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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-A6328. LEVEL OF CARE 1: OUTPATIENT
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6328 LEVEL OF CARE 1: OUTPATIENT
6328.1 Level 1 Outpatient providers shall be able to provide one (1) to eight (8) hours of treatment services per week, in accordance with this section. Level 1 Outpatient is the appropriate LOC for individuals who are assessed as meeting the ASAM criteria for Level 1 and:
(a) Recognize their SUD and are committed to recovery;
(b) Are transitioning from a higher LOC;
(c) Are in the early stages of change and not yet ready to commit to full recovery;
(d) Have a co-occurring condition that is stable; or
(e) Have achieved stability in recovery and can benefit from ongoing monitoring and disease management.
6328.2Level I Outpatient providers may also be certified in the specialty service of Adolescent-Community Reinforcement Approach (ACRA) in accordance with § 6344 of this chapter for services to youth and young adults with co-occurring substance use and mental health disorders ages twelve (12) to twenty-one (21) for youth providers and twenty-two (22) to twenty- four (24) for adult providers.
6328.3 Level 1 Outpatient treatment duration varies but generally lasts up to one hundred eighty (180) days for an initial authorization. Level 1 treatment can continue long-term in accordance with the treatment plan, for individuals needing long-term disease management.
6328.4 Level 1 Outpatient services are determined by a Comprehensive Assessment, performed in accordance with § 6336 of this chapter.
6328.5 Unless clinically inappropriate or a client does not consent, all providers shall adhere to the service requirements for this level of care.
6328.7 Level 1 Outpatient shall include the following mix of services in accordance with the client’s treatment plan and this chapter (unless the client is receiving ACRA services in which case SUD Counseling, Case Management and Clinical Care Coordination shall be provided in accordance with § 6344):
(a) Assessment/Diagnostic and Treatment Planning in accordance with § 6336 of this chapter:
(1) Comprehensive Assessment: Required if this is the individual’s first LOC in a single course of treatment; optional for a new provider if the client has been transferred from another LOC;
(2) Ongoing Assessment: Required within seven (7) calendar days of admission if no comprehensive was performed at intake into Level 1, cannot be billed more than twice within a sixty (60)-day period, cannot occur on the same day as a comprehensive assessment, and an ongoing assessment with a corresponding treatment plan update must occur prior to a planned discharge from the LOC;
(3) Brief Assessment: Cannot exceed six (6) occurrences within the period of time that the individual is in Level 1.
(b) SUD Counseling (in accordance with § 6340 of this chapter): Counseling shall be provided as a clinically appropriate combination of Individual, Family, and Group Counseling, including Group Counseling-Psychoeducation, according to the client’s assessed needs.
(c) Clinical Care Coordination (CCC) (in accordance with § 6337 of this chapter): Cannot exceed one hundred ninety-two (192) units (48 hours) during this LOC in a single course of treatment. The Clinical Care Coordinator is responsible for establishing the frequency of the ongoing assessments and must ensure the treatment plan is updated a minimum of every ninety (90) days.
(d) Case Management (in accordance with § 6338 of this chapter): For providers with a Human Care Agreement, a minimum of four (4) units (1 hour) of Case Management-HIV is required for the duration of the LOC. For all providers, a minimum of four (4) units (1 hour) of Case Management per month is required during the first six (6) months of the LOC in a single course of treatment; for those individuals in long-term Level 1, after the first year a minimum of eight (8) units (2 hours) annually is required.
(e) Drug Screening (in accordance with § 6341 of this chapter): Required at admission and as clinically indicated throughout the course of treatment.
(f) Crisis Intervention: As required and in accordance with § 6339 of this chapter.
6328.8 Level 1 providers may provide Medication Assisted Treatment (MAT) per § 6343 of this chapter, if so certified.