Code of the District of Columbia

Chapter 11C. Department of Behavioral Health.

Subchapter I. Establishment.

§ 7–1141.01. Definitions.

For the purposes of this chapter, the term:

(1) “Behavioral health” means a person’s overall social, emotional, and psychological well-being and development.

(2) “Behavioral health services” means stand-alone and co-occurring, integrated treatment services for substance abuse and mental health disorders that are designed to promote a person’s behavioral health.

(3) “Comprehensive Psychiatric Emergency Program” or “CPEP” means a 24-hour/7-days a week program providing emergency psychiatric evaluation and stabilization.

(4) “Department” means the Department of Behavioral Health.

(5) “Director” means the Director of the Department of Behavioral Health.

(6) “Recovery” means a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.

(7) “Recovery support services” means substance abuse treatment, care coordination, and community-based support that promote recovery.

(8) “Substance abuse” means a pattern of pathological use of a drug or alcohol that causes impairment in social or occupational functioning or produces physiological dependency evidenced by physical tolerance or physical symptoms when the drug or alcohol is not used.

§ 7–1141.02. Establishment of the Department of Behavioral Health.

(a) There is established as a separate, cabinet-level Department, subordinate to the Mayor, the Department of Behavioral Health.

(b) The Department shall be the successor-in-interest to the Department of Mental Health, established by Chapter 11A of this title [§ 7-1131.01 et seq.], and the Department of Health Addiction Prevention and Recovery Administration, established in the Department of Health by the Reorganization Plan No. 4 of 1996, effective July 17, 1996 [§ 1-1514.01].

§ 7–1141.03. Appointment of Director.

The Department shall be headed by a Director, who shall:

(1) Be appointed by the Mayor with the advice and consent of the Council, pursuant to § 1-523.01(a);

(2) Be qualified by experience and training to carry out the purposes of the Department as set forth in § 7-1141.05; and

(3) Serve at the pleasure of the Mayor.

§ 7–1141.04. Duties of Director.

In addition to other duties as may be lawfully imposed, the Director shall:

(1) Supervise and direct the Department;

(2) Organize the Department for its efficient operation, including creating offices within the Department, as necessary; and

(3) Exercise any other powers necessary and appropriate to implement the provisions of this chapter.

§ 7–1141.05. Purpose of the Department.

The Department shall:

(1) Ensure the provision of high-quality behavioral health services by establishing District-wide behavioral health standards and policies;

(2) Foster and promote behavioral health education and disease prevention;

(3) Provide high-quality prevention, treatment, and recovery support services related to mental health disorders, addictions, and the abuse of alcohol, tobacco, and other drugs in the District;

(4) Develop and maintain an efficient and cost-effective behavioral health care financing system; and

(5) Implement, monitor, and evaluate the District’s strategic behavioral health plan.

§ 7–1141.06. Powers and duties of the Department.

Notwithstanding any other provision of law, the Department shall:

(1) Plan, develop, coordinate, and monitor comprehensive and integrated behavioral health systems of care for adults and for children, youth, and their families in the District, so as to maximize utilization of behavioral health services and behavioral health supports;

(2) Assure that services for priority populations identified in the Department’s annual plan are funded within the Department’s appropriations or authorizations by Congress and are available;

(3) Serve as the state mental health authority and arrange for all authorized, publicly funded behavioral health services and behavioral health supports for the residents of the District, whether operated directly by, or through contract with, the Department; provided, that the Department of Youth Rehabilitation Services (“DYRS”) shall be responsible for the delivery of behavioral health services to youth in custody in DYRS secure facilities;

(4) Serve as the single state agency for substance abuse services and promulgate rules, regulations, and certification standards for high-quality prevention, treatment, and recovery support services related to addictions and the abuse of alcohol, tobacco, and other drugs in the District of Columbia;

(5) Maximize and leverage local, federal, and other available funding to support behavioral health prevention, treatment, and recovery support services;

(6) Directly operate a hospital to provide inpatient mental health services, and maintain the hospital’s certification by the Department of Health and the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services;

(7) Make grants, pay subsidies, purchase services, and provide reimbursement for behavioral health services and behavioral health supports; provided, that any grants shall be administered pursuant to part B of subchapter XII-A of Chapter 3 of Title 1 [§ 1-328.11 et seq.];

(8) Arrange for, or directly provide, a Comprehensive Psychiatric Emergency Program for all persons identified to the Department who meet criteria for admission for such services;

(9) Arrange for a 24-hour, District-wide telephone communication service to provide intervention services for adults, children, and youth in need of behavioral health services and behavioral health supports, including observation, evaluation, emergency treatment, and, when necessary, referral for behavioral health services and behavioral health supports;

(10) Be the exclusive agency to regulate all behavioral health services and behavioral health supports, including outpatient behavioral health services and all substance abuse and detoxification services;

(11) Facilitate the delivery of acute inpatient behavioral health services and behavioral health supports through community or public hospitals in the District, including coordinating comprehensive behavioral health services and behavioral health supports for children, youth, and their families;

(12) Upon request or on its own initiative, investigate, or ask another agency to investigate, any complaint alleging abuse or neglect of any consumer of behavioral health services, and, if the investigation by the Department or an investigation by any other agency or entity substantiates the charge of abuse or neglect, take appropriate action to correct the situation, including notification of other appropriate authorities; and

(13) Exercise all other powers, duties, functions, and responsibilities previously assigned to the Department of Mental Health pursuant to Chapter 11A of this title [§ 7-1131.01 et seq.], and to the Department of Health Addiction Prevention and Recovery Administration pursuant to Reorganization Plan No. 4 of 1996, effective July 17, 1996 (D.C. Official Code, Vol. 3) [Part A of subchapter XIV of Chapter 15 of Title 1].

§ 7–1141.06a. Superior Court mental health urgent care clinic.

(a) By October 1, 2024, the Department shall contract with a non-governmental organization for the purpose of establishing and operating a mental-health urgent-care clinic in Fiscal Year 2025. The clinic shall be located within the Moultrie Courthouse, at 500 Indiana Avenue, NW, location of the Superior Court of the District of Columbia.

(b) To qualify, the non-governmental organization shall:

(1) Have experience operating a mental health urgent care clinic within the Superior Court that provides behavioral health and substance use disorder services to individuals;

(2) Possess no less than 2 years of experience in establishing and managing free-standing mental health clinics;

(3) Be certified by the Department to provide mental health rehabilitation services;

(4) Have previously been awarded a contract by a local, state, or federal agency to conduct mental health and substance abuse assessments and treatment, conduct housing need assessments and referrals, and deliver brief therapeutic interventions for individuals within the justice system;

(5) Possess no fewer than 3 years of experience working with individuals with behavioral health needs involved in the legal system, including the ability to collaborate with Superior Court personnel, criminal justice agencies, and community-based providers;

(6) Possess expertise in providing comprehensive mental health and substance use disorder services to diverse populations;

(7) Possess knowledge of local laws and regulations related to mental health crisis support and hospitalization; and

(8) Possess a commitment to person-centered care and evidence-based practices in mental health and substance abuse disorder treatment.

(c) The mental health urgent care clinic established by this section shall:

(1) Employ an evidence-based or evidence-informed care management model that provides individualized support and referrals to resources;

(2) Ensure that one or more staff members are qualified to respond to a petition to conduct an emergency evaluation and observation when there is concern that an individual poses a significant risk to themselves or others due to a severe mental health condition. A staff member is qualified to conduct an emergency evaluation and observation if the staff member is certified by the Department as an Officer Agent or otherwise permitted by law to conduct an emergency evaluation and observation;

(3) Maintain staffing sufficient to provide services to no fewer than 600 individuals;

(4) Conduct assessments, diagnose mental health and co-occurring disorders, and conduct substance abuse screenings;

(5) Maintain an electronic health record system that collects uniform information that meets at least the following criteria:

(A) Maintains and keeps track of an individual's health history;

(B) Provides a method for clinic communication and treatment planning among providers and practitioners serving individuals visiting the clinic;

(C) Serves as a legal document describing healthcare services provided; and

(D) Serves as a source of data for the behavioral health services and outcomes that are rendered;

(6) Provide care coordination and intervention management services for high utilizers of the District's behavioral health and justice system;

(7) Provide evaluations for juveniles who are court-ordered for emergency evaluation;

(8) Conduct housing assessments;

(9) Provide immediate mental health clinical interventions, as required;

(10) Coordinate with organizations certified by the Department to provide behavioral health services, if necessary; and

(11) Refer individuals to community-based treatment and resources.

§ 7–1141.06b. Problem-gambling report and program.

(a) By October 31, 2024, the Department shall award a contract of $300,000 to a non-governmental organization for the purpose of conducting a needs assessment aimed at better understanding how problem gambling is impacting the District's residents and developing strategies for establishing an evidence-based or evidence-informed problem-gambling prevention, harm reduction, and treatment program.

(b) The non-governmental organization awarded the contract pursuant to subsection (a) of this section shall submit a report of its fundings by November 1, 2025, to the Department, which the Department shall submit to the Council by December 31, 2025.

(c) The report shall, at a minimum, include:

(1) Surveys and interviews with community members to gather information about their experiences with gambling, including issues related to problem gambling;

(2) Analysis of existing data sources, including hospital admissions, emergency room visits, treatment records, and Medicaid billing reports, to identify trends and patterns related to problem gambling;

(3) Community meetings and focus groups to facilitate discussions about problem gambling and its effects on individuals, families, and communities;

(4) Collaborations with stakeholders such as advocacy groups and treatment providers that specialize in gambling addiction;

(5) Mapping of local gambling resources to create an inventory or map of gambling-related services, including gambling addiction helplines, support groups, and treatment centers; and

(6) Evaluations of existing policies and programs aimed at addressing problem gambling, including public awareness campaigns, responsible gambling initiatives, and treatment services, to identify areas for improvement and opportunities for innovation.

(d) Beginning in Fiscal Year 2026, the Department shall establish:

(1) A pilot problem-gambling program for up to 200 individuals, based on the findings from the report outlined in subsection (a) of this section; and

(2) A pilot training program for up to 50 certified mental health and substance use disorder providers on best practices for screening, assessing, and providing treatment to individuals with problem-gambling disorder.

(e) For purposes of this section, "problem gambling" means a condition characterized by persistent and recurrent problematic gambling behavior that adversely affects individuals or their families, often disrupting their daily lives and careers, resulting in significant distress or impairment.

§ 7–1141.07. Transfer of authority, functions, property, and personnel.

(a) The following powers, duties, functions, and responsibilities are hereby transferred to the Department of Behavioral Health, effective October 1, 2013:

(1) All real and personal property, Career and Excepted Service, Management Supervisory Service, trainee positions, assets, records, obligations, unexpended balances of appropriations, allocations, and other funds available or to be made available to the Department of Mental Health and the Department of Health Addiction Prevention and Recovery Administration, or relating to the powers, duties, functions, operations, and administration set forth in § 7-1141.06;

(2) All of the functions assigned and authorities granted and delegated to the Director of the Department of Mental Health, and the Department of Mental Health, as set forth in Chapter 11A of this title [§ 7-1131.01 et seq.]; and

(3) All of the functions assigned and authorities granted and delegated to the Department of Health Addiction Prevention and Recovery as set forth in section IV(A)(3) of Reorganization Plan No. 4 of 1996, effective July 17, 1996 (D.C. Official Code, Vol. 3) [Part A of subchapter XIV of Chapter 15 of Title 1].

(b) The following powers, duties, functions, and responsibilities are hereby transferred to the Department of Health, effective October 1, 2014:

(1) All property, Career and Excepted Service, Management Supervisory Service, and trainee positions, personnel, assets, records, obligations, unexpended balances of appropriations, allocations, and other funds available or to be made available to the Tobacco Control Program.

(2) The Mayor shall coordinate, as necessary, the transfer from the Department to the Department of Health of any property, positions, personnel, assets, records, obligations, unexpended balances of appropriations, allocations, and other funds required for the management and operation of the Tobacco Control Program.

§ 7–1141.08. Rules.

(a) All rulemaking and regulations for the administration of the District’s public mental health system and the addiction, recovery, and prevention system, issued under appropriate authority, shall continue in full force and effect until otherwise superseded.

(b)(1) Any amendment to the terms medical necessity or medically necessary, as those terms are defined in section 3499.1 of Title 22A of the District of Columbia Municipal Regulations (22A DCMR § 3499.1), shall be issued by the Department by rulemaking.

(2) The Department shall issue rules to establish criteria to determine whether mental health rehabilitation services, as that term is defined in section 3499.1 of Title 22A of the District of Columbia Municipal Regulations (22A DCMR § 3499.1), are medically necessary pursuant to section 3404.2 of Title 22A of the District of Columbia Municipal Regulations (22A DCMR § 3404.2).

(3) The rules issued pursuant to this subsection shall be submitted to the Council for a 45-day period of review, excluding days of Council recess. If the Council does not approve or disapprove the proposed rules, by resolution, within the 45-day review period, the proposed rules shall be deemed approved.

§ 7–1141.09. Construction and abolishment.

(a) To the extent any provision of Chapter 11A of this title [§ 7-1131.01 et seq.], is inconsistent with a provision of this chapter, the provision of this chapter shall govern and shall be deemed to supersede the inconsistent provision.

(b) The Department of Health Addiction Prevention and Recovery Administration as set forth in section IV(A)(3) of Reorganization Plan No. 4 of 1996, effective July 17, 1996 (D.C. Official Code, Vol. 3) [Part A of subchapter XIV of Chapter 15 of Title 1], is abolished.

Subchapter II. Behavioral Health Access Project.

§ 7–1142.01. Definitions.

[Not funded].

§ 7–1142.02. Establishment of Behavioral Health Access Project.

[Not funded].

§ 7–1142.03. Reporting requirements.

[Not funded].