1941.1The purpose of this section is to establish standards governing eligibility for assistive technology services for persons enrolled in the Home and Community-Based Services Waiver for Persons with Intellectual and Developmental Disabilities (Waiver), and to establish conditions of participation for professionals and providers of assistive technology services to receive reimbursement.
1941.2Assistive technology services include both goods and services that are designed to enable the person to function with greater independence, avoid institutionalization and reduce the need for human assistance.
1941.3Assistive technology good means an item, piece of equipment, service animal or product system, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve functional capabilities and can also support increased community inclusion, including in employment settings. Assistive technology goods must not be otherwise available through another funding source.
1941.4Covered assistive technology goods include:
(a) Remotes and switches;(c) Mobile and smartphone applications ("apps:);(d) Smart home devices for completing activities of daily living;(e) Electronic motion sensor devices;(h) Telephones with modifications such as large buttons, flashing lights, and picture buttons programmed with that person's telephone number;(i) Devices that may be affixed to a wheelchair or walker to send an alert when someone falls (these may be slightly different than a Personal Emergency Response System);(j) Text-to-speech software;(k) Devices that enhance images for people with low vision; and(l) Intercom systems and other devices to enhance mobility and assist with performing daily tasks;(m) Virtual assistants/smart speakers;(n) Environmental control devices;(o) Applications for prompting; and(p) Guidance and navigation devices.1941.5Assistive technology service means a service that directly assists a person in the selection, acquisition, or use of an assistive technology device and includes:
(a) The evaluation of assistive technology needs, including a functional evaluation of the impact of the provision of appropriate assistive technology and appropriate services to the person in his/her customary environment;(b) Services consisting of purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices for persons served through the Waiver;(c) Services consisting of selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices;(d) Coordination and use of necessary therapies, interventions, or services with assistive technology devices, such as therapies, interventions, or services associated with other services in the service plan;(e) Training or technical assistance for the person or, where appropriate, his/her family members, guardians, advocates, or authorized representatives who provide unpaid support, training, companionship or supervision; and(f) Training or technical assistance for professionals or other individuals who provide services to, employ, or are otherwise substantially involved in the major life functions of the person served.1941.6A person qualifies for assistive technology services when he or she requests the service or the service is recommended by the person's support team, via in-person or remote supports services, to enhance or maintain the person's independence, increase, maintain, or improve functional capabilities, or support increased community inclusion; or there is a physician's order for the service. Assistive technology services shall be included in the person's ISP and Plan of Care.
1941.7To be eligible for Medicaid reimbursement, each professional providing assistive technology services shall:
(a) Conduct a comprehensive assessment within the first four (4) hours of service delivery, which shall include the following: (1) A background review and current functional review of the person's capabilities in different environments;(2) An environmental review in places of employment, residence, and other sites as necessary; and(3) A needs assessment for the use of assistive technology;(b) Develop and implement an assistive technology plan within the first four (4) hours of service delivery that describes strategies, including recommended assistive technology goods, coordination with professional services, training of caregivers, monitoring requirements and instructions, and the anticipated and measurable functional outcomes, based upon what is important to and for the person as reflected in his or her Person-Centered Thinking tools and the goals in his or her ISP and Plan of Care; and(c) A comprehensive assessment is not required by a professional providing assistive technology services for purchases of assistive technology goods costing less than one thousand dollars ($1,000).1941.8If the person enrolled in the Waiver is between the ages of eighteen (18) and twenty-one (21) years old, the DDS Service Coordinator shall ensure that Early Periodic Screening and Diagnostic Treatment (EPSDT) services under the District of Columbia State Plan for Medical Assistance are fully utilized before accessing assistive technology services under the Waiver.
1941.9Assistive technology services may be provided by the following professionals:
(a) Approved Waiver providers of occupational therapy, physical therapy, and speech, hearing and language services, who are licensed pursuant to the District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §3-1201et seq.) and implementing rules;(b) Assistive technology professionals who are certified through the Rehabilitation Engineering and Assistive Technology Society of North America, or another comparable national accreditation body, as approved by DDS; and(c) Assistive technology professionals who are certified through Shift training to include Enabling Technology Credential ("ETC") and/or Enabling Technology Integration Specialist ("ETIS") employed by a Shift accredited Waiver service provider.1941.10Assistive technology services may be provided by the following agency provider types:
(a) An Assistive Technology Professional Agency or Supplier that is an approved vendor for the Rehabilitation Services Administration; or(b) A licensed provider agency of any of the following clinical services: occupational therapy, physical therapy, and speech, hearing and language pathology.1941.11Each provider of Medicaid reimbursable assistive technology services shall comply with Section 1904 (Provider Qualifications) and Section 1905 (Provider Enrollment Process) of Chapter 19 of Title 29 DCMR.
1941.12Each provider of Medicaid reimbursable assistive technology services shall maintain the following documents for monitoring and audit reviews:
(a) A copy of the assistive technology assessment and treatment plan;(b) A copy of the physician's order, if applicable;(c) A copy of receipts documenting the date, item, amount expended, and any related warranty; and(d) Any other applicable documents required to be maintained under Section 1909 (Records and Confidentiality of Information) of Chapter 19 of Title 29 DCMR, where applicable.1941.13In order to be eligible for Medicaid reimbursement, each provider shall comply with Section 1908 (Reporting Requirements) and Section 1911 (Individual Rights) of Chapter 19 of Title 29 DCMR.
1941.14In order to be eligible for reimbursement, each Medicaid provider of assistive technology services must obtain a written Service Authorization from the Department on Disability Services (DDS) before providing assistive technology services.
1941.15Assistive technology services are subject to the following limitations:
(a) There is a maximum dollar amount per participant over a five-year period for this service. A person may be able to exceed this limitation on a case-by-case basis with the approval of DDS, based upon documented need, but shall be authorized prior to rendering the Waiver service; and(b) Assistive technology provided through the Waiver is available only after the person has fully utilized services available under the Medicaid State Plan, or programs funded under Section 110 of the Rehabilitation Act of 1973, enacted September 26, 1973, as amended ( Pub. L. 93-112; 29 USC §§ 720 et seq .), or Sections 602(16) and (17) of the Individuals with Disabilities Education Act, enacted April 13, 1970, as amended ( Pub. L. 91-230; 20 USC §§ 1400 et seq .), and where the assistive technology is not the obligation of the individual's employer.1941.16The billable unit of service for assistive technology services shall be fifteen (15) minutes. A provider shall provide at least eight (8) minutes of service in a span of fifteen (15) continuous minutes to bill a unit of service.
D.C. Mun. Regs. tit. 29, r. 29-1941
Final Rulemaking published at 65 DCR 2190 (March 2, 2018); amended by Final Rulemaking published at 69 DCR 10218 (8/12/2022); amended by Final Rulemaking published at 71 DCR 10372 (8/16/2024)