572220 These rules establish the reimbursement rate for agencies that provide CBI Level IV - FFT pursuant to a Human Care Agreement with the Department of Mental Health.
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DEPARTMENT OF MENTAL HEALTH
NOTICE OF EMERGENCY AND PROPOSED RULEMAKING
The Director of the Department of Mental Health (Department), pursuant to the authority set forth in sections 104 and 105 of the Department of Mental Health Establishment Amendment Act of 2001, effective December 18, 2001 (D.C. Law 14-56; D.C. Official Code §§ 7-1131.04 and 7-1131.05), hereby gives notice of his intent to adopt a new Chapter 52, to be entitled “Community-Based Intervention Level IV –Functional Family Therapy — Reimbursement”, of Subtitle A, “Mental Health,” of Title 22 of the District of Columbia Municipal Regulations.
The Department is making changes to the requirements for certification of specialty providers of community based intervention (CBI) services for children and youth to add a CBI Level IV, Functional Family Therapy (FFT). The Department will pay a flat rate as established in these rules for the provision of FFT to District of Columbia children, youth and their families by certified providers in accordance with the terms of the Human Care Agreement the providers have with the Department.
Issuance of these rules on an emergency basis is necessary to expand the availability of community-based recovery-oriented programs for mental health consumers in the District of Columbia. Emergency action is necessary for the immediate preservation of the health, welfare, and safety of children, youth, and adults with mental illness in need of mental health services.
The emergency rulemaking was adopted on October 21, 2010, and became effective on October 21, 2010. The emergency rules will remain in effect for one hundred twenty (120) days or until February 17, 2011, unless superseded by publication of another rulemaking notice in the D.C. Register, whichever comes first.
The Director also gives notice of intent to take final rulemaking action to adopt the proposed rules in not less than thirty (30) days after the date of publication of this notice in the D.C. Register.
Subtitle A, “MENTAL HEALTH,” of Title 22 of the District of Columbia Municipal Regulations is amended by adding a new chapter 52 to read as follows:
CHAPTER 52 COMMUNITY-BASED INTERVENTION LEVEL IV – FUNCTIONAL FAMILY THERAPY —REIMBURSEMENT
5200 PURPOSE
5200.1 This chapter establishes the reimbursement rate for the Community-Based Intervention Level IV – Functional Family Therapy (FFT). Establishment of a reimbursement rate will allow the Department of Mental Health (Department) to reimburse certified mental health providers who are qualified to provide FFT to Department consumers at an established rate pursuant to a Human Care Agreement (HCA).
5200.2 Nothing in this chapter grants to an FFT provider the right to reimbursement for costs of providing FFT. Eligibility for reimbursement for FFT services is determined solely by the HCA between the Department and the FFT provider and is subject to the availability of appropriated funds.
5201 REIMBURSEMENT RATE
5201.1 The Community-Based Intervention Level IV –Functional Family Therapy rate is as set forth below:
SERVICE
CODE
RATE
UNIT
CBI Level IV - FFT
H2033HU
$57.42
15 minutes
5202 ELIGIBILITY
5202.1 Only a qualified Mental Health Rehabilitation Services (MHRS) provider who has a Human Care Agreement (HCA) with the Department, and is certified by the Department to provide CBI Level IV – FFT services, that has incurred expenses eligible for reimbursement in accordance with the requirements of Chapter 34 of this Title may bill the Department under this chapter.
5203 SUBMISSION OF CLAIM; PAYMENT OF VOUCHER
5203.1 The FFT provider shall submit all FFT claims pursuant to this chapter and the terms of the HCA between the Department and the FFT provider.
5203.2 The FFT provider shall submit appropriate documentation to support all claims under its HCA with the Department.
5203.3 The Department will reimburse an FFT provider for a claim that is determined by the Department to be eligible for reimbursement pursuant to the terms of the HCA between the Department and the provider, subject to the availability of appropriated funds.
5204 AUDITS
5204.1 An FFT provider shall, upon the request of the Department, cooperate in any audit or investigation concerning the FFT program and FFT claims.
5299 DEFINITIONS
5299.1 When used in this chapter, the following terms shall have the meaning ascribed:
Functional Family Therapy (FFT) – an evidence-based proprietary therapeutic service for children, youth and their families to prevent children and youth who are already involved or youth at risk of juvenile justice system involvement from further penetrating the system. FFT is a trademarked therapeutic service that requires accreditation from FFT Inc.
Functional Family Therapy Provider – a Mental Health Rehabilitation Service (MHRS) provider that is certified by the Department to provide FFT.
All persons desiring to comment on the subject matter of this proposed rulemaking should file comments, in writing, no later than thirty (30) days after the date of publication of this notice in the D.C. Register. Comments should be filed with the Office of General Counsel for the Department of Mental Health at 64 New York Avenue, N.E., 4th Floor, Washington, D.C. 20002, or e-mailed to Suzanne Fenzel, Assistant Attorney General, at Suzanne.Fenzel@dc.gov. Copies of the proposed rules may be obtained from dmh.dc.gov or from the Department of Mental Health at the address above.
