Regulation detail

22-A1202

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22-A1202 PERSONS WITH SERIOUS MENTAL ILLNESS

Jurisdiction: DC Agency: DC Department of Behavioral Health (DBH) — Title 22-A; and DC Department of Health Care Finance (DHCF) — Title 29 Medicaid behavioral-health chapters
CCBHC (50%) CMHC (80%) MH_IOP (60%) MH_PHP (60%) MH_RESIDENTIAL (60%) OUTPATIENT (60%) PRTF (40%) PSYCH_FACILITY (60%)
Plain-English summary

This regulation defines the term 'Persons with Serious Mental Illness' (SMI) for regulatory purposes under DC's behavioral health framework. It establishes diagnostic, durational, and functional-impairment criteria for adults age 22 and older to qualify as having SMI, explicitly excluding standalone substance use or developmental disorders unless co-occurring with another mental illness. This is a definitional provision and does not itself license or set operating standards for any specific facility or level of care.

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Regulation text
1202 PERSONS WITH SERIOUS MENTAL ILLNESS

1202.1 Persons with serious mental illness are individuals age 22 or over who currently have, or at any time during the prior year have had, a diagnosable mental, behavioral or emotional disorder (including those of biological etiology) that:

(a) Is or was of sufficient duration to meet diagnostic criteria specified within DSM-IV or the ICD-9-CM equivalent (and subsequent revisions), except for DSM-IV "V" codes;

(b) Is not a substance abuse disorder or a developmental disorder, unless co-occurring with another diagnosable mental illness; and

(c) Results, resulted in, or will without treatment or other support services result in a functional impairment that substantially interferes with or limits one or more major life activities, including basic daily living skills, instrumental living skills, and functioning in social, family and vocational or educational contexts.

 SOURCE: New by emergency and proposed rulemaking at 49 DCR 1734 (February 22, 2002)[EXPIRED]; Final Rulemaking published at 49 DCR 5811 (June 21, 2002).