For District residents who want to stay out of a nursing facility, the Elderly and Persons with Physical Disabilities Waiver — known as the EPD Waiver — is the primary path. It allows people who would otherwise need nursing-home-level care to instead receive services at home or in an assisted-living setting. The District's Department of Aging and Community Living (DACL) opens eligibility to adults 65 and older as well as adults 18 through 64 who have a physical disability, provided they also meet Medicaid, residency, financial, and level-of-need requirements.
Program requirements include a Prescription Order Form from a DC Medicaid provider, an in-person level-of-need assessment, and a $4,000 individual countable-asset limit. One caution worth flagging: DACL's own materials still reference a 2023 income figure and a spend-down option, so for current 2026 dollar amounts, DHCF's long-term-care page — with its $2,982 Special Income Standard and medically needy spend-down rules — is the more reliable source. Using DACL for how the program works and DHCF for what the numbers are today is the safer combination.
Once enrolled, participants can access case management, personal care aide services, a personal emergency response system, participant-directed services through the Services MyWay option, and assisted-living support — though services are delivered through an individualized plan rather than automatically including everything on the list. It's also worth knowing the District runs a completely separate set of waivers for people with intellectual or developmental disabilities (IDD), so EPD eligibility doesn't carry over to those programs or vice versa.
One more operational detail: DHCF shifted its Independent Assessment work for long-term-services programs to a new contractor, Telligen, effective February 1, 2025. Because that kind of administrative detail can change again, it's worth confirming the current referral and assessment process directly with DACL or DHCF rather than relying on an older vendor name. On waitlists, the publicly available material didn't show a current EPD waiting list count, though the District's IDD Waiver did activate a waiting list during its 2025 amendment process — so don't assume an EPD queue exists just because an IDD notice does; ask the enrollment unit directly about capacity.