These rules establish certification requirements for Mental Health Rehabilitation Services (MHRS) Core Services Agencies (CSAs) and Freestanding Mental Health Clinics (FSMHCs) to operate as Health Home providers in DC. A Health Home serves as the central coordinating entity for individuals with serious and persistent mental illness who have or are at risk of co-occurring chronic medical conditions, integrating behavioral health, physical health, and community-based services. Providers are reimbursed on a per member per month basis and must coordinate care across behavioral health, specialty, and primary care providers to improve chronic condition management and reduce avoidable hospitalizations.
View official sourceHEALTH HOME PROGRAM These rules establish the requirements and process for certifying a Mental Health Rehabilitation Services (MHRS) Core Services Agency (CSA) or a Freestanding Mental Health Clinic (FSMHC) as a Health Home provider in the District of Columbia. A Health Home is an MHRS CSA or FSMHC that serves as the coordinating entity for services offered to a person with a serious and persistent mental illness (consumer) who has or is at risk of developing co-occurring chronic medical conditions. The provider is the central point for coordinating patient-centered and population-focused care for both behavioral health and other medical services. The Health Home provider is compensated on a per member per month (PMPM) basis to coordinate care between itself as the behavioral health provider, and other physical and specialty health care providers and community-based services and supports. The purpose and goal of individualized care coordination is to increase collaboration and integration of behavioral, health and community based services, improve management of chronic conditions, and reduce avoidable health care costs, specifically for hospital admissions, readmissions and emergency room visits. SOURCE: Final Rulemaking published at 63 DCR 849 (January 22, 2016); as amended by Final Rulemaking published at 66 DCR 5625 (May 3, 2019). District of Columbia Municipal Regulations Mental Health 22-A DCMR § 2500