D.C. Mun. Regs. tit. 29, r. 29-9021

Current through Register Vol. 71, No. 43, October 25, 2024

Rule 29-9021 - EDUCATION SUPPORTS SERVICES

9021.1

The purpose of this section is to establish standards governing Medicaid eligibility for education supports services for persons enrolled in the IFS Waiver, and to establish conditions of participation for providers of education supports services in order to receive Medicaid reimbursement.

9021.2

Education supports services will be authorized when:

(a) The person requests the service or is recommended by the person's support team;

(b) The person has a demonstrated need for the service to enhance or maintain independence; to increase, maintain, or improve education; or to support increased community inclusion;

(c) The person has an employment outcome or outcome-related goals for skill attainment or development that is documented in the service plan and is related to the need for education supports services;

(d) Education supports services is included in the person's ISP and Plan of Care;

(e) The person demonstrates that a previous application for Rehabilitation Services Administration (RSA) funded post-secondary education was made, by the submission of a letter documenting either ineligibility for RSA services or documenting that the person has fully utilized services available under related services as defined in Sections 602(9) and 602(26) of the Individuals with Disabilities Education Act (20 U.S.C. §§ 1400et seq.);

(f) The person submits a financial aid application annually to the following:

(1) The post-secondary institution the individual is attending or to which the individual has applied;

(2) The D.C. Tuition Assistance Grant, if applicable;

(3) All other District or state funded educational assistance programs and school grants or financial aid;

(4) The U.S. Department of Education (The Free Application for Federal Student Aid (FAFSA));

(5) All federal grant programs, including the Pell Grant; and

(6) The Leverage Educational Assistance Program (LEAP);

(g) The person provides DDA with a copy of the FAFSA Student Aid Report (SAR) and any other aid award from each source; and

(h) The person signs DDA's form authorizing the post-secondary institution to provide DDA with information relating to the person's training or educational program, including, but not limited to:

(1) A copy of the person's official transcript;

(2) A copy of the person's grades at the conclusion of each quarter or semester;

(3) Attendance records;

(4) Financial awards;

(5) Notice of any disciplinary or adverse action; and

(6) A copy of the person's Americans with Disabilities Act (ADA) accommodation plan.

9021.3

Medicaid-eligible reimbursement for education supports services shall be limited to the following:

(a) Payment for classes to teach people who are deaf American Sign Language, Visual Gestural Communication, or another form of communication, which shall be in one-to-one classes with a communication education professional or group classes of no more than four (4) persons taught by communication education professional. In order to participate in these communication classes, the person shall:

(1) Be twenty-one (21) years of age or older (or have a high school diploma if under twenty-one (21) years of age); and

(2) Have been assessed as benefitting from learning American Sign Language, Visual Gestural Communication, or another form of communication.

9021.4

Medicaid-eligible reimbursable education supports services shall be services that are delivered in the District of Columbia, Maryland, and Virginia within a twenty-five (25) mile radius of the District of Columbia.

9021.5

Medicaid-eligible reimbursement for education supports services shall not include:

(a) Room and board;

(b) Payment for books or supplies;

(c) Payment for recreational classes, activities and programs offered through recreational commissions, townships, boroughs, or other governmental entities;

(d) Tuition for adult education classes offered by online universities;

(e) Tuition for online classes; or

(f) Tuition for adult education classes provided on disability-specific campuses.

9021.6

Medicaid-eligible reimbursement for education supports services shall not be authorized concurrently with the following Waiver services:

(a) Companion;

(b) Creative Arts Therapies;

(c) Day Habilitation and Day Habilitation (small group);

(d) Employment Readiness;

(e) Individualized Day Supports;

(f) In-Home Supports;

(g) Respite;

(h) Supported Employment; and

(i) Wellness.

9021.7

Medicaid reimbursable education supports services shall not be authorized concurrently when on-campus peer support is offered by the institution of postsecondary education and authorized in the ISP.

9021.8

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

9021.9

In order to be eligible for Medicaid reimbursement, each provider of education supports services must first obtain a written Service Authorization from DDS before providing education supports services. DDS shall not be responsible for the payment of any post-secondary educational institution costs that the person may incur before receiving DDS's written commitment to fund the eligible costs at the post-secondary educational institution.

9021.10

Services shall only be authorized for Medicaid reimbursement in accordance with the following provider requirement procedures:

(a) DDS shall provide a written service authorization before the commencement of services;

(b) The service name and Waiver provider delivering services shall be identified in the ISP and Plan of Care;

(c) The ISP, Plan of Care, and Summary of Supports and Services shall document the amount and frequency of services to be received; and

(d) The services to be provided shall not conflict with the service limitations described under § 9021.12.

9021.11

Education supports services are subject to the following limitations:

(a) Education supports services provided through the IFS Waiver are available only to the extent that the person has fully utilized services available under related services as defined in Sections 602(9) and 602(26) of the Individuals with Disabilities Education Act (20 U.S.C. §§ 1400et seq.), or available for funding by the Rehabilitation Services Administration;

(b) If used in combination with other day services or vocational support services (including day habilitation, employment readiness, small group supported employment, and individualized day supports), the combined hours for education supports services and these other services shall not exceed forty (40) hours per week, including the amount of time spent in classes;

(c) The maximum amount of reimbursement for education supports services a person may receive may not exceed either five thousand dollars ($5,000) toward tuition per semester of communications education for participants taking at least six (6) credit hours of classes per semester.

9021.12

In order to be eligible for Medicaid reimbursement, an institution of postsecondary education providing education supports services shall be a postsecondary institution or program accredited by the United States Department of Education.

9021.13

In order to be eligible for Medicaid reimbursement, each adult education program providing education supports services shall:

(a) Have a Waiver service location in the District of Columbia, Maryland, or Virginia;

(b) Have a signed Waiver provider agreement on file with DDS;

(c) Have at least one staff person with a four (4) year degree and state teaching credentials; and

(d) Comply with DDS standards related to provider qualifications.

9021.14

In order to be eligible for Medicaid reimbursement, each communication education agency providing education supports services to teach communications to people who are deaf or hard of hearing must:

(a) Have a Waiver service location in the District of Columbia, Maryland, or Virginia;

(b) Have a signed Waiver provider agreement on file with DDS;

(c) Complete standard DDS-required provider orientation and training;

(d) Demonstrate compliance with DDS standards through completion of a self-assessment and validation of required documentation, policies and procedures;

(e) Comply with DDS standards related to provider qualifications; and

(f) Utilize teachers who, at a minimum, possess Qualified Level Certification from the American Sign Language Teachers Association (ASLTA).

9021.15

In order to be eligible for Medicaid reimbursement, each communication education professional employed by a communication education agency providing education supports services, as well as volunteers utilized in providing education supports services if they will spend any time alone with the person, must meet the following minimum standards:

(a) Be acceptable to the person;

(b) Be at least eighteen (18) years of age;

(c) Have at least advanced or higher Sign Language Skills as determined by the Sign Language Proficiency Interview (SLPI); and

(d) Comply with the requirements of the Health Care Facility Unlicensed Personnel Criminal Background Check Act of 1998 effective April 20, 1999 (D.C. Law 12- 238; D.C. Official Code §§ 44-551et seq.); as amended by the Health-Care Facility Unlicensed Personnel Criminal Background Check Amendment Act of 2002, effective April 13, 2002 (D.C. Law 14-98; D.C. Official Code §§ 44-551et seq.).

9021.16

In order to be eligible for Medicaid reimbursement, each communication education professional providing education supports services to teach communications to people who are deaf or hard of hearing must:

(a) Be acceptable to the person;

(b) Be at least eighteen (18) years of age;

(c) Have a Waiver service location in the District of Columbia, Maryland, or Virginia;

(d) Have a signed Waiver provider agreement on file with DDS;

(e) Complete standard DDS-required provider orientation and training;

(f) Demonstrate compliance with DDS standards through completion of a self-assessment and validation of required documentation, policies and procedures;

(g) Comply with DDS standards related to provider qualifications;

(h) Have at least advanced or higher Sign Language Skills as determined by the SLPI; and

(i) Comply with the requirements of the Health Care Facility Unlicensed Personnel Criminal Background Check Act of 1998 effective April 20, 1999 (D.C. Law 12- 238; D.C. Official Code §§ 44-551et seq.); as amended by the Health-Care Facility Unlicensed Personnel Criminal Background Check Amendment Act of 2002, effective April 13, 2002 (D.C. Law 14-98; D.C. Official Code §§ 44-551et seq.).

9021.17

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

9021.18

There shall be a total of four (4) Medicaid reimbursement rates for education supports services for communication classes for people who are deaf or hard of hearing: for 1:1 services and for small group services (i.e. 1:2, 1:3 and 1:4 staffing ratios).

D.C. Mun. Regs. tit. 29, r. 29-9021

Final Rulemaking published at 69 DCR 10229 (8/12/2022)