This regulation establishes the operating standards for ASAM Level 3.1 Clinically Managed Low-Intensity Residential substance use disorder treatment in the District of Columbia. Providers must deliver a minimum of five hours of SUD treatment services per week per client, maintain independently licensed clinicians competent in SUD and co-occurring mental illness, and ensure 24/7 physician availability on-site or by telephone. Required services include diagnostic assessment, SUD counseling, care coordination, drug screening, medication management, and recovery support services, all guided by a Plan of Care. Providers must also conduct structured discharge planning for all clients, including referrals, community appointments, and client participation in the discharge process.
View official sourceLEVEL OF CARE 3.1: CLINICALLY MANAGED LOW-INTENSITY RESIDENTIAL Level 3.1 Clinically Managed Low-Intensity Residential providers shall have the capacity to provide a minimum of five (5) hours of a mixture of SUD treatment services per week, per client, in accordance with this section and medical necessity based on ASAM criteria. Level 3.1 providers must be staffed with independently licensed clinicians who are competent to treat SUD and mental illness. A physician must be available on-site or by telephone twenty-four (24) hours a day, seven (7) days a week. Level 3.1 Clinically Managed Low-Intensity Residential is the appropriate LOC for clients who are assessed as meeting the ASAM criteria for Level 3.1 and: Are employed, in school, in pre-vocational programs, actively seeking employment, or involved in a structured day program; Recognize their SUD and are committed to recovery or are in the early stages of change and not yet ready to commit to full recovery but need a stable supportive living environment to support their treatment or recovery; May have a stable co-occurring physical or mental illness; Who meet the ASAM criteria for Level 3.1, or its equivalent, as approved by the Department; and Who are capable of self-care but are not ready to return to family or independent living. Unless clinically inappropriate or a client does not consent, all providers shall adhere to the minimum service requirements for this LOC. Level 3.1 Clinically Managed Low-Intensity Residential includes the following mix of core and specialty services, as indicated on the Plan of Care and in accordance with this chapter: 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; [REPEALED]; Medication Management in accordance with § 6345; and RSS in accordance with § 6344. The provider shall conduct discharge planning shall for all clients discharged from Level 3.1. Discharge planning criteria shall include at least the following activities prior to discharge from a Level 3.1 program: A review of the client’s behavioral health, social, and physical needs; Completion of referrals to appropriate community services providers, to address the client’s identified needs; If the client desires, the provider shall arrange for appointments with community providers which shall be made as soon as possible after discharge; and Each client shall be given the opportunity to participate in the development of his or her discharge plan, including selecting appropriate community providers. With the consent of the client, and when clinically appropriate, reasonable attempts shall be made to contact family members for their participation in the discharge planning process. No client or family member shall be required to agree to a discharge. A provider shall make a notation in the client’s record if any objection is raised to the discharge plan. 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 § 6334