D.C. Mun. Regs. tit. 22, r. 22-A3415

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

Rule 22-A3415 - SUB-PROVIDER AND SPECIALTY PROVIDER REQUIREMENTS

3415.1

Each sub-provider and specialty provider shall comply with the certification standards described in § 3413, the service specific standards applicable to the MHRS offered by the sub-provider or specialty provider, and the other certification standards in this chapter.

3415.2

Each sub-provider and specialty provider shall establish and adhere to policies and procedures ("CSA Referral Policy") governing its relationship with a CSA that address access to records, clinical responsibilities, legal liability, dispute resolution, and all other MHRS certification standards.

3415.3

Sub-providers shall provide one (1) or more of the core services only through a written agreement with a CSA. Sub-providers shall ensure consumers are enrolled with a CSA.

3415.4

Except for the provision of ACT, CBI, or Clubhouse services, specialty providers shall ensure consumers are enrolled with a CSA.

3415.5

Each specialty provider shall screen and assess consumers for EBP as appropriate and applicable, and shall refer them to services as necessary. Each specialty provider shall have an Evidence-Based Practices Information Policy, which includes how providers shall:

(a) Screen and document screening consumers for EBP;

(b) Describe the process of referring and linking consumers to another provider using a warm hand off, if the specialty provider does not render the appropriate EBP; and

(c) Collaborate with the CSA to ensure there are periodic assessments for the need for EBP.

3415.6

Each sub-provider and specialty provider shall satisfy the following minimum staffing requirements:

(a) A Chief Executive Officer or Program Director with professional qualifications and experience who shall meet requirements as established by the MHRS provider's governing authority and is responsible for day-to-day management of the MHRS provider;

(b) A sub-provider or specialty provider who provides Rehabilitation Day services shall also have a Consulting Psychiatrist who is a board-eligible psychiatrist and advises the sub-provider or specialty provider on the quality of medical and psychiatric care provided;

(c) A Clinical Director who is anindependently licensed qualified practitioner with overall responsibility for oversight of the clinical program of the sub-provider or specialty provider. If not full- time, the Clinical Director must dedicate sufficient time to execute the duties of the position;

(d) Each sub-provider who provides either Diagnostic Assessment or Medication/Somatic Treatment shall demonstrate adequate oversight of quality of medical and psychiatric care by employing or contracting with a Medical Director or arranging for the Medical Director of the consumer's CSA to provide such oversight; and

(e) The required staff listed in this subsection shall be either employees of the sub-provider or specialty provider or under contract to the sub-provider or specialty provider for an amount of time sufficient to carry out the duties assigned.

3415.7

Each sub-provider and specialty provider shall establish and adhere to policies and procedures governing its collaboration with a referring CSA in the development, implementation, evaluation, and revision of each consumer's Plan of Care, that comply with the Department rules (Collaboration Policy). The Collaboration Policy shall:

(a) Be a part of each sub-provider and specialty provider's Treatment Planning Policy;

(b) Require sub-providers and specialty providers to incorporate CSA-developed Diagnostic Assessment material into the sub-provider and specialty provider's treatment planning process, including the use of EBP as an intervention; and

(c) Require sub-providers and specialty providers to coordinate the consumer's treatment with the consumer's CSA assigned staff.

3415.8

Each sub-provider shall offercore services in accordance with requirements in § 3413.21. At a minimum, the sub-provider shall offer services during these hours at its primary service site.

3415.9

At a minimum, each specialty provider shall offer access to specialty services in accordance with requirements in § 3413.22.

3415.10

Each sub-provider and specialty provider with total annual revenues at or exceeding three hundred thousand dollars ($300,000.00) shall have an annual audit by an independent certified public accountant or certified public accounting firm in accordance with generally accepted auditing standards. The resulting financial audit report shall be consistent with formats recommended by the American Institute of Public Accountants. Each sub-provider and specialty provider shall submit a copy of the financial audit report to the Department within one hundred and twenty (120) calendar days after the end of its fiscal year.

3415.11

Each sub-provider and specialty provider with total annual revenues less than three hundred thousand dollars ($300,000.00) shall submit financial statements reviewed by an independent certified public accountant or certified public accounting firm within one hundred twenty (120) calendar days after the end of its fiscal year.

3415.12

Each sub-provider and specialty provider shall only provide MHRS to consumers as specified in the consumers' Plans of Care as designated by the consumers' CSA.

3415.13

The Department shall review and approve the CSA Referral Policy, Collaboration Policy, and the Evidence-Based Programs Information Policy during the certification process.

D.C. Mun. Regs. tit. 22, r. 22-A3415

Final Rulemaking published at 48 DCR 10297 (November 9, 2001); as amended by Final Rulemaking published at 51 DCR 9308 (October 1, 2004); as amended by Final Rulemaking published at 52 DCR 5682 (June 17, 2005); as amended by Notice of Final Rulemaking published at 58 DCR 8366, 8369 (September 30, 2011); amended by Final Rulemaking published at 67 DCR 10674 (9/4/2020)

Authority: 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 (2008 Repl.)).