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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-A3421. INTENSIVE DAY TREATMENT
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3421.1Intensive Day Treatment is a facility-based, structured, intensive, and coordinated acute treatment program which serves as an alternative to acute inpatient treatment or as a step-down service from inpatient care, rendered by an interdisciplinary team to provide stabilization of psychiatric impairments.
3421.2Daily physician and nursing services are essential components of Intensive Day Treatment services.
3421.3Intensive Day Treatment shall:
(a)Be time-limited and provided in an ambulatory setting to consumers who are not in danger but have behavioral health issues that are incapacitating and interfering with their ability to carry out daily activities;
(b)Be provided within a structured program of care which offers individualized, strengths-based, active, and timely treatment directed toward the alleviation of the impairment which caused the admission to Intensive Day Treatment;
(c)Be an active treatment program that consists of documented mental health interventions that address the individualized needs of the consumer as identified in the IRP/IPC;
(d)Consist of structured individual and group activities and therapies that are planned and goal-oriented and provided under active psychiatric supervision;
(e)Offer short-term day-programming consisting of therapeutically intensive, acute, and active treatment;
(f)Be services that closely resemble the intensity and comprehensiveness of inpatient services; and
(g)Include psychiatric, medical, nursing, social work, occupational therapy, Medication/Somatic Treatment, and psychology services focusing on timely crisis intervention and psychiatric stabilization so that consumers can return to their normal daily lives.
3421.4Each consumer shall participate in at least five (5) hours of Intensive Day Treatment per day, in order for the services to be reimbursable.
3421.5Each consumer shall be directly evaluated by a qualified practitioner as part of the admissions process.
3421.6Each consumer's care shall be supervised by a qualified practitioner who assumes primary responsibility for the consumer's assessment, treatment planning, and treatment services.
3421.7Each consumer shall be assigned to a full-time staff member who assists the consumer and the consumer's family to assess the consumer's needs and progress toward achievement of Treatment Goals.
3421.8 An interdisciplinary treatment team shall meet within one (1) working day of the consumer’s admission to develop an initial Intensive Day Treatment IRP.
3421.9 Each Intensive Day Treatment IRP shall be updated every three (3) days and shall be reviewed by the interdisciplinary treatment team on a weekly basis and upon termination of treatment.
3421.10All Intensive Day Treatment services shall occur under the supervision of a psychiatrist. A psychiatrist shall assess each consumer on a daily basis.
3421.11 Each Intensive Day Treatment provider shall have policies and procedures included in its Service Specific Policies addressing the provision of Intensive Day Treatment (Intensive Day Treatment Organizational Plan) which includes the following:
(a) A description of the particular treatment models utilized, types of intervention practiced, and typical daily curriculum and schedule;
(b) A description of the staffing pattern and how staff is deployed to ensure that the required staff-to-consumer ratios are maintained, including how unplanned staff absences and illnesses are accommodated; and
(c)A description of how the Intensive Day Treatment IRP is modified or adjusted to meet the needs specified in each consumer’s IRP/IPC.
3421.12The Intensive Day Treatment provider shall maintain a minimum staffing ratio of one (1) staff for every eight (8) consumers. The Intensive Day Treatment provider shall maintain a minimum staffing pattern sufficient to address consumer needs, including adequate physician, nursing, social work, therapy, and psychology services to assure the availability of intensive services.
3421.13Intensive Day Treatment units in excess of seven (7) units within a twelve (12) month period shall require pre-authorization from DMH.
3421.14Intensive Day Treatment shall not be billed on the same day as any other MHRS except for Community Support, Crisis/Emergency or CBI.
3421.15Intensive Day Treatment shall only be provided in an MHRS provider service site.
3421.16Qualified practitioners of Intensive Day Treatment are:
(a)Psychiatrists;
(b)Psychologists;
(c)LICSWs;
(d)APRNs;
(e)RNs;
(f)LPCs;
(g)LISWs; and
(h)Addiction counselors.
3421.17Credentialed staff shall be authorized to provide Intensive Day Treatment under the supervision of a qualified practitioner as set forth in § 3413.3.