District of Columbia Administrative Code

515 USE OF RESTRAINTS OR SECLUSION WITH SPECIAL POPULATIONS 515.1 Consideration should be given to removing dentures or other dental devices either prior to the use of restraints or seclusion, or at the earliest opportunity after initiation of restraints or seclusion. 515.2 Only …

516 INJURY OR DEATH AS A RESULT OF RESTRAINT OR SECLUSION 516.1 If a consumer is injured during the process of being placed in restraints or seclusion or while in restraints or seclusion, MH provider staff shall: (a) Immediately obtain medical treatment from qualified medical per…

517 PROTECTIVE MEASURES 517.1 Protective measures involve the use of gerichairs, chairs with trays, bed rails, straps, mitts or other devices which restrict freedom of movement or access to one's body in order to prevent falls, maintain posture and for other medical purposes. 517…

518 NOTIFICATION OF PARENT(S) OR LEGAL GUARDIAN(S) OF USE OR CONTINUATION OF RESTRAINTS OR SECLUSION 518.1 If the consumer is a minor or an adult with a legal guardian, the MH provider staff shall notify the parent(s) or legal guardian(s) of the consumer who has been restrained o…

519 MH PROVIDER POLICIES AND PROCEDURES 519.1 Each MH provider shall establish, maintain, and adhere to written policies and procedures regarding the use of restraints and seclusion for consumers that comply with applicable federal and District laws and regulations. A MH provider…

520 MH PROVIDER REPORTING REQUIREMENTS 520.1 Each MH provider shall provide certification of its compliance with this chapter to DMH within thirty (30) days of the effective date of this chapter and annually thereafter. The MH provider shall prepare its initial and annual certifi…

521 STAFF EDUCATION AND TRAINING 521.1 Each MH provider identified in § 500.7 shall design and implement a training and education program for all MH provider staff aimed at minimizing the use of restraint and seclusion and maximizing safety for consumers and MH provider staff whe…

522 VIOLATIONS OF THIS CHAPTER 522.1 If the consumer or any third party believes that the consumer's rights with respect to the use of restraints or seclusion have been violated for any reason, such consumer or third party may file a grievance in accordance with the procedures pr…

599 DEFINITIONS "Assertive community treatment or "ACT" - intensive, integrated rehabilitative, crisis, treatment, and community support provided to adult consumers with serious and persistent mental illness by an interdisciplinary team, in accordance with the requirements of 22-…

5100 [REPEALED] SOURCE: Final Rulemaking published at 57 DCR 9477 (October 8, 2010); as amended by Final Rulemaking published at 60 DCR 6666 (May 10, 2013); as amended by Final Rulemaking published at 67 DCR 10775 (September 4, 2020). District of Columbia Municipal Regulations Me…

5101 [REPEALED] SOURCE: Final Rulemaking published at 57 DCR 9477, 9478 (October 8, 2010); as amended by Final Rulemaking published at 60 DCR 6666 (May 10, 2013); as amended by Final Rulemaking published at 61 DCR 6197 (June 20, 2014); as amended by Final Rulemaking published at …

5102 [REPEALED] SOURCE: Final Rulemaking published at 57 DCR 9477, 9478 (October 8, 2010); as amended by Final Rulemaking published at 60 DCR 6666 (May 10, 2013); as amended by Final Rulemaking published at 67 DCR 10775 (September 4, 2020). District of Columbia Municipal Regulati…

5103 [REPEALED] SOURCE: Final Rulemaking published at 57 DCR 9477, 9478 (October 8, 2010); as amended by Final Rulemaking published at 60 DCR 6666 (May 10, 2013); as amended by Final Rulemaking published at 67 DCR 10775 (September 4, 2020). District of Columbia Municipal Regulati…

5104 [REPEALED] SOURCE: Final Rulemaking published at 57 DCR 9477, 9478 (October 8, 2010); as amended by Final Rulemaking published at 60 DCR 6666 (May 10, 2013); as amended by Final Rulemaking published at 67 DCR 10775 (September 4, 2020). District of Columbia Municipal Regulati…

5199 [REPEALED] SOURCE: Final Rulemaking published at 57 DCR 9477, 9478 (October 8, 2010); as amended by Final Rulemaking published at 60 DCR 6666 (May 10, 2013); as amended by Final Rulemaking published at 67 DCR 10775 (September 4, 2020). District of Columbia Municipal Regulati…

5200 FUNCTIONAL FAMILY THERAPY REIMBURSEMENT 5200.1 The Department of Health Care Finance has published rates for Medicaid-funded services under Title 22-A District of Columbia Municipal Regulations (DCMR) Chapter 34. Those rates are contained in the District of Columbia Medicaid…

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 Source: Notice of Emergency and Proposed Rulemaking published at 57 DCR 10226, 1022…

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 reimbursemen…

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 und…

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. Source: Notice of Emergency and Proposed Rulemaking published at 57 DCR 10226, 10227 (October 29, 2010)[EXPIRED]; Notic…

5299 DEFINITIONS 5299.1 When used in this chapter, the following terms shall have the meanings 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 involv…

5300 PURPOSE 5300.1 This chapter establishes the reimbursement rates for the treatment planning and supportive treatment services provided by certified Mental Health Rehabilitation Services (MHRS) providers to Department of Behavioral Health (Department) consumers while the consu…

5301 DESCRIPTION OF REIMBURSABLE SERVICES 5301.1 Reimbursable “Mental Health Service – Continuity of Care Treatment Planning, Institution” services (MHS-CTPI) are services to assist consumers in institutional settings. MHS-CTPI is to be used for any mental health service not for …

5302 REIMBURSEMENT RATE 5302.1 The rates for reimbursement are as set forth below: CODE SERVICE RATE UNIT UNITS AUTHORIZED H0032HK Mental Health Service – Continuity of Care Treatment Planning, Institution for all MHRS consumers (MHS-CTPI) $21.97 15 minutes Up to 24 units within …

5303 ELIGIBILITY 5303.1 Only a certified MHRS provider with an HCA that has provided one of these identified services to a Department consumer may be reimbursed for services billed to the Department under this chapter. 5303.2 Reimbursement for MHS-CTPI requires prior authorizatio…

5304 SUBMISSION OF CLAIM 5304.1 In order for claims to be eligible for reimbursement, the MHRS provider shall: Submit claims through the Department’s electronic billing system pursuant to this chapter, the Department billing policy, and the terms of the HCA between the Department…

5305 AUDITS 5305.1 An MHRS provider shall, upon the request of the Department, cooperate in any audit or investigation concerning claims for the provision of these services. Failure to cooperate or to provide the necessary information and documentation shall result in recoupment …

5399 DEFINITIONS 5399.1 When used in this chapter, the following terms shall have the meaning ascribed: Assertive Community Treatment or “ACT” - Intensive, integrated rehabilitative, crisis, treatment, and mental health rehabilitative community support provided by an interdiscipl…

5400 PURPOSE 5400.1 This chapter establishes the reimbursement rate for private hospitals in the District of Columbia which, pursuant to a contract with the Department of Mental Health (Department), accept patients who are involuntarily hospitalized pursuant to D.C. Official Code…

5401 REIMBURSEMENT RATE 5401.1 The Private Hospital Probable Cause Hearing Rate is as set forth below: SERVICE RATE UNIT Probable Cause Hearing $650.00 Per Event 5401.2 The Department shall not provide any other reimbursement for any cost incurred by a private hospital with a con…

5402 ELIGIBILITY 5402.1 Only a private hospital located in the District of Columbia who has entered into a contract with the Department to accept involuntary patients authorized by the Department for hospitalization may incur expenses eligible for reimbursement in accordance with…

5403 SUBMISSION OF CLAIM; PAYMENT OF VOUCHER 5403.1 The private hospital shall submit all claims for probable cause hearings by invoice, pursuant to this chapter and the terms of the contract between the Department and the private hospital. 5403.2 The private hospital shall submi…

5404 AUDITS 5404.1 A private hospital shall, upon the request of the Department, cooperate in any audit or investigation concerning the claims for a probable cause hearing. SOURCE: Final Rulemaking published at 60 DCR 2166 (February 22, 2013). AUTHORITY: DC-DCMR Sections 104 and …

5499 DEFINITIONS 5499.1 When used in this chapter, the following terms shall have the meaning ascribed: Private hospital – a nongovernmental hospital or institution, or part thereof, in the District of Columbia, equipped and qualified to provide inpatient care and treatment for a…

5500 PURPOSE 5500.1 This chapter establishes the standard per diem charge at Saint Elizabeths Hospital and the process for determining adjustments to this charge. The per diem charge established by this chapter and the process proscribed for determining adjustments to this charge…

5501 CURRENT RATE 5501.1 Beginning on the effective date of this section, the per diem charge for an inpatient at Saint Elizabeths Hospital shall be seven hundred eighty-three dollars ($783) per day. This charge is based on the fully loaded cost of care as reflected in the most r…

5502 ANNUAL ADJUSTMENT 5502.1 The per diem charge shall be adjusted when a new annual Medicare cost report is filed with the Centers for Medicare and Medicaid Services’ (CMS) Fiscal Intermediary (FI) Highmark to reflect changes in cost of care. 5502.2 The adjusted per diem charge…

5599 DEFINITIONS 5599.1 When used in this chapter, the following terms shall have the meaning ascribed: Fully loaded cost of care – the average cost per day to provide inpatient hospital services to a patient. This rate includes direct medical service costs and administrative and…

5600 PURPOSE 5600.1 This chapter establishes the daily reimbursement rate for the Supported Independent Living (SIL) service. Establishment of a daily reimbursement rate will allow the Department of Behavioral Health (Department) to contract with providers who enter into a contra…

5601 REIMBURSEMENT RATE 5601.1 The SIL rate is as set forth below: SERVICE RATE UNIT Supported Independent Living $13.50 Daily SOURCE: Final Rulemaking published at 61 DCR 840 (January 31, 2014). District of Columbia Municipal Regulations Mental Health 22-A DCMR § 5601…

5602 ELIGIBILITY 5602.1 A qualified SIL provider must be a Department-certified Mental Health Rehabilitation Services (MHRS) provider in good standing, maintain a valid Certificate of Occupancy that authorizes the number of housing units to be provided for SIL and have a valid bu…

5603 SUBMISSION OF CLAIM; PAYMENT OF VOUCHER 5603.1 In order for claims to be eligible for reimbursement, the MHRS provider shall: Submit claims through the Department’s electronic billing system pursuant to this chapter, the Department’s billing policy, and the terms of the HCA …

5604 AUDITS 5604.1 An SIL provider shall, upon the request of the Department, cooperate in any audit or investigation concerning the SIL. Failure to cooperate or to provide the necessary information and documentation shall result in recoupment of the reimbursement and may result …

5699 DEFINITIONS 5699.1 When used in this chapter, the following terms shall have the meaning ascribed: Consumer - Adult, child, or youth who seeks or receives mental health services or mental health supports funded or regulated by the Department. Mental Health Rehabilitation Ser…

5700 PURPOSE 5700.1 This chapter establishes the reimbursement rates for the Mental Health Community Residence Facility (MHCRF) Per Diem for the care and support of individuals with serious mental illness residing in these facilities. Establishment of this locally-funded per diem…

5701 REIMBURSEMENT RATE 5701.1 The MHCRF Per Diem rates effective June 14, 2024, are as set forth below: SERVICE CODE RATE UNIT Transitional Supported Residence MHCRF Per Diem TSR01 $ 81.70 Daily Supported Residence MHCRF Per Diem SR01 $ 77.90 Daily Supported Rehabilitative Resid…

5702 ELIGIBILITY 5702.1 Only a licensed MHCRF operator who has entered into a contract with the Department will be eligible for reimbursement under this chapter. An MHCRF shall not be eligible to receive a per diem under this chapter if the MHCRF is receiving District of Columbia…

5703 SUBMISSION OF CLAIM; PAYMENT OF INVOICE 5703.1 The licensed MHCRF operator shall submit all per diem claims under the contract, pursuant to this chapter and the terms of the contract. 5703.2 The licensed independent MHCRF operator shall submit appropriate documentation to su…

5704 AUDITS 5704.1 A licensed MHCRF operator shall, upon the request of the Department, cooperate in any audit or investigation concerning the MHCRF Per Diem program. SOURCE: Final Rulemaking published at 61 DCR 12771 (December 19, 2014). District of Columbia Municipal Regulation…

5799 DEFINITIONS 5799.1 When used in this chapter, the following terms shall have the meaning ascribed: Mental Health Community Residence Facility (MHCRF) - a publicly or privately owned residence licensed in accordance with 22-B DCMR Chapter 38, that houses individuals, eighteen…