Code of the District of Columbia

Part C. Medicaid and Special Education Reform Fund.


§ 4–204.51. Short title.

This part may be cited as the “Medicaid and Special Education Reform Fund Establishment Act of 2002”.


(Oct. 1, 2002, D.C. Law 14-190, § 1551, 49 DCR 6968.)

Editor's Notes

Section 1506 of D.C. Law 14-190 provided that this part shall apply as of October 1, 2002.


§ 4–204.52. Definitions.

For the purposes of this part, the term:

(1) “District” shall mean the District of Columbia.

(1A) “Foster care and adoption assistance” means the programs authorized by Part E of Title IV of the Social Security Act, approved June 17, 1980 (94 Stat. 501; 42 U.S.C. § 670 et seq.).

(2) “Fund” shall mean the Medicaid and Special Education Reform Fund established by § 4-204.53

(3) “Medicaid” means the medical assistance programs authorized by title XIX of the Social Security Act, approved July 30, 1965 (79 Stat. 343; 42 U.S.C. § 1396 et seq.), or by § 1-307.02, and administered by the Department of Health.

(4) “Medicare” means the health insurance programs authorized by title XVIII of the Social Security Act, approved July 30, 1965 (79 Stat. 290; 42 U.S.C. § 1395 et seq.).

(5) “Special Education” means services provided under § 38-2501 to students who are classified as having a disability, as defined in section 101(a)(1) of the Individuals with Disabilities Education Act, approved April 13, 1970 (84 Stat. 175; 20 U.S.C. § 1401(a)(1)), or in section 7(8) of the Rehabilitation Act of 1973, approved September 26, 1973 (87 Stat. 359; 29 U. S.C. § 706(8)).


(Oct. 1, 2002, D.C. Law 14-190, § 1552, 49 DCR 6968; Nov. 13, 2003, D.C. Law 15-39, § 1503(a), 50 DCR 5668.)

Effect of Amendments

D.C. Law 15-39, added pars. (1A), (4), and (5); and in par. (3), substituted “or by” for “and by”.

Emergency Legislation

For temporary (90 day) amendment of section, see § 1503(a) of Fiscal Year 2004 Budget Support Emergency Act of 2003 (D.C. Act 15-105, June 20, 2003, 50 DCR 5613).

For temporary (90 day) amendment of section, see § 1503(a) of Fiscal Year 2004 Budget Support Congressional Review Emergency Act of 2003 (D.C. Act 15-149, September 22, 2003, 50 DCR 8360).


§ 4–204.53. Establishment of the Medicaid and Special Education Reform Fund.

(a) There is established as a nonlapsing, revolving fund the Medicaid and Special Education Reform Fund into which shall be deposited funds made available for the purposes of Medicaid, Medicare, Foster Care and Adoption Assistance, and Special Education reform described in § 4-204.54. The Fund shall be administered by the Chief Financial Officer.

(b) All amounts deposited in the Fund shall be appropriated without fiscal year limitation pursuant to an act of Congress. All amounts deposited in the Fund shall not revert to the General Fund at the end of any fiscal year or at any other time, but shall be continually available for the purposes of Medicaid, Medicare, Foster Care and Adoption Assistance, and Special Education reform described in § 4-204.54, subject to authorization by Congress in an appropriations act.


(Oct. 1, 2002, D.C. Law 14-190, § 1553, 49 DCR 6968; Nov. 13, 2003, D.C. Law 15-39, § 1503(b), 50 DCR 5668.)

Section References

This section is referenced in § 4-204.52 and § 7-1811.03.

Effect of Amendments

D.C. Law 15-39, in subsecs. (a) and (b), substituted “Medicaid, Medicare, Foster Care and Adoption Assistance, and Special Education reform” for “Medicaid and Special Education reform”.

Emergency Legislation

For temporary (90 day) amendment of section, see § 1503(b) of Fiscal Year 2004 Budget Support Emergency Act of 2003 (D.C. Act 15-105, June 20, 2003, 50 DCR 5613).

For temporary (90 day) amendment of section, see § 1503(b) of Fiscal Year 2004 Budget Support Congressional Review Emergency Act of 2003 (D.C. Act 15-149, September 22, 2003, 50 DCR 8360).

For temporary (90 day) addition of section, see § 5142 of Fiscal Year 2013 Budget Support Emergency Act of 2012 (D.C. Act 19-383, June 19, 2012, 59 DCR 7764).

For temporary (90 day) addition of section, see § 5142 of Fiscal Year 2013 Budget Support Congressional Review Emergency Act of 2012 (D.C. Act 19-413, July 25, 2012, 59 DCR 9290).

Editor's Notes

Section 5142 of D.C. Law 19-168 provided:

“(a) Beginning on June 1, 2012, unspent funds from Medicaid underenrollment, calculated on a fiscal year basis, shall be set aside in a fund to offset the costs to implement the South Capitol Street Memorial Amendment Act of 2012 effective June 7, 2012 (D.C. Law 19-141; 59 DCR 3083) (‘South Capitol Street Memorial Amendment Act’).

“(b) This section shall not apply if the South Capitol Street Memorial Amendment Act is fully funded, as certified by the Chief Financial Officer, either by the terms of this section or pursuant to section 10002(3) of the Revised Revenue Estimate Contingency Priority List Act of 2012, passed on 2nd reading on June 5, 2012 (Enrolled version of Bill 19-743).”


§ 4–204.54. Purposes of the Fund.

The Fund shall be used for the following purposes:

(1) Ensuring adequate resources are available to support District-wide Medicaid costs and revenue shortfalls;

(1A) Ensuring adequate resources are available to support District-wide Medicare costs and revenue shortfalls;

(1B) Ensuring adequate resources are available to support District-wide Foster Care and Adoption Assistance costs and revenue shortfalls;

(2) Ensuring adequate resources are available to support District-wide Special Education costs and revenue shortfalls;

(3) Supporting Medicaid, Medicare, and Foster Care and Adoption Assistance reform activities designed to establish cost-effective, agency-based Medicaid, Medicare, and Foster Care and Adoption Assistance operations; and

(4) Optimizing Medicaid, Medicare, Foster Care and Adoption Assistance and other third-party revenues.


(Oct. 1, 2002, D.C. Law 14-190, § 1554, 49 DCR 6968; Nov. 13, 2003, D.C. Law 15-39, § 1503(c), 50 DCR 5668.)

Section References

This section is referenced in § 4-204.53 and § 4-204.55.

Effect of Amendments

D.C. Law 15-39, in the introductory language, substituted “The Fund shall be used for the following purposes:” for “The purposes of the Fund shall include:”; added pars. (1A) and (1B); in par. (3), substituted “Medicaid, Medicare, and Foster Care and Adoption Assistance” for “Medicaid” in two places; and in par. (4), substituted “Medicaid, Medicare, Foster Care and Adoption Assistance” for “Medicaid”.

Emergency Legislation

For temporary (90 day) amendment of section, see § 1503(c) of Fiscal Year 2004 Budget Support Emergency Act of 2003 (D.C. Act 15-105, June 20, 2003, 50 DCR 5613).

For temporary (90 day) amendment of section, see § 1503(c) of Fiscal Year 2004 Budget Support Congressional Review Emergency Act of 2003 (D.C. Act 15-149, September 22, 2003, 50 DCR 8360).

For temporary (90 day) addition of section, see § 5142 of Fiscal Year 2013 Budget Support Emergency Act of 2012 (D.C. Act 19-383, June 19, 2012, 59 DCR 7764).

For temporary (90 day) addition of section, see § 5142 of Fiscal Year 2013 Budget Support Congressional Review Emergency Act of 2012 (D.C. Act 19-413, July 25, 2012, 59 DCR 9290).


§ 4–204.55. Distribution of funds.

(a) The Chief Financial Officer shall distribute funds from the Fund only after:

(1) Certifying that the funds are needed by the District of Columbia Public Schools, the Child and Family Services Agency, the Department of Human Services, the Department of Mental Health, or the Department of Health for the purposes described in § 4-204.54;

(2)(A) Certifying either that:

(i) A savings plan to be submitted by the Director of the Office of Medicaid Operations Reform to the Mayor will generate savings for the Child and Family Services Agency, the Department of Human Services, the Department of Mental Health, or the Department of Health, respectively, comparable to the funds to be allocated to the agency during Fiscal Year 2003 or Fiscal Year 2004; or

(ii) If a savings plan that will generate savings comparable to the funds allocated is not possible, a performance plan to be submitted by the Director of the Office of Medicaid Operations Reform to the Mayor will ensure that the agency to which the requested funds are to be allocated will implement policies and procedures and develop the infrastructure necessary to enable the agency to reduce costs and maximize third-party revenues by no later than October 1, 2004; or

(B) Certifying that a savings plan to be submitted by the District of Columbia Public Schools will generate savings comparable to the funds allocated to the agency during Fiscal Year 2003 or Fiscal Year 2004; and

(3) Providing notification of the distribution to the Mayor and Council.

(a-1) A savings plan required under subsection (a)(2)(A)(i) of this section that pertains to the allocation of funds to an agency in Fiscal Year 2003 shall be submitted no later than December 31, 2002. The plan shall commence no later than October 1, 2003, and shall generate savings comparable to the funds allocated to the agency from the Fund in Fiscal Year 2003.

(a-2) A savings plan required under subsection (a)(2)(A)(i) of this section that pertains to the allocation of funds to an agency in Fiscal Year 2004 shall be submitted no later than December 31, 2003. The plan shall commence no later than October 1, 2004, and shall generate savings comparable to the funds allocated to the agency from the Fund in Fiscal Year 2004.

(a-3) A performance plan required under subsection (a)(2)(A)(ii) of this section shall be submitted no later than December 31, 2003, and shall commence no later than October 1, 2004.

(a-4) The savings plan required under subsection (a)(2)(B) of this section that pertains to the allocation of funds to the District of Columbia Public Schools in Fiscal Year 2003 shall be submitted, no later than December 31, 2002, by the District of Columbia Public Schools to the Special Education Task Force established by Chapter 25A of Title 38. The plan shall commence no later than October 1, 2003, and generate savings comparable to the funds allocated to the agency from the Fund in Fiscal Year 2003.

(a-5) The savings plan required under subsection (a)(2)(B) of this section that pertains to the allocation of funds to the District of Columbia Public Schools in Fiscal Year 2004 shall be submitted, no later than December 31, 2003, by the District of Columbia Public Schools to the Special Education Task Force established by Chapter 25A of Title 38. The plan shall commence no later than October 1, 2004, and generate savings comparable to the funds allocated to the agency from the Fund in Fiscal Year 2004.

(a-6) Beginning 3 months following the commencement of any plan submitted pursuant to subsection (a)(2) of this section, or no later than January 2, 2004, the Mayor and the Special Education Task Force shall provide the Council with quarterly reports on the progress made by the Department of Human Services, the Child and Family Services Agency, the Department of Mental Health, the Department of Health, and the District of Columbia Public Schools, in reducing costs associated with the Medicaid, Medicare, Foster Care and Adoption Assistance, and Special Education programs.

(b) Total distribution of funds from the Fund to the District of Columbia Public Schools, the Child and Family Services Agency, the Department of Human Services, the Department of Mental Health, or the Department of Health in any given fiscal year shall not exceed the amount appropriated for that agency in that fiscal year for the purposes of § 7-1811.03(b).


(Oct. 1, 2002, D.C. Law 14-190, § 1555, 49 DCR 6968; Nov. 13, 2003, D.C. Law 15-39, § 1503(d), 50 DCR 5668; Apr. 13, 2005, D.C. Law 15-354, §§ 12, 84(g), 52 DCR 2638.)

Section References

This section is referenced in § 4-204.13 and § 7-1811.03.

Effect of Amendments

D.C. Law 15-39, in subsec. (a), substituted “the Department of Human Services, the Department of Mental Health, or the Department of Health” for “or the Department of Human Services” in par. (1), and rewrote par. (2); added subsecs. (a-1), (a-2), (a-3), (a-4), (a-5), and (a-6); and in subsec. (b), substituted “the Department of Human Services, the Department of Mental Health, or the Department of Health” for “or the Department of Human Services”. Prior to amendment, par. (2) of subsec. (a) had read as follows: “(2) Certifying that a savings plan to be submitted by the Director of the Office of Medicaid Public Provider Operations Reform to the Mayor in accordance with § 7-1811.03(b)(5)(A)(i), will generate savings comparable to the funds allocated; and”

D.C. Law 15-354, in subsecs. (a-4) and (a-5), validated previously made technical corrections.

Emergency Legislation

For temporary (90 day) amendment of section, see § 1503(d) of Fiscal Year 2004 Budget Support Emergency Act of 2003 (D.C. Act 15-105, June 20, 2003, 50 DCR 5613).

For temporary (90 day) amendment of section, see § 1503(d) of Fiscal Year 2004 Budget Support Congressional Review Emergency Act of 2003 (D.C. Act 15-149, September 22, 2003, 50 DCR 8360).


§ 4–204.56. Annual report.

The Mayor shall report annually to the Council on the revenues and activities of the Fund.


(Oct. 1, 2002, D.C. Law 14-190, § 1556, 49 DCR 6968.)