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 consist 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 a R.N.;

(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).

Public Welfare