D.C. Mun. Regs. tit. 29, r. 29-9015

Current through Register Vol. 71, No. 49, December 6, 2024
Rule 29-9015 - ASSISTIVE TECHNOLOGY SERVICES
9015.1

The 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 Individual and Family Support (IFS Waiver), and to establish conditions of participation for professionals and providers of assistive technology services to receive reimbursement.

9015.2

Assistive 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 as follows:

(a) Assistive technology goods are 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.
(b) Covered assistive technology goods include:
(1) Remotes and switches;
(2) Service animals;
(3) Mobile and smartphone applications ("apps");
(4) Smart home devices for completing activities of daily living;
(5) Electronic motion sensor devices;
(6) Door alarms;
(7) Web cameras;
(8) Telephones with modifications such as large buttons, telephones with flashing lights, and telephones equipped with picture buttons programmed with that person's telephone number;
(9) 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);
(10) Text-to-speech software;
(11) Devices that enhance images for people with low vision; and
(12) Intercom systems and other devices to enhance mobility and assist with performing daily tasks;
(13) Virtual assistants/smart speakers; and
(14) Environmental control devices.
9015.3

A person qualifies for assistive technology services when he or she requests the service and/or it is recommended by the person's support team to enhance or maintain the person's independence, increase, maintain, or improve functional capabilities, and/or support increased community inclusion; or there is a physician's order for the service. Assistive technology services must be included in the person's Individual Support Plan (ISP) and Plan of Care.

9015.4

In order to 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 PersonCentered Thinking tools and the goals in his or her ISP and Plan of Care.
9015.5

If 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.

9015.6

Assistive 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 professional who are certified through Shift training to include Enabling Technology Credential (ETC) and/or Certified Enabling Technology Integration Specialist (ETIS) employed by a Shift Accredited Waiver Service Provider.
9015.7

Assistive 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 occupational therapy, physical therapy, and speech, hearing and language pathology.
9015.8

Each provider of Medicaid reimbursable assistive technology services shall comply with Section 9010 (Provider Qualifications) and Section 9009 (Provider Enrollment Process) of Chapter 90 of Title 29 DCMR.

9015.9

Each 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 9006 (Records and Confidentiality of Information) of Chapter 90 of Title 29 DCMR, where applicable.
9015.10

In order to be eligible for Medicaid reimbursement, each provider shall comply with Section 9013 (Reporting Requirements) and Section 9005 (Individual Rights) of Chapter 90 of Title 29 DCMR.

9015.11

In order to be eligible for reimbursement, each Medicaid provider of assistive technology services must obtain a written Service Authorization from the DDS before providing assistive technology services.

9015.12

Assistive 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 §§ 720et 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 §§ 1400et seq.), and the assistive technology is not the obligation of the individual's employer.
9015.13

The Medicaid reimbursable 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 that is reimbursable by Medicaid.

9015.14

A comprehensive assessment is not required by a professional providing assistive technology services for the purchase of assistive technology goods costing less than one thousand dollars ($1,000).

D.C. Mun. Regs. tit. 29, r. 29-9015

Final Rulemaking published at 69 DCR 10229 (8/12/2022); amended by Final Rulemaking published at 71 DCR 10475 (8/23/2024)