9724.1 In accordance with Section 9817 of the American Rescue Plan Act of 2021, approved March 11, 2022 (Pub. L. 117-2; 135 Stat. 4), supplemental payments shall be made to adult day health programs (ADHP) that have personal care aides employed as direct care support staff, for dates of service on or after October 1, 2022, and on or before March 31, 2025.

9724.2 Supplemental payments shall be disbursed to ADHPs that have personal care aides employed as direct care support staff in annual, lump-sum allotments.

9724.3 To qualify for a supplemental payment, ADHPs shall submit cost and employment data (such as personal care aides employed as direct care support staff schedules, wages paid, hours worked, hire dates, and vacancy rates). ADHPs shall demonstrate that the supplemental payments were used, in their entirety, to pay personal care aides employed as direct care support staff a benchmark wage rate, set above the District’s living wage rate set forth in the Living Wage Act of 2006, effective June 8, 2006 (D.C. Law 16-118; D.C. Official Code § 2-220.01 et seq.).

9724.4 ADHPs shall receive an annual supplemental payment that takes into account the increased costs associated with paying personal care aides employed as direct care support staff for providing ADHP services to Medicaid beneficiaries at a rate that is seventeen and six tenths percent (17.6%) above the District’s living wage rate.

9724.5 To determine the annual supplemental payment, described in § 9724.4, DHCF shall project the expenditures for salary, wages, fringe benefits, and administration associated with paying personal care aides employed as direct care support staff at seventeen and six tenths percent (17.6%) above the District’s living wage rate. This projection shall be based on the current rate methodology applicable to the ADHP and shall be for the year in which the supplemental payment is made.

9724.6 An ADHP that has personal care aides employed as direct care support staff shall retain one hundred percent (100%) of the total computable expenditure claims by the District to CMS, except:

(a) The District shall recoup supplemental payments from home health agencies that fail to submit the required cost data or fail to pay personal care aides an average wage rate at seventeen and six tenths percent (17.6%) above the District’s living wage rate.

(b) Overpayments made to providers shall be recouped through reconciliation of

subsequent payments.

(c) The federal share for any recouped payments shall be returned through an adjustment to the CMS 64 Report.

SOURCE: Final Rulemaking published at 72 DCR 005041 (April 25, 2025).