D.C. Mun. Regs. tit. 29, r. 29-11108
Respite services provide relief to a participant's family or primary caregiver to enable them to participate in scheduled or unscheduled time away from the participant, and to prevent gaps in the delivery of the participant's services.
Participant-directed Medicaid-eligible respite services shall:
To be eligible for Medicaid reimbursement, PDWs shall ensure that each participant receives hands-on supports including, but not be limited to, the following areas:
Medicaid reimbursement shall not be available if respite services are provided by the following individuals or provider:
Medicaid reimbursement for daily respite services shall be limited to thirty (30) days per calendar year.
Daily respite service may be extended in situations when the primary caretaker is hospitalized or otherwise unable to continue as a primary caretaker and may only be extended until other arrangements are made for the participant; and if remaining funds in the PDS budget support extended services.
Respite daily services in the My Life, My Way program shall be designed to promote independence and ensure the health, welfare, and safety of the participant.
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 respite services.
Supports shall be available to assist the participant/representative-employer with their own employer-related responsibilities as described in § 11108.8 through the VF/EA FMS-Support Broker entity.
All participant-directed respite services 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.
To be eligible for PDS respite daily services, a participant shall be in receipt of a service authorization for respite daily 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 Chapter 90 of Title 29 DCMR.
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, the wage paid for respite services.
Payment for respite daily 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 § 11108.12.
In order to ensure respite services are provided in a manner that ensures the participant's health and safety, if a participant submits a PDS budget in accordance with § 11113 that includes respite services as described in 29 DCMR § 11108, respite services must be provided by at least two (2) PDWs each day.
D.C. Mun. Regs. tit. 29, r. 29-11108