How to Apply for DC's EPD Waiver Without a Case Manager

You don't need a case manager to start the EPD Waiver process in DC — and in fact, you can't get one assigned until you're already three steps into the application. The District's EPD Waiver workflow runs through intake, medical certification, and a functional assessment before case manager selection ever comes up. That means the part families assume requires professional help is actually the part you're expected to navigate yourself first.

Here's the exact sequence, agency by agency, so you can move through the first three steps without waiting on anyone to be assigned to your case.

Why This Confuses Families

Most people assume a case manager is the entry point — someone assigned to your parent's case who then walks you through everything else. In DC, it's the reverse. A case manager is selected at Step 4, after your parent has already been screened for basic eligibility, medically certified as needing assistance, and clinically assessed by Liberty Healthcare. Waiting for a case manager to appear before you start is one of the most common reasons families lose weeks at the front of the process.

Step 1: DACL Intake

Call the Department of Aging and Community Living's Aging and Disability Resource Center (ADRC) at 202-724-5626. This is free, and it's the single entry point for the EPD Waiver. You're screening for two basic criteria: your parent must be either age 65 or older, or between 18 and 64 with a qualifying disability. DACL will initiate an Intake Referral Screening Form based on your parent's demographics and contact details. There's no clinical evaluation at this stage — it's a basic eligibility screen to open the case.

What to have ready: your parent's full name, date of birth, address, and a brief description of the care need (fall risk, difficulty with daily tasks, cognitive changes). If you're calling on your parent's behalf, be prepared to explain your relationship and, ideally, have Power of Attorney documentation available if you'll be signing anything later.

Step 2: Medical Certification (The Prescription Order Form)

This is the step that trips up the most families, and it doesn't involve DACL at all — it requires your parent's primary care physician. The physician (or an enrolled Advanced Practice Registered Nurse) must complete a Prescription Order Form (POF) certifying medical need for home care services, based on documented physical or cognitive impairment.

The critical detail: the physician's office must be enrolled as a DC Medicaid provider. If they aren't, the POF cannot be entered into DC Care Connect, the back-end system that routes the request to the next step, regardless of how complete the form looks. Before your parent's next appointment, call the physician's office directly and ask two questions: are you enrolled as a DC Medicaid provider, and can you complete a Prescription Order Form for EPD Waiver eligibility? If the answer to the first question is no, you need to find a physician who is enrolled before this step can move forward.

What to bring to the appointment: a detailed description of your parent's daily functional limitations — specific difficulty with bathing, dressing, mobility, medication management, or cognitive tasks. Vague descriptions produce vague certifications, which can slow the next step.

Step 3: The Functional Assessment (Liberty Healthcare)

Once the POF is uploaded, DHCF and Liberty Healthcare — the clinical contractor that conducts the state's functional assessments — are notified that an in-person evaluation needs to be scheduled. This assessment uses the interRAI Home Care Assessment Protocol, and your parent needs a total score of 9 points or higher across the evaluation to establish a Nursing Facility Level of Care (NFLOC), which is the clinical threshold required for EPD Waiver eligibility.

This is a free, in-person evaluation conducted in your parent's home. It covers activities of daily living (ADLs), cognitive status, and safety risks. If you're not local, arrange for someone who can be present — a sibling, a trusted neighbor, or, if no one is available, look into whether your parent's case management agency (once selected) or a private geriatric care manager can help coordinate this.

How to prepare: don't let your parent minimize their limitations out of pride during the assessment, which happens often. Walk through specific recent incidents beforehand — a fall, a missed medication, a stove left on — so the assessor gets an accurate picture rather than an optimistic one from a parent trying to seem more capable than they are.

What Happens After Step 3 — This Is Where the Case Manager Comes In

Only after DACL intake, the POF, and the Liberty Healthcare assessment are complete does Step 4 — Case Manager Selection — begin. At this point, your family selects and ranks your top three preferred case management agencies from DACL's approved list. From here, the case manager helps with Step 5 (submitting the complete application packet), Step 6 (the financial Medicaid application through DHS), and Step 7 (designing the Person-Centered Service Plan).

In other words: everything before this point is on you. Everything after it, a case manager can help carry.

Common Points of Failure in the First Three Steps

An unenrolled physician. This is the single most common silent stall. The POF can look perfect and still go nowhere if the signing provider isn't registered with DC Medicaid.

Assuming DC Care Connect is something you can log into. It isn't. DC Care Connect is a provider-facing system used by physicians' offices, case management agencies, and DHCF — not a portal for families. If you want a status update, you have to call and ask a specific person a specific question; there's no dashboard to check yourself.

Underselling functional need during the assessment. A parent who says "I'm fine, I just need a little help sometimes" during the Liberty Healthcare assessment can end up scoring below the 9-point NFLOC threshold, even if daily reality looks very different. Prepare specific, factual examples in advance.

Not tracking the timeline. The standard window from intake to an approved application is 45 to 90 days, but that assumes clean handoffs at every stage. If several weeks pass with no update, call DACL's intake line and ask specifically whether the POF has been uploaded and whether the assessment has been scheduled — a vague "checking on my application" question tends to get a vague answer.

Who This Is For

• Adult children starting the EPD Waiver process for the first time who don't yet have a case manager and weren't sure they could do anything without one
• Families whose parent's physician hasn't yet completed a Prescription Order Form
• Anyone who has called DACL, gotten a case number, and then wasn't sure what to do next while waiting for a case manager to be assigned

Who This Is NOT For

• Families already past Step 4 with an active case manager — at that point, your case manager is the right point of contact for next steps, not a self-service guide
• Situations where your parent's physician refuses to complete a POF or won't enroll as a DC Medicaid provider — this may require finding a new primary care physician, which is a separate problem from the application sequence itself
• Anyone needing to appeal a denial from an earlier point in the process — that requires DHCF's formal appeal channels, not a restart of the intake steps

Frequently Asked Questions

Do I need a case manager to even start the EPD Waiver application?

No. Case manager selection is Step 4 in the process, after DACL intake, medical certification via the POF, and the Liberty Healthcare functional assessment are already complete. You can and should start the first three steps on your own.

What if my parent's doctor isn't enrolled as a DC Medicaid provider?

The Prescription Order Form cannot be processed through DC Care Connect if the signing physician isn't an enrolled DC Medicaid provider. You'll need to either ask the current physician's office to enroll or find a new primary care provider who already is. Confirm this before the appointment, not after submitting the form.

How long does it take to get from intake to an approved waiver?

The standard processing window is 45 to 90 days, assuming each step is completed cleanly. Delays most often happen because of an unenrolled physician, an incomplete POF, or a scheduling gap for the Liberty Healthcare assessment — not because of anything wrong with the application itself.

What score does my parent need on the functional assessment?

The interRAI Home Care Assessment Protocol requires a total score of 9 points or higher to establish a Nursing Facility Level of Care, which is the clinical eligibility threshold for the EPD Waiver.

Can I check my parent's application status online?

No. There's no consumer-facing status portal for the EPD Waiver's clinical and application steps. DC Care Connect, the system that routes information between agencies, is provider-facing only. For a status update, call DACL's Information and Referral/Assistance line at 202-724-5626 and ask a specific question about where your parent's case stands.

Is the EPD Waiver guaranteed once my parent qualifies clinically and financially?

No. The EPD Waiver is not an entitlement — it has a capped number of slots, and enrollment is prioritized first-come, first-served rather than by medical urgency. Starting the process as early as possible, even before a full crisis, matters because there's no expedited track for urgent cases.

If you're navigating the EPD Waiver's early steps right now, the DC Aging in Place Guide includes the full 7-step application roadmap, the exact documents each agency requires, and scripts for the phone calls that move a stalled case forward.

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