Chapter 20. Direct Services to Individuals with Intellectual and Developmental Disabilities.
§ 4–2001. Definitions.
For the purpose of this chapter, the term:
(1) Repealed.
(2) "Direct care services" means home and community-based, rehabilitative, and Intermediate Care Facilities for Individuals with Intellectual Disabilities services authorized under the District of Columbia Medicaid State Plan or waivers thereof, including the District's Medicaid Home and Community-Based Services Waiver for Persons with Intellectual and Developmental Disabilities program, the District's Medicaid Home and Community-Based Services Waiver for Individual and Family Supports, and the District's Medicaid Home- and Community-Based Services Waiver for the Elderly and Persons with Physical Disabilities.
(3) "Direct care professional" means an employee of a direct care service provider who provides direct care services for at least 50% of the employee's work hours.
(4) "Direct care service provider" means an entity enrolled with the District of Columbia Medicaid program that provides direct care services.
§ 4–2002. Payment.
(a) By Fiscal Year 2026, the Mayor shall determine the reimbursement rate that the District will pay to direct care service providers for the provision of direct care services so that the reimbursement rate is sufficient to support direct care service provider payments to direct care professionals of a wage that, on average, is equal to at least the greater of either 117.6% of the District minimum wage pursuant to § 32-1003 or 117.6% of the District living wage pursuant to subchapter X-A of Chapter 2 of Title 2.
(a-1) In Fiscal Year 2025, the Mayor shall provide a supplemental payment from the Home and Community-Based Services Enhancement Fund, established pursuant to § 7-771.07d, to direct care service providers for the purpose of supporting payments to direct care professionals of a wage that, on average, is equal to at least the greater of either 117.6% of the District minimum wage pursuant to § 32-1003, or 117.6% of the District living wage pursuant to subchapter X-A of Chapter 2 of Title 2.
(b) In determining the reimbursement rate to be provided to an eligible direct care service provider under this section, the Mayor shall consider:
(1) If applicable, the then-current reimbursement rates paid by the District to direct care service providers under the District of Columbia Medicaid State Plan or waivers thereof;
(2) The total cost, including wages, that the direct care service provider incurred during the previous year in providing direct care services;
(3) The additional operating support that the direct care service provider may need to allow it to pay its direct care professionals in accordance with the requirements of this section; and
(4) Any other factor the Mayor considers relevant to the determination of the reimbursement rate.
§ 4–2003. Calculating the annual payment. [Repealed]
Repealed.
§ 4–2003.01. Report to Council.
The Mayor shall, by October 1, 2022, and each year thereafter, submit a written determination to the Council on the reimbursement rate to be provided to direct care service providers for the upcoming year pursuant to § 4-2002.
§ 4–2004. Eligibility for payment.
(a) It shall not be a violation of this act for a direct care service provider to pay a direct care professional less than 117.6% of the District minimum wage pursuant to § 32-1003, or 117.6% of the District living wage pursuant to subchapter X-A of Chapter 2 of Title 2 if the direct care service provider creates a tiered compensation schedule that:
(1) Considers a direct care professional's qualified experience in the field and their demonstrated competency; and
(2) Ensures that, on average, all direct care professionals were paid a wage that is equal to at least the greater of either 117.6% of the District minimum wage pursuant to § 32-1003 or 117.6% of the District living wage pursuant to subchapter X-A of Chapter 2 of Title 2.
(b) During Fiscal Year 2026 and each fiscal year thereafter, a direct care service provider reimbursed by the District at a rate established pursuant to this act shall demonstrate to the Mayor that it paid its direct care professionals a wage that, on average, is equal to at least the greater of either 117.6% of the District minimum wage pursuant to § 32-1003 or 117.6% of the District living wage pursuant to subchapter X-A of Chapter 2 of Title 2 in the service provider's operating budget cycle, inclusive of overtime wages and bonuses, to remain eligible for payment for the current year.
(c) A direct care service provider who received a supplemental payment from the District in Fiscal Year 2025 pursuant to § 4-2002(a-1) shall demonstrate to the Mayor that it paid its direct care professionals a wage that, on average, is equal to at least the greater of either 117.6% of the District minimum wage pursuant to § 32-1003, or 117.6% of the District living wage pursuant to subchapter X-A of Chapter 2 of Title 2, in the service provider's operating budget cycle, inclusive of overtime wages and bonuses.
§ 4–2005. Rules.
The Mayor, pursuant to subchapter I of Chapter 5 of Title 2, may issue rules to implement the provisions of this chapter, including rules relating to enforcement of this chapter and relating to fines and penalties for failure to comply with any provision of this chapter.
§ 4–2006. Applicability.
This chapter shall not apply until such time that the Centers for Medicare and Medicaid Services approves any amendments to the Medicaid State Plan or waivers that are necessary to implement this chapter.
