D.C. Mun. Regs. tit. 22, r. 22-A2501

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 22-A2501 - CERTIFICATION REQUIREMENTS

2501.1

No person or entity shall operate a Health Home unless certified in accordance with this chapter.

2501.2

The following minimum eligibility requirements shall apply to any FSMHC or CSA seeking certification as a Health Home:

(a) Current certification as an MHRS CSA in accordance with Chapter 34 of this subtitle or FSMHC in accordance with Chapter 8 of Title 29 (Public Welfare) of the D.C. Municipal Regulations;

(b) Current enrollment as a D.C. Medicaid provider for the delivery of MHRS or FSMHC services;

(c) Use of the Department of Behavioral Health's (the Department's), data management system for all Health Home-related services and functions;

(d) No current or pending exclusions, suspensions or debarment from any federal or D.C. healthcare program; and

(e) Demonstrated ability through readiness assessments and training to comply with the terms and requirements of this chapter.

2501.3

An MHRS CSA seeking certification shall submit an application in a format established by the Department.

2501.4

The Department shall process applications for certification as a Health Home provider in accordance with the procedures for MHRS certification in Subsection 3401 of Chapter 34 of this subtitle.

2501.5

Initial certification as a Health Home program is effective for a one (1)-year period. Certification shall remain in effect until it expires, is revoked or the provider is re-certified in accordance with Section 2502 of this chapter.

2501.6

The Department's certification shall specify the number of Health Home teams certified at each provider. A Health Home team can serve up to three hundred (300) individuals and consists of the following staff: Health Home Director, Primary Care Liaison, Nurse Care Manager (s) and Care Coordinators. No provider shall add additional Health Home teams unless the addition is approved by the Department.

2501.7

Certification is not transferable to any other organization.

2501.8

Nothing in these rules shall be interpreted to mean that certification is a right or an entitlement. Certification as a provider depends upon the Director's assessment of the need for additional Health Home providers.

2501.9

Corrective action plans and decertification of Health Home providers shall comply with the procedures set forth in Chapter 34 of this subtitle.

D.C. Mun. Regs. tit. 22, r. 22-A2501

Final Rulemaking published at 63 DCR 849 (1/22/2016); amended by Final Rulemaking published at 66 DCR 5625 (5/3/2019)