D.C. Mun. Regs. tit. 29, r. 29-9008

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 29-9008 - HOME AND COMMUNITY-BASED SETTING REQUIREMENTS

9008.1

All Day Habilitation, Small Group Day Habilitation, Individualized Day Supports, Companion, Supported Employment, Small Group Supported Employment and Employment Readiness settings shall:

(a) Be chosen by the person from HCBS settings options including nondisability settings. For residential settings, this includes, but is not limited to, ensuring that:

(1) The person selects their home and knows that they have protections against eviction;

(2) The person chooses their roommates and knows how to request a roommate change; and

(3) When the person has a roommate, they are offered the choice of available residential settings with a private bedroom, if they have the ability to pay.

(b) Ensure the person's right to privacy, dignity, and respect, and freedom from coercion and restraint. This includes, but is not limited to, ensuring that:

(1) The person is provided personal care assistance in private, as appropriate;

(2) Information is provided to the person on how to make an anonymous complaint;

(3) The person's health and other personal information (e.g., mealtime protocols, therapy schedules) are kept private;

(4) Staff do not talk about the person's private information in front of others who do not have a right and/ or need to know; and

(5) Staff address the person by her/his name or preferred nickname.

(c) Be physically accessible to the person and allow the person access to all common areas. For residential settings, this includes, but is not limited to, ensuring that:

(1) The person has full access to the kitchen, dining area, living room, laundry, and all other common areas of their home; and

(2) The home is fully accessible to meet the needs of the person living there, including all common areas and supports as needed, such as grab bars and ramps.

(d) Support the person's community integration and inclusion, including relationship-building and maintenance, support for self-determination and self-advocacy;

(e) Provide opportunities for the person to seek employment and meaningful non-work activities in the community. This is evidenced in part by the following:

(1) A person who desires to work is supported to pursue work in the community; and

(2) The person engages in meaningful non-work activities in the community.

(f) Provide information on individual rights;

(g) Optimize the person's initiative, autonomy, and independence in making life choices including, but not limited to, daily activities, physical environment, and with whom to interact;

(h) Facilitate the person's choices regarding services and supports, and who provides them;

(i) Create individualized daily schedules for each person receiving supports, that includes activities that align with the person's goals, interests and preferences, as reflected in his or her ISP, in accordance with DDS guidance;

(j) Provide opportunities for the person to engage in community life, as evidenced in part by people being able to shop, attend religious services, schedule appointments, have lunch with friends and family, etc. in the community, as they choose;

(k) Provide opportunities to receive services in the community to the same degree of access as individuals not receiving Medicaid HCBS, as evidenced in part by the person using community resources, such as parks, recreational centers, community health clinics, etc.;

(l) Control over his or her personal funds and bank accounts, as evidenced in part by the person being able to access their funds, when they want to, and without advanced notice;

(m) Allow visitors at any time within the limits of the lease or other residency agreement;

(n) Be integrated in the community and support access to the greater community. This is evidenced in part by the following:

(1) The person receives the supports they need to see family and friends and spend time doing activities of their choosing in the community; and

(2) The person is encouraged to learn travel skills so that they can use public transportation.

(o) Allow full access to the greater community.

9008.2

All Day Habilitation, Small Group Day Habilitation, Individualized Day Supports, Supported Employment, Small Group Supported Employment, Companion and Employment Readiness settings must develop and adhere to policies which ensure that each person receiving services has the right to the following:

(a) A secure place to keep their belongings;

(b) Access to snacks at any time;

(c) Privacy for telephone calls, texts and/or emails, or any other form of electronic communication, e.g. FaceTime or Skype, with or without support, based on the person's preference; and

(d) Meals at the time and place of a person's choosing.

9008.3

Any deviations from the requirements in §§ 9008.1(l) and (m) and § 9008.3 must be supported by a specific assessed need, justified and documented in the person's person-centered ISP, as well as reviewed and approved as a restriction by the Provider's Human Rights Committee (HRC). There must be documentation that the Provider's HRC review and person-centered planning meeting included discussion of the following elements:

(a) What the person's specific individualized assessed need is that results in the restriction;

(b) What prior interventions and supports have been attempted, including less intrusive methods;

(c) Whether the proposed restriction is proportionate to the person's assessed needs;

(d) What the plan is for ongoing data collection to measure the effectiveness of the restriction;

(e) When the HRC and the person's support team will review the restriction again;

(f) Whether the person, or his or her substitute decision-maker, gives informed consent; and

(g) Whether the HRC and the person's support team has assurance that the proposed restriction or intervention will not cause harm.

D.C. Mun. Regs. tit. 29, r. 29-9008

Final Rulemaking published at 69 DCR 10229 (8/12/2022)