3423 REHABILITATION DAY SERVICES

3423.1 Rehabilitation Day Services is a structured, clinical program intended to develop skills and foster social role integration through a range of social, psycho-educational, behavioral, and cognitive mental health interventions. Rehabilitation Day Services:

1. (a) Are curriculum-driven and psycho-educational and assist the consumer in the retention or restoration of independent and community living, socialization, and adaptive skills;
2. (b) Include cognitive-behavioral interventions and diagnostic, psychiatric, rehabilitative, psychosocial, counseling, and adjunctive treatment; and
3. (c) Are offered most often in group settings, but may be provided individually.

3423.2 Rehabilitation Day Services shall:

1. (a) Be founded on the principles of consumer choice and the active involvement of each consumer in their mental health recovery;
2. (b) Provide both formal and informal structures through which consumers can influence and shape service development;
3. (c) Facilitate the development of a consumer's independent living and social skills, including the ability to make decisions regarding self-care, management of illness, life, work, and community participation;
4. (d) Promote the use of resources to integrate the consumer into the community; and
5. (e) Include education on self-management of symptoms, medications and side effects, the identification of rehabilitation preferences, the setting of rehabilitation goals, and skills teaching and development.

3423.3 Each consumer shall have a person-centered plan that addresses the consumer's needs and progress toward achievement of Rehabilitation Day Services treatment goals.

3423.4 Each Rehabilitation Day Services provider shall provide adequate space, equipment, and supplies to ensure that services can be provided effectively. Rehabilitation Day Services program space and furnishings shall be separate and distinct from other services offered within the same service site(s).

3423.5 Each Rehabilitation Day Services provider shall have policies and procedures included in its Service Specific Policies addressing the provision of Rehabilitation Day Services (“Rehabilitation Day Services Organizational Plan”) which includes:

(a) A description of the particular rehabilitation models utilized, types of intervention practiced, and typical daily curriculum and schedule; and

(b) A description of the staffing pattern, including a staffing plan to ensure that the required staff-to-consumer ratios are maintained, and a plan for coverage during unplanned staff absences.

3423.6 Each Rehabilitation Day Services provider shall have a minimum of one (1) full-time equivalent staff for every ten (10) consumers based on average daily attendance.

3423.7 At least one (1) independently licensed qualified practitioner shall be present on site at all times.

3423.8 Each Rehabilitation Day Services provider shall have a clinical supervisor or director who is an independently licensed qualified practitioner on site at least thirty (30) hours per week.

3423.9 Providers shall deliver at least one (1) hour of Rehabilitation Day Services per day to qualify for reimbursement. The District shall reimburse no more than six (6) hours of Rehabilitation Day services per day.

3423.10 Rehabilitation Day Services shall require prior authorization from the Department. Rehabilitation Day Services provided in excess of two hundred and seventy (270) units within the initial one hundred and eighty (180) day period shall require supplemental authorization from the Department. Each subsequent authorization shall not exceed two hundred and seventy (270) units within a one hundred and eighty (180) day period.

3423.11 Rehabilitation Day Services shall not be billed:

(a) On the same day as:

(1) Group Community Support;

(2) Intensive Day Treatment (IDT);

(3) Trauma-Focused Cognitive Behavioral Therapy (TF-CBT);

(4) Trauma Recovery and Empowerment Model (TREM);

(5) Trauma Systems Therapy (TST);

(6) Psychosocial Rehabilitation Clubhouse; or

(b) During:

(1) A Counseling encounter; or

(2) An Individual Community Support encounter.

3423.12 Rehabilitation Day Services shall only be provided at an MHRS provider's service site.

3423.13 The following are qualified practitioners of Rehabilitation Day Services:

(a) Psychiatrists;

(b) Psychologists;

(c) LICSWs;

(d) APRNs;

(e) LISWs;

(f) LMFTs;

(g) LPCs;

(h) RNs;

(i) LGSWs;

(j) LGPCs;

(k) Psychology Associates; and

(l) PAs.

3423.14 Credentialed staff shall be permitted to provide Rehabilitation Day Services under the supervision of an independently licensed qualified practitioner.

SOURCE: Final Rulemaking published at 48 DCR 10297 (November 9, 2001); as amended by Final Rulemaking published at 51 DCR 9308 (October 1, 2004); as amended by Final Rulemaking published at 52 DCR 5682 (June 17, 2005); as amended by Notice of Emergency and Proposed Rulemaking published at 58 DCR 1482 (February 18, 2011)[EXPIRED]; as amended by Notice of Final Rulemaking published at 58 DCR 3476, 3482 (April 22, 2011); as amended by Final Rulemaking published at 67 DCR 10674 (September 4, 2020); as amended by Final Rulemaking 68 DCR 012400 (November 26, 2021); as amended by Final Rulemaking published at 72 DCR 014041 (December 19, 2025).