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DISTRICT OF COLUMBIA

The District of Columbia Department of Health, which is responsible for the Medicaid program for the city, has been overseeing the redesign of the District's long-term care system through a Real Choice Systems Change Advisory Committee since June 2001. The District received two grants totaling slightly more than $2.1 million in 2002 from the federal Centers for Medicare and Medicaid Services to help facilitate this work.

One $725,000 grant is being used to build the infrastructure for a personal assistance services system; to streamline the eligibility determination process; to disseminate information to consumers about home and community-based services; and to recruit, train, and support personal assistants and mentors. The other $1.4 million grant will be used to develop a resource center to serve as a single point of entry that will initially provide frail elderly people and people with physical disabilities with information and access to long-term care services. The resource center will be modeled after the Aging and Disability Resource Center system that has been developed in several Wisconsin counties through the state's pilot Family Care Program. The project also will establish a care coordination system that incorporates financial incentives for providers to increase flexibility, improve quality of life and care, and control costs.

The advisory committee includes consumers, providers and officials from city agencies that provide services to individuals with disabilities. Early activities of the committee have included the expansion of two Medicaid waiver programs, one for the elderly and the other for people with mental retardation and developmental disabilities. The District requested 200 additional waiver slots per year for each waiver for a period of five years. The city also is expanding services under its Elderly/Physically Disabled waiver program to include assisted living and consumer-directed attendant care and is expanding coverage of assistive technology.

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