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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-A6337. CORE SERVICE: CLINICAL CARE COORDINATION
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6337 CORE SERVICE: CLINICAL CARE COORDINATION
6337.1 Clinical Care Coordination (CCC) is the initial and ongoing process of identifying, planning, coordinating, implementing, monitoring, and evaluating options and services to best meet a client’s health needs.
6337.2 The Clinical Care Coordinator is responsible for ensuring that the client is at the appropriate level of care. If the client fails to make progress or has met all of his or her treatment goals, it is the Coordinator’s responsibility to ensure timely assessment and transfer to a more appropriate level of care.
6337.3 CCC focuses on linking clients as they transition through the levels of care, ensuring that the treatment plan is formulated with the overarching goal of recovery regardless of the client’s current status. The Clinical Care Coordinator is responsible for facilitating specified outcomes through recovery that will restore a client’s functional status in the community. The Clinical Care Coordinator has the overall responsibility for the development and implementation of the client’s treatment plan.
6337.4 CCC also includes oversight of linkages to off-site services to meet additional needs related to a co-occurring medical and/or psychiatric condition, as documented in the treatment plan.
6337.5 The assigned clinical care coordinator in each case will monitor the compliance with, and effectiveness of, services over the treatment period and make a determination of the frequency of ongoing assessments. A clinical care coordinator shall have no more than seventy-five (75) clients assigned to his or her caseload, and shall ensure that each client receives a clinically appropriate amount of CCC.
6337.6 The CCC service must be provided by a licensed practitioner under Subsection 6337.7 of this chapter and must address the health and behavioral health of the client. CCC shall not include administrative facilitation of the client’s service needs, which is the primary purpose of the Case Management service.
6337.7 The CCC service must be documented in an encounter note that indicates the intended purpose of that particular service, the actions taken, and the result(s) achieved.
6337.8 Qualified Practitioners for CCC are:
(a) Qualified Physicians;
(b) Psychologists;
(c) LICSWs;
(d) LGSWs;
(e) APRNs;
(f) RNs;
(g) LISWs;
(h) LPCs; and
(i) LMFTs.
6337.9 For providers with a Human Care Agreement with the Department, the following restrictions apply to CCC:
(a)CCC may not be billed in conjunction with a staff person’s clinical supervision or at the same time as any assessment/diagnostic/treatment planning service;
(b)CCC may not be billed separately for a person in MMIWM;
(c)CCC may only be billed by the client’s designated clinical care coordinator; and
(d)A maximum of one hundred twenty-eight (128) units of CCC are allowed under Level 3, a maximum of one hundred thirty-two (132) units are allowed under Level 2, a maximum of one hundred ninety-two (192) units are allowed under Level 1, and a maximum of two hundred eight (208) units are allowed under Level-1 with MAT.