5851445 Health Care Finance, Department of - Notice of Emergency and Proposed Rulemaking - Governing Family Training Services for Participants Enrolled in the Home and Community Based Services Waiver for Individuals with Intellectual and ...

DEPARTMENT OF HEALTH CARE FINANCE

 

NOTICE OF SECOND EMERGENCY AND PROPOSED RULEMAKING

 

The Director of the Department of Health Care Finance (DHCF), pursuant to the authority set forth in 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. 774; D.C. Official Code § 1-307.02 (2014 Repl. & 2015 Supp.)), and in 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.)), hereby gives notice of the adoption, on an emergency basis, of amendments to Section 1924, entitled “Family Training Services,” of Chapter 19 (Home and Community-Based Services Waiver for Individuals with Intellectual and Developmental Disabilities), of Title 29 (Public Welfare) of the District of Columbia Municipal Regulations (DCMR).

 

These emergency and proposed rules establish standards governing reimbursement for professionals who provide family training services to caregivers of participants in the Home and Community-Based Services Waiver for Individuals with Intellectual and Developmental Disabilities (“ID/ID Waiver”), and conditions of participation for the Medicaid providers employing family training services professionals. 

 

The ID/DD Waiver was approved by the Council of the District of Columbia (Council) and renewed by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS), for a five (5) year period beginning November 20, 2012. An amendment to the ID/DD Waiver was approved by the Council through the Medicaid Assistance Program Amendment Act of 2014, effective February 26, 2015 (D.C. Law 20-155; 61 DCR 9990) (October 3, 2014)).  CMS approved the amendment to the ID/DD Waiver effective September 24, 2015.

 

Family training services are training, counseling, and other professional support services offered to the families of persons enrolled in the ID/DD Waiver or to other uncompensated persons providing support to an ID/DD Waiver participant.  The Notice of Final Rulemaking for 29 DCMR § 1924 (Family Training Services) was published in the D.C. Register on January 31, 2014, at 61 DCR 000846.  A Notice of Emergency and Proposed Rulemaking, which was published in the D.C. Register on October 30, 2015, at 62 DCR 014125, was adopted and became effective on October 20, 2015, and remains in effect until February 17, 2016, or adoption of this second emergency and proposed rulemaking, whichever occurs first.  The first emergency and proposed rules amend the previously published final rules by: (1) modifying rates to reflect increased costs of providing service; (2) allowing Medicaid reimbursement of family training  provided to uncompensated caregivers of people receiving supported living periodic services; and (3) excluding Medicaid reimbursement of family training services provided to people receiving supported living with transportation services, with the exception of family training provided to uncompensated caregivers of people receiving supported living with transportation periodic services.  DHCF received no public comments on the first emergency and proposed rules, but is promulgating this Notice of Second Emergency and Proposed Rulemaking to update the rates in Section 1924.16 to align with Waiver Year 4. 

 

Emergency action is necessary for the immediate preservation of the health, safety, and welfare of ID/DD Waiver participants who are in need of family training services. Based upon current service authorization, reporting and record maintenance requirements, there are insufficient safeguards in place to ensure that providers are taking the necessary steps to deliver adequate family training services.  By taking emergency action, this rule will clarify the duties and responsibilities of family training services professionals and Medicaid providers employing these professionals, and enable the District to increase oversight and enhance quality of care.

 

The emergency rulemaking was adopted on February 1, 2016, and became effective immediately. The emergency rules shall remain in effect for not longer than one hundred and twenty (120) days from the adoption date or until May 31, 2016, unless superseded by publication of a Notice of Final Rulemaking in the D.C. Register.   The Director of DHCF also gives notice of the intent to take final rulemaking action to adopt these proposed rules in not less than thirty (30) days after the date of publication of this notice in the D.C. Register.

 

Chapter 19, HOME AND COMMUNITY-BASED SERVICES WAIVER FOR INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES, of Title 29 DCMR, PUBLIC WELFARE, is amended as follows:

 

Subsections 1924.13 and 1924.16 of Section 1924, FAMILY TRAINING SERVICES, are amended to read as follows:

 

1924.13                   Medicaid reimbursement shall not be available when family training services that are included in a person’s ISP are provided concurrently with the following ID/DD Waiver services:

 

(a)        Supported living and supported living with transportation, with the exception of family training services which may be provided to uncompensated caregivers for people receiving supported living periodic or supported living with transportation periodic services;

 

(b)        Residential habilitation; or

 

(c)        Host home without transportation.

 

1924.16                      The Medicaid reimbursement rate for family training services shall be sixty-one dollars ($61.00) per hour, or fifteen dollars and twenty-five cents ($15.25) per unit.  The billable unit of service for family training services shall be fifteen (15) minutes.

 

 

Comments on these second emergency and proposed rules shall be submitted, in writing, to Claudia Schlosberg, J.D., Senior Deputy Director/State Medicaid Director, District of Columbia Department of Health Care Finance, 441 Fourth Street, N.W., Suite 900 South, Washington, D.C.  20001, by telephone on [phone], by email at [e-mail], or online at www.dcregs.dc.gov, within thirty (30) days after the date of publication of this notice in the D.C. Register.  Copies of these second emergency and proposed rules may be obtained from the above address.