Your Experience with DDS/DBH Coordination

DHCF head Wayne Turnage used his performance review testimony last week to talk about the troubling budget outlook for Medicaid, and there is no doubt that that that will be the big issue once the DC council starts budget hearings for FY 2026 later next month.  However, in the meantime, DDS still has not had its performance review hearing, scheduled for March 3.  As you know, I've been very focused in my blog recently on the kind of treatment people with disabilities receive when they get services from DBH.  Here is what DDS had to say in its pre-hearing questions on the subject of coordination with DBH:

28. Describe DDS’ collaboration with the Department of Behavioral Health. Include any specific partnerships on programs, initiatives, and events that DDS had with DBH in FY 24 and FY 25, to date.

In FY24 DDS and DBH collaborated to transition 147 DDS people to new behavioral health providers following the closure of the DBH Intellectual-Developmental Disability program at 35 K St.

In FY24, upon official notification that the 35 K St IDD clinic would be closing, DBH and DDS collaborated to ensure that patients were provided choice in the selection of new psychiatric service providers by: a. Collaborating on the official notification letters informing of the closing to ensure consistent messaging to CSAs, DDS service coordinators, DDS residential providers, guardians/decision makers, and patients. b. Identifying specific CSAs that had the capacity to take on the patients from 35 K St without delay, including the ability to schedule an intake within 7 days of referral. c. Requiring DDS service coordinators to work with the person and their interdisciplinary teams to choose a new psychiatry service provider.

DBH Provider Relations tracked 30- day, 60 -day, and 90- day follow-up appointments. Biweekly meetings between DBH Provider Relations and DDS Service Coordination were held throughout the transition to ensure patients were successfully placed with new providers. Currently, all DDS-linked patients have been placed with a new provider. DBH-IDD psychiatrist, Dr. Todd Augustus, has been available throughout the transition process to assist with questions/concerns and to consult with the 35 K St. Urgent Care Clinic on people with IDD who presented to UCC during the transition. In FY 25, DDS and DBH will continue this joint initiative to ensure that people with IDD receive high-quality and consistent behavioral health services. Dr. Augustus will provide ongoing consultative services to DDS and participate in interdisciplinary treatment team meetings for complex IDD cases, when requested. Dr. Augustus will also provide educational trainings to DDS and group home providers pertaining to mental health needs of IDD consumers through the DDS Nursing Roundtable. DBH and DDS have a well-established collaborative relationship which will continue to expand and evolve in FY 2025.

a. Does DDS encourage providers to contact DBH’s Community Response Team when an individual is in crisis or to contact 911?

The decision whether to call 911, the Community Response Team, or the Department of Behavioral Health (“DBH”) Assertive Community Treatment (“ACT”) team is made by the service provider, who acts based on the specific situation (i.e., whether there is a life-threatening emergency, or particular services are needed to ensure the safety of the person and staff). When 911 is called, a Crisis Intervention Officer (“CIO”) can be dispatched, meaning that a police officer with 40 hours of training in working with people who have mental illness and/or developmental disabilities will respond. Their training includes recognizing indicators that a person may have I/DD, communication procedures for people who have I/DD, and procedures for interacting with people who have disabilities. Two goals of the CIO program are to promote safe interactions between the police and citizens with mental health challenges and/or disabilities along with diversion of nonviolent mentally ill individuals, including people with dual diagnosis, from the criminal justice system to appropriate behavioral health services. Since June 2021, District 911 operators have been trained to identify situations involving mental health crises and to assess whether a police response is appropriate or whether they should redirect the call to the Community Response Team. Providers can also contact the Community Response Team directly or request DBH ACT services for people who receive those services as part of their mental
health treatment.

b. If someone receiving supports from both DBH and DDS needs housing and
supports, how do DBH and DDS work together to meet their needs?

DDS considers the suitability of the person’s current housing situation for meeting the person’s needs and, if necessary, explores the housing resources offered by DBH, DDS or other agencies. When a person requires individualized housing to promote their mental health recovery, DBH and DDS collaborate with the person’s ACT Team and the core service agency to identify housing options, rental subsidies, and community based behavioral health treatment services. If necessary, DDS will contact the Director of the DBH Housing Development Division or the Director of Residential Services and Supports to identify rental subsidies for the person. If the person receives housing supports from DBH and requires supports in the home and in the community, the DDS service coordinator works with the person and their circle of support to identify the appropriate waiver services based on the person’s assessed needs. The person selects a DDA provider for the service.

If you've had direct experience with DDS/DBH coordination, how has that worked out?  The DDS performance review hearing is an opportunity to testify and let the committee know what you've experienced - even if you can only send written testimony.

And if this isn't your topic but you plan to testify about some other aspect of DDS performance over the past year, you can take a look at all the committee questions, with DDS answers, here.by clicking here.