Staying Informed on the Georgetown Health Contract

In addition to the comment that Andy Reese, director of D.C.’s Department on Disability Services (DDS) posted at the end of my blog post on July 5, “Andy, You Need a Plan” (https://www.DDinWDC.com/2019/07/andy-you-need-plan.html), he issued a formal statement via email on July 12 which I quote in full below:

Several people have reached out recently expressing concern that the Department on Disability Services’ (DDS’s) contract with Georgetown’s University Center for Excellence in Developmental Disabilities (UCEDD) will conclude at the end of August 2019.  Although this contract is ending, and the mechanism for providing these services may change, as DDS Director I want to clarify for you that no services currently available under this contract to people supported by DDS’s Developmental Disabilities Administration are being terminated.  DDS will continue to ensure that people receive high quality, innovative services from DDS and our provider network.

The UCEDD has been a vital partner with DDS for the past thirteen years, and its Developmental Disabilities Administration Quality Assurance Health Initiative (DDA Health Initiative) was a critical component over many years. Together, we strengthened our system’s ability to support people with intellectual disabilities living with complex clinical and medical needs within our community. Today, our service delivery system has matured to the point that the services not already provided under the Medicaid Home and Community-Based Services (HCBS) Waiver for Persons with Intellectual Disabilities can be successfully transitioned to agency staff and other providers.  

With the expiration of Georgetown’s latest contract on August 31, 2019, which included a base year and four, one-year options, DDS revisited each of the elements of the contractual requirements to determine how best to deliver those services. Two of the services included in the current contract (i.e. Parenting Support and Sexuality Education) are now HCBS waiver services for which DDS has adequate providers. For the remaining services, DDS will be continuing services through in-house staff or external contracts. The development and provision of training, technical assistance and onboarding of new nurses will continue and be provided by the DDS’s State Office of Policy, Planning and Innovation (SOPPI). Already SOPPI has hired a registered nurse trained as a nurse educator who has experience providing this type of support. Having this position within DDS’s office on innovation ensures a focus on best practices in the field of ID. Coordination of care will continue to be supported during hospitalizations, sub-acute, and long-term acute care placements by a transition specialist under a contract, with the flexibility in hours and scheduling to enable the specialist to successfully support people in their evening, night and weekend work. DDS plans to contract with a physician who will continue the work of serving as a liaison between physicians, specialists, surgeons, providers and DDS. This contractor will have the same flexibility in both hours and scheduling. 

We are actively working with Georgetown University to transition all of these activities. This transition has been thoughtfully planned. I am confident that all necessary services will continue, without interruption. DDS will continue to move forward in ensuring the health and safety of people with intellectual disabilities and providing innovative high quality services that enable people with disabilities to lead meaningful and productive lives as vital members of their families, schools, workplaces and communities in every neighborhood in the District of Columbia.

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Andrew Reese, Director

DC Department on Disability Services

At the same time, today’s Washington Post contains this follow-up article by Theresa Vargas: https://tinyurl.com/y2kj7sjq, which quotes former DDS director Laura Nuss on the subject.  Andy’s comment on my blog, and his follow-up statement above, tells such a different story from that told in the Post that it can be quite hard to disentangle.  Hopefully, the human services committee’s roundtable on July 23 (https://dccouncil.us/event/committee-of-the-whole-human-services-public-roundtable/) will give everyone the full picture.  What I will say for now is this, though:

This is yet another example of DDS’ not engaging its stakeholders adequately at the front end – having not adequately explained and discussed ahead of time with stakeholders where it’s proposing to take health services in the future, it has laid itself open to a media furor.  Much of this could have been avoided.  More broadly, I do not personally feel satisfied by the invitation Andy extended in his July 9 comment contained below, for people to join established DDS working groups in order to shape the future of disability services:  DDS needs to reach out to people in a more open-ended, receptive way about the strategic direction of the Department.  Otherwise I’m afraid we will all be seeing too many disagreements playing out in the pages of the Post, and that is in no one’s best interests.