D.C. Mun. Regs. tit. 29, r. 4222

Current through Register Vol. 71, No. 44, November 1, 2024
Rule 4222 - PROVIDER REQUIREMENTS: GENERAL
4222.1

Each provider approved to provide one or more Waiver services shall meet the following minimum requirements:

(a) Demonstrate compliance with all applicable provisions of Chapter 94 (Medicaid Provider and Supplier Screening, Enrollment, and Termination) of Title 29 DCMR;
(b) Have a completed, approved, and current Medicaid Provider Agreement with DHCF before providing any waiver services; and
(c) Be licensed to do business in the District of Columbia, if required by this chapter.
4222.2

Each provider of waiver services shall demonstrate a comprehensive knowledge and understanding of the EPD Waiver program including:

(a) Knowledge of Medicaid State Plan services and limitations;
(b) Knowledge of community resources (legal, housing, energy, food, transportation, and other medical and social assistance) and the methods of accessing these resources; and
(c) An understanding of the relationship between Medicaid State Plan and waiver services.
4222.3

Each provider of waiver services shall immediately notify DHCF's Long Term Care Administration when a beneficiary is institutionalized, hospitalized or has his or her waiver services suspended for a reason other than those which do not result in an official notice of suspension as set forth in Section 4205.

4222.4

Each provider of waiver services shall demonstrate a service history and current capacity to assist beneficiaries in accessing services provided through the District of Columbia Office on Aging or other agencies serving the elderly and individuals with physical disabilities.

4222.5

Each provider of waiver services shall require and thoroughly check at least two (2) professional references on all staff entering the home of a waiver beneficiary.

4222.6

Each waiver service provider with employees providing direct care in a beneficiary's home or permanent place of residence shall have a proof of compliance with the Health-Care Facility Unlicensed Personnel Criminal Background Check Act of 1998, effective April 20, 1999, 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.).

4222.7

No employee of a waiver services provider who has been convicted of a felony, a crime involving abuse, neglect, or violence against the person of another, or crime involving theft or larceny under federal or District law shall provide services to a beneficiary.

4222.8

Each provider of waiver services shall conduct a performance evaluation of all staff after the first three (3) months of employment and annually thereafter, maintain all performance evaluation files for a period of no less than ten (10) years, and make such files available for review by appropriate DHCF personnel, representatives of the U.S. Department of Health and Human Services and other authorized designees or officials of the District of Columbia government and federal government.

4222.9

Each provider of direct care services shall ensure that all staff providing direct care services is trained in universal precautions prior to the provision of any service.

4222.10

Universal precautions training shall be included as a component of annual continuing education classes for all staff, including homemakers, who may encounter blood or bodily fluids while providing direct care services. https://www.osha.gov/SLTC/etools/hospital/hazards/univprec/univ.html. Documentation of universal precautions training shall be maintained in an employee's file for a period of no less than ten (10) years.

4222.11

Each provider of waiver services shall establish and implement a process to ensure that each beneficiary has:

(a) Been informed of and given his or her freedom of choice in the selection of all qualified service providers; and
(b) Been informed of his or her rights and responsibilities under the waiver program.
4222.12

When a waiver beneficiary chooses an individual, or family member other than a primary caregiver, the beneficiary's spouse, or other legally responsible relative, or court-appointed guardian to provide direct care services, these individuals shall be subject to the same certification requirements as other service providers described within this chapter.

4222.13

Each provider of waiver services shall attend all mandatory provider meetings and trainings hosted by DHCF when scheduled.

4222.14

All Case Managers, Adult Day Health, Assisted Living providers, Community Residence Facility providers and Home Care Agencies providing EPD Waiver services shall complete mandatory training in Person-Centered Thinking, Supported Decision-Making, and Supported Community Integration.

4222.15

Each provider of waiver services shall immediately report all instances of suspected fraud, theft, or abuse committed by an employee or agent of the provider, or by a beneficiary to whom the provider is rendering waiver services, to the DHCF Division of Program Integrity.

D.C. Mun. Regs. tit. 29, r. 4222

Final Rulemaking published at 64 DCR 6787 (7/21/2017)