District of Columbia Elderly and Persons with Physical Disabilities (EPD) Waiver
The Elderly and Persons with Physical Disabilities (EPD) Waiver is DC Medicaid’s home and community-based waiver. It helps DC residents who need a nursing home level of care live at home or in assisted living. This page is part of our District of Columbia Long-Term Care Medicaid guide.
Figures change periodically. Double-check current amounts before relying on them.
At a glance
| Item | Details |
|---|---|
| Type of program | Medicaid home and community-based services (HCBS) waiver |
| Who runs it | DC Department of Health Care Finance (DHCF), with the DC Department of Aging and Community Living (ADRC) |
| Age | 65 and older, or 18 to 64 with a physical disability |
| Care need | Needs a nursing facility level of care |
| District of Columbia 2026 income rule (long-term care) | $2,982 a month (special income standard) |
| District of Columbia 2026 asset limit (single applicant) | $4,000 |
| Waiting list | Yes, when capacity is full (first come, first served) |
The EPD Waiver in brief
Put simply, responsibility for the EPD Waiver sits with DC Department of Health Care Finance (DHCF), with the DC Department of Aging and Community Living (ADRC). Who it is for: 65 and older, or 18 to 64 with a physical disability. Care need required: Needs a nursing facility level of care. On waiting lists, the current picture is: Yes, when capacity is full (first come, first served). More detail on each point follows, and the District of Columbia state guide covers the shared financial rules. If the EPD Waiver is not the right fit, the related pages at the end point to other District of Columbia programs and general guides.
What the program is
DHCF runs the EPD Waiver. A person usually starts with the Aging and Disability Resource Center, gets an assessment for level of care, and then works with a case manager who writes a person-centered plan. EPD includes a participant-directed option called Services My Way, under which participants can hire their own workers.
A waiver is a program a state runs with federal permission to set aside some normal Medicaid rules so it can pay for long-term care outside a nursing home. Waivers usually have a fixed number of slots each year, a care plan written for each person, and a case manager or support coordinator who arranges services. Participants keep their regular DC DHCF coverage for medical care; the waiver adds long-term care services to it. See our overview of HCBS waivers.
Who qualifies in 2026
Eligibility for the EPD Waiver comes down to these points. The person:
- Is 65 or older, or 18 to 64 with a physical disability
- Is eligible for DC Medicaid
- Needs a nursing facility level of care
- Lives in DC
Financial eligibility. Applicants for the EPD Waiver must meet District of Columbia’s long-term care Medicaid financial rules. The table’s figures are District of Columbia’s 2026 long-term care numbers, taken from our state guide. DC DHCF’s countable assets do not usually include the home (within the equity limit, if the applicant or a spouse lives there or intends to return), one car, personal belongings and a small burial fund. Married couples get extra protection in District of Columbia: the spouse at home keeps a share of assets and may get some of the applicant’s income. See Spousal impoverishment rules.
About the level-of-care assessment. The care test looks at how much help a person needs with everyday activities such as bathing, dressing, eating, using the toilet, moving around and taking medicines, and at memory problems and supervision needs. The visit is normally face to face, at home or in a hospital or facility. Before a the EPD Waiver assessment, it helps to line up a family member who can describe a typical bad day, and to have a list of diagnoses and medications ready. See Nursing home level of care and Activities of daily living.
What services it can pay for
The plan of care decides which services are used. The EPD Waiver can cover:
- Case management
- Personal care aides
- Adult day health
- Respite
- Home changes (environmental accessibility)
- Occupational and physical therapy
- Personal emergency response systems
- Participant-directed services
- Assisted living services
The menu is broad, but the plan is built from need, and unpaid family help is factored in. If needs change, ask for a new assessment.
Directing your own care and paying family
EPD’s Services My Way option lets participants hire, train and supervise their own workers with a budget, with help from a fiscal agent.
How to apply
There are two tracks, a financial one and a care one, and both must say yes. The usual path for the EPD Waiver is:
- Contact the DC Aging and Disability Resource Center to request EPD.
- Apply for DC Long-Term Care Medicaid with DHCF’s Economic Security Administration.
- Complete the level of care assessment.
- Choose a case management agency, which writes the plan and arranges services.
Our documents checklist and Applying for a waiver guide list the paperwork.
Waiting lists
The EPD Waiver has a fixed capacity. When it is full, DHCF keeps a first-come, first-served waiting list. Applicants get a waiting-list number and are told when a slot opens. DHCF has not published how long the current list is.
General advice is in Waiver waiting lists.
How it relates to nursing home Medicaid
EPD uses the same nursing facility level of care and DC’s 2026 special income standard ($2,982 a month) and asset limit ($4,000) as nursing home Medicaid. It covers assisted living services, but not room and board.
Where the nursing home rules still apply. As in nearly every state, District of Columbia’s financial rules for home and community programs follow its nursing home rules closely. The five-year look-back for gifts generally applies, so a gift or transfer for less than fair value can cause a period when Medicaid will not pay for long-term care services. Estate recovery also applies: the state can seek repayment from the estate of a person who received long-term care services after age 55. Under the EPD Waiver, income above an allowance may go toward the cost of care each month.
Personal needs allowance. If the person does move to a nursing home, District of Columbia’s 2026 personal needs allowance is $109 a month. Most of the rest of their income goes toward the cost of care. Our state guide covers the nursing home rules in detail.
Tips for families
- Start early. If there is a waiting list or a slow assessment, the clock usually starts when you ask, not when the crisis comes.
- Keep a paper trail: copies of forms and notices, plus the names and dates of every call to DC DHCF.
- Use your appeal rights. Notices that deny or reduce services explain how to request a fair hearing; acting quickly can protect current services.
- Report changes promptly, including income, assets, a move or a new living arrangement.
- Mark renewal dates. Eligibility and the care plan are usually reviewed annually; see Renewals.
- Get help with complex the EPD Waiver cases, such as a spouse at home or past gifts. A certified Medicaid planner or a legal aid office can review how District of Columbia’s rules fit a family’s situation.
Common questions
Can family be paid? Through Services My Way, participants can hire their own workers, which can include some family members.
Does EPD pay for assisted living? It can pay for care services. The resident pays room and board.
Is EPD the same as personal care aide services? No. State plan PCA services are separate and do not require a waiver slot.
Related pages
- District of Columbia Long-Term Care Medicaid guide
- DC personal care aide services
- DC adult day health program
- Three kinds of Long-Term Care Medicaid
- PACE programs
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.