5099

When used in this chapter, the following terms and phrases shall have the meanings ascribed below:

Activities of Daily Living - The ability to bathe, transfer, dress, eat and feed oneself, engage in toileting, and maintain bowel and bladder control (continence).

Advanced Practice Registered Nurse - A person who is licensed or authorized to practice as an advanced practice registered nurse pursuant to the District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201 et seq.).

Authorized representative – Any person other than a provider:

1. (a) Who is knowledgeable about a beneficiary's circumstances and has been designated by that beneficiary to represent him or her; or
2. (b) Who is legally authorized either to administer a beneficiary's financial or personal affairs or to protect and advocate for his/her rights.

Cueing - Using verbal prompts in the form of instructions or reminders to assist persons with activities of daily living.

Department of Health Care Finance – The executive agency of the government responsible for administering the Medicaid program within the District of Columbia.

Family - Any person related to the beneficiary by blood, marriage, or adoption.

Licensed Independent Clinical Social Worker– A person who is licensed or authorized to practice as an independent clinical social worker pursuant to the District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201 et seq.).

Limited English Proficient - Individuals who do not speak English as their primary language and who have a limited ability to read, write, speak or understand English.

Order – A formal, written instruction signed by a physician or APRN in the form of the Prescription Order Form or any successor document supplied by

DHCF or its agent.

PCA Service Authorization Form – A form that has been developed or approved by DHCF that identifies the amount, duration, and scope of PCA services and the number of hours authorized based upon a face-to-face assessment in accordance with § 5003.

Physician - A person who is licensed or authorized to practice medicine pursuant to the District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201 et seq.).

Registered Nurse - A person who is licensed or authorized to practice registered nursing pursuant to the District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201 et seq.), as amended, or licensed as a registered nurse in the jurisdiction where services are provided.

Significant change - Changes in a beneficiary’s health status that warrant an increase or decrease of supports/services outlined in their plan of care.

Staffing Agency – Shall have the same meaning as set forth in the Nurse Staffing Agency Act of 2003, effective March 10, 2004 (D.C. Law 15-74; D.C. Official Code §§ 44-1051.01 et seq.).

Start of Care – The first date upon which a beneficiary receives or is scheduled to receive PCA services.

SOURCE: Final Rulemaking published at 50 DCR 3957 (May 23, 2003); as amended by Final Rulemaking published at 59 DCR 1760, 1761 (March 2, 2012); as amended by Final Rulemaking published at 60 DCR 15537 (November 8, 2013); as amended by Final Rulemaking published at 63 DCR 14134 (November 18, 2016); as amended by Final Rulemaking published at 64 DCR 10525 (October 20, 2017); as amended by Final Rulemaking published at 72 DCR 004996 (April 25, 2025).