D.C. Mun. Regs. tit. 22, r. 22-A3422

Current through Register Vol. 71, No. 49, December 6, 2024
Rule 22-A3422 - CRISIS/EMERGENCY SERVICES
3422.1

A Crisis/Emergency Service is an immediate response face-to-face or via telehealth in accordance with 29 DCMR § 910 to an emergency situation involving a consumer with mental illness or emotional disturbance that is available twenty-four (24) hours per day, seven (7) days per week.

3422.2

Crisis/Emergency Services are provided by a CSA to their enrolled consumers involved in an active mental health crisis and consist of immediate response to evaluate and screen the presenting situation, assist in immediate crisis stabilization and resolution, and provide the consumer's access to care at the appropriate level.

3422.3

The Crisis/Emergency Services provider shall adjust its staffing to meet the requirements for immediate response.

3422.4

Each Crisis/Emergency Services provider shall:

(a) Consult with other service providers, locate other MHRS and resources, and provide written and oral information to assist the consumer in obtaining follow- up MHRS;
(b) Be a certified MHRS provider of Diagnostic Assessment or have an agreement with a CSA as a sub-provider or specialty provider to provide hospital pre-admission screenings; and
(c) Demonstrate the capacity to assure continuity of care for consumers by facilitating follow-up mental health appointments and providing telephonic support until outpatient services occur.
3422.5

Each Crisis/Emergency Services provider shall have waiting, assessment, and treatment areas for children, youth, and families that are separate from the areas for adults.

3422.6

Each Crisis/Emergency Services provider shall establish and adhere to policies, procedures, and staffing sufficient to ensure that all individuals seeking and in need of Crisis/Emergency Services receive face-to- face services within one (1) hour of request or referral ("Crisis/Emergency Staffing Policy"). The Crisis/Emergency Staffing Policy shall:

(a) Require independently licensed qualified practitioners to be available twenty-four (24) hours per day, seven (7) days per week for telephone, face-to-face and mobile interventions for individuals needing crisis services;
(b) Delineate the criteria upon which appropriate venue for service delivery is determined;
(c) Require that backup support for staff who need assistance during an intervention is always available;
(d) Require that all staff receive current training in persuasion, engagement, and de-escalation techniques for disruptive or aggressive acts, consumers, and situations; and
(e) Require all staff to hold current certification in cardiopulmonary resuscitation and first aid.
3422.7

Crisis/Emergency Services shall be provided with no annual limits on services.

3422.8

ACT providers shall not bill Crisis/Emergency Services when provided to one of their current consumers.

3422.9

Crisis/Emergency Services shall be provided:

(a) At the MHRS provider's service site;
(b) By telemedicine pursuant to 29 DCMR § 910; or
(c) In natural settings, including the consumer's home or community settings.
3422.10

The following are qualified practitioners of Crisis/Emergency Services:

(a) Psychiatrists;
(b) Psychologists;
(c) LICSWs;
(d) APRNs;
(e) LISWs;
(f) LPCs;
(g) RNs;
(h) LMFTs;
(i) LGSWs;
(j) LGPCs;
(k) Psychology Associates; and
(l) PAs.
3422.11

Credentialed staff shall be permitted to provide Crisis/Emergency Services under the supervision of an independently licensed qualified practitioner.

D.C. Mun. Regs. tit. 22, r. 22-A3422

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 Final Rulemaking published at 53 DCR 9197 (November 10, 2006); as amended by Final Rulemaking published at 57 DCR 10392, 10394 (November 5, 2010); as amended by Notice of Emergency and Proposed Rulemaking published at 58 DCR 1482 (February 18, 2011)[EXPIRED]; as amended by Notice of Final Rulemaking published at 58 DCR 3476, 3480 (April 22, 2011); as amended by Notice of Emergency and Proposed Rulemaking published at 58 DCR 2857 (April 1, 2011)[EXPIRED]; as amended by Notice of Final Rulemaking published at 58 DCR 4159 (May 13, 2011); amended by Final Rulemaking published at 67 DCR 10674 (9/4/2020); amended by Final Rulemaking published at 68 DCR 012400 (11/26/2021); amended by Final Rulemaking published at 70 DCR 3050 (3/10/2023), effective date corrected to 4/7/2023, by Errata Notice published at 71 DCR 4474 (4/19/2024).
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 ).