The CR is National News — But Its Consequences Land Right Here in DC
Congress may have replaced a shutdown with a continuing resolution (CR), but here in the District, that doesn’t mean our long term care system can exhale. Yes, the federal government avoided disruption. But for DC’s aging, disability, and home care infrastructure, this moment feels less like progress and more like being stuck in traffic with the engine idling. Nearly all residents and certainly low income residents will experience the negative ramifications of top down…or trickle-down economics.
The CR buys time, not solutions.
The Good News for DC: Our Day-to-Day Operations Stay Steady
Because Medicaid remains funded at last year’s levels, several core DC systems keep moving without interruption:
- DC Health Care Finance (DHCF) continues processing claims, eligibility, and HCBS authorizations.
- DC Health (DOH) maintains inspections, licensing, CNA/CMT oversight, and regulatory operations.
- DACL continues case management, senior nutrition, caregiver support, and community-based services.
- Villages, home care agencies, and community providers avoid the immediate chaos that a shutdown would have created.
Consumers don’t lose services. Providers don’t face payment delays. And our direct care workforce avoids another moment of unnecessary uncertainty.
This stability matters for residents aging in place, family caregivers, and the community organizations who support them.
Where DC Hits the Wall: Progress Is Frozen
But here’s the part we cannot ignore: while basic operations continue, all meaningful improvement work stalls.
Because a CR freezes federal agencies and funding levels, DC cannot advance several priorities that depend—directly or indirectly—on federal approval, flexibility, or matching dollars:
1. Workforce Improvements Slow Down
DC’s efforts to strengthen the long term care workforce—especially home care workers and CNAs—lose momentum.
That means:
- No additional federal resources for CNA test modernization
- Delays in implementing medication aide training
- Limited room for rate enhancements that stabilize the workforce
2. HCBS Modernization Gets Stuck
DC has been working to shore up HCBS providers, improve reimbursement logic, and expand community-based supports.
Under a CR:
- No new federal matching funds flow to support targeted HCBS improvements
- Planned upgrades to quality measures and technology interoperability slow
- Innovations like value-based payments or specialized dementia supports remain in waiting mode
3. Cross-Agency DC Planning Loses Momentum
Many of DC’s long-term improvements require coordination between:
- DHCF
- DOH
- DACL
- DDS
- HFA and housing partners
- The Long Term Care Strategic Coordinator
When federal rules and dollars freeze, DC agencies must become risk-averse—advancing only what is already funded rather than what is needed.
4. Community Infrastructure Stalls
Villages, Ward-based senior collaboratives, community nonprofits, and home care agencies rely on steady public investment and clear policy direction.
Under a CR:
- Planned expansions of community outreach or caregiver support programs get delayed
- Smaller providers cannot plan staffing, wages, or service growth with confidence
- Collaboration across agencies and providers shifts into “wait and see” mode
Implications for Long Term Care in the District
The CR protects the system from immediate harm—but freezes nearly everything DC needs to make long term care more accessible, higher-quality, and more equitable.
DC residents who rely on:
- home care,
- community-based supports,
- caregiver services,
- Villages and senior collaboratives, and
- aging and disability programs
will experience stability, but not improvement.
For a city with rapidly increasing numbers of older adults and residents living with disabilities, “standing still” is not a neutral position—it’s a setback.
The Coalition’s Focus in This Moment
During this policy holding pattern, the DC Coalition on Long Term Care is focused on:
- Pressing DC leaders to protect and grow local investment in long term care, even when federal momentum slows.
- Advancing our near-term goals: CNA testing improvements, medication aide rollout, and strengthened oversight of the Long Term Care Strategic Coordinator.
- Supporting members—Villages, providers, advocates, and community partners—to remain visible and vocal, ensuring long term care does not slip off the policy radar.
Bottom Line
The CR keeps DC’s long term care system stable, but it also keeps it stuck.
To move forward, the District will need to rely on its own leadership, its own priorities, and its own commitment to older adults, people with disabilities, caregivers, and the workforce that makes independence possible. The Mayor, District agencies and the City Council must do all it can to ensure that older residents and people requiring long term care get the services they require.
You and your neighbors matter – in this moment when federal progress is frozen, your advocacy matters more than ever.
— Neil Richardson
Coordinator, DC Coalition on Long Term Care