A Provider may contract with a licensed staffing agency that will perform personal care services not to exceed a maximum of ten percent (10%) of the units of service provided in any given four (4) month period. Agreements between the Provider and the agency providing personal care staffing services shall be in writing and include at a minimum, the following:

(a) The staffing agency's NPI number obtained from the National Plan and Provider Enumeration System (NPPES) and the NPI numbers of all staff supplied to the home health agency listed on all beneficiary documentation;

(b) A description of the services to be provided;

(c) Business address of each staffing agency location;

(d) The procedures used for managing, supervising, and evaluating the services delivered by agency personnel;

(e) Procedures for implementing plans of care; submitting clinical and progress notes; scheduling of visits; preparing beneficiary assessments; and other designated reports by agency personnel;

(f) The procedure identified for payments for services furnished and the terms of those payments;

(g) The duration of the agreement, including provisions for renewal, if applicable; and

(h) Assurances that the agency shall comply with:

(1) All applicable home health Provider policies, including the assurance that contract personnel meet the qualifications and fulfill the responsibilities of agency employees in accordance with these rules;

(2) All insurance and bonding requirements as set forth in section 5002 of these rules; and

(3) All applicable federal and District laws and rules, including all relevant licensing requirements imposed

by the District of Columbia;

5001.2 Each Home Health Provider contracting with a staffing agency for personal care services shall:- (a) Ensure that the staffing agency obtains NPI numbers for the agency and all personnel performing personal care services;

- (b) Provide DHCF with a copy of any and all contract(s) entered into with a staffing agency for the delivery of all personal care services on behalf of the Provider. Each of these contracts shall contain the personal care staffing agency NPI number and a list of NPI numbers for all individuals providing personal care services under the auspices of the personal care staffing agency on the date of the contract;

- (c) Require that each staffing agency providing personal care services conduct a performance assessment of each personal care aide after the first three (3) months of service under the auspices of the staffing agency and annually thereafter.5001.3 Marketing and solicitation of Medicaid beneficiaries or their representatives by staffing agencies shall be prohibited. Those prohibited marketing and solicitation activities shall include, but not be limited to:- (a) Direct advertising or marketing to Medicaid beneficiaries;

- (b) Representation of the staffing agency as the Medicaid Provider of personal care services; and

- (c) Offering financial or other types of inducements to individuals for the referral of Medicaid beneficiaries, their names, or other identifying information to the staffing agency.5001.4 Ownership rights between home health Providers and staffing agencies shall be prohibited. Ownership rights may include but not be limited to:- (a) A direct or indirect ownership or investment interest (including an option or non-vested interest) by the staffing agency in any home health agency. This interest may be in the form of equity, debt, or other means and includes any indirect ownership or investment interest;

(b) A direct or indirect ownership of investment interest (including an option or non-vested interest) by the home health agency in any staffing agency; or

(c) A compensation arrangement other than the contract between the home health agency and the staffing agency in performance of personal care services.

5001.5 A staffing agency providing personal care services shall be considered an agent of the Provider.

5001.6 All beneficiary records accumulated by a staffing agency in delivery of personal care services shall be the property of the home health Provider and maintained within the home health Provider's office.

SOURCE: Final Rulemaking published at 50 DCR 3957 (May 23, 2003); as amended by Notice of Final Rulemaking published at 59 DCR 1760, 1762 (March 2, 2012).