Thursday, April 30, 2015

A Complicated Picture

Sometimes it pays to stay until the end. I was reminded of that at yesterday’s hearing on DDS’s FY 2016 budget before the DC Council’s Health and Human Services committee, chaired by council member Yvette Alexander (Ward 7).  DDS director Laura Nuss testified ( after seventeen other witnesses, and the chair’s very last question to her touched on eligibility criteria for waiver services and the inclusion of persons who have a developmental disability but not an intellectual disability.  The director indicated that DDA is planning to institute greater flexibility with respect to the IQ cutoff of 69 or below, but on expanding eligibility, I was concerned to hear her reply that “a better financial climate for the city” is required.  I’ve heard Laura speak much more forcefully on this subject before, and I’m concerned her answer may mean that expanding Medicaid waiver services to other D.C. citizens in need is not going to be a budget priority for the new mayor.   I continue to be encouraged, however, that the issue has the committee chair’s attention, and hopefully she’ll keep the light shining on this grave and longstanding concern.

The budget hearing ranged across a great variety of topics.  Witnesses’ testimony fell mainly into the following categories (recall that DDA and RSA both fall under the DDS budget): 

-          -- Advocates applauding DDA and strongly supporting its budget.  Several individuals currently benefiting from the DDA waiver (almost all of them receiving services from one particular provider) spoke out forcefully in this regard.  In my own testimony, I advocated in favor of the proposed budget to ensure that DDA can meet its current commitments to waiver-eligible individuals, but at the same time I pointed to the need for services to expand to others who are not currently eligible.

-          -- Advocates for the proposed increase in the RSA budget.  Several of these witnesses were from organizations that have received funding from RSA, and in the interest of transparency, I believe the council should require witnesses to disclose any such past, present, or potential financial interest in their testimony.  These favorable commentaries were challenged by at-large council member Grosso, who said he has heard from many individuals – some of whom testified in February at the performance review hearing - about substandard service from RSA.

-          -- Critics of DDS, a number of whom spoke about reimbursement rates and other policies affecting DDS providers while others addressed problems with the department’s internal personnel policies.    At-large council member David Grosso was especially vocal about this last issue, on which several individuals had apparently approached him personally.  One parent also spoke eloquently about the difficulties she has had in gaining waiver eligibility for her daughter and her ongoing struggles in getting appropriate, community-based services from DDA.  Committee chair Alexander asked whether my personal experience was similar, and I confirmed that it was, although this family’s ongoing challenges with DDA are more significant than those we’ve encountered recently.

I realize this summary won’t provide enough detail on the particular concerns that you may have, and I encourage you to watch the video of the hearing at  The hearing actually starts about 20 minutes into the video and begins with an initial panel from the Office of Disability Rights.  Then come several panels of witnesses addressing DDS issues, and DDS director Nuss’s testimony starts around the beginning of the third hour.

Finally, a word on council members’ attendance.  Committee chair Alexander was of course there for the whole time, and very engaged.  At-large member Grosso had to leave a couple of times, but had a staff member there throughout and was obviously extremely active and interested in the subjects covered, especially but not only where he saw overlap with the Committee on Education, which he chairs.  Ward 1 member Brianne Nadeau was briefly there at the beginning of the hearing and made a statement.  And the remaining member of the committee, Mary Cheh, as in February, won the prize for her utter, complete, and unexplained absence.  I hope she does not imagine there are no persons with disabilities in Ward 3.

In light of some of my past postings about the need for DDS to get more information online, I’d like to give Erin Leveton a shout-out for having provided the link to the Power Point presentation on the budget:  You should find this quite a bit more readable than the version I scanned for my last posting.

Saturday, April 18, 2015

It Takes Money to Make Things Run

This past Monday, April 13, I attended the first of two briefings by Laura Nuss on the mayor’s FY2016 budget proposal and, in particular, the budget proposal for DDS.  There will be a second briefing on Monday, 4/20, 3:30 at the Anacostia library, 1800 Good Hope Road SE - attend if you can.  On the DDS website you’ll see an announcement of the 4/20 meeting, but if the Power Point is there I can’t find it.  I’ve scanned my hard copy to share it with you:

The good news:  In a fiscally constrained budget environment, the DDS budget held up well.  There is even a slight proposed increase of $1.7 million for RSA to allow compliance with new federal requirements for transition programming for in-school youth without squeezing other parts of the RSA budget.  The mayor also accepted the argument that most of the DDS budget is D.C. matching with federal Medicaid funds to support the approximately 1650 people currently served under the DDA waiver.  Since D.C. has found these people eligible, the funds have to be provided.  Hopefully the D.C. council will also understand this.

The bad news:  This is, as I said above, a fiscally constrained budget environment.  The mayor has submitted a request that not only involves cuts in some agency budgets, but also proposes an increase in the D.C. sales tax to fund affordable housing.  This means that any thought of developing a waiver to serve people with developmental disabilities who don’t meet the IQ requirement for an intellectual disability is, for now, off the table.  Why?  Because the D.C. matching funds for these additional people would create a new budget requirement.  These are realities.  And until the mayor, and the council, hear that we want justice for citizens with developmental disabilities in our city, the situation is not going to change, even in FY 2017 or beyond.

You have a chance to start being heard on this issue.  On April 29 at 10 a.m., the D.C. council’s Committee on Health and Human Services will hold a hearing on the DDS budget – room 500 of the Wilson Building.  Council members need to hear that we want the council to support the proposed funding for DDS in the mayor’s FY 2016 budget, as the minimum necessary to meet current requirements.  But we also need council members to hear that we want something even better in FY 2017.  So do one or all of these things:  contact Rayna Smith at to get your name on the list to testify in person on the 29th; write her at the same address to say you plan to submit written testimony; or write your council member ( to say you support the DDS budget request.

The squeaky wheel gets the grease, folks.  So squeak!

Friday, April 3, 2015

Supporting Families Community of Practice

On several occasions I’ve mentioned the Supporting Families Community of Practice (CoP), and in my last posting I said the CoP’s next meeting would be on March 13.  I was out of town for that meeting (also the reason it’s taken me so long to write a new post) but there was a lot on the agenda that’s of interest so I’ve caught myself up on the content and wanted to highlight a few things that deserve your attention:

-           Family Support Council (FSC).  DDS ( is seeking applications for membership on this new Council, which is being set up to ensure that D.C. government agencies are held accountable to citizens with intellectual and developmental disabilities and their families.  The CoP was set up in 2013 under a grant from the Department of Health and Human Services, and the FSC is being created to make sure there’s a continued voice for family concerns when the five-year grant comes to an end.

-           No Wrong Door (NWD).  Since October of last year DDS, in collaboration with other D.C. government agencies that deliver long-term support services to people with disabilities, chronic illnesses or other challenges, has been developing a three-year plan to streamline application processes and develop a customer-oriented entry point and person-centered procedures for all citizens in need of these services.  If the District gets a follow-up grant it will start implementing the NWD plan this fall.  If you’ve tried to figure out the world of service provision in D.C., you’ll know that this is really worth doing, so provide feedback and ideas if you have them, to Erin Leveton at

-           Supported Decision Making (SDM) Work Group.  In close collaboration with the Quality Trust, the CoP is setting up a work group to examine D.C. laws that may interfere with the ability of people to have family or friends involved in helping with their decision making.  This work group will have a short time fuse – the plan is for it to report in six months.   Either Erin (see above) or Rhonda White of the Quality Trust ( can tell you more about this effort.

I’m told that DDS is going to start posting minutes and other materials from the CoP meetings to its website ( and when that’s happening I’ll let folks know.  In the meantime, I’m attaching a number of handouts from the March 13 meeting, at this link:

The next meeting of the CoP will likely be in June.  The plan is for it to focus on community supports and organizations, and ways to ensure such information is regularly available and updated for those who need it.  It’s also possible that there will be a keynote by someone well placed in the new administration, presenting an opportunity to sensitize Mayor Bowser to the concerns of D.C. citizens with developmental disabilities.  Stay tuned to the DDS website and you’ll hopefully see information on the June meeting there by next month.