4211.1 A home care agency seeking reimbursement for PCA services shall meet the conditions of participation for home health agencies set forth in 42 CFR part 484, and shall comply with the requirements set forth in the Health-Care and Community Residence Facility, Hospice, and Home Care Licensure Act of 1983, effective February 24, 1984 (D.C. Law 5-48; D.C. Official Code §§ 44-501 et seq.).

4211.2 Each provider of PCA services shall comply with the Living Wage Act of 2006, effective June 8, 2006 (D.C. Law 16-118; D.C. Official Code §§ 2-220.01 et seq.).

4211.3 A unit of service for PCA services shall be fifteen (15) minutes spent performing allowable tasks.

4211.4 Reimbursement for PCA services under the waiver shall not exceed sixteen (16) hours of service per day per beneficiary.

4211.5 A provider of waiver services shall not bill the beneficiary or any member of the beneficiary's family for PCA services.

4211.6 DHCF shall not reimburse a provider of PCA services for services provided by the waiver beneficiary's spouse, other legally responsible relative, or court-appointed guardian, with the exception of the parent of an adult child enrolled in the waiver.

SOURCE: Final Rulemaking published at 50 DCR 9025 (October 24, 2003); as amended by Final Rulemaking published at 53 DCR 1696 (March 10, 2006); as amended by Final Rulemaking published at 64 DCR 6784 (July 21, 2017); as amended by Final Rulemaking published at 72 DCR 004996 (April 25, 2025).