District of Columbia Administrative Code

3859 INTENSIVE RESIDENCE 3859.1 An Intensive Residence (IR) shall provide on-site medical assistance, nursing, and rehabilitative services, in addition to meeting the minimum MHCRF requirements for a home-like environment, staffing, and resident care set forth in §§ 3800, 3850 an…

3860 TRANSITIONAL RESIDENTIAL BEDS 3860.1 Transitional residential beds (SR-Transitional) shall be located in a Supported Residence facility and shall meet all requirements of a SR MHCRF; except that a SR-Transitional may have up to ten (10) beds in a single facility and may main…

3861 MHCRF TRANSFER, DISCHARGE, AND RELOCATION 3861.1 The MHCRF shall promptly notify the Director, the resident’s CSA treatment team or other mental health care provider, and the resident’s physician when the resident’s physical or mental condition changes and the resident requi…

3899 DEFINITIONS When used in this chapter, the following terms shall have the meanings ascribed: “Activities of daily living” – Basic life activities that include ambulating and transferring, bathing, dressing, grooming, toileting, and eating. “Administrative Procedure Act” – th…

3900 PSYCHOSOCIAL REHABILITATION CLUBHOUSE CERTIFICATION STANDARDS 3900.1 This chapter establishes the requirements and process for obtaining and maintaining certification to provide mental health rehabilitation services as a Psychosocial Rehabilitation Clubhouse (Clubhouse) in t…

3901 CERTIFICATION APPLICATION 3901.1 No person shall operate a Psychosocial Rehabilitation Clubhouse unless certified in accordance with this chapter. 3901.2 An organization seeking certification from the Department as a Clubhouse shall submit an application to the Department in…

3902 CERTIFICATION REQUIREMENTS 3902.1 A Clubhouse providing services to members shall comply with all of the requirements set forth in Chapter 34 of this subtitle except for the requirements set forth in §§ 3411, 3412, 3413.7, 3413.12-3413.16, 3413.19, 3413.26, 3413.29(c), 3414,…

3903 CLUBHOUSE SERVICES ELIGIBILITY 3903.1 To be eligible for Clubhouse services, a consumer shall: Be eligible for MHRS services in accordance to Chapter 34; and Be at least eighteen (18) years of age. SOURCE: Emergency and Proposed Rulemaking published at 57 DCR 4010 (May 7, 20…

3904 CLUBHOUSE SERVICES 3904.1 Clubhouse services are primarily rehabilitative in nature. Clubhouse services assist individuals with behavioral health diagnoses to develop social networking, independent living, budgeting, self-care, and other skills that will assist them to live …

3905 CLUBHOUSE STAFF 3905.1 A provider of Clubhouse services must have one or more staff persons certified by the Psychiatric Rehabilitation Association (PRA) as a Certified Psychiatric Rehabilitation Practitioner (CPRP) or that have an equivalent certification. 3905.2 Any staff …

3906 DISTRICT REIMBURSEMENT LIMITATIONS 3906.1 Clubhouse treatment duration varies but generally last up to one hundred eighty (180) days. Clubhouse treatment can continue long-term in accordance with the Plan of Care for individuals experiencing ongoing rehabilitation needs. Clu…

3907 DOCUMENTATION REQUIREMENTS 3907.1 Each Clubhouse shall establish and adhere to policies and procedures concerning documentation, retention, maintenance, purging and destruction of clinical and rehabilitative records; security, confidentiality, and disclosure of consumer and …

3908 CLUBHOUSE REFERRALS 3908.1 Referrals to the Clubhouse may be made by a CSA, family member, advocates, other service providers, or by the consumer. 3908.2 Referrals from a CSA shall be made in writing and include the following information: (a) Current Plan of Care; (b) Curren…

3909 CLUBHOUSE PLAN OF CARE DEVELOPMENT PROCESS 3909.1 The Clubhouse Plan of Care development process for members shall, at a minimum, include: (a) The completion of a Diagnostic Assessment service and required components as described in § 3418 of this subtitle, unless the referr…

3910 CLUBHOUSE PLAN OF CARE DEVELOPMENT 3910.1 Each Clubhouse Plan of Care shall: Be person-centered: Include the member’s self-identified recovery goals; and Provide for the delivery of services in the most normative, least restrictive environment that is appropriate for the mem…

3911 CLUBHOUSE PLAN OF CARE IMPLEMENTATION 3911.1 Clubhouse assigned staff and the member shall discuss the Plan of Care on an ongoing basis. An encounter note describing the member’s response to, participation in and agreement to the Plan of Care shall be recorded in the member’…

3912 CLUBHOUSE STAFF TRAINING REQUIREMENTS 3912.1 A staff member shall receive training in accordance with the Clubhouse Standards before he or she may work independently with a member. 3912.2 A Clubhouse provider shall have a current written plan for staff development and organi…

3999 DEFINITIONS 3999.1 The definitions in § 3499 of this subtitle are incorporated by reference into and applicable to this chapter unless otherwise defined in § 3999.2. 3999.2 The following terms have the following meaning: Clubhouse International – the international organizati…

4400 GENERAL PROVISIONS 4400.1 This chapter establishes uniform requirements for transferring funds appropriated to the Department, or other things of value, to recipients outside of the District government, where the Department is authorized to make grants. Subgrants of federal …

4401 GRANT AVAILABILITY ANNOUNCEMENTS AND APPLICATIONS 4401.1 Except as provided in §§ 4401.3 and 4401.4, the availability of a Department grant shall be announced by one (1) of the following methods: (a) Publication in a newspaper of general circulation in the District of Columb…

4402 APPLICATION REVIEW 4402.1 A review panel selected by the Department shall review each application to determine if it meets the requirements that apply to the particular grant. 4402.2 The review panel shall advise the Department Grant Officer and the Director of all those app…

4403 REVIEW FACTORS 4403.1 The recommendations of the review panel and the award decisions of the Director shall be based on the following criteria: (a) Feasibility of the project; (b) Soundness of research design, statistical technique, and procedures and methodology, if appropr…

4404 DISPOSITION OF PROPOSAL 4404.1 The Director shall make the final selection of the grant award. 4404.2 To ensure that the Department has followed the competitive process specified above, the Department Grant Officer shall review each proposed grant award before it can become …

4405 GRANT AGREEMENT 4405.1 Each grant award shall be in the form of a written grant agreement between the Director and the awardee that is consistent with those statutes and regulations that apply to the grant. 4405.2 The grant agreement shall include, but not be limited to, the…

4406 CERTIFICATION OF A DRUG-FREE WORKPLACE 4406.1 By submission of its application, the grantee, if other than an individual, certifies and agrees that with respect to all its employees under the grant it shall, no later than thirty (30) calendar days after grant award (unless a…

4407 FINANCIAL MANAGEMENT BY GRANTEES 4407.1 Each grantee shall make accurate, current, and complete disclosure of the financial results of each project or program in accordance with the financial reporting requirements of the grant agreement. 4407.2 Each grantee shall maintain r…

4408 MONITORING BY GRANTEES 4408.1 Each grantee shall monitor grant and subgrant supported activities by reviewing each program, function or activity to assure that adequate progress is being made towards achieving the goals of the grant or subgrant. 4408.2 Each grantee shall sub…

4409 AUDITS AND DISALLOWANCES 4409.1 Appropriate District or federal personnel may conduct fiscal and program audits of the grantee. 4409.2 Each grantee shall have an annual audit performed by an auditor who is independent of the staff person who authorizes expenditure of project…

4410 PAYMENT OF FUNDS BY GRANTEE 4410.1 As a condition of each grant awarded, the grantee shall agree to do the following: (a) Repay the District for final audit disallowances within thirty (30) days from receipt of notification by a disallowance letter; and (b) Pay interest at t…

4411 CLOSE-OUT 4411.1 The Grant Officer shall close-out the grant when he or she determines that all applicable administrative actions and all required work of the grant have been completed. 4411.2 Upon termination or close-out of the grant, the Grant Officer shall promptly provi…

4412 RECORD RETENTION AND ACCESS 4412.1 The grantee shall retain all records for a period of at least three (3) years following final close-out of the grant, if no other period is specified in the grant agreement. 4412.2 The grantee shall make all records available to the Directo…

4413 TERMINATION AND SUSPENSION PROCEDURES 4413.1 If a grantee has materially failed to comply with the terms of a grant agreement, the Grant Officer may, after giving reasonable written notice to the grantee, do the following: (a) Suspend the grant in whole or in part; (b) Termi…

4414 INFORMAL DISPUTE RESOLUTION 4414.1 The provisions contained in this section and in § 4415 shall establish an informal procedure for resolution of disputes between the grantee and the Director. 4414.2 The procedure shall apply to the following adverse determinations made by t…

4415 DECISION OF THE DIRECTOR 4415.1 The Director may require informal, non-binding mediation between the parties before issuing a final decision if, due to the nature of the dispute, the Director considers it to be in the best interests of the District. 4415.2 The Director shall…

4499 DEFINITIONS 4499.1 When used in this chapter, the following terms shall have the meanings ascribed: Controlled Substance - a controlled substance in schedules I through V or Section 202 of the Controlled Substances Act (21 U.S.C. § 812) and as further defined, in regulation,…

500 PURPOSES AND APPLICATION 500.1 The purpose of these rules is to: (a) Provide a safe and therapeutic environment for consumers; (b) Significantly reduce the incidence of emergencies that necessitate the use of restraints and seclusion; (c) Establish positive, trusting relation…

501 GENERAL PROVISIONS REGARDING THE USE OF RESTRAINT AND SECLUSION 501.1 Each MH provider shall comply with the requirements of this chapter regarding the use of restraints and seclusion. Each MH provider shall have a policy addressing the use of restraint and seclusion that sat…

502 CONSUMER RIGHTS REGARDING THE USE OF RESTRAINTS AND SECLUSION 502.1 All MH provider staff shall treat each consumer receiving mental health services and supports with consideration and respect for the consumer's dignity, autonomy and privacy at all times. 502.2 Each consumer …

503 RESTRAINTS GENERALLY 503.1 Restraints shall include devices and techniques designed and used to control a consumer's behavior in an emergency. 503.2 Methods of restraint that may be prescribed in an emergency for consumers receiving services from an MH provider identified in …

504 SECLUSION GENERALLY 504.1 Methods of seclusion that may be prescribed pursuant to this chapter include the confinement of a consumer alone in a room or an area from which the consumer: (a) Is physically prevented from leaving; or (b) Believes he or she cannot leave at will. 5…

505 PROHIBITIONS ON THE USE OF RESTRAINTS AND SECLUSION 505.1 In employing restraints and seclusion, the following measures are strictly prohibited: (a) The use of restraining nets; (b) Ambulatory restraints (restraints which allow the consumer to walk around while restrained, su…

506 INITIATING THE USE OF FOUR-POINT AND FIVE-POINT RESTRAINTS OR SECLUSION 506.1 Unless otherwise specified in this section or in federal regulations, only a physician or a physician assistant, may order the use of restraints or seclusion. Such orders shall be in writing, except…

507 SPECIFIC PROCEDURES FOR THE USE OF SECLUSION 507.1 When secluding a consumer, the following procedures shall be observed: (a) All potentially dangerous articles shall be removed from the consumer's person and the seclusion area; (b) If unclothed, the consumer shall be offered…

508 MONITORING THE USE OF FOUR-POINT AND FIVE-POINT RESTRAINT OR SECLUSION 508.1 Within one (1) hour after initiation of the use of restraint or seclusion and following the discontinuation of any restraints or seclusion of a consumer pursuant to this chapter, the physician or phy…

509 POST EVENT ANALYSIS OF THE USE OF FOUR-POINT AND FIVE-POINT RESTRAINT OR SECLUSION 509.1 All staff involved in the use of restraint or seclusion shall, within twenty-four (24) hours of the application of restraint or seclusion, conduct a post event analysis among themselves r…

510 TREATMENT TEAM DEBRIEFING MEETING REGARDING THE USE OF FOUR-POINT AND FIVE POINT RESTRAINTS OR SECLUSION 510.1 The consumer's treatment team shall conduct a treatment team debriefing following each incident of restraint or seclusion. If use of restraint or seclusion occurred …

511 PHYSICAL HOLDS 511.1 A physical hold is the application of physical force by a trained or qualified staff person without the use of any mechanical device, for the purpose of restraining free movement of a consumer's body. A physical hold does not include briefly holding witho…

512 MEDICAL RESTRAINTS 512.1 Medical restraints may be used to administer medical or surgical treatment to an uncooperative consumer, if: (a) In the written opinion of a physician licensed to practice medicine in the District, medical or surgical treatment is necessary to prevent…

513 LEGALLY MANDATED RESTRAINTS 513.1 This chapter does not govern the use of legally mandated restraints. Legally mandated restraints are restraints ordered by a court of law or restraints that are applied, monitored, and removed at the discretion of a law enforcement officer, s…

514 DRUG(S) USED AS A RESTRAINT 514.1 Only a physician licensed to practice medicine in the District may order a drug(s) to be used as a restraint. 514.2 A drug(s) used as a restraint is permitted only in an emergency when the consumer presents an imminent risk of serious injury …