District of Columbia Administrative Code

402 PROPOSED USES OF ALLOTMENT FUNDS 402.1 A proposal for using funds available from a state allotment which is subject to SHCC review shall be submitted to the SHPDA by the state program agency, or at the option of the state program agency, by the applicant according to procedur…

403 NONREVIEWABLE GRANT APPLICATIONS 403.1 Except as provided in §404, the SHCC and SHPDA shall not review, comment upon, approve, or disapprove proposed uses of federal funds which are either of the following: (a) Noncompeting extension grant applications; or (b) Supplemental gr…

404 REVIEW OF NONCOMPETING CONTINUATION APPLICATIONS 404.1 Each applicant shall provide SHPDA with a copy of each application for a noncompeting continuation grant at the time the application is submitted to the federal funding agency or the Regional A-95 Clearinghouse, whichever…

405 CONFIDENTIAL MATERIAL 405.1 In accordance with 42 CRF 122.408(b)(3), if an application contains material which the applicant believes to be confidential or proprietary (and which, therefore, should not become public), the applicant may submit a summary of this material to the…

406 SHPDA REVIEW PROCEDURES AND CRITERIA 406.1 The performance of any review by the SHPDA and SHCC shall be in accordance with and consistent with review procedures set forth in this chapter. 406.2 Before adopting or revising the review procedures and criteria, the SHPDA shall co…

407 GENERAL REVIEW CRITERIA 407.1 Review criteria shall be established by the SHPDA within the guidelines established under Public Law 93-641, as amended. 407.2 The criteria may vary according to the purpose for which a particular review is being conducted or the type of health s…

408 GENERAL REVIEW PROCESS 408.1 The District SHPDA or SHCC review process shall be an open process that is structured in a manner that ensures that each application reviewed by the state agency is conducted in a timely and equitable fashion. 408.2 All interested parties shall ha…

409 RESERVED SOURCE: Final Rulemaking published at 28 DCR 1086 (March 13, 1981). AUTHORITY: DC-DCMR Unless otherwise noted, the authority for this chapter is Reorganization Plan No. 2 of 1979, 3 D.C. Code, 2001 Ed. at 338.

410 TECHNICAL ASSISTANCE AND SITE VISITATION 410.1 Upon request, the SHPDA staff shall provide technical assistance to applicants relative to the development of grant applications. A pre-application conference shall allow the SHPDA staff to assist the applicant in developing appl…

411 INTERAGENCY REVIEW COORDINATION 411.1 In accordance with 42 CFR 122.405, when the proposed uses of federal funds would involve the development, expansion, or support of health resources in the District and another health service area in the Washington Metropolitan area, if th…

412 CONFLICT OF INTEREST BY SHCC MEMBERS 412.1 No member of the reviewing committee or the SHCC shall vote on any proposed use of federal funds if he or she has (or has had within the prior twelve (12) months) a substantial ownership, employment, medical staff, fiduciary, contrac…

413 LETTERS OF INTENT 413.1 Prior to submission of a formal application for a proposed use of federal funds, the applicant shall submit to the SHPDA a letter of intent to apply for federal assistance. 413.2 A letter of intent shall include at least the following basic information…

414 SUBMISSION OF APPLICATIONS FOR REVIEW 414.1 Application forms and instructions or guidelines respecting the preparation of a grant application, contract, and related matters shall be available through the appropriate federal or state funding agency. It shall be the responsibi…

415 REQUESTS FOR ADDITIONAL INFORMATION 415.1 Upon the SHPDA's receipt of an application, a preliminary review shall be made to determine whether additional information is needed to conduct a complete and reasonable review. 415.2 SHPDA shall, whenever possible, rely on the applic…

416 NOTICE OF REVIEW TO AFFECTED PERSONS 416.1 Direct written notification to affected persons shall be provided within seven (7) days of the receipt of the grant application and shall include notification of the proposed schedule for the review and the period in which a public h…

417 PUBLIC HEARINGS 417.1 If requested by one (1) or more persons directly affected by the review, the SHPDA or SHCC shall conduct a public hearing in the course of the review. 417.2 A request for a public hearing shall be made in writing and received by the SHPDA within five (5)…

418 PERIOD OF REVIEW 418.1 The period for SHPDA or SHCC review shall begin no more than seven (7) days after the receipt of the application to the SHPDA. 418.2 The SHPDA or the SHCC shall be allowed up to sixty (60) days to conduct a review of grant applications and categorical s…

419 ANALYSIS OF GRANT APPLICATIONS 419.1 Upon receipt of a grant application, followed by the necessary notifications to affected persons, the SHPDA staff shall prepare a summary and analysis of the application for consideration by the appropriate SHCC committee. A copy of the st…

420 NOTIFICATION OF REVIEW DECISIONS 420.1 Not later than the close of the first business day following the end of the sixty (60) day review period, the SHPDA shall provide written notification of its or the SHCC's decision to the applicant, the appropriate federal funding agency…

421 CONSEQUENCES OF REVIEW DECISIONS 421.1 SHCC or SHPDA approval shall not guarantee funding of an application, although under 42 CFR 122.415 no award of federal funds subject to review and approval shall be made unless one (1) of the following has occurred: (a) The SHCC or SHPD…

422 OTHER REVIEWS 422.1 SHPDA review procedures shall not preclude the need for review of applications under OMB Circular A-95 by the appropriate agencies. 422.2 The applicant shall notify the appropriate A-95 clearinghouse (state or local, as required) of its intent to apply for…

423 PERIODIC REPORTS FROM PROVIDERS OF HEALTH SERVICES 423.1 Providers of health services and other persons subject to SHPDA or SHCC review shall submit periodic reports to the state agency with respect to the development of proposals. 423.2 Applicants whose grant requests have b…

424 PUBLICATION OF ANNUAL STATUS REPORT 424.1 The SHPDA shall prepare and publish an annual report of the Agency reviews conducted. 424.2 The annual report shall include a statement concerning the status of each review, a general statement of the findings and decisions made in th…

499 DEFINITIONS 499.1 When used in this chapter, the following terms and phrases shall have the meanings ascribed: Affected persons - includes, at a minimum, the following: (a) The person (referred to as the "applicant") whose application for a proposed use of federal funds (refe…

4000 GENERAL PROVISIONS 4000.1 This chapter establishes uniform requirements for transferring money or other things of value to recipients outside the District government, where the Department is authorized to make grants. 4000.2 The Director of the Department of Human Services i…

4001 GRANT AVAILABILITY ANNOUNCEMENTS AND APPLICATIONS 4001.1 Except where the grant authority specifies the grantee, the availability of a grant shall be announced by one (1) of the following methods: (a) Publication in a newspaper of general circulation in the District of Colum…

4002 APPLICATION REVIEW 4002.1 A review panel shall review each application to determine if it meets the requirements that apply to the particular grant. 4002.2 The review panel shall advise the Director of all those applications which satisfy the applicable grant requirements an…

4003 REVIEW FACTORS 4003.1 The Director shall review applications and make awards based upon the following criteria: (a) Feasibility of the project; (b) Soundness of research design, statistical technique, and procedures and methodology, if appropriate; and (c) Theoretical and te…

4004 DISPOSITION OF APPLICATIONS 4004.1 The Director shall make the final selection of the grant award. 4004.2 Based upon his or her review, the Director shall do one (1) of the following: (a) Approve the application, in whole or in part, for such amount of funds and subject to s…

4005 GRANT AGREEMENT 4005.1 Each grant award shall be in the form of a written grant agreement between the Director and the awardee that is consistent with those statutes and regulations that apply to the grant. 4005.2 The grant agreement shall include, but not be limited to, the…

4006 CERTIFICATION OF A DRUG-FREE WORKPLACE 4006.1 By submission of its application, the grantee, if other than an individual, certifies and agrees that with respect to all its employees under the grant it shall, no later than thirty (30) calendar days after grant award (unless a…

4007 FINANCIAL MANAGEMENT BY GRANTEES 4007.1 Each grantee shall make accurate, current, and complete disclosure of the financial results of each project or program in accordance with the financial reporting requirements of the grant agreement. 4007.2 Each grantee shall maintain r…

4008 MONITORING BY GRANTEES 4008.1 Each grantee shall monitor grant and subgrant supported activities by reviewing each program, function or activity to assure that adequate progress is being made towards achieving the goals of the grant or subgrant. 4008.2 Each grantee shall sub…

4009 AUDITS AND DISALLOWANCES 4009.1 Appropriate District or Federal personnel may conduct fiscal and program audits of the grantee. 4009.2 Each grantee shall have an annual audit performed by an auditor who is independent of the staff person who authorizes expenditure of project…

4010 REPAYMENT OF FUNDS BY GRANTEE 4010.1 As a condition of each grant awarded, the grantee shall agree to do the following: (a) Repay the District for final audit disallowances within thirty (30) days from receipt of notification by a disallowance letter; and (b) Pay interest at…

4011 CLOSE-OUT 4011.1 The Grant Officer shall close-out the grant when he or she determines that all applicable administrative actions and all required work of the grant have been completed. 4011.2 Upon termination or close-out of the grant, the Grant Officer shall promptly provi…

4012 RECORD RETENTION AND ACCESS 4012.1 The grantee shall retain all records for a period of at least three (3) years following final closeout of the grant, if no other period is specified in the grant agreement. 4012.2 The grantee shall make all records available to the Director…

4013 TERMINATION AND SUSPENSION PROCEDURES 4013.1 If a grantee has materially failed to comply with the terms of a grant agreement, the Grant Officer may, after giving reasonable written notice to the grantee, do the following: (a) Suspend the grant in whole or in part; (b) Termi…

4014 INFORMAL DISPUTE RESOLUTION 4014.1 The provisions contained in this section and in § 4015 shall establish an informal procedure for resolution of disputes between the grantee and the Director. 4014.2 The procedures shall apply to the following adverse determinations made by …

4015 DECISION OF THE DIRECTOR 4015.1 The Director may require informal, non-binding mediation between the parties before issuing a final decision if, due to the nature of the dispute, the Director considers it to be in the best interests of the District. 4015.2 The Director shall…

4099 DEFINITIONS 4099.1 When used in this chapter, the following terms shall have the meanings ascribed: Controlled substance - a controlled substance in schedules I through V or § 202 of the Controlled Substances Act (21 U.S.C. § 812) and as further defined, in regulation, at 21…

4100 GENERAL PROVISIONS This chapter shall establish principles of reimbursement that shall apply to each intermediate care facility for individuals with intellectual disabilities (ICF/IID) participating in the District of Columbia Medicaid program. For an ICF/IID to be eligible …

4101 ACUITY LEVEL ASSIGNMENTS Reimbursement rates shall be differentiated based on the individual’s acuity level, as recommended by DDS, through the Level of Need Assessment and Risk Screening Tool (LON), and interdisciplinary teams of health and habilitation professionals, pursu…

4102 REIMBURSEMENT METHODOLOGY The rates for ICF/IID services were developed based on Fiscal Year (FY) 2010 cost data reported by providers of different sizes serving individuals at varying acuity levels. The rates shall vary based on staffing ratios, facility size, and beneficia…

4103 ACTIVE TREATMENT SERVICES 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…

4104 SUPPLEMENTAL PAYMENT FOR QUALITY OF CARE IMPROVEMENTS Consistent with the requirements set forth in the Stevie Sellows Intermediate Care Facility for the Intellectually and Developmentally Disabled Quality Improvement Act of 2005, effective March 8, 2006 (D.C. Law 16-68; D.C…

4105 REBASING 4105.1 Effective October 1, 2018, and every three (3) years thereafter, reimbursement rates shall be rebased based on the cost reports from the most recently audited year, as determined by DHCF. Effective October 1, 2019, and every three (3) years thereafter, reimbu…

4106 COST REPORTING AND RECORD MAINTENANCE Each ICF/IID shall report costs annually to DHCF no later than ninety (90) days after the end of the provider’s cost reporting period, which shall correspond to the fiscal year used by the provider for all other financial reporting purpo…

4107 FISCAL ACCOUNTABILITY Effective October 1, 2013 through September 30, 2017, except for the Administration, Capital, and Active Treatment cost centers, each facility shall spend at least ninety-five percent (95%) of the rate under each cost center on service delivery to Medic…

4108 RIGHT TO APPEAL DHCF shall issue a notice to each beneficiary when DHCF disapproves the acuity level assignment submitted by the provider. The notice shall comply with District and federal law and rules. A copy of the notice shall also be sent to the provider. If the benefic…