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OFFICE OF THE DEPUTY MAYOR FOR HEALTH AND HUMAN SERVICES
OVERSIGHT QUESTIONS
Q1: Please provide a current organizational chart for the Office of the Deputy Mayor for Health and
Human Services (DMHHS). Please provide information to the activity level. In addition, please
identify the number of full time equivalents at each organizational level, including detailed
employees, and the employee responsible for the management of each program and activity. If
applicable, please provide a narrative explanation of any organizational changes made during FY13
or to date in FY14.
Attached is the organizational chart for the Office of the Deputy Mayor for Health and Human
Services (DMHHS). As of February 2014, this office will have six full-time FTEs, three detailed
FTEs, two AmeriCorps members, two District Leadership Program interns and one part-time
contractor, as indicated on the organizational chart.
There have been several changes since FY12:
1. FY13 Sonia Nagda was hired as the Special Assistant for Health Policy
2. FY13 Matt Scalf, former Capital City Fellow, was hired by DYRS and detailed to DMHHS
3. FY13 Gail Kohn hired by DCOA as Age-Friendly DC Coordinator and detailed to DMHHS
4. FY13 Brandon Pless joined us as a Public Ally/AmeriCorps member replacing Katy Argueta
5. FY13 Pamela Davis joined us as a VISTA/AmeriCorps member
6. FY14 Vadym Guliuk joined us as a DLP intern on the Age-Friendly DC initiative
7. FY14 Jennifer Dixon-Cravens joined us as a DLP intern on the Age-Friendly DC initiative
8. FY14 Matt Scalf transfers from DYRS to DMHHS as Special Assistant for Human Services
9. FY14 Rachel Joseph promoted to Deputy Chief of Staff
10. FY14 Cristian Barrera replaces Sonia Nagda as Special Assistant for Health Policy
11. FY14 Laura Newland hired by DCOA as Special Assistant for Senior Services and detailed to
DMHHS (March 2014)
Q2: Please provide the source and amount of funds used by DMHHS to operate in FY13. Please provide
the Committee with expenditures at the agency level, broken out by source of funds and by
Comptroller Source Group and Comptroller Object.
Please note, all funds are local funds.
Comp Source Group Comp Object Budget Expended Variance
0011 - Regular Pay 0111 - Continuing Full Time 435,000 507,956 -72,956
0012 - Regular Pay - Other 0122 - Continuing Part-Time 150,079 150,079
0013 - Additional Gross Pay 0136 - Sunday Pay 2,346 -2,346
Subtotal 585,079 510,302 74,777
0014 - Fringe Benefits 0141 - Group Life Insurance 252 -252
0142 - Health Benefits 38,488 -38,488
0147 - Misc Fringe Benefits 96,635 96,635
0148 - Retirement - FICA 25,869 -25,869
0154 - Optical Plan 375 -375
0155 - Dental Plan 1,135 -1,135
0158 - Medicare Contribution 7,136 -7,136
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Comp Source Group Comp Object Budget Expended Variance
0159 - Retirement 22,010 -22,010
0161 - DC Health Benefit Fees 1,028 -1,028
Subtotal 96,635 96,293 342
0020 - Supplies 0201 - Office Supplies 9,682 9,886 -204
Subtotal 9,682 9,886 -204
0031 - Telecom 0308 - Telecom 4,401 4,390 11
Subtotal 4,401 4,390 11
0040 - Other Services 0401 - Travel - Local 5,281 1,827.88 5,281
0402 - Travel - Out of City 10,563 580.00 10,563
0405 - Maintenance/Repairs 8,802 8,802
0408 - Prof Service Fees 11,993 41,547 -29,554
0410 - Office Support -2,038.12 -2,038.12
0411 - Printing, Duplicating 6,162 6,162
0428 - Pers Services Contracts 5,281 5,281
0429 - Professional Services 3,671 3,671
Subtotal 51,753 37,101 14,652
0041 - Contractual Services 0409 - Contractual Services 200,000 194,910 5,090
Subtotal 200,000 194,910 5,090
0070 - Equipment 0704 - Other Equipment 0 2,601 -2,601
Subtotal 0 2,601 -2,601
TOTAL 947,550 855,483 92,067
Q3: Please provide the following budget information for DMHHS, including the amount budgeted and
actually spent to date in FY14. In addition, please describe any variance between the amount
budgeted and actually spent to date FY14:
- At the agency level, please provide the information broken out by source of funds and by
Comptroller Source Group and Comptroller Object.
- At the program level, please provide the information broken out by source of funds and by
Comptroller Source Group and Comptroller Object.
- At the activity level, please provide the information broken out by source of funds and by
Comptroller Source Group.
Comp Source Group Comp Object Budget Expended Variance
0011 - Regular Pay 0111 - Continuing Full Time 613,363 169,431 443,932
0012 - Regular Pay - Other 0122 - Continuing Part-Time 475 -475
0013 - Additional Gross Pay 0136 - Sunday Pay 594 -594
Subtotal 613,363 170,500 442,863
0014 - Fringe Benefits 0141 - Group Life Insurance 75 -75
0142 - Health Benefits 11,461 -11,461
0147 - Misc Fringe Benefits 141,540 141,540
0148 - Retirement - FICA 7,724 -7,724
0154 - Optical Plan 117 -117
0155 - Dental Plan 385 -385
0158 - Medicare Contribution 2,398 -2,398
0159 - Retirement 7,623 -7,623
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Comp Source Group Comp Object Budget Expended Variance
0161 - DC Health Benefit Fees
612 -612
Subtotal 141,540 30,395 111,145
0020 - Supplies 0201 - Office Supplies 9,001 9,000 1
Subtotal 9,001 9,000 1
0031 - Telecom 0308 - Telecom 7,146 4,840 2,306
Subtotal 7,146 4,840 2,306
0040 - Other Services 0401 - Travel - Local 1,800 -587 2,387
0402 - Travel - Out of City 7,000 -1,882 8,882
0405 - Maintenance/Repairs 1,000 -120 1,120
0408 - Prof Service Fees 8,437 21,320 -12,883
0410 - Office Support 5,054 -5,054
0411 - Printing, Duplicating 3,000 -1,236 4,236
0416 - Postage 135 135
0428 - Pers Services Contracts
0429 - Professional Services
Subtotal 21,372 22,549 -1,177
0041 - Contractual Services 0409 - Contractual Services 165,000 58,712 106,288
Subtotal 165,000 58,712 106,288
0070 - Equipment 0701 - Purchases - Furniture 500 -995 -495
0702 - Purchases - Equipment -1,606 -1,606
0704 - Purchases - Other 5,601 -5,601
0710 - IT Hardware 1,500 0 1,500
0711 - IT Software 1,000 0 1,000
Subtotal 3,000 3,000 -5,202
TOTAL 960,422 298,996 656,224
Q4: Please complete the attached Program and Activity Detail Worksheet for each program and activity
within DMHHS.
See attached
Q5: Please provide a complete accounting of all intra-district transfers received by or transferred from
DMHHS during FY13 and to date in FY14. For each, please provide a narrative description as to
the purpose of the transfer and which programs, activities and services within DMHHS the transfer
affected.
Please note, all funds are local funds.
FY13 Amount
Program/PCA DMHHS
Role Partner Agency Description
$13,273.00 Human Support Services (2000), Agency Oversight & Support (2010)
Buyer Office of United Communications
311 Service Request Type development and annual management & maintenance cost.
$6,000.00 Human Support Services (2000), Agency Oversight & Support (2010)
Buyer EOM Support Services
Administrative Costs, Courier, Transportation and Telecommunication Services.
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FY14 Amount
Program/PCA DMHHS
Role Partner Agency Description
$6,000.0 Human Support Services (2000), Agency Oversight & Support (2010)
Buyer EOM Support Services
Administrative Costs, Courier, Transportation and Telecommunication Services.
Q6: Please provide a complete accounting of all reprogrammings received by or transferred from
DMHHS during FY13 and to date in FY14. For each, please provide a narrative description as to
the purpose of the transfer and which programs, activities and services within DMHHS the
reprogramming affected.
Please note, all funds are local funds.
FY13 Amount
From To Purpose
$300,079.00 Child and Family Services Administration
Deputy Mayor for Health and Human Services, Agency Management (1000) and Human Support Services (2000)
To expand DMHHS staff capacity to ensure that the legislatively-mandated activities and critical inter-agency coordination and efficiency initiatives can be implemented.
$149,314.93 Deputy Mayor for Health and Human Service
Office of the Deputy Mayor for Public Safety and Justice, Agency Management (1000)
For Truancy Prevention measures throughout the District.
$50,000.00 Department of Youth Rehabilitation Services
Office of the Deputy Mayor for Public Safety and Justice, Agency Management (1000)
These funds are for DC One Card activities for DCPS/DCPCS students.
FY14 Amount
From To Purpose
$768,112.00 Deputy Mayor for Health and Human Services
Department of Human Services, Family Services Administration
These funds will be used for Truancy Prevention measures throughout the District.
$231,888.00 Deputy Mayor for Health and Human Services
Deputy Mayor for Public Safety and Justice, Agency Management (1000)
These funds will be used for Truancy Prevention measures thought out the District.
In Fiscal Year 2014, the Mayor placed $1,000,000 in the Office of the Deputy Mayor for Health and
Human Services (DMHHS) for the purposes of addressing truancy. A portion of these dollars have
been reprogrammed to the Department of Human Services, in the amount of $768,112, to expand
the agency’s Parent and Adolescent Support Services (PASS) program.
This money was transferred to PASS because the program is uniquely situated to access and partner
with other government agencies—such as the Department of Behavioral Health (DBH), LEAs and
others—and community-based organizations to address truancy in a comprehensive manner.
Additionally, because PASS is housed within DHS, staff can access information about referred-
families’ public benefits status and thus ensure that case planning regarding the truant youth is
integrated into the family’s self-sufficiency planning.
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The remaining $231,888 has been reprogrammed to the Office of the Deputy Mayor for Public
Safety and Justice (DMPSJ) for the purposes of evaluating efforts being made by the PASS program
by the Justice Grants Administration (JGA), which falls under the DMPSJ cluster.
The Justice Grants Administration (JGA) was chosen for the evaluation process because they have
already contracted with Choice Research Associates (CRA) to evaluate the District’s elementary
and middle school truancy initiatives. The PASS program will be included as a part of the
evaluation. CRA has broad-based experience establishing implementation standards and overseeing
data collection process specifically with school-based and community-based programs and conducts
process and outcome evaluations on prevention interventions for at-risk youth. Dr. Shawn Flower,
CRA’s principal, also serves as a consultant for the Justice Research and Statistics Association
(JRSA), based in DC, which is a national non-profit organization of state Statistical Analysis
Centers (SAC) directors and researchers.
Q7: Please provide the following information for all grants awarded to DMHHS during FY13 and to
date in FY14, broken down by DMHHS program and activity:
Not Applicable
Q8: Please provide the following information for all grants/subgrants awarded by DMHHS during FY13
and to date in FY14, broken down by program and activity:
Not Applicable
Q9: Please provide the following information for all contracts awarded by DMHHS during FY13 and to
date in FY14, broken down by program and activity:
Vendor Contract Purpose Contract Amount
Contract Term
Funding Source
Competitive or Sole Source
MB Staffing Senior Budget Analyst $103,716.16 I year Local Competitive
MB Staffing Hoarding Expert $20,000.00 I year Local Competitive
MB Staffing Senior Writer $20,000.00 I year Local Competitive
MB Staffing Meeting Facilitator $1,283.84 I year Local Competitive
Midtown Temp Program Analyst $7,000.00 I year Local Competitive
Public Allies AmeriCorps Member $13,000.00 1 year Local Competitive
TOTAL $165,000.00
Q10: Please provide the following information for all contract modifications made by DMHHS during
FY13 and to date in FY14 broken down by program and activity:
- Name of the vendor
- Purpose of the contract modification
- DMHHS employee/s responsible for overseeing the contract
- Modification cost, including budgeted amount and actual spent
- Funding source
Not Applicable
Q11: Does your Agency use purchase orders and purchase cards to acquire supplies or services? If so:
- What safeguards has your agency put in place to prevent waste, fraud, and abuse;
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All staff having use of or approval functions for the purchase card have attended required training.
DMHHS has established an Agency Review Team (ART) to oversee our purchase card activities.
This team meets monthly to review expenditure reports and verify the appropriate usage of the
purchase card. Non-compliance with the reconciliation deadline, spending limitations, or other
requirements can result in purchase card account suspension or revocation.
- How many purchase cards were issued in FY13 and to date in FY14;
One purchase card was issued in FY12; no new cards have been issued in FY 13 or 14.
- Who has been issued a purchase card in FY13 and to date in FY14;
The purchase card was issued to Sandra Gomez, Administrative Support Specialist.
- What is the maximum amount that can be purchased with a I year card;
The maximum per day is $2,500 and the total maximum is $10,000 per month.
- What limitations are placed on the items that can be purchased; and
DMHHS staff follow the standards for limitations and prohibitions placed on purchase cards as per
the training affidavit attesting to their understanding of an agreement to be bound by the policies
and procedures governing the use of the purchase card.
- What has been purchased using these methods in FY13 or to date in FY14?
The following items have been purchased with the Purchase card: office supplies, laptop, furniture,
software, Metro Smartrip cards, airfare, hotel, conference registration fees, upholstery cleaning,
photocopier maintenance service, printing, and document translation. There were 68 purchases
made in FY13 totaling $18,800.60 and 30 purchases to date in FY14 totaling $3,823.65.
Q12: Please provide the Committee with the following for FY13 and to date in FY14:
- A list of all employees who receive cell phones, personal digital assistants, or similar
communication devices at agency expense;
- A list of employees receiving bonuses, special pay, additional compensation, or hiring
incentives in FY13 and to date in FY14 and the amount;
- A list of travel expenses for FY13 and to date in FY14, arranged by employee; and
FY13 update
Employee Name DMHHS Issued Cell
Phone?
Bonus, Special Pay,
Etc.
Travel Expenses
BB Otero Yes NA $1827.88
Ariana Quiñones Yes NA $116.00
Rachel Joseph Yes NA $116.00
Sonia Nagda Yes NA $116.00
Sandra Gomez Yes NA $116.00
Abby Bonder No NA $116.00
FY14 to Date
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Employee Name DMHHS Issued Cell
Phone?
Bonus, Special Pay,
Etc.
Travel Expenses
BB Otero Yes NA TBD
Ariana Quiñones Yes NA TBD
Rachel Joseph Yes NA TBD
Sonia Nagda Yes NA TBD
Sandra Gomez Yes NA TBD
Matt Scalf Yes NA TBD
Abby Bonder No NA TBD
- The number of land lines provided to DMHHS;
The DMHHS has a total of 18 land lines in the office. This has remained the same in FY13 and
FY14.
- A list of all employees with a salary over $100,000. The list should provide the name of the
employee, their salary, the salary schedule, grade, and step for each position. Also, please
provide a position description for each employee.
Employee Name Salary Schedule Grade Step
BB Otero $190,550 XS 11 NA
Ariana Quiñones $123,600 ES 10 NA
See attached for Chief of Staff position description.
Q13: Please provide a list of all FY13 and FY14 FTEs for DMHHS broken down by program and
activity. In addition, please provide current vacancy information. In addition, for each position
please note whether the position is filled (and if filled, the name of the employee) or whether it is
vacant.
FY13 Positions Status Employee Name
Deputy Mayor Filled Beatriz Otero
Chief of Staff Filled Ariana Quiñones
Special Assistant Filled Rachel Joseph
Special Assistant Filled Sonia Nagda
Administrative Support Specialist Filled Sandra Gomez
FY14 Positions Status Employee Name
Deputy Mayor Filled Beatriz Otero
Chief of Staff Filled Ariana Quiñones
Special Assistant Filled Rachel Joseph
Special Assistant Filled Sonia Nagda/Cristian Barrera
Special Assistant Filled Matt Scalf
Administrative Support Specialist Filled Sandra Gomez
Q14: How many employee performance evaluations were completed in FY13? To date in FY14? What is
the process for establishing employee goals, responsibilities, and objectives? What steps were taken
to ensure that all DMHHS employees are meeting individual job requirements? What remedial
actions were taken for employees that failed to meet employee goals, responsibilities, and
objectives?
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Four performance evaluations were completed for the staff employed in FY13: Ariana Quinones,
Rachel Joseph, Sonia Nagda and Sandra Gomez. No performance evaluations have yet been
conducted for FY14.
Each year, employees and supervisors identify the desired goals, responsibilities and objectives for
the position and submit them to DCHR using a standardized template. The supervisor and the
employee review the goals, responsibilities and objectives on an ongoing basis to ensure that the
employee is meeting individual job requirements.
Supervisors are responsible for establishing Performance Improvement Plans (PIP) for low
performing employees and in such a case, will meet on a monthly basis to monitor performance,
determine if objectives have been met and if corrective action is required. Employees who fail to
meet goals, responsibilities and objectives described in the PIP are subject to corrective action,
which includes reassignment, reduction in grade or removal. All DMHHS employees had
satisfactory performance evaluations. There have been no failed employee goals, responsibilities
and objectives thus far.
Q15: For FY13 and to date in FY14, how many employees are detailed to DMHHS from other agencies
and from which agencies are employees detailed? Please provide each detailed employee’s position
at the detailing agency and their salary.
Employee Name Agency Position Salary
Abby Bonder DYRS Management and Program Analyst 80,359
Matt Scalf DYRS Public Affairs Specialist 64,375
Gail Kohn DCOA Age Friendly DC Coordinator 113,300
Q16: How did DMHHS monitor the implementation of recommendations made in investigations, reviews
or program/fiscal audits of agencies and programs under its jurisdiction in FY13? Specifically, how
has DMHHS responded to the September 2013 OAG Report of Special Evaluation on the
Department of Health, Health Regulation Licensing Administration?
The DMHHS reviews all reports released by the Inspector General related to cluster agencies. With
regard to the September 2013 OIG Report on the Department of Health, Health Regulation
Licensing Administration, the DMHHS reviewed this report as it does all OIG reports. DOH has
issued a response to the September 2013 OIG Special Evaluation Report. Since the report, DOH has
taken steps with regards to the destruction of cancelled checks and their timely processing.
Furthermore, DOH requested, and was granted an extension of its grant award for the Criminal
Background Check program for calendar year 2014.
Q17: What goals or objectives were set by DMHHS for FY13? Were these objectives met? Please
provide a narrative description of what actions DMHHS took to meet its goals and objectives. If
goals or objectives were not met, please provide an explanation on why they were not met and a
timeline for accomplishing them.
OBJECTIVE 1: Oversee and facilitate the coordination of interagency activities and initiatives
among District agencies
INITIATIVE 1.1: Oversee and facilitate, with the Deputy Mayor for Education, the
interagency collaboration necessary to address the issue of truancy in the District’s public
schools.
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As part of the larger Truancy Taskforce, the DMHHS and DME offices collaborate in an on-going
capacity with other District stakeholders to identify and understand barriers to attendance and then
work towards identifying and implementing solutions to reduce the high number of unexcused
student absences, particularly at the middle and high school level. DMHHS will work with partner
agencies to look at the compliance of educational neglect laws in the District and will help to ensure
that students and families in some of our most at-risk communities are receiving the services they
need to improve school attendance, academic achievement and family stability. Completion Date:
September 2013 and ongoing
Response to Initiative: Fully achieved. The Truancy Taskforce has been convened, is active, and
ongoing. The Truancy Taskforce meets quarterly and has expanded strategies to reduce truancy in
the District.
INITIATIVE 1.2: Oversee and facilitate, with the Deputy Mayor for Public Safety and
Justice, the interagency collaboration necessary to reduce youth violence during the summer
and throughout the year through the One City Youth Initiative.
DMHHS works with the Deputy Mayor for Public Safety and other District stakeholders to
implement strategies related to keeping youth safe and positively engaged during the summer with
the desired outcome of reducing youth violence. The Deputy Mayor’s Office helps to facilitate
cross-agency and community based organization coordination and ensures that particular attention
is paid to the identified Police Service Areas. Completion Date: September 2013 and ongoing
Response to Initiative: Fully achieved. MHHS convened multiple agencies to meet monthly to
develop the One City Summer Initiative (OCSI) Plan. The scope of the One City Summer Initiative
is substantial and has been increasing year by year. In FY13, 27 District agencies and over 100
community-based partners planned and implemented the Initiative; 19,622 youth participated in 121
programs at 602 sites across the District; 33,967 children, youth and families participated in 441
events hosted by government agencies and CBOs; and a total of 67 District agencies hosted 4,738
youth through the Summer Youth Employment Program. Over the last 3 years the initiative has
been so successful, that the District is creating a year-round initiative to ensure youth safety and
engagement in meaningful activities. The OCSI is now the One City Youth Initiative (OCYI).
INITIATIVE 1.3: Oversee and facilitate, with the Deputy Mayor for Education, the
interagency collaboration necessary to implement the Mayor’s Early Success Initiative.
DMHHS works with the Deputy Mayor for Education and other District stakeholders to implement
strategies related to ensuring children and their families thrive. Specifically, DMHHS and DME are
working with the Statewide Early Childhood Development and Coordinating Council to achieve the
four Early Success goals and ensure that they key outcomes outlined by the Mayor are measured,
tracked and met by District agencies and community partners. Completion Date: September 2013
and ongoing
Response to Initiative: Fully achieved. The DC State Early Childhood Development Coordinating
Council has been co-convened, is active, and ongoing. DMHHS and DME supported OSSE in the
submission of a proposal for the Race to the Top Early Learning Challenge Grant, a competitive
federal grant, to bring $37.5M to the District to define a system of early care and education that
ensures that all children and families are thriving. While the District did not win this federal grant,
the plan created is the right one for the District at the right time and we are committed to propelling
it forward.
INITIATIVE 1.4: Oversee and facilitate, with the Department of Mental Health (DMH), the
System of Care Initiative to better invest public sector resources and improve behavioral
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health outcomes by integrating policy and decision making for behavioral health services for
children and youth.
DMH received the planning grant at the end of FY12. During FY13, the DMHHS and DMH will
focus on implementation of the grant. Completion Date: ongoing
Response to Initiative: The first year of the SOC expansion implementation grant has seen
significant progress toward the overarching goal of “improving the mental health of all youth in the
District of Columbia by building an enhanced System of Care infrastructure to increase capacity for
effective mental health services that are family driven and youth guided.” A diverse group of
family members, community organizations, providers and DC agencies have worked together and
collaborated to design and implement the goals which include:
o Improved access - A pilot is currently underway to provide training on screening and
linkage to services for possible mental health concerns to intake workers at community
organizations and to finalize a universal intake form that will support effective linkage and
communication. This universal intake form will be implemented across agencies. It will
provide a common set of information that documents a family’s identified needs and
supports effective cross agency communication and care coordination.
o Parent and youth peer support - Total Family Care Coalition as the Lead Family Agency has
hired both a Family Engagement and Education Coordinator and Youth Development Lead
Specialist. Outreach to family members including an ongoing support group and a Family
Conference have occurred. Youth were engaged in the SOC process during their summer
employment at TFCC. However, ongoing youth support and engagement remains a
challenge. A Parent Support Specialist role has been developed along with the training
curriculum. This position has been designed to be able to provide Medicaid billable services
and thus be sustainable. The first class of trainees is scheduled for June, 2014.
o Functional assessment utilizing the CAFAS - DC Child serving agencies have agreed to
implement the CAFAS for youth receiving services for behavioral and/or emotional
concerns. This assessment will be used for children involved with juvenile justice and child
welfare along with youth receiving mental health services in the community and school.
The implementation of the CAFAS has the potential to not only increase the understanding
of the areas of strength and concern for an individual child but also across the system. The
development of the contracts for access to the CAFAS is ongoing along with the
development of a data warehouse.
o Integration of Behavioral Health and Primary Care - Pediatricians, DC agencies, community
organizations and Georgetown University are collaborating to integrate behavioral health
and primary care. This includes the implementation of social emotional screening at all well
child checkups. The learning collaborative has identified three screening tools and will be
providing training and support for pediatricians and their office staff on screening and
linkage to services.
o Reinvestment strategies to promote sustainability: Strategies to decrease the number of
youth placed in nonpublic schools was identified as the initial goal. Providing wraparound
services to these youth and/or academic transition services will support their return to their
home public school. Several alternatives for use of the savings associated with the return of
these youth to public school are being considered. This includes supporting ongoing
wraparound and academic transition services for youth returning to their community school
and funding the implementation of the CAFAS in the school system.
o Social Marketing - Ongoing community outreach including a school based Children’s
Mental Health Awareness Day event has focused on decreasing mental health stigma and
increasing awareness of the resources available. By focusing on mental wellness, early
screening and identification is supported through the access and primary care provider
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initiatives listed above. Youth Mental Health First Aid is being provided to diverse groups
of parents, community organizations, and DC agencies.
INITIATIVE 1.5: In coordination with the Deputy Mayor for Education, merge the
Integrated Case Management Executive Committee with the System of Care initiative to
coordinate public benefits, services, and supports to individuals or families who display
various risk factors across multiple District health and human service agencies.
DMHHS will assist in the coordination of activities with the appropriate Health and Human Service
agencies, specified in Title II, Section VII of this Mayor’s Order, as necessary to: (1) establish a
connection to District services to the extent possible; (2) coordinate benefits; (3) provide quality
case management, as deemed appropriate; and (4) work closely with other Health and Human
Service Agencies. The work of the Integrated Case Management Executive Committee will be
integrated with that of the System of Care initiative. The work is ongoing and the merger will take
place this fiscal year. Completion Date: September 2013 and ongoing
Response to Initiative: While the necessary staff support for creation and sustaining of such an
Executive Committee did not happen last year, the work did move forward to coordinate public
benefits, services, and supports to individuals or families who display various risk factors across
multiple District health and human service agencies.
In year one, the focus was on the integration and coordination of these benefits and services for
families who receive the following array of benefits: DHS: TANF, Food Stamps, Medicaid,
Homeless Services, (OSSE) Child Care Subsidy and McKinney-Vento Homeless Liaison, (CFSA)
Child protection and Family Strengthening, (OAG) Child Support, and (DBH) coordination with
System of Care Intake, and preliminary planning around children's mental health services.
In year two, we are expanding to include DCHA, DBH (adult and child mental health), DHS
(PASS), and community homeless service providers. Year two is also the second year of building
the IT coordinated case management infrastructure through Release 2 of the DC Access System,
which is scheduled to be completed in the summer of 2015. In this release all Medicaid, Food
Stamp (SNAP), TANF and other health and human services programs administered by DHS will be
accessible through the same basic infrastructure set up for the DC Health Link. Discussions are
currently underway with agencies, such as OSSE, CFSA, and others on opportunities to link into
this same infrastructure to support the integrated case management initiative.
INITIATIVE 1.6: Establish and/or support interagency working groups, commissions and
panels when necessary and desirable to efficiently meet District goals. DMHHS facilitation of meetings between District agencies and community stakeholders is a
necessary component towards developing state plans, coordinating inter-agency action, and
otherwise building a comprehensive system of benefits, goods and services. The focus of these
work groups is to develop plans and protocols and to institutionalize effective practices within
government that allow for the forward movement of the goals set out by the Mayor for the District
of Columbia. This is an ongoing activity but the work groups evolve from year to year. Target
Completion Date: As needed
Response to Initiative: Fully achieved. The initiative is ongoing and evolves as agencies establish
working groups throughout the year. In FY13 DMHHS convened and/or supported seven inter-
agency groups: the Homeless Encampment Work Group, Hoarding Work Group, System of Care
Executive Committee, One City Summer Initiative, Nursing Home Work Group, Service Members
Veterans and their Families Work Group, and Alzheimer’s Work Group. The work of these groups
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is continuing. Additionally in FY13, the Age-Friendly DC Task Force was established and began
the planning phase with a strategic plan to be finalized in FY14.
OBJECTIVE 2: Oversee the development of policies and programs to improve the delivery and
coordination of services by public agencies and contracted providers.
INITIATIVE 2.1: DMHHS ensures that cluster agencies comply with local and federal
mandates through secondary review and approval of all promulgated rules and regulations. DMHHS receives and approves all legislative and rulemaking requests from cluster agencies to
ensure compliance with local and federal mandates, as well as the overall policy agenda of the
Mayor and the city. This is an ongoing activity. Target Completion Date: On-going
Response to Initiative: Fully achieved. DMHHS reviewed and approved 135 rule and legislative
requests in FY 13. The initiative is an ongoing function.
OBJECTIVE 3: Monitor the Performance Plans for Cluster Agencies
INITIATIVE 3.1: Support Cluster Agencies in meeting Performance Plan goals. DMHHS
receives and approves all cluster agency performance plan goals prior to submission to the City
Administrator, helping to ensure compliance with local and federal law, as well as the overall policy
agenda of the Mayor and the city. This is an ongoing activity. Target Completion Date: January
2013
Response to Initiative: DMHHS received, provided feedback and approved all cluster agency
performance plan goals. This is an annual activity.
OBJECTIVE 4: Coordinate inter-agency work to responsibly exit five consent decrees and one
settlement agreement.
INITIATIVE 4.1: Support the Child and Family Services Agency (CFSA), Department of
Disability Services (DDS), Department of Health Care Finance (DHCF), Department of
Mental Health (DMH) and Department of Youth Rehabilitation Services (DYRS) in
completion of strategies related to each agency’s respective consent decree/settlement
agreement. DMHHS focuses primarily on assisting cluster agencies with inter-agency issues that
arise in implementation of agreed upon strategies. Additionally, DMHHS helps to facilitate and
problem solve any barriers that arise as a result of the lawsuits. This is an ongoing activity. Target
Completion Date: September 2013
Response to Initiative: DMHHS successfully supported the Department of Mental Health in exiting
the Dixon consent decree. All other agencies made progress towards meeting their exit criteria.
OBJECTIVE 5: Assist residents in navigating the many services offered by District agencies and
service providers
INITIATIVE 5.1: Develop a system to track constituent inquiries and concerns as they
pertain to our cluster agencies. Work with the Office of Unified Communications to develop new
311 “service requests types” to assist with proper routing and timely resolution of constituent
reports and complaints. Specifically, OUC will be adding service types for homeless encampments
and hoarding cases. Having these service types will allow the DMHHS to track progress towards
abatement and generate reports by ward and other indicators. Target Completion Date: July 2013
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Response to Initiative: Fully achieved. DMHHS worked with OUC and completed development of
the two Service request Types and trained key agency staff on their use.
INITIATIVE 5.2: Support DHS, OUC and HSEMA in the updating and implementation of
the 211, Answers Please! System. Work with agencies with independent procurement authority
and with OCP to include a provision in all contracts and grant agreements that would require
vendors/providers to update their profile in the 211 system. The goal of this initiative is to have any
vendors/providers receiving District funding to update all of their information in the 211 system, not
just the information for which they are receiving funding. This will allow the city to ensure that 211
is kept up to date on current services available. Target Completion Date: September 2013
Response to Initiative: In FY13, a working group was established. An upgrade of the 211 system
occurred with the support of the United Way which provides technical assistance and regional
coordination and support to DC, MD and VA in the operation of their respective 211 systems.
Additional work has been done to identify methods to enhance the front-end user experience. This
is an ongoing initiative.
OBJECTIVE 6: Increase public access and exposure to health and human services information.
INITIATIVE 6.1: Ensure that at least two DMHHS staff are trained in Drupal to maintain
the DMHHS website and expand its functionality.
The DMHHS website was built in FY12 and staff need to be trained in order to maintain it on an
ongoing basis. DMHHS will work with OCTO to ensure the ongoing ability of staff to properly
maintain and update the website. Target Completion Date: April 2013
Response to Initiative: Fully achieved. Three current staff has been trained on the Drupal platform.
INITIATIVE 6.2: Participate in community engagement opportunities in coordination with
cluster agencies to disseminate information about available government services and
programs. This is an ongoing activity that allows the DMHHS to have a public presence and
receive community input. Completion Date: September 2013
Response to Initiative: DMHHS engaged the public in a variety of ways around improving the
annual Children’s Budget Report. We held six community input sessions across the city,
implemented an on-line survey, and had numerous on-on-one conversations with advocates about
the utility of the document and the process. DMHHS also held several input sessions with DC
government staff to elicit their comments on what would make the annual report most useful to
them in terms of policy, planning, and reporting. All told, more than 50 individuals and
organizations provided valuable information, much of which was used to create the FY 2014
Children’s Budget Report.
Q18: What are the objectives set forth in the performance plan for FY14? Please provide a narrative
description of the progress DMHHS has made in meeting the objectives of the FY14 performance
plan. What legislative initiatives will DMHHS pursue in FY14?
OBJECTIVE 1: Oversee the development of policies and programs to improve the delivery and
coordination of services by public agencies and contracted providers.
INITIATIVE 1.1: Assist residents in navigating the many services offered by District agencies
and local service providers by upgrading and updating the 211, Answers Please! System.
DMHHS will support DHS in transition to a new “back-end” database for the 211 system to serve
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as the master repository of all health and human services resources and referral information for the
District. DMHHS will work with OCTO to ensure the successful migration of data from existing
agency systems into 211. DMHHS will also work with agencies with independent procurement
authority and with OCP to include a provision in all contracts and grant agreements that would
require vendors/providers to update their profile in the 211 system. The goal of this initiative is to
have any vendors/providers receiving District funding to update all of their information in the 211
system, not just the information for which they are receiving funding. This will allow the city to
ensure that 211 is kept up to date on current services available. Completion Date: September 2014.
Response to Initiative: The working group meets regularly to plan for the system enhancements and
updates.
OBJECTIVE 2: Oversee and facilitate the coordination of interagency activities and initiatives
among District agencies.
INITIATIVE 2.1: Oversee and facilitate the use of $1 Million placed in the DMHHS FY14
budget to address the issue of truancy in the District of Columbia public schools. As part of the
larger Truancy Taskforce, the DMHHS and DME offices will develop a plan to allocate, use, and
track new and dedicated FY14 funds in order to support agency activities related to addressing the
issue of truancy in the District’s public schools. Completion Date: September 2014.
Response to Initiative: The $1 Million dollars placed in the DMHHS budget were reprogrammed to
the Department of Human Services' PASS program and to the Justice Grants Administration. The
funds dedicated to the PASS program will be used for ensuring that services are provided to young
people who are experiencing issues with truancy at Anacostia and Dunbar Senior High Schools, as
well as Maya Angelou and Friendship Public Charter Schools. In order to double the PASS
program's capacity, an additional ten staff members need to be hired. Potential staff have been
identified for all ten positions, two of which have been on boarded and are accepting cases. The
funds dedicated to JGA will be used towards an evaluation of the PASS program. (For additional
information on how the funds will be utilized, please see attached Council Report).
INITIATIVE 2.2: In conjunction with the Deputy Mayor for Public Safety and Justice,
facilitate conversations and build on the One City Summer Initiative to expand activities and
services to reduce youth violence throughout the year through the One City Youth Initiative.
DMHHS has worked with the Deputy Mayor for Public Safety and other District stakeholders to
implement strategies related to keeping youth safe and positively engaged during the summer. A
plan will be developed to expand and coordinate these activities more robustly during the school
year. Completion Date: September 2014.
Response to Initiative: Over the last three years, DMHHS, along with the Deputy Mayors for Public
Safety and Justice and Education have convened multiple agencies to develop the One City Summer
Initiative (OCSI) Plan. The scope of the One City Summer Initiative is substantial and has been
increasing year by year. In FY13, 27 District agencies and over 100 community-based partners
planned and implemented the Initiative; 19,622 youth participated in 121 programs at 602 sites
across the District; 33,967 children, youth and families participated in 441 events hosted by
government agencies and CBOs; and a total of 67 District agencies hosted 4,738 youth through the
Summer Youth Employment Program. The initiative has been so successful in keeping our youth
crime numbers down and ensuring that youth have meaningful programs to access, that the District
is creating a year-round initiative to ensure that these same outcomes for youth occur not just during
the summer months. The OCSI is now the One City Youth Initiative (OCYI). This is being
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spearheaded by the Children and Youth Investment Trust Corporation (CYITC) and will involve the
participation of many of the same agencies that participate during the summer.
INITIATIVE 2.3: Oversee and facilitate, with the Deputy Mayor for Education, the
interagency collaboration necessary to implement the Mayor’s Early Success Initiative.
DMHHS will work in collaboration with the Deputy Mayor for Education to revise, enhance and
incentivize adoption of the Quality Rating and Improvement System (QRIS) across all early
learning and development programs in the District. Additionally, DMHHS will support OSSE in the
submission of a proposal for the Race to the Top Early Learning Challenge Grant, a competitive
federal grant, to bring $37.5M to the district to define a system of early care and education that
ensures that all children and families are thriving. Completion Date: September 2014.
Response to Initiative: DMHHS and DME supported OSSE in the submission of a proposal for the
Race to the Top Early Learning Challenge Grant, a competitive federal grant, to bring $37.5M to
the District to define a system of early care and education that ensures that all children and families
are thriving. While the District did not win this federal grant, the plan created is the right one for the
District at the right time and we are committed to propelling it forward. To date in FY14, DMHHS
and DME continue to work together to implement the Mayor’s Early Success Initiative.
INITIATIVE 2.4: Oversee and facilitate, with the Office on Aging, the interagency
collaboration necessary to make the District of Columbia an Age-Friendly City, an inclusive
urban environment that encourages active and healthy aging. DMHHS will assist with the
coordination of activities necessary to transform the District into an Age-Friendly City by 2017 as
part of the World Health Organization’s (WHO) international Age-Friendly City initiative. DMHHS
will establish the Mayor’s Age-Friendly DC Task Force and Committees. A strategic plan will be
developed that identifies goals for 10 areas of living (“domains”): transportation, housing, social
participation, respect and social inclusion, civic participation and employment, communication and
information, community support and health services, outdoor spaces and buildings, emergency
preparedness and response, and elder abuse, neglect, and fraud. Completion Date: September 2014.
Response to Initiative: In FY13, the Mayor, with unanimous Council approval, set in motion a
transformation to an Age-Friendly DC by 2017 – a more inclusive, more walkable metropolis in
accordance with World Health Organization guidelines. Through listening consultations with more
than 1,000 individuals over age 50 across the city and from surveys completed by more than 3,000
mature residents at May and September symposia and by AARP and Senior Beacon, we have a
baseline on what DC residents love about their neighborhoods and the city and where changes are
needed. Appointed by the Mayor in September, the 23-member Age-Friendly DC Task Force
(including all Deputy Mayors and private sector leaders) led by George Washington University
President Steven Knapp and Deputy Mayor for Health and Human Services Beatriz Otero, is
expected to recommend in July 2014 the Age-Friendly by 2017 Strategic Plan.
INITIATIVE 2.5: Develop a Strategic Plan to improve access to health, education and human
services for SMVF (services members, veterans and their families). DMHHS will re-engage the
SMVF work group to produce and publish a Strategic Plan that that will ensure economic security
and self-sufficiency, through improved access to health, education and human services, for service
members, veterans and their families in the District of Columbia. Completion Date: September
2014.
Response to Initiative: DMHHS secured an AmeriCorps VISTA member to coordinate this project
in September 2013. Subject matter expert vacancies on the SMVF work group are being filled in
preparation for the re-convening meeting scheduled for February 28, 2014. The SMVF workgroup
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will meet for a total of three to four times to produce a final SMVF action plan by June 2014. In
conjunction with the workgroup meetings, delegations from the SMVF workgroup will be selected
to participate in several of SAMHSA’ s topical Implementation Academies that will be held this
fiscal year. DMHHS will continue to participate and utilize SAMHSA’s Service Members, Veterans
and their Families Technical Assistance Center resources to educate and prepare the District of
Columbia for the needs of service members, returning veterans and their families.
INITIATIVE 2.6: Address health and safety issues of low-income residents who hoard.
DMHHS will oversee the development of a training plan related to the inter-agency hoarding
protocol. The Hoarding Work Group will ensure that protocol training is provided to agency
Directors, caseworkers, and inspectors. Completion Date: September 2014.
Response to Initiative: DMHHS has contracted with a consultant and national hoarding expert, Dr.
Darnita Payden, to develop training modules for DC government employees and to provide
guidance on case management. The training modules are currently under review and will be
implemented in 2014. DMHHS will establish monthly hoarding case review meetings starting in
Spring 2014.
OBJECTIVE 3: Identifying opportunities for reducing redundancies, leveraging resources, creating
economies of scale, and improving outcomes.
INITIATIVE 3.1: Create an inventory of HHS cluster agency grantees and contractors.
Conduct an inventory of both grantees and contractors and grant and contract instruments used by
HHS cluster agencies. Analyze the HHS cluster data to determine grantees/contractors working with
multiple agencies in order to identify possible service redundancies and pricing variations.
Completion Date: September 2014.
Response to Initiative: This work has not begun as it was proposed to be taken on by a Captial City
Fellow who has not yet been placed with DMHHS.
OBJECTIVE 4: Coordinate inter-agency work to responsibly exit consent decrees and/or settlement
agreements.
INITIATIVE 4.1: Support the Department of Disability Services (DDS), in completion of
strategies to exit the Evans consent decree. DMHHS assists cluster agencies with inter-agency
issues that arise in the implementation of agreed upon exit strategies any barriers that arise as a
result of the lawsuits. In FY14 we expect to exit the Evans law suit and DMHHS will support the
work of the Inter-agency Intellectual/Developmental Disabilities (IDD) task force and implement
budget priorities toward responsible exit. Completion Date: September 2014.
Response to Initiative: The DMHHS continues to assist cluster agencies with inter-agency issues
that arise in the implementation of agreed upon exit strategies as a result of consent decrees. To date
in FY14, the DMHHS has worked with IDD Task force, DDS and DHCF to expeditiously publish
requisite rules for the Home and Community Based Service Waiver. This work will continue
throughout FY14.
Q19. Please provide a detailed description of utilization of the $1 million awarded to DMHHS in the
FY14 budget for truancy prevention.
See attachment – October 1, 2013 Report to Council
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Due to the Federal Shutdown, the reprogramming of dollars to DHS did not occur until November
27, 2013.
The $1M was reprogrammed as follows:
$768,112 directly to DHS for the Parent Adolescent Support Services (PASS) program
$231,888 to JGA through DMPSJ for the evaluation component of the PASS program. JGA
will be including the evaluation of the PASS program in the evaluation of the truancy work
that is being done at the elementary and middle schools.
Since this time, DHS has been working diligently to hire the 10 new staff members needed to
expand the program’s capacity to serve young people. To date, applicants for all ten positions have
been chosen and eight are waiting for Human Resources approval. One social worker started at
Dunbar during the week of February 3rd and another social worker will start at Anacostia during the
week of February 17th.
In SY13-14:
PASS has served and continues to serve a total of 77 youth this school year. Of the 77, 55 are DCPS
students. And of these 55, 4 students (2 at Anacostia, 2 at Dunbar) are being served specifically by
referrals made for the truancy expansion work. The remaining 22 are students from public charter
schools. Of these 22 students, 4 students (2 at Maya Angelou, 2 at Friendship) are being served
specifically by referrals made for the truancy expansion work
Once fully staffed, capacity of the program will be 24-30 per school at any given time, as there will
be two new staff members at each school and they can carry a caseload of 12-15 cases. Normal
length of a case is 6 months. DHS expects that PASS will be fully staffed by mid-March 2014.
Q20: The Office provided detailed descriptions last year of interagency cooperation for the agencies
under its purview and the other Deputy Mayors’ offices to address and coordinate the provision of
services to address substance abuse and mental health issues, homelessness, housing, and
HIV/AIDS. Are there any updates to provide? Did the IT Workgroup succeed in winning the federal
funding it sought from the Centers for Medicaid and Medicare Services (CMS) and Food &
Nutrition Services (FNS) for the IT infrastructure to support a consolidated web-based eligibility
and enrollment system as required by the Affordable Care Act (ACA) and a consolidated case
management system?
Interagency collaboration continues to be a core function of the DMHHS. To this end, DMHHS
uses a variety of strategies to facilitate interagency collaboration, including identifying
opportunities for reducing redundancies, leveraging resources, creating economies of scale, and
improving outcomes. While many interagency initiatives pre-date the establishment of the DMHHS
in 2011, there are several current initiatives, in which the DMHHS plays a convening or facilitating
role, which are highlighted below.
Substance Abuse and Mental Health
The DMHHS has facilitated the establishment of the Department of Behavioral Health (DBH), a
merger of DMH and APRA. Mental health and substance abuse disorders are frequently co-
occurring, and the formation of DBH, which went into effect in October 2013, allows these services
to be offered in a seamless manner. DMHHS has facilitated DBH involvement in all relevant
initiatives to ensure mental health services are integrated and mental health issues are addressed for
the residents of the District.
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Homelessness and Housing
The Inter-agency Council on Homelessness (ICH), led by the City Administrator, is a primary
vehicle for interagency collaboration and consists of agency directors across all clusters. It
meets bi-monthly as an entire body and the sub-committees (which include sub-committees
which work to coordinate homeless services and permanent supportive housing) meet monthly.
DMHHS participates in the bi-monthly ICH meetings and in various subcommittees that track
progress in homeless services and housing production.
Additionally, the DMHHS has convened a number of interagency meetings this year to
coordinate agency efforts and discuss strategies to address homelessness and housing issues.
Agency partners in these meetings include the Office of the Deputy Mayor for Planning and
Economic Development (DMPED), the Department of Human Services (DHS), the Department
of Behavioral Health (DBH), the Department of Housing and Community Development
(DHCD), the Department of General Services (DGS), and the DC Housing Authority (DCHA).
DMHHS has worked with DMPED and other agency partners over the last year to implement
the $100 million affordable housing investment in FY13 and FY14, which was increased to a
total of $187 million.
The $187 million investment supported the 2013 DHCD SuperNOFA, which featured a
consolidated RFP for the first time ever. This RFP matched capital and supportive services
resources from the DMHHS cluster to capital resources from the DMPED cluster and was very
successful, yielding 975 total units, 430 of which are for permanent supportive housing (44% of
the total).
The $187 million investment is also supporting the Affordable Housing Database Project, which
is being co-led by DMHHS and DMPED and the technology is being implemented by OCTO.
The Affordable Housing Database is now transitioning from the data gathering phase into the
delivery phase.
HIV/AIDS
The DMHHS sits on the Mayor’s Commission on HIV/AIDS which represents a successful
collaboration across the District government and with community stakeholders. The Commission
has been instrumental in helping the District move policy forward at the highest level. There was
one meeting of each of the youth and older adults intergovernmental councils in May 2013. The
Commission was reauthorized July 12, 2013 and members were sworn in on December 2, 2013.
The next meeting of the Commission is February 26, 2014 from 2-4pm.
Health IT and Client Data Software The HRIC IT sub-committee received approval for an expedited implementation advance planning
(IAPD) grant from Department of Health and Human Services and Food and Nutrients Services on
December 30, 2011. The Departments of Health Care Finance (DHCF) and Human Services (DHS)
jointly updated the IAPD in December of 2012 resulting in the District receiving over $30 million
dollars in Federal grants to modernize the DC consolidated health and human services eligibility
and enrollment system.
This funding along with Exchange Establishment grants administered by the Health Benefit
Exchange Authority (HBX) were used to implement Release 1 of DC Access system that went live
on October 1, 2013 to accommodate the DC state based exchange. The DCHealthLink.com site has
been one of the more successful state based exchanges in the country. To date the combination of
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the applications received on-line and at DHS Service Centers have resulted in over 26,000 people
enrolling in private health plans or Medicaid.
The two agencies are preparing another update to the IAPD that will be submitted to the federal
funding agencies by the end of February 2014 to request additional funding for the remaining
releases planned for the project. Release 2 of the DC Access System is scheduled to be completed in
the summer of 2015. In this release all Medicaid, Food Stamp (SNAP), TANF and other health and
human services programs administered by DHS will be accessible through the same basic
infrastructure set up for the DC Health Link.
Q21: Significant progress was made last year in the Office’s efforts to maximize available federal
Medicaid revenue within the agencies under the purview of DMHHS. Please provide any updates
that have transpired to date in FY14.
Significant progress was made last year in the Office’s efforts to maximize available federal
Medicaid revenue within the agencies under the purview of DMHHS. Please provide any updates
that have transpired to date in FY14.
Department of Behavioral Health (DBH)
The transition of APRA into the new DBH was effective October 1, 2013. In accordance with the
transition, DBH is reviewing the State Plan and DC Municipal Regulations that govern the ASARS
benefit and recommending updates to ensure both correlate to the agency’s new organizational
structure and regulatory framework. DHCF will collaborate with DBH in reviewing and submitting
an updated State Plan Amendment to the Centers for Medicare and Medicaid Services.
Department of Health – HIV/AIDS Administration (DOH – HAHSTA)
Department of Health HIV/AIDS, Hepatitis, STD and TB Administration (HAHSTA) initiated a
project to build capacity for third party reimbursement at its STD and TB clinics and programs.
DHCF has collaborated with HAHSTA with providing technical assistance, coordinating meetings
and briefings with relevant DHCF staff and HAHSTA representatives, provided background
information to the HAHSTA consultant preparing a business plan and has held regular conference
calls with HAHSTA on project progress.
District of Columbia Public Schools (DCPS)
DHCF and DCPS have worked together on the implementation of the Administrative Services
Organization (ASO) to expand the number of Medicaid reimbursable services for local education
agencies (LEAs), including DCPS. The ASO and DHCF have worked with DCPS to improve the
quality of documentation and billing. DCPS has standardized their Medicaid claims management
procedures for claims processing and quality control of clinical documentation by validating each
claim submitted for Medicaid reimbursement. Together, the ASO, DHCF and DCPS are working to
reduce the rate of federal recoupment for Medicaid-paid claims due to insufficient or erroneous
documentation and provider errors or mistakes in claims submission by passing each claim through
a rigorous review process based on Federal and District rules, regulations and policies. Two percent
of the claims are then assessed during a qualitative validation process focused on identifying proper
and quality documentation. During FY 2013, DCPS submitted 104,893 claims of which 98,327
claims were paid ($2,213,635.93).
District of Columbia Public Charter Schools (DCPCS)
DHCF and the Public Charter School Board have collaborated on the implementation of the ASO
program to include public charter schools. In April 2013, seven schools submitted their first claims
to the ASO (Apple Tree Early Learning Academy PCS, DC Preparatory Academy PCS, The Arts &
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Technology Academy PCS, Maya Angelou PCS, Elsie W. Stokes PCS, and William E. Doar, Jr
PCS) using a third party biller. During FY2013, the public charter schools collectively submitted
1,533 claims, of which 1,211 were paid ($28,215.71).
As the public charter schools are submitting for identical services as DCPS, the protocol for
documentation and processing is already established and simplifies the process. In FY2014, the
DHCF Director, Wayne Turnage, mandated that all public charter schools seeking Medicaid
reimbursement would be required to implement with the ASO. DHCF and the ASO are
collaborating to implement all currently billing public charter schools to the ASO Program by the
end of FY2014.
Office of the State Superintendent of Education (OSSE)
OSSE enrolled as a Medicaid provider in FY2010. OSSE is providing and being reimbursed for
specialized transportation services, as allowed under the School Based Health Services State Plan.
As with DCPS, OSSE and DHCF have worked together with the Administrative Services
Organization (ASO) to improve the quality of documentation and billing. OSSE has standardized
their procedures for Medicaid claims management procedures for claims processing and quality
control of clinical documentation by validating each claim submitted for Medicaid reimbursement.
Together, the ASO, DHCF and OSSE are working to reduce the rate of federal recoupment for
Medicaid-paid claims due to insufficient or erroneous documentation and provider errors or
mistakes in claims submission by passing each claim through a rigorous review process based on
Federal and District rules, regulations and policies. Two percent of the claims are then assessed
during a qualitative validation process focused on identifying proper and quality documentation.
During FY2013, OSSE submitted 53,791 claims of which 45,195 were paid ($1,944,902.78).
Child and Family Services Agency (CFSA)
DHCF and CFSA worked together on two programs for the ASO implementation: Clinic Option
and Targeted Case Management (TCM). For the Clinic Option, the collaboration included the
completion of Phase Three, which was to complete the documentation for the Qualitative Review
and establish the audit processes. CFSA is in a regular cycle of Qualitative Reviews and the audits
continue to demonstrate successful outcomes in the collaborative partnership. During FY2013,
CFSA submitted 2,291 claims, of which 2,184 claims were paid ($309,298.15).
At the end of FY13, CFSA made the fiscal decision to abandon the TCM program, in order to
pursue other federal funding aside from the Medicaid Program.
District of Columbia Department of the Environment (DDOE)
DHCF and DDOE collaborated on the Lead Based Paint Testing Program and DDOE started
claiming for Medicaid services in FY2012. Documented by blood test results which show high lead
levels, DDOE provides testing in a child’s environment, which includes home, school, day care and
extended family members’ homes, to look for the source of lead based paint exposure. The
Memorandum of Understanding between DHCF and DDOE allows a maximum of 150 tests per
fiscal year. In FY2013, DDOE submitted 33 claims, of which 25 claims paid ($8,376.61).
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Q22: Now that the Health Benefits Exchange Authority is fully functioning, please provide us with
updates on its performance. Are goals and objectives being met for FY14?
The Health Benefits Exchange has exceeded all expectations. Congress and the President are
enrolled and based on the latest data released on February 10th
, 2014, 26,180 people enrolled
through DC Health Link in private health plans or Medicaid:
5,090 people enrolled in private health plans through the DC Health Link individual and
family marketplace and 965 of those have coverage that will be effective March 1, 2014;
8,451 people gained Medicaid coverage through DC Health Link; and
12,639 people enrolled through the DC Health Link small business marketplace
Q23: The Dixon Settlement had four major areas for which the District was required to meet certain
benchmarks by September 30, 2013, with some interim benchmarks depending on criteria. Were
these benchmarks achieved? If not, please discuss the District’s timeline and plan for meeting these
requirements.
The District exceeded, met, or substantially complied with fifteen of sixteen criteria in the four
general areas contained in the Settlement Agreement. The areas were 1) Children and Youth
Services 2) Supported Housing 3) Continuity of Care and 4) Supported Employment. As explained
in further detail below, DBH met all the requirements except for the total number of people served
in the area of Supported Employment.
1) Children and Youth Services: The District either substantially exceeded or met the seven specific
criteria. The District achieved an overall system performance score of 70% on the children and
youth Community Service Reviews (CSRs). The CSRs were developed with outside technical
assistance but the Department now has developed its own protocol to continue the annual reviews.
The Department decreased the total number of bed-days that children and youth spent in Psychiatric
Residential Treatment Facilities (PRTFs) by 36% well over the 30% required in the Agreement, and
continued to track outcomes after the child or youth was returned to the community. Finally, the
Department increased evidence-based practices of Multi-Systemic Therapy and Functional Family
Therapy provided to youth by 62% in FY 12 and 32% in FY 13, well above the 20% required in the
Settlement Agreement. Children and youth who received High-Fidelity Wraparound, a promising
practice, also increased by 34% in FY 12 and 20% in FY 13, again above the 10% increase required
in FY 12, and in line with the 20% increase required for FY 13.
2) Supported Housing: The District met all three specific criteria. The number of consumers served
with supported Housing increased by 401—from a baseline of 1,396 two years ago to 1,797,
exceeding the requirement of 300 by over 33%. The Department provided an additional 269 new
housing vouchers and identified an additional 175 units supported by capital grant funds. (The total
number was adjusted to subtract consumers living in capital-funded units who were receiving a
voucher, and had some movement in the capital units.) Additionally, the Department finalized its
Supported Housing rules, issued housing subsidies according to priority populations, and published
its Strategic Housing Plan.
3) Continuity of Care: The District substantially met three specific criteria in this area. The
Settlement Agreement required that 70% of adults and children be seen within seven (7) days of an
inpatient discharge, and that 80% be seen within 30 days of an inpatient discharge. In FY 13, the
Department substantially met the requirements for both adults and children: 68% of adults were
seen within seven days and 78.2% were seen within 30 days; and 67.3% of children were seen
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within seven days and 83% were seen within 30 days. We expect these numbers to increase slightly
for FY13 as more claims are submitted, since Medicaid allows one year for billing. Finally, the
Department memorialized the Continuity of Care requirements in its Human Care Agreements with
its providers and is committed to improving its continuity of care services.
4) Supported Employment: The District substantially met two of the three specific criteria. The
Department established standards for assessment and referrals, as required. Secondly, at 56%, the
District substantially met the requirement that 60% of individuals who were interested and eligible
for Supported Employment services were referred for services. The third criterion was to increase
the number of individuals served by 10% in FY 12 and 15% in FY 13. Though the Department took
significant steps to meet this requirement, including providing grants to four certified mental health
providers to assist them in hiring new staff and partnering with the District’s Rehabilitation Services
Administration, the targets were not met. The Department is committed to continuing to increase
the capacity of the Supportive Employment service in addition to exploring methods to improve the
service as a whole. However, it should be noted that the program’s actual employment rate in FY
12 was 51% which exceeds the national average of 43% as compiled by the Dartmouth National
Evidence-Based Supported Employment Project. This is a far better indicator of the success of a
supported employment program than the number who only receive supported employment
counseling services.
Q24: Please provide a status report on Evans v. United States (original case Evans v. Washington, 459 F.
Supp. 483 (D.D.C. 1978). Specifically, was the District successful in being granted further
enlargement of time through December 2013 to come into full compliance with the remaining six
outcome criteria for the 2010 Revision?
Evans. v. Gray, No. 76-0293 (ESH) (D.D.C.) is a class action involving ongoing federal court
oversight of the service delivery system for persons with intellectual disability who were once
housed at Forest Haven. On August 10, 2010, the Court approved the 2010 Revision to the 2001
Plan for Compliance and Conclusion of Evans v. Williams (“2010 Exit Plan”), and appointed an
Independent Compliance Administrator to oversee and guide the defendants’ implementation of
corrective measures to exit court supervision within two years. On August 1, 2012, the Court issued
an order granting a six-month extension to February 10, 2013; on March 13, 2013, the Court issued
an order granting an extension to March 14, 2014; and, on February 6, 2014, issued an order
granting an extension to June 30, 2014.
Beginning in July 2012, and ending with the most current certification efforts in October 2013, the
Court has issued orders accepting the Special Master’s determination that the District has achieved
compliance with 38 of 70 outcome criteria in eight of nine goals under the 2010 Exit Plan, including
determinations of compliance with all of the outcome criteria in Goal A.3. (Staff Training), Goal C
(Safeguarding Personal Possessions), and Goal F (Adequate Budget). Thus, the defendants have
achieved compliance more than half of the 2010 Exit Plan outcome criteria, including all of the
outcome criteria for three of nine goal areas.
On January 31, 2014, the DDS Director submitted her certification on the seven remaining Goal B
(Protection from Harm) outcome criteria with the Special Master under the agreed-upon
certification procedures in the case. The DDS Director’s certification filings with respect to the
remaining five goal areas in the 2010 Exit Plan – (Goals A.1. (Individualized Habilitation
Plans/Individual Service Plans), A.2. (Provision of Residential, Vocational and Day Services), A.4.
(Restricted Controls Procedures), D.1. (Case Management) and D.2. (Quality Assurance Programs)
– will be submitted to the Special Master on or before June 30, 2014.
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Q25: Please provide a report on the outcomes of the actions implemented to meet the requirements set
forth in LaShawn A. v. Fenty.
LaShawn A. v. Gray is a class action lawsuit that primarily involves the District’s operation of its
child welfare agency, the Child and Family Services Agency (CFSA). The currently controlling
order, the Implementation and Exit Plan (“IEP”), consists of 92 separately measured exit standards
that are categorized as “outcomes to be achieved” and “outcomes to be maintained.” As CFSA
achieves an exit standard, it is re-categorized into the maintenance group. A longstanding Court
Monitor oversees CFSA’s progress toward meeting the exit standards and she issues progress
reports every six months. Since the IEP was entered in December 2010, there have been six
monitoring reports issued, the last having been issued on November 21, 2013. In December 2010,
there were 28 exit standards that had been achieved and were in the maintenance category and 64
exit standards that were not yet achieved. As of the November 2013 progress report, 40 additional
exit standards have been deemed achieved (for a total of 68 standards achieved) and 24 remain to be
achieved.
The Court Monitor’s November 2013 report noted that achievement of the eight exit standards
between January and June 2013 “is a significant accomplishment for CFSA, and demonstrates that
the management improvement and range of practice strategies being implemented by CFSA’s
leaders has had positive and cumulative impact.”
Q26: Please provide listing of costs for any penalties resulting in bringing the District into compliance
with these cases.
There have been no costs for penalties resulting from bringing the District into compliance with
these cases.
Q27: Are any additional cases pending under the auspices of DMHHS? If so, please describe in detail.
Jerry M. v. Gray During FY13, various work plan requirements for Jerry M. v. Gray were vacated by the Court. On
July 3, 2013, the court issued an order vacating Work Plan goals VI.A.3 and IV.A.4, which relate to
the educational program at New Beginnings Youth Development Center (NBYDC). Also, on
November 19, 2013, the court issued two orders vacating Work Plan goals IX and XI which
concerned completion of construction of the NBYDC facility and the closure of the Oak Hill Youth
Center facility, respectively. During FY13, DYRS has experienced additional accomplishments
with respect to poising itself to achieve compliance with the outstanding work plan exit criteria,
including: requesting the Special Arbiter’s review of its compliance with Goal I.A.4.a, concerning
mechanical restraint use at NBYDC; reaching an agreement with Plaintiffs’ counsel regarding the
performance standards related to staffing at both facilities; coming to a consensus with Plaintiffs’
counsel and the Special Arbiter regarding the scope and definition of crucial terms used in the Work
Plan (including ‘critical incident’); and devising a schedule to ensure increased communication
occurs with the Plaintiffs to maximize collaboration in an effort to achieve compliance. Although
not in FY13, during December 2013, DYRS requested the Special Arbiter’s review of its
compliance with Goal 1.A.4.a, concerning mechanical restraint use at the Youth Services Center,
and Goal VII concerning environmental health and safety and fire safety at both facilities. Finally,
on December 30, 2013, the District filed a Motion to Vacate the Consent Decree Including Any
Subsequent Remedial Orders and to Dismiss the Case.
Salazar v. D.C.
24
Three major issues initially were raised in Salazar v. D.C., a 1993 lawsuit: 1) Early Periodic
Screening Development and Treatment (EPSDT) service delivery; 2) timely processing of
applications and re-certifications for Medicaid eligibility; and 3) out-of-pocket expenditures
processing. Since the 1999 Consent Decree, three additional court orders on dental, lead, and
notice/outreach were entered. The Court regularly schedules (about every 6-8 weeks) Status
Conferences with the Court Monitor and parties to discuss items related to complying with the
Consent Decree and the other related Court Orders. In 2013, the District was in compliance with
meeting all deliverables and reports to the Court. The District also continued to engage in mediation
proceedings through the United States Court of Appeals for the District of Columbia Circuit
Mediation Program regarding an exit from the current Dental Order. Those proceedings continue.
On October 16, 2013 the Court heard oral argument on the District’s Motion to Modify the Consent
Order to relieve the District from the requirements in Section III of the Order in connection with
recertification and reporting based on changes in the Affordable Care Act. On October 17, 2013
Judge Kessler granted the District’s Motion to Modify and relieved the District of further
compliance with Section III of the Consent Order.