NDAC 75-03-44-25
General service provisions
Cite as N.D. Admin. Code ยง 75-03-44-25
1.
Whether delivered directly or through a designated collaborating organization agreement, the
certified clinic is responsible for ensuring access to all care specified in the Protecting Access
to Medicare Act of 2014 [Pub. L. No. 113-93], including, as more explicitly provided in sections
75-03-44-27 through 75-03-44-36 the following required services:
a.
Crisis services;
b.
Screening, assessment, and diagnosis;
c.
Person-centered and family-centered treatment planning;
d.
Outpatient behavioral health services;
e.
Outpatient primary care screening and monitoring;
f.
Targeted case management;
g.
Psychiatric rehabilitation;
h.
Peer, parent, or legal representative supports; and
i.
Intensive community-based outpatient behavioral health care for members of the United
States armed forces and veterans.
2.
The certified clinic shall deliver directly the majority of encounters across the required
services, excluding crisis services, rather than through a designated collaborating
organization.
3.
The certified clinic shall ensure all certified community behavioral health clinic services, if not
available directly through the certified clinic, are provided through a designated collaborating
organization, consistent with the freedom of choice of the individual to choose appropriate
providers within the certified clinic and its designated collaborating organizations, unless
limited by federal or state laws or regulations. This subsection does not preclude the certified
clinic's use of referrals outside the certified clinic or designated collaborating organization if a
needed specialty service is unavailable through the certified clinic or designated collaborating
organizations.
4.
Regarding certified clinic and designated collaborating organization services, individuals must
be informed of and have access to the certified clinic's existing grievance procedures, which
must satisfy the minimum requirements of Medicaid and other grievance requirements such as
those mandated by relevant accrediting entities or state laws and regulations.
5.
Designated collaborating organization-provided services for individuals must meet the same
quality standards as those provided by the certified clinic. The entities with which the certified
clinic coordinates care and all designated collaborating organizations, taken in conjunction
with the certified clinic itself, shall satisfy the mandatory aspects of this chapter.