D.C. Mun. Regs. tit. 29, r. 29-1924
This section shall establish conditions of participation for Medicaid providers enumerated in §§ 1924.9 ("Medicaid Providers") and family training services professionals enumerated in §§ 1924.8 ("professionals") to provide family training services to caregivers of persons enrolled in the Home and Community-Based Services Waiver for Persons with Intellectual and Developmental Disabilities (ID/DD Waiver).
Family training services are training, counseling, and other professional support services offered to uncompensated caregivers who provide support, training, companionship, or supervision to persons enrolled in the ID/DD Waiver.
Uncompensated caregivers include any family member, neighbor, friend, companion, or co-worker who regularly provides uncompensated care to the person.
In order to be eligible for reimbursement, each Medicaid provider must obtain prior authorization from the Department on Disabilities Services (DDS) prior to providing, or allowing any professional to provide, family training services. In its request for prior authorization, the Medicaid provider shall document the following:
In order to be eligible for Medicaid reimbursement, each family training services professional shall conduct an assessment of family training needs within the first four (4) hours of service delivery, and shall develop a training plan with training goals and techniques that will assist the ID/DD Waiver participant's unpaid caregivers. The training plan shall include measurable outcomes and a schedule of approved family training services to be provided, and shall be submitted by the Medicaid provider to DDS before services are delivered.
To be eligible for Medicaid reimbursement, each Medicaid provider shall document the following in the IDD Waiver participant's ISP and Plan of Care:
Medicaid reimbursable family training services shall include the following activities:
Medicaid reimbursable family training services shall be provided by the following professionals:
In order to be eligible for Medicaid reimbursement, each family training services professional shall be employed by the following Medicaid providers:
Each Medicaid provider shall comply with Section 1904 (Provider Qualifications) and Section 1905 (Provider Enrollment Process) of Chapter 19 of Title 29 of the DCMR.
Each Medicaid provider shall maintain the following documents for monitoring and audit reviews:
Each Medicaid provider shall comply with Section 1908 (Reporting Requirements) and Section 1911 (Individual Rights) of Chapter 19 of Title 29 of the DCMR.
Medicaid reimbursement shall not be available when family training services that are included in a person's ISP are provided concurrently with the following ID/DD Waiver services:
Medicaid reimbursable family training services shall not exceed a total of four (4) hours per day and one hundred (100) hours per year. Any hours in excess of these limits must be pre-approved by DDS pursuant to §§ 1924.15.
In order to be eligible for Medicaid reimbursement, professionals requesting pre-approval from DDS to provide family training services in excess of four (4) hours per day and one hundred (100) hours per year must demonstrate the need for such services. The decision of DDS to approve or disapprove the request for additional services, in whole or in part, shall be final.
The Medicaid reimbursement rate for family training services shall be sixty-one dollars ($61.00) per hour, or fifteen dollars and twenty-five cents ($15.25) per unit. The billable unit of service for family training services shall be fifteen (15) minutes.
Each provider of remote family training services shall comply with the requirements of Section 1943 (Remote Supports Services) of Chapter 19 of Title 29 of DCMR.
Remote Family training services shall be issued as a separate service authorization indicating the frequency of usage. A hybrid model may be used for in-person and remote supports services family training hours where two (2) service authorizations are issued to cover the in-person service hours and the remote supports service hours.
Remote family training services reimbursement rates shall reflect the same rates as professional in-person family training reimbursement rates.
HCBS Waiver providers providing family training through remote supports services must meet the criteria, as specified at §§ 1943.
D.C. Mun. Regs. tit. 29, r. 29-1924