intake to determine if the individual may suffer from a mental illness or SUD. Assessment shall include an initial health screening that incorporates the following, as applicable:

(a) Presenting problem, including source of distress, precipitating events, associated problems or symptoms, and recent progression;

(b) Immediate risks for self- harm, suicide and violence;

(c) Past and present substance use;

(d) Immediate risks related to serious intoxication or withdrawal;

(e) Past and present mental disorders, including posttraumatic stress disorder ("PTSD") and other anxiety disorders, mood disorders, and eating disorders;

(f) Past and present experience of violence and trauma, including sexual victimization and interpersonal violence;

(g) Legal history, including whether an individual is court-ordered to treatment or under the supervision of the Department of Corrections; and

(h) Employment and housing status.

8024.2

If an individual screens positive for SUD, the provider shall do the following:

(a) Offer the opportunity for the individual to receive SUD treatment in addition to behavioral health stabilization services, if the provider also offers the applicable services. If the individual declines, the provider shall make referrals for the individual to receive SUD treatment at another qualified provider; or

(b) If the provider does not offer treatment for SUD, the provider shall ensure the individual is referred to an appropriate SUD provider.

8024.3

A certified provider shall not deny admission for services to an individual because that individual is receiving MAT services.

8024.4

Each provider shall ensure that all staff comply with all Federal and District laws and regulations pertaining to scope of practice, licensing requirements, and supervision requirements.

8024.5

Behavioral health stabilization facilities' physical design and structure shall have sufficient area(s) for indoor social and recreational activities.

8024.6

Behavioral health stabilization providers shall comply with all construction codes housing codes and zoning requirements applicable to the facility, including all Certificate of Occupancy, BBL, and Construction Permit requirements.

8024.7

Each newly established behavioral health stabilization provider shall provide proof of a satisfactory pre-certification inspection by DCRA for initial certification, dated not more than forty- five (45) calendar days prior to the date of submission to the Department, including proof that the provider is in compliance with the District of Columbia Property Maintenance Code (12-G DCMR) and Housing Code (14 DCMR), documentation of the inspection date, findings and proof of abatement certified by DCRA of all deficiencies identified during the inspection (as applicable). This requirement may be met by submission of a Certificate of Occupancy or a BBL dated within the past six (6) months, provided that the applicant can demonstrate that DCRA performed an onsite inspection of the premises.

8024.8

A provider that offers overnight accommodations shall not operate more beds than the number for which it is authorized by the Department.

8024.9

Other than routine household duties, no individual shall be required to perform unpaid work.

8024.10

Each behavioral health stabilization program shall have rules consistent with this chapter and that include rules concerning the following, as appropriate:

(a) The use of tobacco, alcohol, and other substances;

(b) The use of the telephone;

(c) Utilizing, viewing, or listening to cell phones, television, radio, computers, CDs, DVDs, or other media such as social media;

(d) Movement of individuals in and out of the facility, including a requirement for escorted movements by program staff or another agency-approved escort;

(e) A policy that addresses search and drug testing upon return to the site; and

(f) The prohibition of sexual relations between staff or volunteers and individuals served.

8024.11

Each provider shall make available the rules defined in §8024.10.

8024.12

A program that provides overnight accommodations shall ensure that evening and overnight shifts have at least two (2) staff members on duty. A clinician shall be on-call or on-site at all times.

8024.13

Each provider shall operate according to all applicable Federal and District laws and regulations relating to fraud, waste, and abuse in health care, the provision of mental health services and the Medicaid program. A provider's failure to report potential or suspected fraud, waste or abuse may result in sanctions, cancellation of a contract, or exclusion from participation as a behavioral health stabilization provider. Each provider shall:

(a) Cooperate and assist any District or Federal agency charged with the duty of identifying, investigating, or prosecuting suspected fraud, waste or abuse;

(b) Provide the Department with regular access to the provider's medical and billing records, including electronic medical records, within twenty- four (24) hours of a Departmental request, or, immediately in the case of emergency;

(c) Be responsible for promptly reporting suspected fraud, waste, or abuse to the Department, taking prompt corrective actions consistent with the terms of any contract or subcontract with the Department, and cooperating with DHCF or other governmental investigations; and

(d) Ensure that none of its practitioners have been excluded from participation as a Medicaid or Medicare provider. If a practitioner is determined to be excluded by the Center for Medicare and Medicaid Services ("CMS"), the provider shall notify the Department immediately.

8024.14

Each provider shall establish and adhere to policies and procedures requiring the provider to make language access services available at no cost as needed for Limited or Non-English proficient individuals, ("Language Access Policy"). The Language Access Policy shall:

(a) Document primary language information in an individual's clinical record at the point of entry, if known, with notations on how to engage the individual in communication if unknown;

(b) Arrange for the provision of language access services at no cost to Limited or Non-English proficient individual;

(c) Ensure public notices regarding language access services are posted in regularly encountered waiting rooms, reception areas, and other areas of initial contact;

(d) Ensure that the public is aware of language interpretation services;

(e) Provide a quarterly report on the number of enrolled individuals who receive language access services to the Department's Language Access Coordinator. The information shall include the following information:

(i) The number of individuals who have Limited or Non-English proficiency, and the languages spoken;

(ii) The frequency with which Limited or Non-English proficient individuals come into contact with the provider; and

(iii) The number and types of languages spoken by agency staff.

(f) Provide annual training to all public access staff on how to provide ongoing language services; and

(g) Ensure immediate notification of the DBH Language Access Coordinator when unable to meet language access needs.

8024.15

The Language Access Policy shall allow staff and contractors who do not possess valid certification from the Registry of Interpreters for the Deaf to be credentialed based on skills in mental health interpreting gained through supervised experience. For purposes of this rule, supervised experience shall include supervision by an interpreter certified by the National Registry of Interpreters for the Deaf and ongoing training in sign language interpreting, preferably related to mental health, and may include on-the-job learning prior to employment by the provider.

8024.16

Each provider shall utilize a Tele Typewriter ("TTY") communications line (or an equivalent) to enhance the provider's ability to respond to service requests and needs of individuals. Provider staff shall be trained in the use of such communication devices as part of the annual language access training.

8024.17

Each provider shall establish and adhere to anti-discrimination policies and procedures relative to hiring, promotion, and provision of services to individuals that comply with applicable Federal and District laws and regulations ("Anti-Discrimination Policy").

D.C. Mun. Regs. r. 22-A8024

Final Rulemaking published at 68 DCR 1623 (2/5/2021)