4231.1 In order to receive Medicaid reimbursement, a respite service provider shall be a Medicaid enrolled home care agency approved by DHCF to deliver respite services in the District of Columbia.

4231.2 In order to receive Medicaid reimbursement for respite services, a home care agency providing respite services shall require that respite staff be certified as a Home Health Aide in accordance with the District of Columbia Health Occupations Revisions Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201.01 et seq. (2016 Repl.)), and implementing rules, Chapter 93 (Home Health Aides) of Title 17 DCMR.

4231.3 DHCF requires respite staff to undergo any training as required pursuant to their DOH certification. Additionally, a respite service provider shall ensure that staff will receive individualized-in-service training about the beneficiary's needs from the supervisory nurse. The continuing education or individualized in-service training for respite services shall be specifically designed to increase the staff's knowledge and understanding of the beneficiary's unique needs.

4231.4 Comprehensive records identifying dates of any training including the individualized in-service training and topics covered shall be maintained in each employee's personnel file.

4231.5 The respite service provider shall develop and implement an initial intake assessment that:

(a) Assesses the beneficiary's respite needs; and

(b) Identifies the appropriate qualifications of the respite staff required to meet the identified needs.

4231.6 A Registered Nurse (R.N.) who possesses the following qualifications shall conduct the initial intake assessment:

(a) Be licensed to practice registered nursing in the District of Columbia in accordance with the District of Columbia Health Occupations Revisions Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201.01 et seq. (2016 Repl.)), and implementing rules, Chapter 54 (Registered Nursing) of Title 17 DCMR;

(b) Be employed or contracted by the approved home care agency; and

1. (c) Have at least one (1) year of experience working with the elderly and individuals with physical disabilities.4231.7 After conducting the initial intake assessment, the R.N. shall:- (a) Establish a written emergency notification plan for each beneficiary receiving respite services;
2. (b) Document that the emergency plan has been reviewed with the beneficiary or representative and the individual staff person providing respite care; and
3. (c) Develop a plan of care for the delivery of all respite services.4231.8 The case manager shall coordinate the approval of respite services to ensure that it aligns with the goals of the PCSP. For respite provided for PCA services, the R.N. referenced in Subsections 4231.6 and 4231.7 shall conduct the supervision of the respite staff.4231.9 To ensure the safety of the beneficiary, respite staff shall not leave the beneficiary unattended during the hours that respite services are authorized.4231.10 Each respite services provider shall maintain all documentation including records documenting dates of training and the written emergency notification plan for a period no less than ten (10) years. The waiver beneficiary shall also receive a copy of the emergency notification plan and shall keep it at his or her home or place of residence.4231.11 Respite services shall not be provided to beneficiaries who do not have primary caregivers who are responsible for the provision of the beneficiary's care on an ongoing basis.4231.12 A waiver beneficiary may choose an individual or family member other than a primary caregiver, the beneficiary's spouse, or other legally responsible relative, or court-appointed guardian to provide respite services. Legally responsible relatives do not include parents of an adult child, so parents of an adult child are not precluded from providing respite services.

SOURCE: Final Rulemaking published at 50 DCR 9025 (October 24, 2003); as amended by Final Rulemaking published at 64 DCR 6784 (July 21, 2017).