D.C. Mun. Regs. tit. 29, r. 29-10103

Current through Register Vol. 72, No. 2, January 10, 2025

Rule 29-10103 - PARTICIPANT-DIRECTED COMMUNITY SUPPORT SERVICES:PROVIDER REQUIREMENTS

10103.1

PDCS services shall be provided only to EPD Waiver beneficiaries enrolled as participants in the Services My Way program.

10103.2

Qualified PDWs shall provide PDCS services as employees of Services My Way participants.

10103.3

PDCS services may be provided by family members and individuals other than a participant's spouse, other legally responsible relative, or court-appointed guardian. A legally responsible relative does not include parent s of adult children, so parents of adult children are not precluded from providing PDCS services. Each family member providing PDCS services shall comply with the requirements set forth in these rules.

10103.4

All PDWs shall meet the following qualifications:

(a) Be at least eighteen (18) years of age;

(b) Complete and pass a criminal background check in accordance with the Health-Care Facility Unlicensed Personnel Criminal Background Check Act of 1998, effective April 20, 1999, as amended by Health-Care Facility Unlicensed Personnel Criminal Background Check Amendment Act of 2002, effective April 13, 2002 (D.C. Law 14-98; D.C. Official Code §§ 44-551et seq.;

(c) Receive customized training provided by the participant and/or the participant's authorized representative that is related to the participant's functional needs and goals as outlined in the PCP;

(d) Be able and willing to perform the service-related responsibilities outlined in the participant's PCP;

(e) Be certified in cardiopulmonary resuscitation (CPR) and First Aid through an in-person training course approved by the American Red Cross or an alternative course approved by DHCF or its designee and maintain current certifications; and

(f) Have an individual NPI number obtained from the National Plan and Provider Enumeration System (NPPES)

10103.5

Services My Way participants shall not serve as PDWs.

10103.6

The VF/EA FMS-Support Broker entity shall be responsible for verifying that criminal background checks are conducted for all prospective PDWs in accordance with § 10103.4(b), and providing participants, authorized representatives, prospective PDWs, and DHCF or its designee with the results of all criminal background checks performed on prospective PDWs.

10103.7

The participant, or the participant's authorized representative if designated as the "common law employer" of the PDW, shall verify that a prospective PDW meets all qualifications set forth in § 10103.4 prior to hiring the PDW to provide PDCS services.

10103.8

The VF/EA FMS-Support Broker entity shall verify that a PDW meets all qualifications set forth in § 10103.4 prior to enrolling the PDW into its payroll system.

10103.9

The VF/EA FMS-Support Broker entity shall execute a Medicaid provider agreement with each PDW on behalf of DHCF at the time a PDW is enrolled into its payroll system.

D.C. Mun. Regs. tit. 29, r. 29-10103

Final Rulemaking published at 64 DCR 9568 (9/29/2017); amended by Final Rulemaking published at 69 DCR 12090 (10/7/2022)