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District of Columbia - Housing Stabilization — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

The District of Columbia Department of Health Care Finance (DHCF) funds Housing Stabilization Services and Housing Navigation Services under the 1915(i) State Plan Home and Community-Based Services (HCBS) benefit. Approval to bill Medicaid for these tenancy supports requires an applicant to first secure an executed PSH3 Human Care Agreement from the Department of Human Services (DHS).

Agencies cannot enroll as standalone Medicaid providers for this service without this DHS certification and active contract. Once the PSH3 agreement is in place, providers submit their enrollment through the DC Provider Data Management System (PDMS) using the case management taxonomy code to receive reimbursement for assisting participants with housing retention and landlord mediation.

1. Service Definition and Scope

The District of Columbia divides this 1915(i) benefit into two distinct services: Housing Navigation Services (pre-tenancy) and Housing Stabilization Services (tenancy sustaining). Both services are designed to help participants find and maintain housing of their own choosing in the community.

Stabilization services require a minimum frequency of twice a month, including at least one face-to-face contact and one other contact, which may be conducted via telephone, email, or text.

2. Regulatory and Oversight Agencies

The Department of Human Services (DHS) acts as the primary operating and certifying agency for the 1915(i) Housing Supportive Services (HSS) benefit. DHS manages the human care agreements and issues prior authorizations.

The Department of Health Care Finance (DHCF) serves as the Single State Medicaid Agency responsible for final provider enrollment, maintaining the Medicaid Provider Agreement, and processing claims.

3. Gatekeeping Prerequisites: Who Can Even Apply

The District of Columbia imposes a strict contracting gate for this service. An entity cannot simply apply to DHCF to become a Housing Stabilization provider; it must first be certified by DHS through a specific procurement vehicle.

Without an active human care agreement with DHS, the Medicaid enrollment portal will not accept or approve an application for the HSS benefit.

4. Licensure and Certification Requirements

The District of Columbia does not issue a traditional healthcare facility license for Housing Stabilization Services. Instead, the state relies on the DHS certification process and the PSH3 Human Care Agreement to validate provider qualifications.

Providers must maintain standard commercial and liability protections as stipulated by their DHS contract and DHCF enrollment rules.

5. Medicaid Provider Enrollment

After securing the DHS PSH3 agreement, agencies enroll as Medicaid providers through the DC Provider Data Management System (PDMS). The application requires uploading the DHS certification and business documents.

Providers must agree to comply with all DHCF data privacy standards and maintain an active Medicaid Provider Agreement.

6. Staffing, Training and Background Checks

The 1915(i) State Plan Amendment strictly defines who can deliver Housing Stabilization and Navigation services. Services must be delivered by specific qualified professionals employed by the HSS agency.

Agencies must ensure their staff are trained in specific engagement techniques to support vulnerable populations.

7. Documentation, Policies and Records

Providers must document all service delivery in the DHS web-based case note system, Housing the Homeless (HTH). This system tracks the mandatory minimum contacts and prior authorization usage.

Agencies must balance HIPAA compliance with the need to share limited protected health information for service coordination.

8. Billing, Rates and Claims

Reimbursement for HSS requires a prior authorization (PA) number generated by DHS staff. Providers cannot bill Medicaid without this active PA number linked to the participant.

DHS provides participants with a list of HSS providers, and once selected, DHS generates the PA and refers the individual to the agency.

9. Approval Sequence and Timeline

The approval sequence begins with DHS procurement and contracting, followed by DHCF Medicaid enrollment. The timeline depends heavily on the DHS PSH3 Human Care Agreement execution process.

Once the DHS contract is secured, the PDMS enrollment process follows standard DHCF credentialing timelines.

10. Common Denials and Survey Findings

Denials typically stem from attempting to enroll without the prerequisite DHS contract or failing to meet the strict staff qualification standards outlined in the 1915(i) SPA.

During audits, providers frequently face recoupments if they fail to document the mandatory face-to-face contacts in the HTH system.

11. Key Contacts and Resources

Providers must coordinate with both DHS for programmatic certification and DHCF for Medicaid enrollment and claims.

Technical assistance for HIPAA compliance and electronic health record adoption is available through DHCF's HCBS Digital Health Technical Assistance program.

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