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6336

LEVEL OF CARE 3.5: CLINICALLY MANAGED HIGH-INTENSITY RESIDENTIAL (ADULT)/ CLINICALLY MANAGED MEDIUM-INTENSITY RESIDENTIAL (YOUTH)

6336.1 Level 3.5 Clinically Managed High-Intensity Residential/Clinically Managed Medium-Intensity Residential providers shall have the capacity to provide a minimum of twenty-five (25) hours of a mixture of SUD treatment services per week, per client, in accordance with this section and medical necessity based on ASAM criteria. One or more clinicians must be available on-site or by telephone twenty-four (24) hours a day, seven (7) days a week. Level 3.5 is the appropriate LOC for clients who are assessed as meeting the ASAM criteria for Level 3.5, need a twenty-four (24) hour supportive treatment environment to initiate or continue their recovery process, and:

1. (a) Have co-occurring or severe social/interpersonal impairments due to substance use; or
2. (b) Significant interaction with the criminal justice system due to substance use.

6336.2 Unless clinically inappropriate or a client does not consent, all providers shall adhere to the minimum service requirements for this LOC.

6336.3 Level 3.5 includes the following mix of services, as indicated on the Plan of Care and in accordance with this chapter:

1. (a) Assessment and Plan of Care in accordance with § 6339;
2. (b) SUD Counseling/Therapy in accordance with § 6342;
3. (c) CCC in accordance with § 6340;
4. (d) Drug Screening in accordance with § 6343;
5. (e) [REPEALED];
6. (f) Medication Management in accordance with § 6345; and
7. (g) RSS in accordance with § 6344.

6336.4 Discharge planning shall be conducted for all clients discharged from Level 3.5. Discharge planning criteria shall include at least the following activities prior to discharge from a Level 3.5 program:

1. (a) A review of the client's behavioral health, social, and physical needs;
2. (b) Completion of referrals to appropriate community services providers to address the client's identified needs;
3. (c) If the client desires, the provider shall arrange for appointments with community providers which shall be made as soon as possible after discharge; and
4. (d) 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).