Section 29-4103. ACTIVE TREATMENT SERVICES

 

4103.1 An individual residing in an ICF/IID shall receive continuous active treatment services, consistent with the requirements set forth in 42 C.F.R. § 483.440.  Active treatment services shall vary depending on the needs of the beneficiary, as determined by the interdisciplinary team.

 

4103.2An ICF/IID shall ensure that a beneficiary receives active treatment services on a daily basis. The ICF/IID may affiliate with outside resources to assist with program planning and service delivery or the facility may provide active treatment services directly.   

 

4103.3A program of active treatment services shall include aggressive, consistent implementation of a program of specialized training, treatment, health services, and other related services that is directed towards:

 

(a) The acquisition of the behaviors necessary for the individual to function with as much self-determination and independence as possible; and

 

(b) The prevention or deceleration of regression or loss of current optimal functional status.  

 

4103.4 In accordance with 42 C.F.R. §§ 483.440(c) - (d), an interdisciplinary team shall determine the type of active treatment services that a beneficiary needs based on preliminary evaluations, assessments, and re-assessments.  Each beneficiary’s active treatment requirements shall be described in his Individual Program Plan (IPP), pursuant to 42 C.F.R. § 483.440(c).  The ICF/IID shall ensure that each beneficiary receives all of the services described in the IPP. 

 

4103.5 For dates of service on or after January 1, 2014, the per diem reimbursement rate for active treatment shall equal the average of FY13 active treatment rates multiplied by two hundred sixty (260) days of service, to account for the maximum days of service provided, inclusive of holidays, and divided by three hundred sixty-five (365).

 

 

authority

An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat. 744; D.C. Official Code § 1-307.02 (2012 Repl. & 2014 Supp.)) and Section 6 (6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6)) (2012 Repl.).

source

Final Rulemaking published at 60 DCR 11590 (August 9, 2013); as amended by Final Rulemaking published at 61 DCR 12231 (November 28, 2014); as amended by Final Rulemaking published at 63 DCR 297 (January 8, 2016).