D.C. Mun. Regs. tit. 29, r. 29-1912

Current through Register Vol. 71, No. 43, October 25, 2024

Rule 29-1912 - INITIATING, CHANGING, OR TERMINATING ANY APPROVED SERVICES

1912.1

A provider shall hold a support team meeting and provide each person receiving Waiver services at least thirty (30) calendar days advance written notice of intent to initiate, suspend, reduce, or terminate services and shall offer a meeting to explain the notice. A copy of the notice shall also be provided to DDS and DHCF. If DDS intends to suspend, reduce or terminate services, DDS shall also provide written notice which complies with the requirements set forth in this section.

1912.2

In accordance with 42 C.F.R. § 431.210 and D.C. Official Code § 4-205.55(a)(2), a provider shall give people receiving services or the person's representative and the DDS Service Coordinator at least thirty (30) calendar days advance written notice prior to the effective date of the termination or reduction of services, and be responsible for notifying DDS of any person who is undergoing treatment of an acute condition.

1912.3

The written notice shall comply with the requirements of 42 C.F.R. § 431.210 and D.C. Official Code § 4-205.55(a)(2) and the provider shall transfer the person's original record to the new service provider at the time of the transfer, unless the person is deceased or no longer chooses to participate in the Waiver program.

1912.4

The DDS Service Coordinator shall be responsible for initiating, changing, or terminating Waiver services for each person in accordance with the ISP and identifying those people for whom an HCBS is no longer an appropriate alternative.

1912.5

The provider shall notify DDS in writing whenever any of the following circumstances occur:

(a) Death of a person;

(b) Hospitalization of a person;

(c) Any other circumstance in which Waiver services are interrupted for more than seven (7) days;

(d) The person is discharged or terminated from services; or

(e) Any other delay in the implementation of Waiver services.

1912.6

In the event of a person's death, a provider shall comply with all written notice requirements and any policies established by DDA in accordance with DDA's Incident Management and Enforcement Policy and Procedures available at: http://dds.dc.gov/page/policies-and-procedures-dda.

1912.7

When the health and safety of the person or provider agency personnel is endangered, the thirty (30) calendar days advance notice shall not be required. The provider shall notify the person or the person's representative and the DDS Service Coordinator as soon as possible and send a written notice on the date of termination in accordance with 42 C.F.R. § 431.210 and D.C. Official Code § 4-205.55(a)(2).

1912.8

Each person enrolled in the Waiver shall be provided a fair hearing in accordance with 42 C.F.R. § 431 and D.C. Official Code § 4-210.01 if the government:

(a) Fails to offer the person a choice of either institutional care in an intermediate care facility for the intellectually disabled (ICF/IID) or home and community-based waiver services;

(b) Denies a waiver service requested by the person;

(c) Terminates, suspends, or reduces a waiver service; or

(c) Fails to give the person the provider of his or her choice.

1912.9

DDS or the provider shall be responsible for issuing each required notice to the person enrolled in the Waiver or their representative regarding the right to request a hearing as described under Subsection 1912.8.

1912.10

The content of the notice issued pursuant to Subsections 1912.8 and 1912.9 shall comply with the requirements of 42 C.F.R. § 431.210 and D.C. Official Code § 4-205.55.

D.C. Mun. Regs. tit. 29, r. 29-1912

Final Rulemaking published at 55 DCR 2882 (March 21, 2008); as amended by Final Rulemaking published at 61 DCR 4406 (May 2, 2014); amended by Final Rulemaking published at 63 DCR 10445 (8/12/2016)

Authority: An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat. 744; D.C. Official Code § 1-307.02 (2012 Repl. & 2013 Supp.)) and Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2012 Repl.)).