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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-A63. CERTIFICATION STANDARDS FOR SUBSTANCE USE DISORDER TREATMENT AND RECOVERY PROVIDERS |
Section 22-A6326. LEVELS OF CARE: ASSESSMENT AND IDENTIFICATION
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6326 LEVELS OF CARE: GENERAL REQUIREMENTS
6326.1 All individuals entering SUD treatment must be assessed and assigned to a particular level of care (LOC) in accordance with the Department-approved assessment tool(s) and the ASAM criteria. Any limitation on services or authorization requirements identified throughout this chapter shall only apply to SUD services provided under the Department’s Human Care Agreement. No limitation on service or pre-authorization requirement shall be applied to a Medicaid managed care beneficiary receiving SUD services under the ASARS program if the limitation or pre-authorization violates federal or District parity requirements.
6326.2 Each provider is responsible for ensuring that the client receives treatment in accordance with ASAM LOC requirements and this chapter.
6326.3 All treatment shall be:
(a) Person-centered;
(b) Provided only if determined to be medically necessary in accordance with the treatment plan; and
(c) Provided as part of organized or structured treatment services.
6326.4 Prior to transitioning to a new LOC, at a minimum, an Ongoing Assessment must be performed to ensure that the client is appropriate for the new LOC.
6326.5 The Clinical Care Coordinator is responsible for ensuring appropriate referral, authorization, and transition to new LOCs.