Services My Way DC — Self-Directed Care Under the EPD Waiver

What Services My Way Actually Is

Services My Way is the self-directed option within DC's Elderly and Persons with Physical Disabilities (EPD) Waiver. Instead of receiving home care from an agency that assigns aides on its own schedule, your parent (or their authorized representative) acts as the common-law employer — hiring, training, scheduling, and paying their own caregivers directly.

The program runs through GT Independence, which serves as the Financial Management Services (FMS) broker. GT Independence handles payroll, tax withholding, workers' compensation, and Medicaid billing on behalf of the participant. Your parent — or you, as their legally authorized representative — makes the care decisions while GT Independence handles the employer paperwork.

The core appeal: family members can be hired as paid caregivers. Under Services My Way, your parent can employ adult children, siblings, grandchildren, or other relatives to provide personal care services. The only exclusion is spouses — a spouse cannot be hired as a paid caregiver under this program.

Eligibility Requirements

Services My Way is not a separate program — it is a delivery model within the EPD Waiver. That means your parent must first qualify for the EPD Waiver itself, which requires:

• DC residency: Must live in the District of Columbia (not just work there)
• Income: Monthly income at or below $2,982 (300% of the SSI Federal Benefit Rate for 2026). Parents above this threshold may still qualify through the Medically Needy spenddown pathway
• Assets: Countable assets at or below $4,000 for individuals. Confirm which assets count with DACL or DHCF before applying
• Clinical need: Must require a Nursing Facility Level of Care, verified through a Prescription Order Form from a DC Medicaid provider and an in-person interRAI assessment by Liberty Healthcare
• Dual eligibility: Must be eligible for both Medicare and Medicaid

Once approved for the EPD Waiver, your parent can choose between traditional agency-directed services or the Services My Way self-directed option. The choice is not permanent — participants can switch between models if self-direction becomes too burdensome or if they want more autonomy than agency care provides.

The Authorized Representative Requirement

Here is where legal authority documents intersect with the care program. If your parent has cognitive impairment and cannot independently manage the employer role — interviewing candidates, directing daily tasks, approving timesheets — someone must serve as their authorized representative.

An authorized representative under Services My Way must hold legal authority to act on the participant's behalf. This can be established through:

• A valid Durable Power of Attorney with specific authority over government benefits
• A court-appointed guardianship or conservatorship
• A Medicaid authorized representative designation under 42 CFR § 435.923

Without one of these legal instruments, you cannot step into the employer role on your parent's behalf, even if you are their primary caregiver. The District's EPD Waiver intake team will ask for documentation of legal authority as part of the enrollment process.

How the Budget Works

Services My Way participants receive an individualized budget based on their Person-Centered Service Plan. The budget covers the same services available under the traditional EPD Waiver — personal care assistance, homemaker services, respite care — but the participant decides how to allocate hours across providers.

The participant's individualized budget sets the available hours and pay arrangements. GT Independence handles the employer paperwork and Medicaid billing on behalf of the participant; ask it for current payroll and tax details.

The participant is responsible for:

• Recruiting and interviewing caregivers
• Setting work schedules
• Training workers on their specific care needs
• Approving timesheets submitted through GT Independence's portal
• Managing backup coverage when a caregiver is unavailable

Getting Started

The enrollment process follows the standard EPD Waiver pathway:

1. Call DACL's Information & Referral line at 202-724-5626 to initiate the intake process
2. Secure a Prescription Order Form from a DC Medicaid–enrolled physician or APRN
3. Complete the interRAI clinical assessment through Liberty Healthcare
4. Submit the Long-Term Care Medicaid Application to DACL's Medicaid Enrollment Unit at 250 E Street SW, Washington, DC 20024 (or email to [email protected])
5. Once approved, indicate your preference for the Services My Way self-directed model during the Person-Centered Service Plan meeting
6. Complete GT Independence's enrollment paperwork and employer orientation

Processing takes up to 45 days from application submission. During this period, if your parent needs immediate assistance, the State Plan Personal Care Aide program has lower barriers — no 60-month look-back period and a lower income limit of $1,330/month — and can serve as a bridge while the EPD Waiver processes.

The DC Power of Attorney & Guardianship Kit covers the legal authority documents you need to serve as an authorized representative — including the durable POA with government benefits authority and the Medicaid authorized representative designation form.

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