4235 SPECIFIC PROVIDER REQUIREMENTS: CHORE AIDE SERVICES

4235.1 In order to receive Medicaid reimbursement, Chore Aide services shall be provided by the following Medicaid-enrolled providers:

1. (a) A home care agency which meets the conditions of participation for home care agencies as set forth in 42 CFR Part 484, by being enrolled as a Medicare provider, and complying with the requirements set forth in the Health-Care and Community Residence Facility, Hospice, and Home Care Licensure Act of 1983, effective Feb. 24, 1984 (D.C. Law 5-48; D.C. Official Code §§ 44-501 et seq.); or
2. (b) A business with a general business license issued by the DCRA to perform housekeeping services in the District of Columbia.

4235.2 Each individual providing chore aide services shall:

1. (a) Be at least eighteen (18) years of age;
2. (b) Pass a criminal background check; and
3. (c) Meet the qualification and training requirements pursuant to Subsections 4235.3 or 4235.4.

4235.3 In order to receive Medicaid reimbursement for chore aide services, a home care agency shall:

1. (a) Require that all individual chore aides be certified as Home Health Aides 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 of Title 17 DCMR, and;
2. (b) Meet any ongoing training requirements required under the Department of Health's Home Health Aide certification requirements.

4235.4 In order to receive Medicaid reimbursement for chore aide services, a business with a general business license issued by the DCRA to provide housekeeping services shall:

1. (a) Require that all individual chore aides shall obtain a minimum of eight (8) hours of training annually in the following areas:
2. (1) Beneficiary Rights;

(2) Communicating effectively with beneficiaries enrolled in the waiver;

(3) Preventing Abuse, Neglect, and Exploitation;

(4) Controlling the Spread of Disease and Infection;

(5) Changing linens and bed bug prevention;

(6) Safe handling of cleaning chemicals (use of gloves, goggles/masks);

(7) Handling hazardous waste;

(8) Blood-borne pathogens and bodily fluids; and

(9) Instruction on the following:

(A) Maintenance of floors (mopping/vacuuming);

(B) Trash handling;

(C) Cleaning the walls and ceiling; and

(D) Kitchen and bathroom cleaning and maintenance.

4235.5 Supervisory staff employed by the provider shall develop a written chore aide service delivery plan (Plan of Care), and the beneficiary's case manager shall approve the service delivery plan before it is implemented.

4235.6 The chore aide provider shall document in-home visits and telephone contacts in the beneficiary's service delivery plan at least within thirty (30) days of its home visit.

4235.7 A copy of the chore aide service delivery plan shall be shared with the case manager and kept on-file at the Home Care Agency or the chore aide service provider licensed to provide housekeeping services.

4235.8 Each provider of chore aide services shall maintain comprehensive records including the service delivery plans, and records identifying dates of training and topics covered in each employee's personnel file for a period of no less than ten (10) years.

4235.9 An individualized in-service training plan shall be developed and implemented for each chore aide when performance evaluations indicate a need for more training.

4235.10 A chore aide service provider shall provide a pre- and post-cleaning inspection of the home or place of residence with documentation indicating that the home environment is in a state that can be maintained by ongoing and routine housekeeping.

4235.11 Each home care agency or business with a general business license issued by DCRA to provide housekeeping services shall ensure that the appropriate supervision of chore aide staff is conducted by an individual who has the following qualifications:

(a) Be trained to evaluate the activities of chore aide staff;

(b) Has at least two (2) years of experience supervising the activities of chore aides; and

(c) Has been trained in basic supervision by the home care agency, or the chore aide service provider licensed to provide housekeeping services.

4235.12 An EPD waiver beneficiary may choose an individual or family member other than a beneficiary's spouse, other legally responsible relative, or court-appointed guardian to provide chore aide services. Legally responsible relatives do not include parents of an adult child, so parents of an adult child shall not be precluded from providing chore aide 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).