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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 22. HEALTH |
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SubTilte 22-A. MENTAL HEALTH |
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Chapter 22-A34. MENTAL HEALTH REHABILITATION SERVICES PROVIDER CERTIFICATION STANDARDS |
Section 22-A3415. DIAGNOSTIC/ASSESSMENT
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3415.1A Diagnostic/Assessment is an intensive clinical and functional evaluation of a consumer's mental health condition by the Diagnostic/Assessment team that results in the issuance of a Diagnostic Assessment report with recommendations for service delivery that provides the basis for the development of an IRP/IPC. A psychiatrist shall supervise and coordinate all psychiatric and medical functions required by a consumer's Diagnostic/Assessment.
3415.2A Diagnostic/Assessment shall:
(a)Determine whether the consumer is appropriate for and can benefit from MHRS based upon the consumer's diagnosis, presenting problems, and recovery goals; and
(b)Evaluate the consumer's level of readiness and motivation to engage in treatment.
3415.3The Diagnostic/Assessment team shall consist of at least two (2) qualified practitioners, and shall include the following persons:
(a)A psychiatrist, psychologist, LICSW, or APRN to establish the diagnosis;
(b)An approving qualified practitioner; and
(c)A qualified practitioner who is knowledgeable about community resources, if one of the required Diagnostic/Assessment team members does not possess this knowledge.
3415.4An initial Diagnostic/Assessment shall be performed by a Diagnostic/Assessment team for each consumer being considered for enrollment with a CSA.
3415.5The Diagnostic/Assessment shall include the following elements:
(a)A chronological behavioral health history of the consumer's symptoms, treatment, treatment response, and attitudes about treatment over time, emphasizing factors that have contributed to or inhibited previous recovery efforts;
(b)For youth and adults, the chronological behavioral health history includes both psychiatric history and substance abuse history, treatment history for either or both diagnoses and the consumer's perception of the outcome;
(c)Biological, psychological, familial, social, and environmental dimensions and identified strengths and weaknesses in each area;
(d)A description of the presenting problem(s), including source of distress, precipitating events, associated problems or symptoms, and recent progression;
(e)Both a strengths summary and a problem summary, which address the following:
(1)Risk of harm;
(2)Functional status, including relevant emotional and behavioral conditions or complications and addressing self-control, self-care, interpersonal abilities, coping, and independent living skills;
(3)Co-morbidity, including biomedical conditions and complications;
(4)Recovery environment, including supports and stressors; and
(5)Treatment and recovery history, including relapse potential;
(f)Diagnoses on all five (5) Axes of the DSM-IV;
(g)A review of the consumer's alcohol and substance abuse history and presenting problem(s), including an assessment of substances used and intensity of use, the likelihood and severity of withdrawal, and the medical and behavioral risk secondary to intoxication. This review either identifies or excludes substance abuse or dependence as a co-occurring treatment need;
(h)Assessment of the need for psychiatric hospitalization for consumers being referred to psychiatric inpatient services to assure that less restrictive alternatives are considered and used when appropriate;
(i)Evidence of an interdisciplinary team process; and
(j)Evidence of consumer participation including, families or guardians where required.
3415.6The Diagnostic/Assessment may include psychological testing.
3415.7Following the completion of the Diagnostic/Assessment, a summary of findings and recommendations for treatment shall be listed in a Diagnostic/Assessment report. A Diagnostic/Assessment report shall identify barriers to be addressed during treatment in order to reduce or eliminate identified deficits.
3415.8A qualified practitioner shall complete the Diagnostic/Assessment report no later than ten (10) business days after the completion of the Diagnostic/Assessment by the Diagnostic/Assessment team. The qualified practitioner shall provide the Diagnostic/Assessment report to the approving qualified practitioner, and the approving qualified practitioner shall incorporate results of the Diagnostic/Assessment into the IRP/IPC.
3415.9The approving qualified practitioner shall convene the consumer, the consumer's family and significant others, if appropriate, and the consumer's clinical manager to review the Diagnostic/Assessment report and develop the IRP/IPC.
3415.10One Diagnostic/Assessment shall be allowable every six (6) months. Additional units of Diagnostic/Assessment shall be allowable when pre-authorized by DMH for:
(a)Periodic assessment;
(b)Pre-Hospitalization screening;
(c)Neuro-psychological assessment; or
(d)Re-Admission to Rehabilitation/Day Services.
3415.11Diagnostic/Assessment shall not be billed on the same day as ACT.
3415.12Diagnostic/Assessment services shall be provided:
(a)At the MHRS provider's service site;
(b)In natural settings, including the consumer's home or other community setting; or
(c)In a residential facility of sixteen (16) beds or less.
3415.13Qualified practitioners of Diagnostic/Assessment authorized to both diagnose and assess are:
(a)Psychiatrists;
(b)Psychologists;
(c)LICSWs; and
(d)APRNs.
3415.14Qualified practitioners of Diagnostic/Assessment authorized to provide assessment services under the supervision of a qualified practitioner identified in § 3415.13 are:
(a)RNs;
(b)LISWs;
(c)LPCs; and
(d)Addiction counselors.
3415.15Credential staff shall be authorized to provide assessment services under the supervision of a qualified practitioner as set forth in § 3413.3.