8027.1 Mobile crisis and outreach providers, or community response teams ("teams"), shall be dispatched into a home or community setting where a crisis may be occurring to begin the process of assessment and treatment. Teams shall provide acute behavioral health crisis interventions and behavioral health outreach services to individuals in the community while minimizing the individual's involvement as appropriate with law enforcement, emergency room use, or hospitalizations.
8027.2 Crisis intervention services provide rapid response, assessment, and treatment of behavioral health crisis situations that involve adults.
8027.3 Behavioral health outreach services identify individuals in the community who need behavioral health and other social services. Providers make repeated visits to individuals to build relationships and connect them to needed services.
8027.4 Teams shall identify individuals in need of behavioral health services and begin the process of engaging them in treatment, including screening for mental health and substance use service needs, developing rapport, support while assisting with immediate needs, and referrals to appropriate resources. Teams shall assist with connections to treatment, care coordination, and other social services as required. Teams shall also administer First Aid, CPR, and naloxone as appropriate.
8027.5 Teams shall be available on-call twenty- four (24) hours per day, seven (7) days per week and shall be staffed with two (2) individuals per team at all times pursuant to § 8027.12, one (1) of whom must be licensed. In the event services are needed to complete an FD-12, only one (1) DBH-certified officer-agent need participate.
8027.6 Teams shall serve all who present for services, regardless of insurance status or ability to pay.
8027.7 Teams shall offer services in a community setting, including the individual's home, on the streets, residential facilities, hospitals, and nursing homes, for assessing the individual's immediate behavioral health needs.
8027.8 Each provider shall establish and adhere to policies and procedures which govern the provision of services in natural settings ("Natural Settings Policy"), including the individual's home or community setting. The Natural Settings Policy shall require the provider to document how it respects individual's and families' rights to privacy and confidentiality when services are provided in natural settings.
8027.9 Teams shall include co-response with local law enforcement as appropriate.
8027.10 An Officer Agent shall complete and follow all FD-12 protocol for individuals who appear to be in imminent danger of harming themselves or others due to mental illness.
8027.11 Adult mobile crisis and outreach providers shall ensure all team members participate in the Department's Officer Agent training.
8027.12 Adult mobile crisis and outreach programs shall provide the following services:
(a) Mobile crisis interventions, subject to the following provisions: (i) Rapid response, assessment, and resolution of behavioral health crisis situations involving adults. Services shall optimize clinical interventions by meeting individuals in home or community settings.(ii) Face-to-face or telephonic service provided to individuals involved in an active behavioral health crisis. The provider shall rapidly respond to, evaluate and screen the presenting situation, assist in immediate stabilization and resolution, reduce the risk of immediate danger to the individual or others, and ensure necessary referrals for the individual's access to care at the appropriate level.(iii) Mobile crisis interventions that are short-term and provide follow-up stabilization services, including additional therapeutic responses as needed, psychiatric consultation, and referrals and linkages to all medically necessary behavioral health services and supports.(iv) Mobile crisis intervention activities shall also include, as appropriate: (A) Screening for eligibility and referral for SUD and/or mental health services;(B) Pre-arrest diversion;(C) Development of a safety plan or crisis diversion plan;(D) Linkage to additional stabilization services;(E) Secure access to higher levels of care; and(F) Assistance identifying natural supports and community supports during a crisis.(v) Mobile crisis intervention services require documentation using at least one (1) encounter note explaining the array of services provided during the service.(b) Behavioral health outreach services, subject to the following provisions:(i) The behavioral health outreach service shall include an initial evaluation and assessment for individuals in the community who are unable or unwilling to use clinic- or hospital-based services, or for individuals for whom hospitalization is not clinically appropriate. Other activities include linkages to other services or providers; providing emotional support; life skills education; and therapeutic interventions as appropriate.(ii) Teams shall offer these services in a community setting, including the individual's home and on the streets.(iii) Behavioral health outreach encounters shall also include, as appropriate: (A) Linkage to relevant insurance and public assistance programs;(C) Recovery coaching; and/or(D) Screening for eligibility and referral for SUD and/or mental health services.(iv) Behavioral health outreach services require documentation using at least one (1) encounter note explaining the array of services provided during the service.8027.13 Qualified practitioners of adult mobile crisis and behavioral health outreach services in accordance with this chapter and with their scope of practice are:
(l) Psychology Associates;(n) Certified Peer Specialists;(o) Certified Recovery Coaches;(p) An individual with at least a bachelor's degree from an accredited college or university in social work, counseling, psychology, or closely related field, and training or relevant experience in substance use or mental health; or (q) An individual with at least four (4) years of relevant, qualifying full-time- equivalent experience in behavioral health service delivery who demonstrates skills in developing positive and productive community relationships and the ability to negotiate complex service systems to obtain needed services and resources for individuals. 8027.14 Credentialed staff shall be permitted to provide psychiatric crisis stabilization services under the supervision of an independently licensed practitioner.
D.C. Mun. Regs. r. 22-A8027
Final Rulemaking published at 68 DCR 1623 (2/5/2021)