11118.1Participant/ representative-employers shall be required to comply with all program rules and terms of the Participant/Representative-Employer Agreement executed at the time of enrollment in the My Life, My Way program.
11118.2Non-compliance with the program rules or the terms of the Participant/Representative-Employer Agreement shall result in referral of the participant to the Remediation, Training and Termination Protocol established by DDS.
11118.3Non-compliance with the terms of the Participant/Representative-Employer Agreement may be identified by the VF/EA FMS-Support Broker entity, the participant's support broker, the participant's Service Coordinator, or DDS staff.
11118.4If a My Life, My Way program participant is found to be non-compliant with the terms of the Participant/Representative-Employer Agreement three (3) times within a thirty-six (36) month period, the third episode of non-compliance shall necessitate termination from the program and transition to agency-based IFS Waiver services.
11118.5When a participant/representative-employer is found to be out of compliance with the Participant/Representative-Employer Agreement for the first time, the following steps shall occur:
(a) DDS shall issue a notice of non-compliance to the participant/representative-employer, the support broker, and the Service Coordinator, which shall:(1) Identify the issue of non-compliance and request that the issue be corrected, if possible, and not repeated;(2) Detail requirements of the Corrective Action Plan (CAP) the participant shall create to address the issue;(3) Offer training and/or technical assistance;(4) Encourage the participant/representative-employer to direct questions to the support broker regarding the issue of noncompliance, including requesting training, obtaining assistance in preparing the CAP, and designating an authorized representative;(5) Identify consequences of further non-compliance with the Participant/Representative-Employer Agreement; and(6) Provide information on the participant's appeal rights for termination from the program should three (3) episodes of noncompliance occur in a thirty-six (36) month period;(b) Within five (5) business days of issuing the notice of non-compliance, the support broker shall contact the participant/representative-employer to discuss the episode of non-compliance;(c) Within five (5) business days of the contact described in (b) above, the participant shall, with the assistance of the authorized representative and/or the support broker, if needed, draft and sign a written CAP regarding the issue of non-compliance; and(d) The support broker shall provide copies of the participant's signed CAP to the participant's Service Coordinator and the VF/EA FMS-Support Broker entity.11118.6The participant's support broker shall be responsible for monitoring the participant's adherence to the CAP.
11118.7If the participant or authorized representative, as applicable, fails to implement all or a portion of the CAP, this failure shall be considered an episode of noncompliance with the terms of the Participant/Representative-Employer Agreement and shall be reported to DDS.
11118.8If a participant/representative-employer is found to be out of compliance with the Participant/Representative-Employer Agreement a second time, the following steps shall occur:
(a) DDS shall issue a second notice of non-compliance to the participant/representative-employer, the support broker, and the Service Coordinator, which shall meet all requirements described in §11118.5(a);(b) Within five (5) business days of issuing the notice of non-compliance, the support broker shall contact the participant/representative-employer to discuss the episode of non-compliance;(c) Within five (5) business days of the contact described in (b) above, the participant shall, with the assistance of the authorized representative and/or the support broker, if needed, draft and sign a written CAP regarding the issue of non-compliance; and(d) The support broker shall provide copies of the participant's signed CAP to the participant's Service Coordinator and the VF/EA FMS-Support Broker entity.11118.9If a participant/representative-employer is found to be out of compliance with the Participant/Representative-Employer Agreement a third time, the following steps shall occur:
(a) DDS shall issue a third notice of non-compliance to the participant, the support broker, and the service coordinator, which shall: (1) Identify the three (3) episodes of non-compliance;(2) Clearly state that DDS is terminating the participant's enrollment in the My Life, My Way program, per notice provided in the first and second notifications of non-compliance;(3) Inform the participant that he/she will be transitioned to agency-based IFS Waiver services, per notice provided in the first and second notifications of non-compliance; and(4) Provide information regarding the participant's right to appeal the My Life, My Way program termination decision by filing a notice of appeal with the Office of Administrative Hearings;(b) The support broker shall provide copies of the termination notice to the participant's service coordinator and the VF/EA FMS-Support Broker entity;(c) Within five (5) business days of issuing the termination notice to the DDS Program Coordinator, the participant's service coordinator shall contact the participant/ representative-employer and address the following topics:(1) Reference to the first and second notices of non-compliance and the termination notice;(2) Review of the consequences of three (3) episodes of noncompliance within a thirty-six (36) month period;(3) Explanation of the process to transition the participant to agencybased IFS Waiver services; and(4) Explanation of the participant's right to appeal the My Life, My Way program termination decision and the appeal process; and(d) Within five (5) business days of the contact described in (c) above, the support broker shall complete all required participant termination forms and submit them to DDS.11118.10If a participant files a notice of appeal with the Office of Administrative Hearings within thirty (30) days of the date on the My Life, My Way program termination notice, the participant shall remain enrolled in the My Life, My Way program and continue to receive PDS and individual-directed goods and services included in the participant's approved PDS budget while the participant's appeal is pending.
11118.11Service Coordinators shall be responsible for transitioning participants to agencybased IFS waiver services. Service Coordinators shall ensure that there is no break in service provision during the transition period and shall coordinate the approval by DDS of the request to initiate agency-based IFS waiver services.
11118.12Nothing in this section shall be construed to limit the District's authority to investigate and prosecute a My Life, My Way program participant for criminal acts including, but not limited to, theft and fraud.
D.C. Mun. Regs. tit. 29, r. 29-11118
Final Rulemaking published at 70 DCR 8909 (6/23/2023)