D.C. Mun. Regs. tit. 29, r. 29-11105

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

Rule 29-11105 - INDIVIDUALIZED DAY SUPPORTS: PROVIDER REQUIREMENTS

11105.1

Qualified PDWs shall provide PDS as employees of My Life, My Way program participants.

11105.2

Parents of adult children may provide PDS.

11105.3

A legally responsible relative does not include parents of adult children, so parents of adult children are not precluded from providing PDS. Each family member providing PDS services shall comply with the requirements set forth in these rules.

11105.4

All PDWs shall comply with the requirements under (Reporting Requirements), (Records and Confidentiality of Information), (Individual Rights) and (HCBS Setting Requirements) of Chapter 90 of Title 29 DCMR, except that the progress notes as described in Subsection 9006.2(m) shall be maintained on a per visit basis. The following additional records shall also be maintained:

(a) Emergency Back-up contacts who are available to provide backup staffing or support if the PDW is unavailable to deliver the service. An initial community integration plan, during the first thirty (30) days a participant is receiving IDS, utilizing the template required by DDS and containing the following information:

(b) The name of the participant receiving the service;

(c) Service start date;

(d) The names of the primary and back-up PDWs that will be delivering the service during the first thirty (30) days of service;

(e) The back-up staffing plan if neither the primary or back-up PDWs are available to deliver the service; and

(f) Goals in ISP that trigger authorization for individualized day supports.

11105.5

After a participant has received IDS for thirty (30) calendar days, an on-going community integration plan should be submitted utilizing the template required by DDS and containing the following information:

(a) The name of the participant receiving the services;

(b) The names of the primary and PDWs delivering services; and

(c) The back-up staffing plan if neither the primary or back-up PDWs are available to deliver the service.

11105.6

All PDWs shall meet the following qualifications:

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

(b) Be at least eighteen (18) years of age;

(c) Possess an active CPR and First Aid certificate and ensure that the CPR and First Aid certifications are renewed every two (2) years, with CPR certification and renewal via an in-person class;

(d) Complete and pass a criminal background check in accordance with the Health-Care Facility Unlicensed Personnel Criminal Background Check Act of 1998, effective April 13, 2002 (D.C. Law 14-98; D.C. Official Code §§ 44-551et seq.);

(e) COVID vaccination consistent with DC Health requirements.

(f) Obtain annual documentation from a physician or other health professional that he or she is free from tuberculosis; and

(g) Have an individual NPI number obtained from the National Plan and NPPES;

(h) Receive customized training provided by the participant and/or his/her authorized representative that is related to the participant's functional needs and goals as outlined in the ISP; and

(i) Receive required trainings and certifications to meet the qualifications as a direct support professional (DSP) and maintain current certifications as described in DDS policy.

11105.7

The VF/EA FMS-Support Broker entity shall be responsible for collecting criminal background check fees from prospective PDWs, performing criminal background checks on all prospective PDWs in accordance with § 11105.6(d), and providing participants, authorized representatives, prospective PDWs, and DDS with the results of all criminal background checks performed on prospective PDWs.

11105.8

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 qualifications set forth in § 11106.5 prior to hiring the PDW to provide PDS.

11105.9

The VF/EA FMS-Support Broker entity shall verify that a PDW meets all qualifications set forth in § 11106.5 prior to enrolling the PDW into its payroll system.

11105.10

The VF/EA FMS-Support Broker entity shall execute a District of Columbia Medicaid provider agreement with each PDW at the time a PDW is enrolled into its payroll system.

D.C. Mun. Regs. tit. 29, r. 29-11105

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