Medicaid Authorized Representative in DC — How to Apply on Your Parent's Behalf

What an Authorized Representative Can Do

When your aging parent needs long-term care Medicaid in the District of Columbia — whether it's the EPD Waiver, nursing facility Medicaid, or State Plan Personal Care Aide services — someone has to submit the application, provide the financial documentation the program requests, respond to requests for additional information, and attend eligibility interviews. EPD Waiver and nursing facility applications involve a 60-month financial review; State Plan Personal Care Aide and Adult Day Health programs do not use that 60-month look-back. If your parent can't do this themselves, an authorized representative steps in.

Under 42 CFR § 435.923, DC Medicaid allows an applicant or beneficiary to designate an authorized representative who can act on their behalf for all Medicaid-related communications. This includes:

• Submitting the Long-Term Care/Waiver Medicaid Application to the Department of Health Care Finance (DHCF) or the Department of Aging and Community Living (DACL)
• Signing renewals and recertifications
• Providing requested documentation (bank statements, asset records, medical evaluations)
• Communicating with the DHS Public Benefits Call Center at 202-727-5355
• Receiving eligibility determinations and notices
• Filing appeals if the application is denied

The authorized representative designation is specific to Medicaid — it doesn't give you authority over your parent's bank accounts, medical decisions, or any other area. For broader authority, you need a durable power of attorney or guardianship.

How the Designation Works

If your parent has capacity and can sign documents, the process is straightforward. The Long-Term Care Medicaid Application includes a section where the applicant names an authorized representative and signs the designation. Once submitted, DHCF recognizes you as the contact for all matters related to that application.

If your parent lacks the capacity to sign the designation, you can still serve as authorized representative if you have one of these:

• A durable financial power of attorney that specifically grants authority to manage government benefits. The POA must include language authorizing the agent to apply for, manage, and appeal public benefits on the principal's behalf. DHCF will review the POA to confirm this authority.
• A court-appointed guardianship or conservatorship. If you're the court-appointed guardian or conservator, your letters of appointment serve as the basis for the authorized representative designation.

The federal regulation explicitly recognizes both voluntary (POA) and involuntary (court-ordered) fiduciaries as eligible authorized representatives. You don't need both — either path works.

Why This Matters for the EPD Waiver Application

The EPD Waiver application is one of the most document-intensive processes a family navigates. DACL's Medicaid Enrollment Unit (250 E Street SW, Washington, DC 20024) requires:

• A completed, signed Long-Term Care Medicaid Application
• The Waiver Beneficiary Freedom of Choice Form
• The Case Management Attestation Form (ranking preferred case management agencies)
• Continuous bank statements, investment records, and life insurance policies spanning the prior 60 months

DHCF has an administrative processing window of up to 45 days from submission to decision. During that window, the agency may request additional documentation — a missing bank statement, clarification on a transferred asset, verification of an insurance policy. Respond by the deadline stated in any notice and keep copies of what you send.

As authorized representative, you're the one receiving these requests and responding. Without the designation, communications may continue to go to your parent — who may not be able to read, understand, or respond to the correspondence — making it harder to answer on time.

The Relationship to Other Legal Instruments

The authorized representative designation and a durable POA serve different purposes, and one doesn't replace the other:

If your parent already has a durable POA that names you as agent with government benefits authority, you can use it to establish yourself as authorized representative. But the POA alone doesn't automatically make you the authorized representative — you still need to submit the designation to DHCF or complete the relevant section of the Medicaid application.

Getting the Documents Right

The most common problem families face isn't the Medicaid application itself — it's discovering that their parent's existing POA doesn't include government benefits authority, or that it wasn't properly notarized, or that the language is too vague for DHCF's compliance review.

The DC Power of Attorney & Guardianship Kit includes the specific government benefits authority clause that DHCF and DACL require, along with the EPD Waiver application workflow and the authorized representative designation process — so you're not piecing it together from three different agency websites.

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