Code of the District of Columbia

§ 7–771.07a. Grant authority.

(a)(1) For Fiscal Year 2018, the Director shall:

(A) Award 4 grants of at least $50,000 to facilitate the development and application of telehealth services to:

(i) Health care providers located in Wards 7 and 8; and

(ii) Residents located in Wards 7 and 8;

(B) Award 2 grants of at least $75,000 to facilitate the development and application of telehealth services to homeless shelters or public housing projects; and

(C) Award a grant of $250,000 to a college of pharmacy located in the District to create and maintain a medication-assisted treatment genomic registry.

(2) In awarding grants pursuant to paragraph (1)(A) of this subsection, the Director shall consider the following:

(A) Promoting telehealth in specialty areas of medicine, including ophthalmology, obstetrics, and endocrinology; and

(B) Expanding the application of telehealth to public schools, patient homes, and skilled nursing facilities.

(a-1) For Fiscal Year 2019, the Director shall:

(1) Award a competitive grant in an amount not to exceed $75,000 to develop a pilot program to strengthen the ability of faith-based organizations to:

(A) Deliver health screening, assessments, and health care services through telehealth; and

(B) Reduce low-acuity, non-emergency room visitation, avoidable hospitalizations, and hospital readmission for persons who live in Wards 5, 7, and 8;

(2) Award 2 competitive grants in an amount not to exceed $50,000 to health care providers with expertise and staff capacity in medical oncology, particularly prostate and gynecologic cancers, that focus on patient screening, treatment planning, and care coordination, to defray the capital and equipment costs associated with the provision of additional oncological services in Wards 7 and 8;

(3) Award a competitive grant in an amount not to exceed $30,000 to a health care provider to establish a program to provide free medical services to teen parents attending a District of Columbia public school or public charter high school located in Ward 7 or 8;

(4) Award a competitive grant in an amount not to exceed $500,000 to an organization to design and develop a community resource inventory that is accessible to health and social support organizations and that has the capacity to communicate and track referrals; and

(5)(A) Award a competitive grant in an amount not to exceed $200,000 to an entity to provide multi-disciplinary, patient-centered preventative health and perinatal educational services to high-risk expectant mothers residing in Wards 7 and 8 and who receive Medicaid or are Medicaid-eligible.

(B) No more than 50% of the selected entity's direct services delivery staff shall possess higher than a bachelor's degree.

(C) At a minimum, the selected entity shall demonstrate an ability to:

(i) Implement a peer-support model of care for expectant mothers;

(ii) Identify a consistent source of referrals for expectant mothers;

(iii) Refer expectant mothers to WIC, health insurance coverage options, and other community resources;

(iv) Provide the following services to expectant mothers:

(I) Regular office and in-home visits;

(II) Mental health supports;

(III) Access to classes and support groups on perinatal fitness, childbirth education, nutritional education, newborn care, and parenting skills;

(IV) Expanded maternity services from the end of pregnancy to 6 months postpartum; and

(v) Initiate delivery of services to expectant mothers as follows:

(I) Prior to 4 weeks postpartum for non-neonatal intensive care unit births; and

(II) Up to 12 weeks postpartum for neonatal intensive care unit births; and

(vi) Increase breastfeeding rates.

(D)(i) The Director shall collect the following data from the selected entity regarding expectant mothers that receive services pursuant to paragraph (5)(A) of this subsection:

(I) Maternal morbidity and mortality rates;

(II) Number of low birth-weight newborns;

(III) Rate of premature births;

(IV) Infant morbidity and mortality rates;

(V) Tobacco and nicotine use during pregnancy and pediatric exposure to second hand smoke; and

(VI) Other data as determined by the Director.

(ii) The Director shall compare the data in sub-subparagraph (i) with outcomes among the general Medicaid and Medicaid-eligible population and report his findings to the Council's Committee on Health.

(a-2) For Fiscal Year 2020, the Director shall:

(1)(A) Award a competitive grant in an amount not to exceed $150,000 to fund operating expenses associated with the provision of medical respite care services to individuals who are homeless; provided, that if such a grant is awarded to a Federally Qualified Health Center ("FQHC"), the amount of the grant shall not be offset against the FQHC's expenses for the purpose of determining its allowable costs in accordance with section 4511.2 of Title 29 of the District of Columbia Municipal Regulations (29 DCMR § 4511.2).

(B) At a minimum, the selected entity shall possess:

(i) The staff capacity and expertise necessary to provide medical respite care, with a particular emphasis on care for women who are homeless; and

(ii) The ability to provide case management services, including assistance in accessing permanent housing services.

(C) By September 30, 2020, the Director shall submit a report to the Council that sets forth:

(i) Recommendations for the establishment of medical respite care services for homeless individuals, through either:

(I) An amendment to the District of Columbia Medicaid State Plan; or

(II) A waiver pursuant to section 1115 of the Social Security Act, approved July 25, 1962 (76 Stat. 192; 42 U.S.C. § 1315), for home and community-based services;

(ii) The types of services that may be offered to homeless individuals through a medical respite care program; and

(iii) An identification of any potential restrictions on the provision of services identified pursuant to sub-subparagraph (ii) of this subparagraph, including the use of prior authorization.

(2)(A)(i) Award competitive grants in an amount not to exceed $100,000 to community-based initiatives focused on addressing the social determinants of health in Wards 7 and 8.

(ii) In establishing criteria for the award of grants pursuant to sub-subparagraph (i) of this subparagraph, the Department shall prioritize community-based initiatives that utilize a cohort-based curriculum that incorporates design-thinking.

(B) By November 1, 2019, the Department shall publish criteria in the District of Columbia Register governing the process for applying for and administering grants issued pursuant to subparagraph (A)(i) of this paragraph; provided, that the Department shall require grant applications to be submitted by January 15, 2020.

(C) By March 1, 2020, the Department shall dispense final awards for all grants issued pursuant to subparagraph (A)(i) of this paragraph.

(a-3) For Fiscal Year 2021, the Director may issue grants pursuant to [§7-771.07b(b)(4)(B)(ii) and (iii) [§ 7-771.07b repealed]] .

(a-4) For Fiscal Year 2021, the Director may:

(1)(A) Award a competitive grant in an amount not to exceed $150,000 to fund operating expenses associated with the provision of medical respite care services to individuals who are homeless; provided, that if such a grant is awarded to a Federally Qualified Health Center ("FQHC"), the amount of the grant shall not be offset against the FQHC's expenses for the purpose of determining its allowable cost in accordance with section 4511.2 of Title 29 of the District of Columbia Municipal Regulations (29 DCMR § 4511.2).

(B) At a minimum, the selected entity shall possess:

(i) The staff capacity and expertise necessary to provide medical respite care, with a particular emphasis on care for women who are homeless; and

(ii) The ability to provide case management services, including assistance in accessing permanent housing services.

(2) If a grant is awarded, then by September 30, 2021, the Director shall submit a report to the Council that sets forth:

(A) Recommendations for the establishment of medical respite care services for homeless individuals, through either:

(i) An amendment to the District of Columbia Medicaid State Plan; or

(ii) A waiver pursuant to section 1115 of the Social Security Act, approved July 25, 1962 (76 Stat. 192; 42 U.S.C. § 1315), for home and community-based services;

(B) The types of services that may be offered to homeless individuals through a medical care respite program; and

(C) An identification of any potential restrictions on the provision of services identified pursuant to sub-subparagraph (ii) of this subparagraph, including the use of prior authorization.

(a-5) For Fiscal Year 2022, subject to the availability of funds, the Director may:

(1)(A) Award a competitive grant in an amount not to exceed $150,000 to fund operating expenses associated with the provision of medical respite care services to individuals who are homeless; provided, that if such a grant is awarded to a Federally Qualified Health Center ("FQHC"), the amount of the grant shall not be offset against the FQHC's expenses for the purpose of determining its allowable cost in accordance with section 4511.2 of Title 29 of the District of Columbia Municipal Regulations (29 DCMR § 4511.2).

(B) At a minimum, the selected entity shall possess:

(i) The staff capacity and expertise necessary to provide medical respite care, with a particular emphasis on care for women who are homeless; and

(ii) The ability to provide case management services, including assistance in accessing permanent housing services.

(2)(A) Award competitive grants in an amount not to exceed $200,000 to community-based initiatives focused on addressing the social determinants of health in Wards 7 and 8.

(B) In establishing criteria for the award of grants pursuant to this paragraph, the Department shall prioritize community-based initiatives that utilize a cohort-based curriculum that incorporates design-thinking.

(3)(A) Award competitive grants in an amount not to exceed $200,000 to study the barriers to telehealth services for clients of the Department of Behavioral Health and the Department of Disability Services, utilizing a design-thinking approach, and to propose a set of recommendations for addressing those barriers.

(B) In establishing criteria for the award of grants pursuant to this paragraph, the Department shall prioritize providers that have an established program dedicated to design-thinking.

(4) Award competitive grants in an amount not to exceed $250,000 to assist FQHCs in educating their patients in Wards 7 and 8 on how to properly access telehealth services; provided, that the amount of the grant shall not be offset against the FQHC's expenses for the purpose of determining its allowable costs in accordance with section 4511.2 of Title 29 of the District of Columbia Municipal Regulations (29 DCMR § 4511.2).

(5) Award a competitive grant in an amount not to exceed $100,000 to a District-based organization to deploy non-physician healthcare practitioners, such as social workers, to facilitate and improve care coordination for pregnant mothers receiving health benefits through Medicaid or the DC HealthCare Alliance; provided, that the Department shall select an awardee with experience providing prenatal and postpartum maternal care to Medicaid beneficiaries by way of digital health or telehealth with a focus on early detection of pregnancy-related illnesses, such as gestational hypertension or preeclampsia.

(b) By April 1, 2019, the Director shall submit a report to the Secretary to the Council on all grants issued pursuant to this section.

(c) All grants issued pursuant to this section shall be administered pursuant to the requirements set forth in part B of subchapter XII-A of Chapter 3 of Title 1.

(d) The Director may set forth health outcome measures for all grants issued pursuant to this section.

(d-1) Funds appropriated for grants issued pursuant to subsection (a-2) of this section shall not be reprogrammed, unless the Council approves the reprogramming request by resolution.

(e) For the purposes of this section, the term:

(1) "Design-thinking" means a structured, human-centered creative process that synthesizes multi-disciplinary ideas to address the social determinants of health.

(1A) "Health-care provider" shall have the same meaning as provided in § 21-2202(4).

(2) "Medication-assisted treatment genomic registry" means a central location for the submission of genetic test information that health care providers can use in the provision of medication assisted treatment, clinical decision support for induction, stabilization, and maintenance treatment, and genomic-guided medication therapy management for opioid addiction.

(2A) "Social determinants of health" means the conditions in the environment in which people are born, live, work, and age that have a significant impact on health outcomes, including socioeconomic status, education, physical environment, employment, social support networks, and access to health-care services.

(3) "Telehealth" shall have the same meaning as provided in § 31-3861(18).

(4) "WIC" means the Special Supplemental Nutrition Program for Women, Infants, and Children, as provided in section 17 of the Child Nutrition Act of 1966, approved September 26, 1972 (86 Stat. 729; 42 U.S.C. § 1786).