Medicaid Home Care Waiver in DC
Medicaid Home Care Waiver in DC
Moving a parent into a nursing home isn't always the right call — and it's not always necessary. DC's EPD Waiver funds intensive home care services through Medicaid, allowing your parent to stay in their own home with professional support.
The program covers everything from personal care aides to home modifications, and includes an option to self-direct the entire care arrangement.
What Home Care Services the EPD Waiver Covers
The Elderly and Persons with Physical Disabilities Waiver funds these services when delivered in the parent's home:
- Personal care aide (PCA) services — assistance with bathing, dressing, toileting, transfers, mobility, and eating
- Home health aide services — skilled personal care under a nurse's supervision
- Homemaker services — meal preparation, light housekeeping, laundry, grocery shopping
- Adult day health programs — structured daytime programs outside the home with medical oversight and socialization
- Environmental accessibility adaptations — wheelchair ramps, bathroom grab bars, stair lifts, doorway widening
- Personal emergency response systems — wearable alert buttons connected to 24-hour monitoring
- Respite care — temporary relief for family caregivers
Services My Way: Self-Directed Care
The EPD Waiver includes a participant-directed option called "Services My Way." Under this model, your parent (or their designated representative) acts as the employer of their care workers. You recruit, hire, train, schedule, and manage Participant-Directed Workers (PDWs) — choosing the people who provide care rather than accepting whoever an agency assigns.
A contracted fiscal intermediary (such as Public Partnerships LLC) handles the administrative burden: processing timesheets, running payroll, withholding taxes, and issuing W-2 forms. The family focuses on care quality and scheduling while the paperwork is managed.
This model gives families significantly more control over who provides care, when they show up, and how care is delivered. It also tends to produce more consistent caregiving relationships than agency-assigned rotation schedules.
Eligibility for Home Care Through the Waiver
The requirements mirror institutional Medicaid:
- Assets: Below $4,000 countable (individual)
- Income: At or below $2,982/month, or eligible through the medically needy spend-down
- Clinical: Nursing Facility Level of Care, assessed by Liberty Healthcare through a face-to-face evaluation
The key is that your parent must clinically qualify for nursing home care but choose to receive services at home instead. The EPD Waiver exists specifically for people who would otherwise be in a facility.
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Getting Started
Contact the DACL Aging and Disability Resource Center (ADRC) to begin the intake process. They'll guide you through options counseling, help coordinate the Liberty Healthcare clinical assessment, and connect you with care coordinators who manage the EPD Waiver enrollment.
The application timeline typically runs 45 to 90 days from initial intake to active services. During that window, the family is responsible for covering any care costs out of pocket.
The DC Medicaid Long-Term Care Guide includes step-by-step instructions for both the standard agency model and the Services My Way self-directed pathway.
Get Your Free District of Columbia — Medicaid Long-Term Care Eligibility Checklist
Download the District of Columbia — Medicaid Long-Term Care Eligibility Checklist — a printable guide with checklists, scripts, and action plans you can start using today.