Code of the District of Columbia

§ 1–1503.01. Reorganization Plan No. 2 of 1979

(Effective February 21, 1980)

Prepared by the Mayor and transmitted to the Council of the District of Columbia on November 20, 1979, pursuant to the provisions of Section 422(12) of the District Charter.

D.C. DEPARTMENT OF HUMAN SERVICES

I. Establishment There is established, in the Executive Branch of the Government of the District of Columbia, the Department of Human Services headed by a Director of Human Services, who shall coordinate and direct the operations of the department through the Commissioners of Public Health and Social Services and subordinate organizational components established herein.

II. Purpose The Department of Human Services is established to assure that public health and social service policy is developed and implemented in response to the needs of individuals and families in the District of Columbia, and to promote the health, mental health and well-being of District residents through the delivery of high quality and equitably distributed services and income assistance programs.

III. Organization There are hereby established in the Department of Human Services: (1) the Office of the Director, with such subordinate staff offices as are required to carry out overall management responsibility for the Department, planning and policy review, and assurance of compliance with statutes and regulations affecting the department; the state responsibility for education and veterans programs shall also be placed in the Director's office; (2) the Office of Public Health, headed by a Commissioner of Public Health who shall be delegated responsibility for developing and implementing health programs through subordinate staff offices and administrations; and (3) the Office of Social Services, headed by a Commissioner of Social Services who shall be delegated responsibility for developing and implementing social service programs through subordinate staff offices and administrations.

IV. Functions The functions of the major organizational components of the Department shall be as follows:

A. Office of the Director of Human Services Oversees operations of a large, complex health and social services agency.

Provides policy leadership to evaluate and improve human services in the District of Columbia, coordinating public programs with private services to achieve equitable, high quality health care and social services for all citizens. Coordinates human services at the delivery and at the policy level, both within the Department and with other District agencies. Analyzes needs of District residents in health, social services, and related areas, and evaluates response of public programs to those needs.

Advises the Mayor and the City Administrator on all aspects of human resource programs, implementing Mayoral policy priorities and recommending specific actions to assure effective utilization of resources.

Assures effective management throughout the Department by means of supervision of key officials, and final approval of major policies and decisions (resource allocation, state plans and grant proposals, legislative or organizational recommendations, personnel actions, contracts and procurement). Assures compliance of health and social services facilities with federal and state regulations standards. Exercises quality control to minimize waste or abuse in large scale transfer payment programs. Assures the efficient and effective use of resources, including both dollars and personnel. Develops and makes operational policies, procedures and systems to assure coordination and integration at all levels within the Department, and with related programs.

Carries out responsibilities through delegation of major functions to a Commissioner of Public Health and a Commissioner of Social Services. Also supervises nine staff offices as follows:

(1) STATE EDUCATION AFFAIRS Develops and administers state plans and programs for State Student Incentive Grants, postsecondary student loan programs, and programs authorized by the Higher Education Act of 1965.

(2) VETERANS AFFAIRS Provides counseling, representation, technical assistance, and support services to veterans, their dependents and beneficiaries. Obtains for its clients the rights, benefits and privileges for which they are eligible.

(3) ADMINISTRATION Responsible for administrative support systems: procurement, contracting, property and supply management, forms management, operation of facilities, audio-visual services, printing, mail, messengers, transportation.

(4) CONTROLLER Coordinates the formulation, justification and presentation of DHS's annual budget submission. Exercises control over DHS expenditures; administers Financial Management System and cost analysis programs. Issues periodic reports to program officials. Maintains control over authorized personnel ceiling.

(5) LICENSING AND CERTIFICATION Consolidates legislative and administrative regulations for health and social services facilities and services. Establishes and implements licensing procedures. Certifies providers for Medicaid reimbursement. Provides nursing and nutrition consultation services.

(6) POLICY AND PLANNING Develops and assures the implementation of the comprehensive state health plan, the state mental health plan, and the medical facilities plan, performing the functions of the State Health Planning and Development Agency, as required by P.L. 93-641 and P.L. 93-64, within the overall framework of District of Columbia comprehensive planning. Assures compliance of District health facilities and providers with state planning goals by implementing the Certificate of Need and federal grant review functions defined by P.L. 93-641. Keeps the Director and the Commissioner of Public Health advised of laws, regulations and policies affecting health services planning. Provides technical and staff support to the State Health Coordinating Committee (SHCC). Reviews and provides for SHCC review of the state health and mental health plan, alcoholism prevention plan, substance abuse plan, and categorical grant requests in compliance with local, state and federal guidelines and District policy goals.

Develops and assures the implementation of the comprehensive state social services plan required by Title XX of the Social Security Act. Keeps the Director and the Commissioner of Social Services advised of laws, regulations and policies affecting social services planning and delivery. Reviews all state and categorical social service plans for compliance with local, state and federal guidelines and District policy goals.

Collects and publishes data and statistics in regard to health care and social services utilization, and selected health and social status indices.

(7) FAIR HEARINGS Assures a hearing to an applicant for or recipient of any type of assistance or service provided by the Department of Human Services, to an applicant for or recipient of a license granted by the Department of Human Services, or to the provider of any service pursuant to a contract with the Department of Human Services, whose claim or application has been denied or who is aggrieved by any other action or inaction of the Department of Human Services which affects the receipt, suspension, reduction, or termination of his assistance.

(8) INSPECTION AND COMPLIANCE Assures compliance with statutes and regulations governing the Department by clients, vendors and employees; conducts quality control audits and investigations; maintains security within the Department.

(9) INFORMATION SYSTEMS Develops, coordinates and operates all automatic data processing systems throughout the Department.

B. Office of the Commissioner of Public Health Oversees planning, financing and delivery of city-wide health care programs and services.

Provides policy leadership and advocacy for assuring equitable access to high quality health and mental health care services; for encouraging the development of high quality health care and hospital services; promoting restraint of health care costs; for assuring the participation of consumers and providers in health and mental health care policy making; and for the overall promotion of health advocacy in the District of Columbia.

Develops and implements management systems, organizational structures, and procedures to assure (1) cost-effective use of public resources to accomplish program goals; (2) full compliance with legislation and regulations affecting health care delivery which are delegated to the Department; and (3) coordination of programs with D.C. General Hospital, with the Office on Aging, and with private sector institutions and health professionals.

Provides policy and program guidance for special initiatives such as health promotion, deinstitutionalization, improved maternal and child health, and improved dental care.

Programs are carried out in four staff offices and five line administrations:

(1) OFFICE OF HEALTH PLANNING AND DEVELOPMENT Has delegated responsibility to develop preparatory material for comprehensive state health and mental health plans. Assists appropriate administrations in program planning and the preparation of federally required state plans, categorical plans, and grant proposals in accordance with the provisions of applicable federal legislation and within the overall framework of District of Columbia comprehensive planning.

Provides technical guidance and assures compliance with federal and state regulations and guidelines governing the submission and implementation of state plans. Keeps the Commissioner advised of pending or proposed legislation and national programs affecting health policies and service delivery.

(2) OFFICE OF CHIEF MEDICAL EXAMINER Administers technical programs and services for the medical investigation of all except clearly natural deaths in the District of Columbia, in accordance with the provisions of Section III of P.L. 91-358 and Commissioner's Order 71-16 as amended.

(3) OFFICE OF HEALTH CARE FINANCING Administers the Medicaid program in respect to policy, scope of service, utilization and compliance with federal guidelines, delegating eligibility determination to the Payments Assistance Administration, and billing and payments to the Office of the Controller. Administers the Medical Charities programs, delegating eligibility determination and payments as above. Provides the Commissioner of Public Health with policy analysis of the impact of Medicare, Medicaid, and Medical Charities programs on the access of low-income and elderly citizens to equitable and high quality health care. Analyzes and recommends rate setting and other mechanisms for appropriate public actions to contain rising medical care costs.

(4) OFFICE OF EMERGENCY MEDICAL SERVICES Assures an effective level of emergency medical services for District residents, workers and visitors, through the establishment and enforcement of state regulations and the designation of cost-effective and well equipped trauma centers. In collaboration with the Fire Department maintains adequate ambulance and paramedic services.

(5) PREVENTIVE HEALTH SERVICES ADMINISTRATION Provides policy leadership to assure the promotion of District residents' health through the development of sound preventive and educational programs which focus on community-based environmental health. Implements state plans for tuberculosis and venereal disease control, lead poisoning control, and maternal and child nutrition programs. Directs programs for prevention and control of communicable and chronic diseases, childhood diseases and cancer. Manages community education programs to promote the health of District residents in relation to smoking, hypertension, accident prevention, and like problems. Operates the Central Laboratory. Analyzes data on morbidity and mortality rates and causes, and recommends program priorities to the Commissioner of Public Health.

(6) AMBULATORY HEALTH CARE ADMINISTRATION Develops, recommends and implements a program of outpatient health care, including needs assessment, resource allocation, scope of services, work force needs, service priorities and strategies for cooperation with private providers. Administers a network of clinic-based services which are preventive, diagnostic, therapeutic and restorative for persons neither hospitalized nor institutionalized. Promotes a high-quality and cost-effective system which emphasizes coordinated and comprehensive care to the patient, while maintaining expertise in identifiable categorical units.

(7) LONG TERM CARE ADMINISTRATION Develops, recommends and implements a program of long term health care, including needs assessment, resource allocation, scope of services, comparative analysis of direct operation and contractual services, work force needs, service priorities and strategies for cooperation with private providers and the Office on Aging. Administers facilities for patients in need of skilled or intermediate nursing care or long-term treatment and rehabilitation (D.C. Village, Glenn Dale Hospital and J.B. Johnson Extended Care Facility). Promotes deinstitutionalization of such patients and the development of sufficient nursing home capacity to accommodate the need. Administers home care, and nursing services to assist eligible aged and disabled patients who do not require inpatient care or supervision.

(8) MENTAL HEALTH CARE ADMINISTRATION Assists in the development of a mental health care plan which meets the requirements of P.L. 93-64 and the needs of District residents, as well as making maximum use of cooperative services developed with Saint Elizabeths Hospital. Provides policy and program leadership for community support programs for patients on convalescent leave or discharged status from Saint Elizabeths Hospital. Emphasizes priority problems including the needs of alienated or disturbed youth. Administers a network of Community Mental Health Centers, consultation services, preventive education, suicide prevention and forensic psychiatry services. Works closely with Ambulatory Health Care Administration and Alcohol and Drug Abuse Administration to make maximum cost-effective use of clinical and preventive resources for related programs.

(9) ALCOHOLISM AND DRUG ABUSE ADMINISTRATION Develops, recommends and implements state alcoholism and drug abuse plans which meet the requirements of P.L. 92-225 and the needs of District residents. Works closely with Ambulatory Health Care Administration and Mental Health Services Administration as well as the courts and the Corrections Department to make maximum cost-effective use of clinical and preventive resources for related programs. Provides policy leadership for community-based prevention, education and treatment programs. Administers detoxification and rehabilitation centers, residential treatment centers and outpatient clinics for the treatment of alcoholics and substance abusers.

C. Office of the Commissioner of Social Services Oversees planning, financing and delivery of city-wide social services programs.

Provides policy leadership and advocacy for assuring equitable access to high quality day care, child welfare, rehabilitation and family services; developing and implementing strategies to promote cooperation with voluntary associations and private providers; assuring the participation of consumers and providers in policy making; and the promotion of family stability and economic independence for District residents.

Develops and implements management systems, organizational structures, and procedures to assure (1) accurate assessment of economic and social status and needs of District residents; (2) cost-effective use of public resources to accomplish program goals; (3) full compliance with legislation and regulations affecting social services delivery which are delegated to the Department; (4) coordination of programs with the Office on Aging, the Departments of Corrections, Recreation, Housing and Community Development and Labor, the Court system and Corporation Counsel [now Attorney General for the District of Columbia], and with private sector institutions and professionals; and (5) prevention of fraud and abuse in payments assistance programs.

Provides policy and program guidance for special initiatives such as the deinstitutionalization of mentally retarded and developmentally disabled persons from Forest Haven; response to the growing need for help for abused and neglected children and their families; coordination of city-wide programs to serve youth; and the development of high quality day care services.

Programs are carried out in one office and five line administrations:

(1) OFFICE OF SOCIAL SERVICES PLANNING AND DEVELOPMENT Has delegated responsibility to develop preparatory material for comprehensive social services planning. Assists appropriate program administrations in the development of the annual and long range state plans for Food Stamps, cash assistance, child welfare, and the Mentally Retarded and Developmentally Disabled, categorical plans and grant proposals in accordance with the provisions of applicable federal legislation and within the overall framework of District of Columbia comprehensive planning. Provides technical guidance on compliance with federal and state regulations and guidelines governing the submission and implementation of state plans. Keeps the Commissioner advised of pending or proposed legislation and national programs affecting social services policies and service delivery.

(2) MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES SERVICES ADMINISTRATION Develops, recommends and implements a program of services to the mentally retarded and developmentally disabled, including needs assessment, resource allocation, and program priorities. Implements the Constitutional Rights of the Mentally Retarded Act of 1979. Operates Forest Haven facility, and assures appropriate outplacement of residents. Administers diagnostic, educational, therapeutic, and home-based services. Coordinates programs with Vocational Rehabilitation Administration.

(3) VOCATIONAL REHABILITATION ADMINISTRATION In cooperation with the Office of Social Services Planning and Development, provides for needs assessment, and develops state plan for resource allocation, program priorities and rehabilitation services to physically, mentally and emotionally disabled residents. Determines eligibility for federal social security disability programs. Administers state plan and individual rehabilitation plans for District residents eligible under provisions of the Vocational Rehabilitation Act.

(4) YOUTH SERVICES ADMINISTRATION Provides institutional and after care services to youth who are adjudicated delinquents, or are in pre-hearing and pre-trial status. Operates the Receiving Home for pre-hearing detention, and the Cedar Knoll School and the Oak Hill Youth Center for adjudicated detention. Administers alternative group homes for status offenders and pre-trial detention. Works closely with the public schools, the Department of Labor, the Department of Recreation and the juvenile justice system to assure city-wide education, training, employment and recreation opportunities for youth.

(5) CHILD AND FAMILY SERVICES ADMINISTRATION Assists in the development of needs assessment and state plan priorities for Title XX services. Develops cooperative and contractual arrangements for Title XX services administered in other organizational units. Develops, recommends and implements a program of child welfare services. Implements the Prevention of Child Abuse and Neglect Act of 1977 (P.L. 2-22). Administers adult protective and emergency shelter services.

(6) INCOME MAINTENANCE ADMINISTRATION Provides financial, medical and food stamp assistance to eligible residents of the District. Determines eligibility for programs. Maintains case files and performs regular recertifications to prevent fraud and abuse. Works closely with the Child and Family Services Administration to integrate client intake at service sites. Issues manuals and trains workers for eligibility determinations. Assures compliance with federal regulations and guidelines governing transfer payment programs.

V. Transfers There is hereby transferred to the Director of Human Services all powers, duties, and functions assigned or delegated to the Director of the Department of Human Resources as of the date immediately prior to the effective date of this Reorganization Plan. All positions, property, allocations, and other funds, available or to be made available relating to the powers, duties and functions assigned herein are hereby transferred to the Department of Human Services.

VI. Realignment The Director of Human Services, in the performance of assigned duties and functions, is authorized to complete the realignment of the organizational components of the Department herein established by means of redelegations of functions among organizational units and reassignment of departmental positions among control and responsibility centers, or by the elimination or establishment of alternative responsibility centers, in order to accomplish the following specific objectives:

1. To strengthen management capacity at the supervisory level of individual programs, and to clarify the missions of program chiefs.

2. To consolidate functions as appropriate to reduce duplication, and improve cost-effectiveness.

3. To consolidate the resources necessary to improve response to legal challenges and implementation of court orders which affect service delivery, and to implement new legislation.

4. To restructure the facilities management and operations functions so that directors of facilities have full responsibility for cost-effective management, for certification of facilities in order to gain federal reimbursement, and for compliance with existing codes and regulations.

5. To restructure the materiel support and procurement functions so that program managers have full responsibility for the development, oversight and evaluation of negotiated services contracts and for compliance with regulations governing the terms of contracts, and so that the procurement of goods and services is accomplished as efficiently and cost-effectively as possible.

6. To restructure the audio-visual and printing services and the consumer information and volunteer coordination functions to make maximum use of these resources throughout the Department.

7. To restructure the Office of the Controller so that the Commissioner of Public Health and the Commissioner of Social Services have adequate fiscal management and budget office resources to perform the high level of budget development and control expected of them.

8. To restructure all data processing, collecting and management information systems offices throughout the Department, in order to improve the accuracy, timeliness, and utility of all such systems.

9. To restructure the licensing and certification functions to assure high level professional participation in state regulation of services, and to avoid potential conflicts of interest between program expansion and strict adherence to high standards.

10. To restructure the state planning functions within the agency to create an appropriate division of responsibility and coordination among the program levels of the department.

11. To restructure the immediate offices of the Commissioners of Public Health and Social Services to assure the most effective staffing patterns to achieve management oversight and leadership on major policy initiatives.

12. To develop greater emphasis on health education, promotion, advocacy and prevention programs.

13. To improve coordination of mental health care services with St. Elizabeths Hospital, and more effectively to address the judicial mandate on deinstitutionalization.

14. To focus appropriate resources on long term care needs and the development of public and private resources to meet those needs.

15. To develop leadership for a more responsible and responsive dental care system.

16. To develop a more adequate Emergency Medical Services system for the District.

17. To develop a more adequate city-wide program to address the needs of the mentally retarded and developmentally disabled, more effectively to carry out the deinstitutionalization program at Forest Haven, and to coordinate more closely with other rehabilitation programs.

18. To restructure the Youth Services and Child and Family Services Administration to consolidate programs where appropriate and manage services more effectively.

VII. Abolishment The District of Columbia Department of Human Resources is hereby abolished.

VIII. Effective Date This Reorganization Plan No. 2 of 1979 shall become effective in accordance with Section 422(12) of P.L. 93-198.