4252.1 Community Transition Services are non-recurring set-up expenses for beneficiaries who are transitioning from an institution or other long term care facility to a more integrated and less restrictive community setting. Allowable expenses are those necessary to enable an individual to establish a basic household that does not constitute room and board.

4252.2 Household set-up expenses provided under community transition services may include the following:

1. (a) Rental application fees and security deposits in the amount of the first month's rent or greater that are required to obtain a lease on an apartment or home;
2. (b) Essential household furnishings and moving expenses required to occupy and use a community domicile, including furniture, window coverings, food preparation items, and bed/bath linens;
3. (c) Set-up fees or deposits for utility or service access, including telephone, electricity, heating and water;
4. (d) Services necessary for the individual's health and safety such as pest eradication and one-time cleaning prior to occupancy;
5. (e) Moving expenses;
6. (f) Necessary home accessibility adaptations; and,
7. (g) Activities to assess need, arrange for, and procure needed resources.

4252.3 Community Transition Services are furnished only to the extent that they are reasonable and necessary as determined through the transition planning process, and clearly identified in the beneficiary's transition plan or PCSP once they are enrolled in the EPD Waiver.

4252.4 The household set-up items shall be approved by the Case Manager as part of the beneficiary's PCSP.

4252.5 Community Transition Services for the household set-up expenses specified under § 4252.2 may be used as determined in the transition plan development, once a tentative discharge date from the long term care facility has been established and EPD Waiver eligibility has been established.

4252.6 Community Transition funds shall be utilized for a period not to exceed sixty (60) calendar days before discharge and up to six (6) months after discharge from an institution or long-term care facility.

4252.7 Claims for reimbursement for Community Transition Services shall not be submitted prior to the beneficiary’s enrollment in the EPD Waiver.

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