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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-A6399. DEFINITIONS
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6399DEFINITIONS
6399.1
Admission - Entry into the SUD treatment or recovery program after completion of intake, screening, and initial assessment and a determination that an individual is eligible for the program.
Advance Practice Registered Nurse (APRN) - A person who is licensed or authorized to practice as an advanced practice registered nurse pursuant to the District of Columbia Health Occupations Revisions Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201.01 et seq. (2012 Repl. & 2014 Supp.)), and who has particular training and expertise in treating clients with SUD. An APRN is a Qualified Practitioner.
Affiliation Agreement - A legal agreement approved by the Department by and between a provider and another entity that describes how they will work together to benefit clients.
Applicant - A program that has applied to the Department for certification as an SUD treatment or recovery program.
Case Manager - Program staff specially designated to provide Case Management services with or on behalf of a client to maximize the client's adjustment and functioning within the community while achieving sobriety and sustaining recovery. A client’s case manager must be designated in his or her treatment plan.
Certification - The process of establishing that standards of care described in this chapter are met; or approval from the Department indicating that an applicant has successfully complied with all requirements for the operation of a substance use disorder treatment or recovery program in the District.
Certified Addiction Counselor (CAC) - A person who is certified to provide SUD counseling services in accordance with Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201 et seq. (2012 Repl. & 2014 Supp.)).. A CAC may be certified as a CAC I or CAC II and must be supervised in accordance with Title 17 DCMR § 8715. A CAC is a Qualified Practitioner.
Child Development Facility - A center, home, or other structure that provides care and other services, supervision, and guidance for children up to fifteen (15) years of age on a regular basis, regardless of its designated name, but does not include a public or private elementary or secondary school engaged in legally required educational and related functions.
Client - A person admitted to an SUD treatment or recovery program and is assessed to need SUD treatment services or recovery services.
Clinical Care Coordination - The clinical and evaluative activities that identify the client’s needs for substance abuse and other treatment services, community needs and other resources to achieve the goals and objectives identified in the treatment plan. Clinical Care Coordination establishes a framework of action to enable the client to achieve specified goals. It involves collaboration with client and significant others, coordination of treatment and referral services, liaison activities with community resources and managed care systems, client advocacy, and ongoing evaluation of treatment progress and client needs
Clinical Care Coordinator - A licensed or certified Qualified Practitioner who has the overall responsibility for the development and implementation of the client’s treatment plan, is responsible for identification, coordination, and monitoring of non-SUD-treatment clinical services, and is identified in the client’s treatment plan.
Clinical Staff - Staff who are licensed, certified, or registered by the District Department of Health, Health Regulation and Licensing Administration (HRLA).
Communicable Disease - Any disease as defined in Title 22-B, § 201 of the District of Columbia Municipal Regulations (DCMR).
Continuity of Care Plan – A plan that provides for the ongoing care of clients in the event that a certified provider is no longer able to provide adequate care. The plan should include provision for the referral and transfer of clients, as well as for the provision of relevant treatment information, medications, and information to the new provider.
Co-Occurring Disorders - The presence of concurrent diagnoses of substance use disorder and a mental disease or disorder.
Crisis - An event that significantly jeopardizes the client’s treatment, recovery progress, health or safety.
Department - The District of Columbia Department of Behavioral Health.
Director - The Director of the District Department of Behavioral Health.
Discharge - The time when a client's active involvement with a program is terminated.
Discharge Planning - Activities with or on behalf of an individual to arrange for appropriate follow-up care to sustain recovery after being discharged from a program, including educating the individual on how to access or reinitiate additional services, as needed.
Discrete Clients - Children accompanied by a parent into a treatment environment that are clinically determined to require admission as a client with their own separate and distinct assessment, treatment plan, course of treatment, and record. Discrete Client does not apply to children who receive services primarily to support a parent's recovery.
District - The District of Columbia.
Drug - Substances that have the likelihood or potential to be misused or abused, including alcohol, prescription drugs, and nicotine.
Facility - Any physical premises which houses one or more SUD treatment or recovery programs.
Family Member - Individual identified by the client as a person with whom the client has a significant relationship and whose participation is important to the client’s recovery.
Health Maintenance Organization (HMO) - A private organization which is a qualifying HMO under Federal regulations or has been determined to be an HMO pursuant to rules issued by the D.C. State Health Planning and Development Agency (SHPDA) in accordance with D.C. Official Code §§ 44-401 et seq.
Initial Treatment Plan - The treatment plan that is developed in conjunction with the first (non-comprehensive) diagnostic assessment conducted upon entry to a client’s first LOC.
In-service Training - Activities undertaken to achieve or improve employees’ competency to perform present jobs or to prepare for other jobs or promotions.
Interdisciplinary Team - Members of the SUD provider staff who provide services to the client. This group shall include the client, the client’s CCC, a CAC, the client’s case manager, and at least one QP with the license and ability to diagnose.
Licensed Graduate Professional Counselor (LGPC) – A person licensed as a graduate professional counselor in accordance with Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201 et seq. (2012 Repl. & 2014 Supp.)) applicable District laws and regulations. An LGPC is a Qualified Practitioner only for providers not providing services pursuant to a Human Care Agreement with the Department and must be appropriately supervised.
Licensed Graduate Social Worker (LGSW) – A person licensed as a graduate social worker in accordance with applicable District laws and regulations. An LGSW is a Qualified Practitioner.
Licensed Independent Clinical Social Worker (LICSW) - A person licensed as an independent clinical social worker in accordance with Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201 et seq. (2012 Repl. & 2014 Supp.)). An LICSW is a Qualified Practitioner.
Licensed Independent Social Worker (LISW) - A person licensed as a licensed independent social worker in accordance with Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201 et seq. (2012 Repl. & 2014 Supp.)). An LISW is a Qualified Practitioner.
Licensed Marriage and Family Therapist (LMFT) – A person licensed as a marriage and family therapist in accordance with Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201 et seq. (2012 Repl. & 2014 Supp.)). An LMFT is a Qualified Practitioner.
Licensed Practical Nurse (LPN) - A person licensed as practical nurse in accordance with Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201 et seq. (2012 Repl. & 2014 Supp.)).
Licensed Professional Counselor (LPC) - A professional counselor licensed in accordance with Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201 et seq. (2012 Repl. & 2014 Supp.)). An LPC is a Qualified Practitioner.
Major Investigations - Refers to the detailed inquiry or systematic examination of deaths related to suicide, unexpected deaths at a facility, death of a child or youth, and any other incident that the Director, DBH or the Deputy Director, OA, determine need a major investigation.
Major Unusual Incidents - Adverse events that can compromise the health, safety, and welfare of persons; employee misconduct; fraud; and actions that are violations of law and policy.
Medicaid - The program described in the District of Columbia State Medicaid Plan, approved by CMS, and administered by the Department of Health Care (DHCF) to enable the District of Columbia to receive Federal financial assistance for a medical assistance program and other purposes as permitted by law.
Medical Necessity (or Medically Necessary) - Those services contained in an approved treatment plan reasonably calculated to prevent the worsening of, alleviate, correct, cure, or ameliorate an identified substance use disorder. For children through age twenty (20), services reasonably calculated to promote the development or maintenance of age-appropriate functioning are also considered medically necessary.
Medical Waste - Any solid waste that is generated in the diagnosis, treatment, or immunization of human beings or in the testing of biologicals, including but not limited to: soiled or blood-soaked bandages, needles used to give shots or draw blood, and lancets.
Mental Illness - A diagnosable mental, behavioral, or emotional disorder (including those of biological etiology) which substantially impairs the mental health of the person or is of sufficient duration to meet diagnostic criteria specified within the DSM-IV or its ICD-9-CM equivalent (and subsequent revisions) with the exception of DSM-IV “V” codes, substance abuse disorders, mental retardation, and other developmental disorders, or seizure disorders, unless those exceptions co-occur with another diagnosable mental illness.
Notice of Infraction - An action taken by agencies to enforce alleged violations of regulatory provisions.
Opioid - A psychoactive substance in the narcotic class derived from opium, including natural and synthetic compounds. Substances in this class may produce pharmacological effects such as physical withdrawal symptoms when used for non-medicinal purposes.
Organized Treatment Services – Treatment that consists of a scheduled series of structured, face-to-face or group therapeutic sessions organized at various levels of intensity and frequency in order to assist the clients served in achieving the goals identified in the person-centered treatment plans. Also may be called structured treatment services.
Outcomes of Care - The results of a course of treatment, including abstinence or reduction of abuse of substances, elimination or reduction of criminal activity, reduction of antisocial activity associated with SUD, reduction in need for medical or mental health services, reduction of need for SUD treatment, increase in pro-social involvement, and increase in productivity and employment.
Outpatient Services - Therapeutic services that are medically or psychologically necessary, provided to a client according to an individualized treatment plan, and do not require the client's admission to a hospital or a non-hospital residential facility. The term "outpatient services" refers to services that may be provided (on an ambulatory basis) in a hospital; a non-hospital residential facility; an outpatient treatment facility; or the office of a person licensed to provide SUD treatment services.
Outreach - Efforts to inform and facilitate access to a program's services.
Parent - A person who has custody of a child as a natural parent, stepparent, adopted parent, or has been appointed as a guardian for the child by a court of competent jurisdiction.
Postpartum - A period of time for up to twenty-four (24) months after birth of an infant.
Privacy Officer - A person designated by an organization that routinely handles protected health information, to develop, implement, and oversee the organization's compliance with the U.S. Health Insurance Portability and Accountability Act (HIPAA) privacy rules, 42 C.F.R. part 2, and D.C. Mental Health Information Act.
Program - An SUD Treatment or Recovery Program certified by the Department at a specific Level of Care to provide substance use treatment or recovery services.
Program Director - An individual having authority and responsibility for the day-to-day operation of an SUD treatment or recovery program.
Protected Health Information (PHI) - Any written, recorded, electronic (ePHI), or oral information which either (1) identifies, or could be used to identify, a consumer; or (2) relates to the physical or mental health or condition of a consumer, provision of health care to a consumer, or payment for health care provided to a consumer. PHI does not include information in the records listed in 45 C.F.R. § 160.103.
Provider - An entity certified by the Department to provide either SUD treatment or recovery support services or both.
Psychiatrist - A physician licensed in accordance with applicable District laws and regulations who has completed a residency program in psychiatry accredited by the Residency Review Committee for Psychiatry of the Accreditation Council for Graduate Medical Education and is eligible to sit for the psychiatric board examination. A psychiatrist is a Qualified Practitioner.
Psychologist - A person licensed to practice psychology in accordance with applicable District laws and regulations. A psychologist is a Qualified Practitioner.
Qualified Physician - A person who is licensed or authorized to practice medicine pursuant to Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201 et seq. (2012 Repl. & 2014 Supp.)) and eligible for a waiver pursuant to the federal Drug Addiction Treatment Act of 2000 or subsequent amendments.
Qualified Practitioner (QP) - Clinical staff authorized to provide treatment and other services. These clinical staff are (i) a qualified physician; (ii) a psychiatrist; (iii) a psychologist; (iv) a licensed independent clinical social worker (LICSW); (v) a licensed graduate social worker (LGSW); (vi) a licensed marriage and family therapist (LMFT); (vii) a physician’s assistant (PA); (viii) an advance practice registered nurse (APRN); (ix) a registered nurse (RN); (x) a licensed professional counselor (LPC); (xi) an independent social worker (LISW); (xii) a graduate professional counselor for services provided outside of a Human Care Agreement with the Department; and (xii) a certified addiction counselor (CAC).
Recovery Coach - A Recovery Coach is a person with lived experience of addiction and recovery that meets the eligibility requirements and provides support to individuals in recovery from an SUD. The role of a Recovery Coach is to serve as a personal guide and mentor for people seeking or already in recovery. A Recovery Coach must have demonstrated recovery from a substance use disorder and be willing to self-disclose his or her own recovery; have a high-school diploma or General Education Degree certified by the state in which it was received; and be at least eighteen years of age.
Recovery Support Plan - A document developed during a Recovery Support Evaluation that outlines the client’s needs, goals, and recovery services to be utilized to achieve those goals. The Recovery Support plan assists a person in recovery to develop goals and objectives to maintain their sobriety in the community with supports from family, community and recovery support programs.
Recovery Support Services - Non-clinical services provided to a client by a certified RSS provider to assist him or her in achieving or sustaining recovery from an SUD.
Registered Nurse (RN) - A person licensed as a registered nurse in accordance with Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201 et seq. (2012 Repl. & 2014 Supp.)). An RN is a Qualified Practitioner.
Representative Payee – An individual or organization appointed by the Social Security Administration to receive Social Security or Supplemental Security Income (SSI) benefits for someone who cannot manage or direct someone else to manage his or her money.
Research - Experiments including new interventions of unknown efficacy applied to clients whether behavioral, psychological, biomedical, or pharmacological.
Residential Program - Any treatment or recovery program which houses clients overnight, including Level III treatment programs and environmental stability programs.
Substance Use Disorder (SUD) - A chronic relapsing disease characterized by a cluster of cognitive, behavioral, and psychological symptoms indicating that the beneficiary continues using a substance despite significant substance-related problems. A diagnosis of a SUD requires a beneficiary to have had persistent, substance related problem(s) within a twelve (12)-month period.
Treatment - A therapeutic effort to improve a client’s cognitive or emotional conditions or the behavior of a client, consistent with generally recognized principles or standards in the SUD treatment field, provided or supervised by a Qualified Practitioner.
Treatment Plan - A document that meets the requirements of Subsection 6335.5 of this chapter and establishes medical necessity for all services identified to address the needs of the client as determined by the assessment.
Withdrawal Management - A program designed to achieve systematic reduction in the degree of physical dependence on alcohol or drugs.