Although D.C. is not a state (as we know), for the purposes
of what I’m discussing here the District has the same structures and
responsibilities that states do, although it only recently has begun to develop
“state” structures to provide oversight of city programs and actions in this
area.
In D.C., the entity with primary responsibility in this
arena is the Department on Disability Services ( http://dds.dc.gov
), headed by Laura Nuss (laura.nuss@dc.gov). DDS’ primary responsibilities pertain to
persons whose disabilities are cognitive, intellectual, and/or developmental rather
than physical. In D.C. both the
Developmental Disabilities Administration (DDA) and the Rehabilitation Services
Administration (RSA, which also serves people with physical disabilities) both
come under DDS and are overseen by two deputies reporting to her, although one
of these positions is currently vacant.
Rehabilitation Services Administration
Every state has a department that
deals with “vocational rehabilitation,” or VR.
This is an oddly named service but essentially is concerned with helping
people with disabilities identify the type of work they’d like to do and then assisting
them to get a job or to get the training or education they need. In D.C. this department is called the
Rehabilitation Services Administration, or RSA, currently headed by deputy
director Andy Reese (andrew.reese@dc.gov
). (In Maryland the VR department is
known as the Division of Rehabilitation Services, or DORS, so as you see the
names can differ a lot.) Qualifying to
receive services from RSA is comparatively easy, there isn’t a high bar for
qualifying. However, once an individual
has qualified, RSA is mainly focused on short-term support. If, for example, the person loses a job into
which RSA has helped place him/her, then the process starts over. RSA has also funded some individuals to
attend out-of-state vocational programs and colleges, but is doing less of this
and is trying to develop more local programming instead. RSA also is trying to develop programs such
as Project Search (www.projectsearch.us
), which can help bridge the gap between school (IDEA-funded) and adulthood, an
area in which D.C. has not been very strong in the past.
Developmental Disabilities Administration
http://dds.dc.gov/service/services-people-idd
The much more meaningful long-term supports for persons with disabilities are provided in all jurisdictions through a system of “Medicaid waivers,” which in essence allows federal Medicaid monies to be used for groups of people who would not normally be eligible. (In a future post I’ll explain something about deinstitutionalization and the move toward “Home and Community Based Waivers.”) Some jurisdictions have a fairly extensive network of Medicaid waivers for different categories of persons with disabilities, but this is not yet the case in D.C. Here, the Medicaid waiver program for persons with developmental disabilities is administered by DDS’s Developmental Disabilities Administration, or DDA, headed until recently by deputy director Cathy Anderson (position now vacant, so Laura Nuss is the contact point). The only waiver available for persons with developmental (i.e. non-physical) disabilities in D.C. is focused on intellectual disability (http://dds.dc.gov/service/services-people-idd).
http://dds.dc.gov/service/services-people-idd
The much more meaningful long-term supports for persons with disabilities are provided in all jurisdictions through a system of “Medicaid waivers,” which in essence allows federal Medicaid monies to be used for groups of people who would not normally be eligible. (In a future post I’ll explain something about deinstitutionalization and the move toward “Home and Community Based Waivers.”) Some jurisdictions have a fairly extensive network of Medicaid waivers for different categories of persons with disabilities, but this is not yet the case in D.C. Here, the Medicaid waiver program for persons with developmental disabilities is administered by DDS’s Developmental Disabilities Administration, or DDA, headed until recently by deputy director Cathy Anderson (position now vacant, so Laura Nuss is the contact point). The only waiver available for persons with developmental (i.e. non-physical) disabilities in D.C. is focused on intellectual disability (http://dds.dc.gov/service/services-people-idd).
With few exceptions, to qualify for this waiver it is necessary
for the person to have been tested with an IQ of 69 or below before the age of
18. Many families are unaware of
this and begin trying to get services after their family member is 19 or older
without having obtained such testing.
This can make it extremely difficult, if not impossible, to qualify for
services. Conditions such as autism, without
this IQ qualification, are not sufficient to qualify: D.C. does not yet have an autism waiver as do
Pennsylvania, Maryland, and quite a few other states. DDA is working to develop a new waiver that
will provide flexible supports to individuals with a broader set of
disabilities, but it has not yet come into effect and will only be helpful to
individuals who have fewer support needs and are generally still living with their
families.
For the so-called I/DD waiver
described above, therefore, the primary hurdle is qualifying. Once a person has been found eligible for
services, there is no waiting list. This
differs significantly from most states, where there may be a broader set of available
waivers and qualifying may not be too difficult, but the person needing
services then may remain on a waiting list for years waiting to receive them. D.C. has begun developing criteria for a
potential waiting list, but at this point it has not put them into effect.
The above is just a primer, there’s
more to say in future blogs.
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