D.C. Mun. Regs. tit. 29, r. 29-1903

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

Rule 29-1903 - LEVEL OF CARE AND FREEDOM OF CHOICE

1903.1

The DC Level of Need (LON) is a comprehensive assessment tool, initiated by the Service Coordinator and completed with the person, their advocate and other members of their support team who serve as the resource for providing the information that is entered into the LON.

1903.2

The LON is reviewed on an annual basis and/or whenever the person experiences a significant change in their life anytime during the year. The LON documents the person's health, intellectual and developmental health diagnoses, and support needs in all major life activities to determine the LOC determination criteria specified in §§ 1902.4.

1903.3

The person shall be evaluated for LOC as described under §§ 1902, by the following process at initial evaluation and re-evaluation:

(a) A Qualified Intellectual Disabilities Professional ("QIDP") or Qualified Developmental Disabilities Professional ("QDDP"), employed by DDS, shall perform the initial evaluation and re-evaluation of the LOC and make an LOC determination; and

(b) Re-evaluations of the LOC shall be conducted every twelve (12) months or more often, if determined medically necessary.

1903.4

Written documentation of each evaluation and re-evaluation shall be maintained by DDS for a minimum period of three (3) years, except when there is an audit or investigation, in which case, the records shall be maintained by DDS until the review has been completed.

1903.5

Once a person has been determined eligible for services under the Waiver, the person and/or legal representative shall document the choice of institutional or HCBS Waiver on a Freedom of Choice form.

1903.6

The choice of either IDD Waiver or IFS Waiver services will be based on the person's individualized and person-centered needs determined through the Interdisciplinary Team process for the Individual Support Plan ("ISP") and Plan of Care.

1903.7

The Freedom of Choice form shall consist of choices between:

(a) Institutional services; and

(b) HCBS IDD Waiver and IFS Waiver services.

1903.8

Each person who is not given the choice of HCBS as an alternative to institutional care in an ICF/IID as set forth in §§ 1902.1(e), shall be entitled to a fair hearing in accordance with 42 C.F.R. Part 431, Subpart E.

D.C. Mun. Regs. tit. 29, r. 29-1903

Final Rulemaking published at 51 DCR 10207 (November 5, 2004); as amended by Final Rulemaking published at 55 DCR 2882 (March 21, 2008); as amended by Final Rulemaking published at 61 DCR 4406 (May 2, 2014); amended by Final Rulemaking published at 71 DCR 10372 (8/16/2024)

Authority: An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat. 744; D.C. Official Code § 1-307.02 (2012 Repl. & 2013 Supp.)) and Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2012 Repl.)).