D.C. Mun. Regs. tit. 29, r. 4213

Current through Register Vol. 71, No. 49, December 6, 2024
Rule 4213 - REIMBURSEMENT RATES: RESPITE SERVICES
4213.1

For individuals needing one (1) to seventeen (17) hours per day, the reimbursement rate for respite services during Waiver Year 5 shall be twenty dollars and sixty cents ($20.60) per hour. For individuals needing eighteen (18) to twenty-four (24) hours per day, the reimbursement rate during Waiver Years 4 and 5 shall be a flat rate of three hundred dollars ($ 300.00) per day.

4213.2

For EPD Waiver Year 1 of the Renewal, the reimbursement rate for respite services for individuals needing one (1) to seventeen (17) hours per day shall be twenty dolla rs and twenty cents ($20.20) per hour. For individuals needing eighteen (18) to twenty-four (24) hours per day, the reimbursement rate during Waiver Year 1 of the Renewal shall be a flat rate of three hundred eleven dollars and fifty cents ($311.50) per day.

4213.3

Consistent with Section 4232, respite services shall be limited to a total of four hundred and eighty (480) hours per year per beneficiary unless the need for additional services is prior authorized by DHCF or its designee.

4213.4

DHCF shall not reimburse a provider of respite services for services provided by the waiver beneficiary's spouse, or other legally responsible relative or court-appointed guardian with the exception of parents of adult children. Non- legally responsible relatives including parents of adult children may provide and be reimbursed for respite services provided they meet the requirements of Section 4231.

4213.5

DHCF shall not reimburse for the cost of room and board except when provided as part of respite care furnished in a facility approved by the District of Columbia that is not a private residence.

4213.6

When respite is provided in a facility, including an Assisted Living Facility, group home, or other Community Residential Facility, the facility must meet all HCBS setting requirements consistent with Section 4200.

D.C. Mun. Regs. tit. 29, r. 4213

Final Rulemaking published at 64 DCR 6787 (7/21/2017)