D.C. Mun. Regs. tit. 29, r. 4249

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

Rule 4249 - SPECIFIC PROVIDER REQUIREMENTS: PARTICIPANT-DIRECTED COMMUNITY SUPPORT SERVICES

4249.1

Participant Directed Community Support Services (PDCS) services shall only be reimbursed to EPD Waiver beneficiaries enrolled as participants in the Services My Way program.

4249.2

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

4249.3

Medicaid reimbursable 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 parents 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 this chapter and Chapter 101 of this title.

4249.4

In order to be reimbursed by Medicaid, 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, April 13, 2002 (D.C. Law 14-98; D.C. Official Code §§ 44-551et seq. (2016 Repl.));

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

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

(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 the Services My Way Program Coordinator and maintain current certifications.

4249.5

Services My Way participants shall not serve as PDWs.

4249.6

The VF/EA FMS-Support Broker entity shall be responsible for verifying that criminal background checks are conducted on all prospective PDWs in accordance with Subsection 4249.4(b), and providing participants, authorized representatives, prospective PDWs, and the Services My Way Program Coordinator with the results of all criminal background checks performed on prospective PDWs.

4249.7

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 qua lifications set forth in Subsection 4249.4 prior to hiring the PDW to provide PDCS services.

4249.8

The VF/EA FMS-Support Broker entity shall verify that a PDW meets all qualifications set forth in Subsection 4249.4 prior to enrolling the PDW into its payroll system.

4249.9

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. 4249

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