10107.1 To be eligible for PDCS services, a Services My Way participant shall be in receipt of a service authorization for personal care aide services that specifies the amount, duration, and scope of services authorized to be provided, in accordance with 29 DCMR § 5003.

10107.2 A PDS budget shall be developed based on the following methodology:

(a) The participant's total assessed hours per week for personal care aide services is determined through the assessment process as set forth in 29 DCMR § 5003.3 and converted to hours per month;

(b) The total number of personal care aide services hours per month is multiplied by the hourly rate paid by DHCF for personal care aide services; and

(c) The total amount computed in (b) above is reduced by a pre-determined percentage that shall be published in the D.C. Register providing thirty (30) days advance notice, to reflect the administrative overhead amount included in the hourly rate paid by DHCF for personal care aide services.

10107.3 The amount resulting from the calculation described in § 10107.2 shall represent the Services My Way participant's monthly PDS allocation amount, which shall be used to compute the participant's PDS budget.

10107.4 A PDS budget shall be developed by the participant and authorized representative, as appropriate, with assistance from the participant's support broker.

10107.5 A PDS budget shall contain the following two (2) cost components:

(a) PDCS services; and

(b) Individual-directed goods and services.

10107.6 Participant/representative-employers shall set the hourly wage rate paid to their PDWs within the wage range established by DHCF as set forth in § 10102.9.

10107.7 Funds available for purchase of individual-directed goods and services shall be those funds, if any, remaining in the PDS budget after the amount for PDCS services has been determined.

10107.8 Support brokers shall be responsible for explaining the method used to develop

the monthly PDS allocation amount to Services My Way participants.

10107.9 DHCF shall calculate the monthly PDS allocation amount for all Services My Way participants.10107.10 DHCF or its agent shall notify all Services My Way participants each time PDS allocation amounts are adjusted as a result of a change to the hourly rate paid by DHCF for personal care aide services.10107.11 The participant and the authorized representative, if applicable, shall work with the support broker to develop the participant's PDS budget based on the allocation amount.10107.12 The participant's support broker shall submit the participant's completed PDS budget to the Services My Way Program Coordinator for approval within the timeframe established by DHCF.10107.13 The Services My Way Program Coordinator shall review all PDCS services and individual-directed goods and services requested in a participant's PDS budget. All PDCS services requested in a PDS budget shall be reviewed in accordance with all relevant provisions of the Fair Labor Standards Act, 29 USC §§ 201 et seq., and attendant regulations.10107.14 If the Services My Way Program Coordinator denies any PDCS services or individual-directed good or service requested in a participant's PDS budget, the Program Coordinator shall send written notice of the denial to the participant, authorized representative as appropriate, and the participant's support broker. The notice shall contain information on the reconsideration process, as described in § 10108, and the participant's appeal rights.10107.15 Once a participant's PDS budget is approved by the Services My Way Program Coordinator, the Program Coordinator shall provide the approved PDS budget to the VF/EA FMS-Support Broker entity.10107.16 The VF/EA FMS-Support Broker entity shall only release payment for PDCS services and individual-directed goods and services included in the participant's approved PDS budget and for which prior authorizations have been issued.

SOURCE: Final Rulemaking published at 64 DCR 9567 (September 29, 2017).