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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-A6333. LEVEL OF CARE 3.5: CLINICALLY MANAGED HIGH-INTENSITY RESIDENTIAL (ADULT)/ CLINICALLY MANAGED MEDIUM-INTENSITY RESIDENTIAL (YOUTH)
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6333 LEVEL OF CARE 3.5: CLINICALLY MANAGED HIGH-INTENSITY RESIDENTIAL (ADULT)/ CLINICALLY MANAGED MEDIUM-INTENSITY RESIDENTIAL (YOUTH)
6333.1 Level 3.5 is a residential program that generally provides twenty-five (25) hours of treatment services per week for a period of up to twenty-eight (28) days. Level 3.5 providers shall provide no less than twenty (20) hours of treatment services per week. Level 3.5 is the appropriate level of care for individuals who are assessed as meeting the ASAM placement criteria for Level 3.5, need a 24-hour supportive treatment environment to initiate or continue their recovery process and:
(a)Have co-occurring or severe social/interpersonal impairments due to substance use; or
(b)Significant interaction with the criminal justice system due to substance use.
6333.2 Level 3.5 generally lasts up to twenty-eight (28) days.
6333.3 Unless clinically inappropriate or a client does not consent, all providers shall adhere to the minimum service requirements for this level of care.
6333.4 Case Management does not satisfy the minimum service hour requirements. Case managed shall be provided as clinically appropriate, in accordance with the client’s treatment plan, and in accordance with Subsection 6332.6.
6333.5 Level 3.5 includes the following mix of services, as indicated on the treatment plan and in accordance with this chapter:
(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 if the client has been transferred from another LOC;
(2) Ongoing assessment: Required within seven (7) days of admission if no comprehensive was performed at intake into Level 3.5. Cannot be billed more than twice within a sixty (60)-day period and cannot occur on the same day as a Comprehensive Assessment. An ongoing assessment with a corresponding treatment plan update must occur prior to a planned discharge from the LOC;
(3) Brief assessment: Cannot exceed three (3) occurrences within the period of time the individual is in Level 3.
(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): The Clinical Care Coordinator is responsible for establishing the frequency of the ongoing assessments and updates to the treatment plan. A minimum of twelve (12) units (3 hours) per week is required.
(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 sixteen (16) units (4 hours) of Case Management is required every twenty-eight (28) days unless the Clinical Care Coordinator documents justification for a lesser amount.
(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.
(g) Medication Management: As required and in accordance with § 6342 of this chapter.
6333.6 Level 3.5 providers may provide Medication Assisted Treatment (MAT) per § 6343 of this chapter, if so certified.