State Medicaid Waiver Directory
Find your state's Katie Beckett waiver, TEFRA pathway, HCBS programs, and Medicaid eligibility rules for children and adults with disabilities. Each guide covers waitlists, application steps, income limits, and parent caregiver pay options.
For informational purposes only — not legal, medical, or financial advice. Medicaid rules, eligibility, and waitlists change frequently. Always verify with your state's official Medicaid agency before making decisions. Cross-check with Medicaid.gov's official waiver page.
District of Columbia
Program Overview
Overview
Washington D.C. has its own Medicaid program administered by the Department of Health Care Finance (DHCF). For children with disabilities, the primary pathways are through DC Medicaid managed care and the Developmental Disabilities Administration (DDA) waiver system.
Katie Beckett or similar pathway
Washington D.C. has a TEFRA/Katie Beckett pathway administered by the DC Department of Health Care Finance (DHCF). It is available for children with long-term disabilities or complex medical needs who require institutional-level care but can safely be cared for at home, and parental income is not counted. Apply through DHCF at dhcf.dc.gov/katiebeckett.
Child-relevant waivers
The primary child-relevant programs are the DDA Home and Community-Based Services (HCBS) Waiver and the Individual and Family Supports (IFS) Waiver, both administered through the Department on Disability Services (DDS).
Eligibility
Who qualifies
DDA waivers serve individuals with intellectual and developmental disabilities who meet ICF/ID level of care. Children must be D.C. residents and Medicaid-eligible.
Financial and income rules
DC Medicaid financial eligibility applies. For DDA waivers, income and resource rules are specific to the program and the child's situation is evaluated separately from parental income in many cases.
Level of care
ICF/ID level of care is required for DDA waiver participation. Level-of-care determinations are conducted through DDS intake.
Age rules
DDA serves individuals of various ages including children. Early intervention services are available from birth to age 3 through DC's Strong Start program.
Getting Started
How to apply
Contact the DC Department on Disability Services (DDS) for DDA waiver intake. Contact DHCF for broader Medicaid questions.
Documents needed
Disability documentation, DDS eligibility determination, medical records, and Medicaid financial information are typically required.
Waitlist information
DC's DDA waivers have historically had waiting lists. Families are strongly encouraged to contact DDS and begin the eligibility process as early as possible.
Practical next step
Contact the DC Department on Disability Services and ask about DDA waiver eligibility, intake, and current waitlist status.
Services & Support
Services available
DDA waivers can cover residential supports, day habilitation, supported employment, in-home supports, respite, assistive technology, and community integration services.
Parent caregiver pay
Washington, DC's DDA waiver includes self-directed supports, and in some cases family members can be hired and compensated as paid support workers under self-direction. Little published guidance exists on paid parent caregiving for minors, so contact the DC Department on Disability Services for current rules.
Mental health and Medicaid coverage
DC Medicaid covers behavioral health services through managed care organizations and the Department of Behavioral Health (DBH). Covered services include outpatient therapy, psychiatric evaluations, medication management, crisis stabilization, assertive community treatment, and community support services. DBH directly operates some services and contracts with community providers. Children can access mental health services through the EPSDT benefit. DC has a strong school-based mental health program and a robust crisis services network. The DBH Access Helpline connects families to behavioral health services.
Additional notes
As a city-state jurisdiction, D.C. has a relatively compact system compared to large states, but services can still be limited and waitlists exist. DDS is the central contact for developmental disability services, making the intake process more streamlined than in states with county-based systems.
Sources
Recent news for District of Columbia
washingtonsun.com · October 20, 2026 · Rights & Law
A wheelchair user is advocating for increased accessibility infrastructure in Washington D.C. by testifying before the city council.
news.bloomberglaw.com · October 2, 2026 · Rights & Law
A legal case regarding disability discrimination and disparate treatment is currently moving through the U.S. District Court for the District of Columbia.
Community Tips & Experience
Comments reflect the personal experiences and opinions of individual community members only. They do not represent the views, positions, or endorsements of National Disability Resource Project or any of its staff, volunteers, or affiliated members. Always verify information with official agencies and qualified professionals before making decisions.
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