Section 29-2362. SPECIALITY SERVICES -- STANDARDS FOR DUAL DIAGNOSTIC SERVICES

 

2362.1 All substance abuse treatment facilities or programs shall have the capability of serving persons with dual diagnosis as defined in the standards. The facilities or program may serve persons with a diagnosis of serious mental illness and substance abuse if it is determined that the facility can adequately address the needs of the individual.

 

2362.2 For persons with a mental disease or disorder, the facility shall ensure inter-facility collaboration to maximize the benefits of service delivery by:

 

(a) Establishing positive working agreements with providers of psychiatric or mental health services including consultation for psychopharmacological interventions as follows:

 

(1) For person(s) with serious and persistent mental illness, the facility shall establish one (1) or more written agreements with a mental health facility, which offers services which include, at a minimum, medication management, psychosocial day programming, case management, and an emergency on-call system; and,

 

(2) For person(s) with a mental disease or disorder which is not a serious and persistent mental illness, the facility shall have a written referral and cooperative agreement with a mental health service provider(s) or facility with staff qualified to provide, at a minimum, medication management and therapy/counseling;

 

(b) Describing in the rehabilitation plan the services and goals of the psychiatric/mental health service provider and involving the service provider in treatment planning and updates; and

 

(c) Requiring that service delivery staff maintain regular and frequent contact with the mental health service provider to achieve coordination and continuity of treatment.

 

2362.3 The facility or program staff shall meet with the mental health service provider(s) to discuss and determine the appropriate treatment strategy to address the patient’s mental illness. At this meeting a treatment plan shall be formulated or an existing treatment plan revised to reflect the needs, problems, and goals identified as a result of the evaluation.

 

2362.4 If the facility or program staff concurs with the mental health service provider(s) that a dually diagnosed individual requires and is capable of benefitting from treatment and rehabilitation, the individual shall be admitted. All necessary services shall be coordinated among the staff, and when applicable a single clinical case manager shall be designated.

 

2362.5 If the facility or program staff concurs with the mental health service provider(s) that a dually diagnosed individual requires admission to address psychiatric rehabilitation needs and requires other specialized alcohol and drug abuse treatment as an adjunct, the individual shall be referred to the mental health facility or equivalent facility for admission with required coordination of services by the agencies.

 

2362.6 The staff of a substance abuse treatment facility or program shall receive specific training to meet the needs of a dually diagnosed patient as follows:

 

(a) An overview of the signs and symptoms, functional impairment and treatment modalities, including the use of medications, for persons with dual diagnosis of substance abuse and mental disorder, with special attention to the broad categories of thought disorders and mood disorders;

 

(b) Guidelines for cooperative service delivery and specific techniques and guidelines for service delivery to dually diagnosed individuals; and

 

(c) For facilities or programs that serve the seriously mentally ill, the training shall also emphasize cognitive functioning, residual symptomatology, psychotropic medication side effects, parental family therapy, and the need for emergency referral when needed.

 

2362.7 The staff of a substance abuse treatment facility or program that serves the seriously and persistently mentally ill shall receive specific training to meet their needs as follows:

 

(a) An overview of the signs and symptoms, functional impairment and treatment modalities, including the use of medications, for persons with dual diagnosis of substance abuse and mental disorder, with special attention to the broad categories of thought disorders and mood disorders; and

 

(b) Guidelines for cooperative service delivery and specific techniques and guidelines for service delivery to dually diagnosed individuals.

 

 

source

Final Rulemaking published at 47 DCR 9341 (November 24, 2000), adopting Emergency and Proposed Rulemaking published at 47 DCR 7708, 7800 (September 22, 2000).