D.C. Mun. Regs. tit. 29, r. 29-11113
To be eligible for PDS, a participant shall be in receipt of a service authorization for in-home supports, individualized day supports, companion services, respite daily services, and/or individual-directed goods and services from DDS that specifies the amount, duration, and scope of services authorized to be provided to the participant, in accordance with applicable provisions in Chapter 90 of Title 29 DMCR.
A PDS budget shall be developed in accordance with services authorized in the participant's ISP and Plan of Care and shall be developed based on the following methodology:
The amount resulting from the calculation described in § 11113.2 shall represent the My Life, My Way program participant's monthly PDS allocation amount, which shall be used to compute the participant's PDS budget.
A PDS budget shall be developed by the participant and/or authorized representative, as appropriate, with assistance from the participant's support broker.
A PDS budget may contain the following five (5) cost components:
PDS services shall include a combination of hands-on care, habilitative supports, skill development and building, community integration and inclusion, supervision, non-medical care, assistance with activities of daily living, and/or access to goods and services as described in 29 DCMR Chapter 90 in § 9017 (Companion Services), § 9024 (Individualized Day Supports Services), § 9025 (In-Home Supports Services), § 9030 (Respite Services), and § 9035 (Individual-Directed Goods and Services (IDGS))
Payment for PDS 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 § 11113.2.
Funds available for purchase of individual-directed goods and services shall be those funds, if any, remaining in the PDS budget after the amount for PDS services has been determined.
Support brokers shall be responsible for explaining the method used to develop the monthly PDS allocation amount to My Life, My Way program participants.
DDS shall calculate the monthly PDS allocation amount for all My Life, My Way program participants.
DHCF or its agent shall notify all My Life, My Way program participants each time the PDS allocation amounts are adjusted as a result of a change to the hourly rate paid for agency-based in-home supports, respite, individualized day supports, and companion services.
The participant and the authorized representative, if applicable, shall work with the support broker to develop the participant's PDS budget based on the allocation amount.
The participant's support broker shall submit the participant's completed PDS budget to DDS for approval within the timeframe established by DDS.
DDS shall review all PDS and individual-directed goods and services requested in a participant's PDS budget.
If DDS denies any PDS or individual-directed good or service requested in a participant's PDS budget, DDS shall send written notice of the denial to the participant, authorized representative as appropriate, and the participant's support broker. The notice shall contain information on the reconsideration process, as described in § 11114, and the participant's appeal rights.
Once a participant's PDS budget is approved by DDS, DDS shall provide the approved PDS budget to the VF/EA FMS-Support Broker entity.
The VF/EA FMS-Support Broker entity shall only release payment for PDS, and individual-directed goods and services included in the participant's approved PDS budget and for which prior authorizations have been issued.
D.C. Mun. Regs. tit. 29, r. 29-11113