Mayor Adrian M. Fenty, Attorney General Peter Nickles and Department on Disability (DDS) Director Judith Heumann today announced substantial progress at the DC Department on Disability Services (DDS), emphasizing initiatives that have won praise from community organizations and the federal Centers for Medicare and Medicaid Services (CMS). Since the creation of DDS in March 2007, the Department has worked to better serve residents with disabilities by improving health care, expanding greater choice in home settings and services, and increasing community integration.
“The Department on Disability Services is winning widespread praise for its marked improvements to services for persons with intellectual and developmental disabilities,” said Mayor Fenty. “The District has moved aggressively to ensure a better quality of life for our most vulnerable residents.”
“It is clear that DDS is making a positive and powerful impact on the lives of the people with disabilities that it serves and earning the trust of all who care about them,” Attorney General Peter Nickles said.
“As we have built our team and undertaken reforms, national and local organizations have noticed our progress. There is still more work to be done, but we now have great momentum,” said DDS Director Judith Heumann.
More Individuals Living in Home Settings
This year, more individuals are living in less restrictive, community settings supported through the Developmental Disability (DD) Home and Community Based Services waiver than the more institutional Intermediate Care Facilities for the Mentally Retarded (ICF/MRs). DDS has worked to aggressively move individuals into less restrictive settings, providing increased access to disability services and supports. At the end of FY08, 1,234 District residents were enrolled in the DD waiver program. Today 1,293 District residents are enrolled in the waiver, with 510 individuals living with family members and receiving in-home supports. In total, 62% of all residential services are delivered through the DD waiver.
Improved Medicaid Waiver Implementation
The District has made steady progress in operating the DD waiver. The Centers for Medicare and Medicaid Services (CMS) previously required the Department of Healthcare Finance (DCHF) and DDS to complete a rigorous corrective action plan around care and service delivery, health and welfare, and administration of the Waiver. However, in February 2009, the District completed all elements of corrective action and was released from additional intensive DD waiver oversight by CMS.
Mortality Review and Fatality Review Committee
DDS has revamped the mortality review process to render a more timely, responsive and transparent system. The process improves data tracking and rapid records collection that help to highlight issues in quality care and preclude their reoccurrence. Upon case review, the Mayor’s Fatality Review Committee refers clinicians believed to be negligent to the appropriate District licensing boards for further investigation.
Expanded Health Care Initiative
DDS has expanded its Health Care Initiative, partnering with George Washington University (GWU) and Georgetown University (GU) to improve health services. GWU conducts monthly Advisory Board meetings that bring together medical and health policy experts to assist the District with improving health care services for residents with intellectual and developmental disabilities. The meetings discuss options and bring forward solutions on how to best serve residents with disabilities with an emphasis in the areas of health policy, education, finance, credentialing and legislation.
To add upon extensive improvements in patient care, DDS has created a pilot program to enhance care coordination, targeting 200 DDA waiver participants with complex medical or behavioral health issues. This program, led by GWU, provides improved patient services by assembling all the members of a client’s primary health care team to ensure that all health issues are being addressed, while focusing on high quality care and patient safety.
DDS has further strengthened the DC Health Resource Partnership (DCHRP), which began in 2006 as a collaborative dedicated to improving access and delivery of health care for District residents with intellectual and developmental disabilities. This partnership is led by faculty of the Georgetown University Medical School and the University Centers for Excellence. Under the 2008 Health Care Initiative, DDS has added additional resources to the DCHRP to form a robust team of medical professionals who have extensive experience working with individuals with development disabilities. The team works closely with providers to improve quality of care and consists of a Medical Director, a psychiatrist, several nurses, an occupational therapist, physical therapist, speech pathologist and behavioral psychologist. This team augments DDA’s Health and Wellness Unit and dramatically increases the capacity of DDS to provide intensive clinical support and oversight.
DCHRP also maintains an electronic health care database of high quality medical, nursing, dental, psychiatry, and behavioral health professionals. DCHRP has further developed and implemented a best practice curriculum to train medical students, medical residents and faculty at area hospitals to provide high quality medical care for DDS clients. At least 20 medical students and 30-35 medical residents from Georgetown and Howard Hospitals have been trained through this curriculum. Additionally 15-20 medical faculty from many area hospitals have been trained to work effectively with DDS clients.
“The Health Care Initiative has demonstrated the effectiveness of a public private partnership towards promoting primary and specialty care tailored to the needs of those with intellectual and developmental disabilities,” said Dr. Lisa Alexandra, Assistant Dean of Community Based Partnerships at George Washington University.
“The DCHRP is an innovative, groundbreaking and multidisciplinary approach where DDS works effectively with multiple partners to improve the quality of care for DC residents with intellectual and developmental disabilities” said Dr. Kim Bullock, Medical Director of the DCHRP.