D.C. Mun. Regs. tit. 29, r. 29-2574

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

Rule 29-2574 - REIMBURSEMENT FOR PSH SUPPORTIVE SERVICES

2574.1

The Department shall reimburse PSH providers, using per member per month (PMPM) rate structure, for the provision of PSH services to adult participants that are not eligible for enrollment in the District's Medicaid Housing Supportive Services (HSS) program, or that temporarily lose their DC Medicaid enrollment status. The PMPM rate paid by the Department shall equal the rate described at 29 DCMR §§ 7420.2.

2574.2

The Department shall also reimburse PSH providers for the provision of adjunct services that facilitate the provision of PSH and promote the housing stability of adult participants on a monthly basis. The reimbursement rates for each type of service are detailed below or in the Department's HCA with the PSH provider:

(a) Services provided to minors in an adult participant's household, at a rate of $400.00 per household, per month;

(b) Utility assistance;

(c) Financial assistance; and

(d) Staff onboarding.

2574.3

In order to be eligible for a PMPM payment for PSH services, a PSH provider shall deliver a minimum of two (2) PSH services to an eligible adult client within a month.

2574.4

To receive a monthly household payment for PSH services delivered to minors in the adult individual's household, the HSS provider shall provide services at the scope and frequency described in the HSS provider's HCA with the Department.

2574.5

The following services are not covered as PSH services:

(a) Room and board residential costs;

(b) Inpatient hospital services, including hospital, nursing facility, intermediate care facility for individuals with intellectual disabilities, and institutions for mental diseases;

(c) Prescription drug costs;

(d) Transportation services;

(e) Educational, vocational, and job training services;

(f) Services rendered by parents or other family members;

(g) Social or recreational services;

(h) Services that are not provided and documented in accordance with these certification standards; and

(i) Services furnished to persons other than the client or client's household members when those services are not directed primarily to the well-being and benefit of the individual.

D.C. Mun. Regs. tit. 29, r. 29-2574

Final Rulemaking published at 71 DCR 6868 (6/7/2024)