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Councilmember accuses DHCF of defying law after agency declines to submit Medicaid SPA for home visiting; deputy mayor cites OAG legal advice
Summary
Councilmember Brianna Nadeau accused DHCF of failing to implement a council-funded home visiting reimbursement law; DHCF said it declined to submit the required SPA after two OAG opinions found the statute—s language legally insufficient and potentially in conflict with the mayor—s executive authority.
Councilmember Brianna Nadeau pressed the Department of Healthcare Finance on Feb. 20 after DHCF declined to submit a state plan amendment (SPA) implementing Medicaid reimbursement for home visiting programs funded by the FY25 budget.
Nadeau, who sponsored the Home Visiting Reimbursement Act of 2023 and helped secure FY25 funds, told Chair Christina Henderson she was "exasperated" that DHCF had not forwarded the SPA for federal approval and directly asked, "Why is DHCF ignoring the law and refusing to submit the home visiting state plan amendment?"
Deputy Mayor Wayne Turnich and DHCF leaders responded that two separate legal opinions from the Office of the Attorney General (OAG) concluded the council—s statute contained language that would infringe the mayor—s exclusive authority to amend the District—s Medicaid state plan. Turnich said the administration would not submit a SPA based on language that OAG found legally insufficient: "Their advice is that when the council passes a bill that directs the mayor to change the state plan, that bill is legally insufficient."
Turnich and DHCF staff urged that the law—s language be revised (for example, changing "shall" to "may") so the mayor could consider a change without what the administration viewed as a charter conflict. Nadeau rejected that approach as insufficient after the council had already funded the work in the budget, saying the delay placed programs and providers at risk.
The exchange was among the testiest of the hearing. Nadeau said the delay threatened established and planned provider work, and said she would not "change wording and then hope and pray that mayor Bowser has a change of heart." Turnich countered that DHCF was following legal advice and that budget and fiscal-plan constraints were real factors in enrolling new benefits.
Why it matters: The dispute concerns statutory drafting, executive authority over the state plan, and whether a law and council-funded budget item can be implemented administratively without revised legislative language. It also affects home visiting programs designed to support new and expectant parents.
What—s next: Committee members asked for further detail and DHCF said it would communicate with the city administrator and mayor on legal sufficiency and budget impacts. Council staff may consider technical language changes to the statute to address OAG concerns and move the SPA forward.
