MURIEL BOWSER
Mayor
January 19, 2021
The Honorable Phil Mendelson
Chairman, Council of the District of Columbia
1350 Pennsylvania Avenue, N.W.
Suite 504
Washington, D.C. 20004
Dear Chairman Mendelson:
Enclosed for Council consideration is the Operating Standards for Group Homes for
Persons with Intellectual Disabilities Amendment Approval Resolution of 2021, which will
approve proposed regulations on Community Residence Facilities for Persons with
Intellectual Disabilities. The regulations are drafted in accordance with the Health-Care and
Community Residence Facility, Hospice and Home Care Licensure Act of 1983, D.C.
Law 5-48, D.C. Official Code 44-501, ef seq. (hereinafter the Act). The proposed
regulations repeal existing regulations on group homes and replace them with updated
operating standards on Community Residence Facilities for Persons with Intellectual
Disabilities.
The proposed regulations were reviewed by and discussed with the Department on
Disability Services (DDS) which is charged with placing citizens in group homes on behalf of
the city. The rulemaking accommodates the Medicaid waiver program, administered by DDS,
in accordance with which many providers deliver services in group homes. It is agreed
that the proposed regulations will function as a much-needed clarification and
streamlining of the rightsofresidents as well as the responsibilities of licensees.
If you need further information, please contact Phillip L. Husband, General Counsel,
Department of Health at 442-5970.
Sincerely,
lurifl Bowger
wre
airman Phil Mendelson
at the request of the Mayor
PROPOSED RESOLUTION
IN THE COUNCIL OF THE DISTRICT OF COLUMBIA
Chairman Mendelson, at the request of the Mayor, introduced the following resolution,
which was referred to the Committee on
To approve proposed rules of the District of Columbia Department of Health that would
amend Title 22-Bofthe District of Columbia Municipal Regulations to revise
operating standards for group homes for persons with intellectual disabilities.
RESOLVED, BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That
this resolution may be cited as the Operating Standards for Group Homes for Persons
19 with Intellectual Disabilities Amendment Approval Resolution of 2021.
20 Sec.2. Pursuant to D.C. Official Code 44-504(j), the Council of the District of
21 Columbia approves the proposed rulemaking by the District of Columbia Department of
22 Health (DOH) that will improve operating standards for groups homes for persons with
23 intellectual disabilities.
24 Sec.3 The proposed rulemaking would amend Chapter 35ofTitle 22-B (Health)
25 ofthe District of Columbia Municipal Regulations. It would repeal the current Chapter
26 35 and replace it with new rules creating operating standards for group homes for persons
27 With intellectual disabilities in the District ofColumbia, addressing such areas as
28 habilitation, health care, qualifications ofstaff and recordkeeping, and would also
recognize the licensingofparticipants in the Home and Community-Based Services
Waiver Residential Habilitation Service Settings (HCBS). The rulemaking would also
change the name ofChapter 35 from Group Homes for Persons with Mental
Retardation to Community Residence Facilities for Persons with Intellectual
Disabilities (CRFPID).
Sec. 4. The Secretary to the Council of the District of Columbia shall transmit a
copyofthis resolution, upon its adoption, to the Mayor and the Director of DOH.
Sec. 5. This resolution shall take effect immediately.
 GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF THE ATTORNEY GENERAL.
xe
KARLA, RACINE coo
ATTORNEY GENERAL Ena
TO: Ronan Gulstone
Director
Officeof Legislative Support
FROM: Brian K, Flowers
Deputy Attorney General
Legal CounselDi
DAT! August 19, 2020
SUBJ
Proposed Rulemaking Amending Chapter 5(Ca idence
Fa for Persons with Intelle i itle 22-B of
the District of Columbia Munici;
(AR-20-221-C)
This iis to ies
that auOffice has reviewed the abow eferenced
questions regarding this
1350 Pennsylvania Avenue, NW, Suite 409, Washington,
DC 20004 * Tel: 202) 724-5524 Email brian flowers@de gov
 DEPARTMENT OF HEALTH
NOTICE OF FINAL RULEMAKING
The Director of the Department of Health, pursuant to the authority set forth in section 5(a) of
the Health-Care and Community Residence Facility, Hospice and Home Care Licensure Act of
1983, effective February 24, 1984, D.C. Law 5-48, D.C. Official Code 44-504(a)(2017 Supp.)
(hereinafter the Act), and in accordance with Mayors Order 98-137, dated August 20, 1998,
hereby gives notice of the of the adoption of the following operating standards for group homes
for persons with intellectual disabilities and to recognize the licensing of participants in the
Home and Community-Based Services Waiver Residential Habilitation Service Settings
(HCBS).
These final rules replace the current regulations on group homes for persons with mental
retardation and create operating standards for group homes for persons with intellectual
disabilities in the District of Columbia, and address such areas as habilitation, health care,
qualificationsofstaff and recordkeeping.
This rulemaking was published in the D.C. Register on October 16, 2020 at 67 DCR 11955. No
comments were received during the allotted thirty (30)-day public comment period, and no
changes were made to the text of the rules as proposed. The rulemaking will be final upon
completion of the forty-five (45) day Council review periodif the Council does not act earlier to
adopt or disapprove a resolution approving the rules.
Chapter 35 of Title 22B DCMR, Group Homes for Persons with Mental Retardation, is renamed
Community Residence Facilities for Persons with Intellectual Disabilities and is amended by
repealing the current Chapter 35 in its entirety, and replacing it with a new Chapter 35 to read as
follows:
CHAPTER 35 COMMUNITY RESIDENCE FACILITIES FOR PERSONS WITH.
INTELLECTUAL DISABILITIES (CRFPID)
3500 GENERAL PROVISIONS
3501 COMPLIANCE AND VARIANCES
3502 ENVIRONMENTAL REQUIREMENTS
3503 HOUSEKEEPING
3504 MEALS AND DINING
3505 BEDROOMS
3506 BATHROOMS
3507 PROGRAM STATEMENT
3508 POLICIES AND PROCEDURES
3509 ADMISSIONS
3510 DISCHARGES AND TRANSFERS
3511 MANAGEMENT OF OPERATIONS
3512 PERSONNEL
3513 RESIDENCE DIRECTOR
3514 QUALIFIED INTELLECTUAL DISABILITIES PROFESSIONAL (QIDP)
3515 STAFF TRAINING
3516 DIRECT CARE STAFF RATIOS
3517 RECORDKEEPING
3518 PROFESSIONAL SERVICES
3519 MEDICAL AND NURSING SERVICES
3520 HABILITATION AND TRAINING
3521 MEDICATIONS
3522 BEHAVIOR SUPPORT
3523 EMERGENCIES
3524 ABUSE AND NEGLECT
3525 VENTILATOR SERVICES
3599 DEFINITIONS
CHAPTER 35 COMMUNITY RESIDENCE FACILITIES FOR PERSONS WITH
INTELLECTUAL DISABILITIES
3500 GENERAL PROVISIONS
3500.1 For purposes of this chapter, a group home for persons with intellectual
disabilities, as defined in 2 of the Act, shall be known as a Community
Residence Facility for Persons with Intellectual Disabilities (CRFPID). CRFPID
shall serve as substitute for the term group home for persons with intellectual
disabilities for the purposesofthis chapter.
3500.2 Each CRFPID shall comply with Chapter 31ofTitle 22Bof the District of
Columbia Municipal Regulations (DCMR), entitled Licensing of Health Care and
Community Residence Facilities. Chapter 31 includes administrative procedures
on the issuance and renewal of licenses as well as enforcement actions.
3500.3 Each CREPID shall comply with all applicable Federal and District laws and
regulations, including D.C. Law 2-137, the Citizens with Intellectual Disabilities
Constitutional Rights and Dignity Act of 1978 (D.C. Official Code 7-1301.01 et
seq.). Providers of Home and Community-Based Waiver Services (HCBS),
known as residential habilitation service settings, shall also comply with
subsection 3500.4 of this Chapter.
3500.4 Each provider of services under the HCBS shall be certified by the Department of
Disability Services (DDS) to be in compliance with Chapter 19of Title 29 of the
District of Columbia Municipal Regulations (DCMR), entitled Home and
Community-Based Waiver Services for Individuals with Intellectual and
Developmental Disabilities. Each provider of waiver services shall comply with
this Chapter, 22B DCMR Chapter 35, in order to obtain and maintain licensure.
3500.5 Each CRFPID participating in the HCBS must be certified by DDS at the time of
the Departments annual licensure survey.
3500.6 Each CREPID that is certified as an Intermediate Care Facility (ICF) shall not
provide HCBS program services.
3500.7 Each CRFPID shall comply with the terms of its license, and the number of
persons living at the home shall not exceed the number permitted by the license
and shall not exceed the statutory limitationofeight (8) people.
3500.8 Each CRFPID Residence Director shall abide by all District of Columbia laws
and regulations relating to the rightsof persons with intellectual disabilities.
3500.9 Each CRFPID shall provide recreational activities, community integration and
inclusion activities outside the home for all ofthe persons residing there in
accordance with the persons choice as identified through the person-centered
assessment process and as documented in the persons Individual Support Plan
(ISP).
3500.10 Each CRFPID shall have equipment to provide a varietyofrecreational activities
inside the home (including, but not limited to, games, crafts, books, television and
radio) and shall maintain such equipment in good repair.
3500.11 Persons shall have access to and open their own mail, packages, texts, emails, or
any other formofelectronic communication, e.g. FaceTime or Skype. No mail or
other formsofcommunication shall be read by CRFPID staff unless written
permission to do so is granted by the person or his or her representative in the
form ofamemorandum or ISP documentation.
3500.12 Visits by friends, relatives or other persons not paid to be in a CRFPID shall be
encouraged and permitted by the CRFPID in accordance with a person's wishes,
provided there is no undue disruption to CRFPID operations and the privacy
concernsofother persons or an assessed need and justified in his or her person-
centered plan.
3500.13 Each CRFPID shall ensure that each person residing there has privacy in his or
her personal space, including entrances that are lockable by the person (with staff
having keys as needed and approved in the persons ISP or within other written
documentation).
3500.14 Each CRFPID shall ensure that each person residing there has control and access
to his or her personal funds and bank accounts.
3500.15 Each CRFPID shall allow appropriate personnel of the Departmentof Health
(hereinafter Department) full access, whether the visit is announced or
unannounced, to all CRFPID locations, including access to the persons receiving
 supports and all records in any form. For purposes of this section, the term
records includes, but is not limited to, all information relating to the provider,
the services and supports being provided, and the persons for whom services are
provided; and any information which is generated by or in possessionofthe
CREPID; the information required by D.C. Law 2-137 (D.C. Official Code 7-
1301, et seq.); and any information required by the regulations implementing
CREPID.
3500.16 The CRFPID shall not use any advertising that contains false, misleading or
deceptive statements or claims, or false or misleading disclosures of fees and
payment for services. The CRFPIDs name shall not imply that it is providing
services it is not licensed to provide or does not deliver.
3501 COMPLIANCE AND VARIANCES
3501.1 Each CRFPID that was licensed before the effective dateofthese regulations shall
have one year to comply with the provisions herein.
3501.2 The Director may grant a variance from anyofthe requirements of these rules, if
the applicant can show undue hardship and the variance can satisfy the following
conditions:
(a) It is not inconsistent with other provisions of the Act;
(6) It isnot deleterious to the public health and safety; and
(c) It would not have the effectof permitting a violationof other laws or
regulationsofthe District of Columbia.
3501.3 ACRFPID requesting a variance shall submit in writing to the Director, the
following:
(a) The regulatory requirement(s) for which a variance from strict compliance
is being requested;
(b) Specific justification as to why the CRFPID cannot meet the
requirement(s); and
() Alternative measures provided to ensure quality care and services
consistent with these rules.
3501.4 The Director shall grant a variance only to the extent necessary to ameliorate an
undue hardship and only when compensating factors are present to give adequate
protection to the public health without impairing the intent and purpose of these
rules.
3501.5 If the Director determines that the applicant has not justified undue hardship, he
or she shall issue a written proposed denial advising the applicant as to his or her
right to a hearing by the Office of Administrative Hearings (OAH) in accordance
with OAH rules,
3501.6 The Director shall maintain a record, open to inspection by the public, of all
variances granted. The record shall contain a complete written explanation of the
basis for each variance.
3502 ENVIRONMENTAL REQUIREMENTS
3502.1 No CREPID shall use a name on the exterior of the facility or display a logo
which distinguishes it as being different from any other residence in the
neighborhood.
3502.2 Each CRFPID is a persons home and shall be physically accessible to the person
and allow the person access to all common areas. The CRFPID must be
integrated in the community and support full access to the greater community.
3502.3 ACRFPID is a residential occupancy and may be located in a single or multi-
family dwelling.
3502.4 Each CRFPID shall be in good general condition in accordance with 3503.3.
3502.5 Each CRFPID shall be within walking distance of public transportation or
demonstrate that it can and does provide accessible transportation to persons,
upon reasonable request, to community activities which may include but are not
limited to:
(a) Stores;
(b) _ Restaurants;
() Movies;
(d) Parks;
(e) Recreational facilities;
(f) Libraries;
(g) Post offices;
(h) Places of worship; and
0) Other recreational facilities.
3502.6 Each CRFPID shall be located away from known sources of loud and irritating
noises and hazardous conditions including, but not limited to, noxious smoke and
fumes.
3502.7 Alll electrical, plumbing and mechanical equipment shall be kept in safe and
operating condition. lll fire safety equipment, including, at a minimum, smoke
detectors, carbon monoxide detectors and fire extinguishers, shall be in good
working order.
3502.8 Each CRFPID shall ensure that it has at all times a working water supply, trash
disposal system and sewage disposal system. The CRFPID shall ensure that
recycling, composting and garbage disposal do not create a nuisance or a breeding
place for insects and rodents.
3502.9 The CRFPIDs hot water tank shall be of such size to provide an adequate supply
of hot water to the kitchen, bathrooms and laundry. The hot water temperature of
all fixtures used by persons residing in the home shall be maintained at a
minimum one hundred degrees Fahrenheit (100F) and not to exceed one hundred
and ten degrees Fahrenheit (110F).
3502.10 The CRFPID shall have a central heating and air conditioning system, radiators or
electric built-in heaters and/or air conditioning window units that are installed so
as to prevent hazards to persons residing in the home or to room furnishings.
3502.11 Active radiators shall be covered to protect persons from burns. Space heaters and
kerosene heaters shall be prohibited.
3502.12 The physical environment shall be well-ventilated. Temperature inside the
CREPID in all rooms shall be maintained to meet persons preference. The
temperature shall not fall below seventy-two degrees Fahrenheit (72F) or exceed
eighty degrees Fahrenheit (80F).
3502.13 The CRFPID shall ensure that all rooms have adequate lighting. All community
space, as defined herein, shall be illuminated sufficiently to meet persons needs,
provided that at a minimum such space shall be illuminated to provide 30-foot
candlesoflight at floor level.
3502.14 Each sliding glass door or transparent panel shall be madeoftempered glass and
shall be marked conspicuously.
3502.15 Space shall be provided for social and recreational purposes including, but
not limited to, a living room or recreation room, and dining area. Space
shall also be provided for the activities of daily living, including, but not limited
to, a kitchen for cooking and preparing meals, and one or more bathrooms for
bathing, toileting and grooming. All space defined in this subsection shall be
 termed community space for purposes of this chapter. The CRFPID shall ensure
that persons have access to all designated community space.
3502.16 Each person living in the CRFPID shall have access to and shall be encouraged to
fully utilize all community space.
3502.17 Community space (excluding kitchens and bathrooms) shall be at least twenty-
five square feet per person above the basement level. Renovated lower floors
used as recreation or family rooms with a separate outside exit are not considered
a basement.
3502.18 Each person in an educational program, includi