D.C. Mun. Regs. tit. 29, r. 29-11102

Current through Register Vol. 71, No. 44, November 1, 2024

Rule 29-11102 - COMPANION SERVICES: SERVICE DESCRIPTION

11102.1

Companion services provide non-medical assistance and supervision to support a participant's goals, desires, and needs as identified in the participant's ISP and reflected in their Person-Centered Thinking and Discovery tools. Goals shall be related to the participant's safety, promotion of independence, community integration, and/or retirement.

11102.2

To be eligible for Medicaid reimbursement of companion services, the services shall be identified in the participant's PDS budget, ISP, Plan of Care, and Summary of Supports for each participant enrolled in the IFS Waiver, and each participant shall:

(a) Demonstrate a need for non-medical support and supervision at home or in the community; and

(b) Have the service recommended by the participant's support team, after having considered the appropriateness of other waiver services and the staffing ratio, if any, in the participant's home.

11102.3

Companion services may be provided in a participant's home or in the community.

11102.4

To be eligible for Medicaid reimbursement, companion services may be provided outside of regular Monday to Friday daytime hours when supervision or other non-medical support is necessary to ensure the participant's safety.

11102.5

To be eligible for Medicaid reimbursement, companion services shall not:

(a) Exceed eight (8) hours per twenty-four (24) hour day;

(b) Exceed forty (40) hours per week when used with Residential Habilitation, 24-Hour Supported Living, and 24-Hour Supported Living with Transportation Services, or when used in combination with Personal Care Services or any other Waiver day or vocational support services, including Day Habilitation, Employment Readiness, Supported Employment, Small Group Supported Employment, or Individualized Day Supports as part of a participant's traditional Monday to Friday day/vocational programming time; and

(c) Be provided at the same time as In-Home Supports, Personal Care Services, Respite, and/or Behavioral Supports Non-Professional.

11102.6

Companion services in the My Life, My Way program shall be designed to promote independence and ensure the health, welfare, and safety of the participant.

11102.7

The participant or their authorized representative, as applicable, shall serve as a "common law employer" of the PDW providing services. In the role of "common law employer," the participant or authorized representative shall be responsible for recruiting, hiring, supervising, and discharging PDWs providing companion services.

11102.8

Supports shall be available to assist the participant/representative-employer with their own employer-related responsibilities as described in § 11102.7 through the VF/EA FMS-Support Broker entity.

11102.9

All PDS provided by a PDW shall be prior authorized by DDS or its agent in order to be reimbursed under the My Life, My Way program.

11102.10

To be eligible for PDS Companion services, a participant must receive a service authorization for companion services from DDS or its designated agent that specifies the amount, duration, and scope of services authorized to be provided to the participant, in accordance with 29 DCMR § 9017.

11102.11

The hourly wage paid to a PDW shall be no lower than the living wage in the District, set in accordance with the Living Wage Act of 2006, effective June 8, 2006 (D.C. Law 16-118; D.C. Official Code §§ 2-220.01et seq.), and no higher, including employment taxes and insurance amounts, than the current rate paid for agency-based companion services.

11102.12

Payment for companion services shall be provided in accordance with the participant's PDS budget, at an hourly wage set by the participant/representative-employer which falls within the wage range established by DHCF as set forth in § 11102.11.

D.C. Mun. Regs. tit. 29, r. 29-11102

Final Rulemaking published at 70 DCR 8909 (6/23/2023)