22-A6331

22-A6331 LEVEL OF CARE 1: OUTPATIENT

This regulation establishes operating standards for Level 1 Outpatient substance use disorder (SUD) treatment providers in the District of Columbia, permitting up to eight hours of SUD treatment services per week per client based on ASAM Level 1 criteria. Providers must deliver a defined mix of services including diagnostic assessment, SUD counseling/therapy, care coordination, drug screening, crisis intervention, and recovery support services. Providers may also obtain certification in specialty services such as Adolescent Community Reinforcement Approach (ACRA) and MET/CBT for youth and young adults with cannabis use disorder. Treatment duration is generally up to 180 days for an initial authorization but may continue long-term as clinically indicated.

LEVEL OF CARE 1: OUTPATIENT
 Level 1 Outpatient providers shall have the capacity to provide up to eight (8) hours of SUD treatment services per week, per client, in accordance with this section and medical necessity based on ASAM criteria. Level 1 Outpatient is the appropriate LOC for individuals who are assessed as meeting the ASAM criteria for Level 1 and:
Recognize their SUD and are committed to recovery;
Are transitioning from a higher LOC;
Are in the early stages of change and not yet ready to commit to full recovery;
Have a co-occurring condition that is stable; or
Have achieved stability in recovery and can benefit from ongoing monitoring and disease management.
6331.2 Level 1 Outpatient providers may also be certified in the following specialty services: 

Adolescent Community Reinforcement Approach in accordance with § 6347 of this chapter for services to youth and young adults with co-occurring substance use and mental health disorders ages twelve (12) to twenty-one (21) for youth providers and twenty-two (22) to twenty-four (24) for adult providers. 

MET/CBT in accordance with § 6352 of this chapter for services to a child/youth up to age twenty-three (23) with a cannabis use disorder.

 Level 1 Outpatient treatment duration varies with the severity of the patient’s SUD and their response to treatment but generally lasts up to one hundred and eighty (180) days for an initial authorization. Level 1 treatment can continue long-term in accordance with the Plan of Care, for clients needing long-term disease management.
 Level 1 Outpatient services are determined by a Diagnostic Assessment, performed in accordance with § 6339.
 Unless clinically inappropriate or a client does not consent, all providers shall adhere to the service requirements for this LOC.
 Level 1 Outpatient shall include the following mix of services in accordance with the client’s Plan of Care and this chapter (unless the client is receiving ACRA services in which case SUD Counseling/Therapy and CCC shall be provided in accordance with § 6347):
Diagnostic Assessment and Plan of Care in accordance with § 6339.
SUD Counseling/Therapy in accordance with § 6342; 
CCC in accordance with § 6340; 
Drug Screening in accordance with § 6343; 
Crisis Intervention in accordance with § 6341; and
 RSS in accordance with § 6344.

SOURCE: Final Rulemaking published at 62 DCR 12056 (September 4, 2015); as amended by Final Rulemaking published at 67 DCR 011585 (October 9, 2020); as amended by Final Rulemaking published at 71 DCR 014542 (November 29, 2024).

District of Columbia Municipal Regulations

 Mental Health
22-A DCMR § 6331