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Amendment to the Home- and Community-Based Services Waiver for the Elderly and Persons with Physical Disabilities (EPD Waiver)

August 18, 2023 Update: DHCF is extending the public comment period through September 18, 2023 at 6:00 pm to allow for additional time for public input. We are also updating the attached proposed waiver amendment to correct Appendix J projections. The updated waiver amendment document is titled EPD Waiver Amendment (Nov 2023 - Jan 2024) _ Updated Draft 08.17.23..

August 11, 2023 Update:

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 (District) 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), and Section 6(4) 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(4)), hereby gives notice of the intent to submit an amendment to the District Medicaid Program’s Home and Community-Based Services (HCBS) Waiver for the Elderly and Persons with Physical Disabilities (EPD Waiver) to the Centers for Medicare and Medicaid Services (CMS) for review and approval.

DHCF made changes to the administration of the EPD Waiver program in response to the COVID-19 federal public health emergency utilizing Section §1915(c) Waiver Appendix K authority. The changes included service expansions for waiver participants and reimbursement increases for HCBS providers. While many of those flexibilities will end on November 11, 2023, effective November 12, 2023, DHCF is proposing an amendment to the EPD Waiver to make the temporary fifteen percent (15%) increase to Assisted Living Facility (ALF) provider reimbursement rates permanent. DHCF intends to keep the increased ALF rates in place until a more comprehensive reimbursement methodology update is established at a future date. Additionally, DHCF is increasing the reimbursement for Case Management service providers to ensure sufficient funding for case manager wages and administrative costs. Finally, DHCF is proposing changes to permit annual inflation of case management reimbursement rates. These changes will remain in place until a more comprehensive update to the case management reimbursement methodology is made following completion of a comprehensive rate study.

The proposed EPD waiver amendment and a corresponding summary will be published on the DHCF website at dhcf.dc.gov/epd-waiver-amendment on August 11, 2023. The District’s thirty (30) day public comment period will be open from August 11, 2023 through September 11, 2023 at 6:00 PM.

Interested parties may submit written comments concerning the proposed amendment to Melisa Byrd, Senior Deputy Director/State Medicaid Director, Department of Health Care Finance, 441 4th Street, NW, Suite 900S, Washington, DC 20001, or via email at [email protected].

An electronic copy of the proposed waiver amendment may be obtained on the DHCF website at https://dhcf.dc.gov/epd-waiver-amendment . A printed copy of the proposed waiver amendment is available for viewing upon request at Department of Health Care Finance, 441 4th Street NW, 9th Floor South, Washington, DC 20001.