D.C. Mun. Regs. tit. 29, r. 29-10100

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 29-10100 - GENERAL PROVISIONS

10100.1

The Services My Way program shall be established as the Medicaid participant-directed services (PDS) program in the District of Columbia to afford persons enrolled in the Home and Community-Based Services Waiver for the Elderly and Persons with Physical Disabilities (EPD Waiver) the opportunity to self-direct certain EPD Waiver services.

10100.2 Participation in the Services My Way program shall be limited to beneficiaries enrolled in the EPD Waiver who live in their own private residence or in the home of a family member or friend.

10100.3

If an EPD Waiver beneficiary is deemed ineligible to participate in the Services My Way program because of his or her failure to meet the criteria outlined in § 10100.2, Department of Health Care Finance (DHCF) shall issue timely written notice to the beneficiary which includes the following :

(a) A clear statement that the beneficiary is not eligible to participate in the Services My Way program;

(b) The reason(s) for the decision;

(c) Citation to regulations supporting the decision; and

(d) Information on the beneficiary's right to appeal the decision by filing a notice of appeal with the Office of Administrative Hearings.

10100.4

The Services My Way program shall include the following services:

(a) Participant-directed community support (PDCS) services as described in § 10102; and

(b) Individual-directed goods and services as described in § 10104.

10100.5

PDCS services and individual-directed goods and services shall only be available to EPD Waiver beneficiaries enrolled as participants in the Services My Way program.

10100.6

Services My Way participants shall be afforded the following self-direction opportunities:

(a) The opportunity to exercise "employer authority" to recruit, hire, supervise and discharge qualified participant-directed workers (PDWs) who provide PDCS services to them; and

(b) The opportunity to exercise "budget authority" to purchase allowable and approved individual-directed goods and services using a participant-directed services (PDS) budget.

10100.7

The Services My Way participant or the participant's authorized representative, if designated by the participant, shall serve as a "common law employer" of all PDWs hired by the participant.

10100.8

Financial management services and information and assistance services, as set forth in § 10106.4 and § 10106.6, respectively, shall be provided to Services My Way participants through the Vendor Fiscal/Employer Agent (VF/EA) Financial Management Services (FMS)-Support Broker entity selected by the Department of Health Care Finance (DHCF) through a competitive procurement process.

10100.9

Services My Way participants shall not serve as PDWs.

D.C. Mun. Regs. tit. 29, r. 29-10100

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