5007.1 When PCA services are no longer desired by the beneficiary or their authorized representative or required in the amount, duration or scope authorized, each Provider shall discontinue or reduce personal care services only after:

1. (a) Giving the beneficiary written notice that meets the requirements set forth in Section 5007.2,
2. (b) The thirty (30) day notice period prescribed in Section 5007.2 elapses; and
3. (c) The beneficiary has not appealed the discontinuation.

5007.2 For Provider initiated denials, suspensions, terminations or reductions of service, each Provider shall notify DHCF or its designated agent and the beneficiary or the beneficiary's authorized representative, in writing, no less than thirty (30) calendar days prior to any denial, suspension, termination or reduction of services, consistent with the requirements set forth in District and Federal law and rules. The beneficiary's record shall contain a copy of the notice and documentation of the date the notice was either personally served upon or mailed to the beneficiary or the beneficiary's designated agent.

5007.3 For denials, suspensions, terminations or reductions of service initiated by DHCF or its agent, DHCF or its designated agent shall notify the beneficiary or the beneficiary's authorized representative, in writing, no less than thirty (30) calendar days prior to any denial, suspension, termination or reduction of services, consistent with the requirements set forth in District and Federal law and rules.

1. 4 If the behavior of a beneficiary poses an immediate threat to the safety and well-being of the PCA or PCA Provider staff, the Provider shall immediately suspend or terminate the beneficiary's services. Suspension of services shall not exceed thirty (30) days.

5007.5 Within seventy-two (72) hours of suspension, the Provider shall notify the beneficiary or authorized representative in writing of the following:

1. (a) The grounds for suspension; and
2. (b) The beneficiary's right to appeal the suspension.

5007.6 At the end of the suspension period, the Provider may re-instate or terminate the beneficiary’s services.

5007.7 The beneficiary or the beneficiary’s representative shall be provided with a written notice of termination at least fifteen (15) days before the effective date of termination, if the decision is made to terminate services following suspension. The written notice shall comply with District and federal law and rules.

SOURCE: Final Rulemaking published at 50 DCR 3957 (May 23, 2003); as amended by Notice of Final Rulemaking published at 59 DCR 1760, 1772 (March 2, 2012); as amended by Final Rulemaking published at 60 DCR 15537 (November 8, 2013).