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Proposed Establishment of a New Home and Community-Based Services Waiver for Individual and Family Support (IFS Waiver)

The Director of the Department of Health Care Finance (DHCF) and the Director of the Department on Disability Services (DDS), pursuant to the authority set forth in the Department of Health Care Finance Establishment Act of 2007 and the Department on Disability Services Establishment Act of 2006, hereby give notice of the intent to submit an application for the District of Columbia Medicaid’s Home and Community-Based Services for Individual and Family Support (IFS) Waiver program to the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) for review and approval with a proposed effective date of November 1, 2020.

The new IFS Waiver will establish a program that will allow District residents with intellectual and developmental disabilities (IDD) who live in an independent environment, either in their own home or with family or friends, to receive HCBS services and supports tailored to their specific needs. DDS is proposing to create a streamlined IFS Waiver to meets the needs of individuals who can leverage supports from family or friends and do not need residential services. In this way, the new IFS Waiver will offer person-centered services that meet the person’s needs in the least restrictive setting needed, applying the highest standards of quality and national best practices.

The IFS Waiver will offer a full range of health and clinical services necessary to help persons with complex support needs and their families to choose an alternative to institutional service that promotes community inclusion and independence by enhancing and not replacing existing informal networks. The new IFS Waiver will offer eighteen (18) services, all of which are currently available under the Medicaid IDD Waiver, and add a new service: Education Supports Services.

The nineteen (19) IFS Waiver services will include:

  1. Assistive Technology Services
  2. Behavioral Supports
  3. Companion
  4. Creative Arts Therapies
  5. Day Habilitation
  6. Employment Readiness
  7. Family Training
  8. Individualized Day Supports
  9. In-Home Supports
  10. Parenting Supports
  11. Personal Care
  12. Physical Therapy
  13. Respite
  14. Skilled Nursing
  15. Speech, Hearing and Language
  16. Supported Employment
  17. Occupational Therapy
  18. Wellness
  19. Education Supports Services

The new service, Education Supports Services, will consist of education (i.e. tuition for adult post-secondary classes) and related services as defined in Sections (22) and (25) of the Individuals with Disabilities Education Act (IDEA) to the extent that they are not available under a program funded by IDEA or available for funding by the Rehabilitation Services Administration (RSA).

Residential supports and services will not be included in the IFS waiver. The District is also proposing a $75,000 per person, aggregate spending cap (per Individual Support Plan year) on waiver services for persons electing the IFS waiver.

Public Comment:

There are two opportunities for the public to provide comments or other input on the proposed HCBS IFS Waiver application:

Written Comments: Written comments on the proposed new HCBS IFS Waiver application may be submitted to: Ieisha Gray, Director, Long Term Care Administration, Department of Health Care Finance, 441 4th Street, NW, Suite 900S, Washington, DC 20001, or via email at [email protected], during the thirty (30) calendar day public comment period, beginning June 12, 2020, and ending July 13, 2020.

Public Forum: DHCF and DDS will hold a virtual public forum during which written and oral comments on the proposed new HCBS IFS Waiver application will be accepted, at the date and time below:

Date: Wednesday, June 24, 2020

Time: 10 to 11:30 am

By Phone: 1-650-479-3208 (Access code: 472 477 560)

Web Conference:

Accommodations for the public forum are available upon request. Please provide your name, address, telephone number, organizational affiliation and accommodation request, if needed, by June 19, 2020, to Cynthia Scott at (202) 910-0148 or [email protected].