D.C. Mun. Regs. tit. 29, § 4242
Program Services:adult Day Health
Effective Apr 25, 202572 DCR 004996Authority: Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6)), An Act To enable the District of Columbia to receive Federal financial assistance under title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat. 744; D.C. Official Code § 1-307.02), and Mayor’s Order 2024-115, dated July 1, 2024. Source: Final Rulemaking published at 64 DCR 6784 (July 21, 2017); as amended by Final Rulemaking published at 72 DCR 004996 (April 25, 2025).District of Columbia, Office of the Secretary
4242.1 Adult day health services shall encourage adults enrolled in the EPD Waiver to live in the community by offering non-residential medical supports and supervised, therapeutic activities in an integrated community setting, to foster opportunities for community inclusion, and to deter more costly facility-based care.
4242.2 In order to receive Medicaid reimbursement, adult day health services shall include all of the following:
- (a) Medical and nursing consultation services including health counseling to improve and maintain the health, safety, and psycho-social needs of the beneficiary;
- (b) Individual and group therapeutic activities which may include various social, recreational, and educational activities;
- (c) Social service supports including consultations to determine the beneficiary's need for services and, guidance through counseling and teaching on matters related to the beneficiary's health, safety, and general welfare;
- (d) Direct care supports including personal care assistance, and offering guidance in performing self-care and activities of daily living;
- (e) Instruction on accident prevention and the use of special aides;
- (f) Medication administration services provided by an RN or Certified Medication Aide (MA-C), in accordance with District regulations;
- (g) Nutrition services; and
- (h) Coordination of transportation services for therapeutic activities that are scheduled off-site.
4242.3 Consistent with Chapter 97 of Title 29 DCMR, ADHP Waiver providers shall not be reimbursed separately for transportation services, including therapeutic activities occurring off-site. However, providers shall coordinate transportation provided under the DHCF non-emergency medical transportation benefit.
4242.4 All services shall be provided 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).