Advocates are cautiously optimistic as the District of Columbia rolls out participant-directed Medicaid services for low-income seniors and people with disabilities. If you live in DC and you’ve never heard of participant-directed services you can be forgiven. That’s because every state Medicaid program in the country provides participant-directed services, except the District of Columbia.
In straightforward terms, participant-direction allows people with disabilities to use their Medicaid benefits to hire friends, family members, or anyone else they choose, to help with daily activities like making meals or getting dressed. The District’s new participant-directed program will be called Services My Way. The program will be available for people in the District’s Medicaid waiver program for individuals who are Elderly or Physically Disabled (EPD). As we’ve previously blogged about, the EPD Waiver Program provides home health care services to some of the District’s most vulnerable residents—seniors and individuals with disabilities who, without the services provided in the EPD Waiver Program, would be required to live in a nursing home or pay out of pocket for assistance.
Currently, the District only allows EPD waiver participants to hire licensed home health aides, and many people who qualify for services have trouble finding a licensed aide to work when they need them. It’s not uncommon for people to be stuck in bed until 10am or forced to go to sleep at 8pm because of staffing problems—if they can find staff at all.
The District is currently reviewing applications from Medicaid beneficiaries who want participant-directed services as part of their overall plan of care. District residents have been waiting for this program to become a reality since 2002 when the federal government first approved this program for the city.
Legal Aid is one of a handful of legal services organizations in the District that has represented and continues to represent and advocate on behalf of individuals in the EPD Waiver Program. Through our representation of numerous clients participating in the waiver program, we have observed what happens when people don’t get the services they need. The addition of participant-directed services will not fix all of these problems. However, the program’s mission is to give people the home health services that they need to remain in their communities, and with the addition of participant-directed services the program will get one step closer to fulfilling its mission. As Ieisha Gray, Director of DHCF’s Long Term Care Administration stated in the District’s press release announcing the creation of Services My Way: “This program is a much-anticipated enhancement to DHCF’s service offerings, and a wonderful step in our ongoing efforts to provide more individual choice and control for our EPD Waiver participants.”
In short, participant-directed services are a win-win for District residents. The program will provide much-needed employment opportunities for people with diverse educational backgrounds. Further, it will make it easier for seniors and people with disabilities to hire and train people they trust.
Advocacy of groups like Legal Aid, Disability Rights DC at University Legal Services, Legal Counsel for the Elderly, and the Neighborhood Legal Services Program, will monitor the implementation of the participant-directed services program to ensure seniors and people with disabilities get the support that they need to stay in their communities.