1942.1The purpose of this section is to establish standards governing eligibility for parenting support services for persons enrolled in the Home and Community-Based Services Waiver for Persons with Intellectual and Developmental Disabilities (ID/DD Waiver), and to establish conditions of participation for professionals and providers of parenting support services to receive Medicaid reimbursement.
1942.2Parenting support services assist people who are or will be parents in developing appropriate parenting skills. Parents will receive training that is individualized and focused on the health and welfare and developmental needs of their child, as well as building necessary parenting skills. Close coordination will be maintained with informal and other formal supports.
(a) Parenting support services may include training of individuals who provide unpaid support, training, companionship or supervision to persons served through the waiver to reinforce strategies provided to the person served;(b) Parenting support services is available both as a 1:1 service for a person, and in small group settings not to exceed 1:4. For persons enrolled in small group parenting support services, the provider must make every effort to match the person with another person or persons of his or her choosing, or with a person who has similar skills or interests;(c) Parenting support services may be provided by professionals or qualified peer employees;(d) Parenting support services shall be provided in the person's home or in a variety of community based settings, based upon the person's needs and choices;(e) A person served through the ID/DD Waiver may utilize both 1:1 and small group parenting support, and services provided by professionals and qualified peer employees and both services combined are subject to the limitations in Subsection 1942.10; and(f) Parenting support services do not include activities that are the responsibility of Supported Living, Supported Living with Transportation, Residential Habilitation, Host Home or In-Home Supports and can be offered in combination with any ID/DD Waiver residential services.1942.3Parenting support services will be authorized when:
(a) The person is an expectant parent, a parent with physical custody or visitation with his or her child, or a parent who is pursuing reunification with his or her child;(b) The person requests the service, or it is recommended by the person's support team;(c) Parenting support services is included in the person's ISP and Plan of Care; and(d) Parenting support services may be delivered through remote supports to the extent the recommended service delivery is through remote supports services, and the person is able to utilize equipment/technology needed for remote supports services as assessed and determined by the support team.1942.4In order to be eligible for Medicaid reimbursement, each parenting support services provider shall comply with the following service delivery requirements:
(a) Conduct an assessment, within the first four (4) hours of service delivery, which shall include the following:(1) A background review and current functional review of the person's parenting capabilities in different environments;(2) An environmental review in the person's home, and other community site as necessary; and(b) Develop and implement a parenting support plan, within the first four (4) hours of service delivery, that describes strategies, and the anticipated and measurable, functional outcomes, based upon what is important to and for the person as reflected in his or her Person-Centered Thinking tools and the goals in his or her ISP and Plan of Care.1942.5Parenting support services may be provided by any of the following agency provider types:
(c) Supported Living with Transportation; and(d) Host Home Without Transportation.1942.6Medicaid reimbursable parenting support services shall be provided by either professionals or peer employees:
(a) Professionals shall meet the following qualifications:(1) Comply with the requirements of the Health Care Facility Unlicensed Personnel Criminal Background Check Act of 1998 effective April 20, 1999 (D.C. Law 12- 238; D.C. Official Code §§ 44-551et seq.); as amended by the 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.);(2) Documented completion of required training in accordance with the DDS Training policy;(3) Master's degree in field related to supporting people with disabilities, including but not limited to social services, education, and psychology;(4) At least five (5) years of experience working with people with intellectual disabilities and/or their families; and(5) Demonstrated ability, experience and education to teach adult learners; conduct support needs assessments; implement service/ support plans; assist parent in specific areas of support described in the plan; serve as an advocate; and work with people of varied ethnic and cultural backgrounds.(b) Peer employees shall meet the basic requirements set forth in 29 DCMR §§ 1906.3. (1) A peer employee may be the person's relative, but may not be legally responsible for the person, or the person's legal guardian.(2) A peer employee shall not provide parenting support services to a person for whom he or she provides the following ID/DD Waiver services: Residential Habilitation; Supported Living; Supported Living with Transportation; Host Home Without Transportation; or In-Home Supports.1942.7Each Medicaid provider of parenting support services shall comply with Section 1904 (Provider Qualifications) and Section 1905 (Provider Enrollment Process) of Chapter 19 of Title 29 DCMR.
1942.8Each Medicaid provider of parenting support services shall maintain the following documents for monitoring and audit reviews:
(a) A copy of the most recent DDS approved ISP and Plan of Care, which shall include the documentation required by Subsection 1942.4;(b) The parenting support plan developed in accordance with the requirements of Subsection 1942.4; and(c) The documents required to be maintained under Section 1909 (Records and Confidentiality of Information) of Chapter 19 of Title 29 DCMR.1942.9Each Medicaid provider of parenting support services shall comply with Section 1908 (Reporting Requirements) and Section 1911 (Individual Rights) of Chapter 19 of Title 29 DCMR.
1942.10There shall be a total of four (4) Medicaid reimbursement rates for parenting support services: for 1:1 services and for small group services (i.e. 1:2, 1:3 and 1:4 staffing ratios) based on whether the services are provided by a professional or peer employee. Parenting support services shall not exceed one thousand four hundred sixty (1,460) hours per ISP year. Support is available from the first trimester until the eligible participant's child transitions from high school.
1942.11The billable unit of service for parenting support services shall be fifteen (15) minutes. A provider shall provide at least eight (8) minutes of service in a span of fifteen (15) continuous minutes to bill a unit of service.
1942.12Each provider of remote parenting support services shall comply with the requirements of Section 1943 (Remote Supports Services) of Chapter 19 of Title 29 of DCMR.
1942.13Remote parenting supports services shall be issued as a separate service authorization indicating the frequency of usage. A hybrid model may be used for in-person and remote supports services parenting supports hours where two (2) service authorizations are issued to cover the in-person service hours and the remote supports services hours.
1942.14Remote parenting supports services reimbursement rates shall reflect the same rate as professional in-person parenting supports reimbursement rates.
1942.15HCBS Waiver providers providing parenting supports through remote supports services must meet the following criteria, as specified in the Remote Supports Services rule: Shift training to include ETC and/or ETIS; Operation of the Remote Support Monitoring Base systems; and Phase I, II and III trainings with the exemption of CPR and Trained Medication Employee ("TME"). Providers shall comply with the rules set forth in Remote Supports Services rule for provider qualifications, service delivery, and documentation of services.
D.C. Mun. Regs. tit. 29, r. 29-1942
Final Rulemaking published at 65 DCR 2190 (March 2, 2018); amended by Final Rulemaking published at 71 DCR 10372 (8/16/2024)