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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.