4241.1 In order to receive Medicaid reimbursement, an adult day health provider under the EPD Waiver shall meet the requirements set forth in Chapter 97 (Adult Day Health Program Services) of Title 29 DCMR, including, but not limited to:

(a) Provider qualifications;

(b) Program Administration; and

(c) Staffing requirements.

4241.2 Each adult day health provider under the EPD Waiver shall meet all HCBS setting requirements consistent with Subsection 4200.6 and DHCF's Provider Readiness Review process.

4241.3 Each ADHP waiver provider shall ensure that an ADHP plan of care is developed for each beneficiary that outlines services to be received at the ADHP.

4241.4 Each ADHP waiver provider shall ensure that the ADHP plan of care is shared with the case manager and other individual service providers to facilitate the coordination of all services for the beneficiary under the PCSP.

4241.5 The adult day health plan of care shall incorporate the goals and principles of the PCSP and be developed in accordance with the requirements set forth in Chapter 97 of Title 29 DCMR.

SOURCE: Final Rulemaking published at 64 DCR 6784 (July 21, 2017); as amended by Final Rulemaking published at 72 DCR 004996 (April 25, 2025).