I write on behalf of all of the other members of the D.C. Council's Human Services committee -- David A. Catania, Jim Graham, Kathy Patterson and Carol Schwartz. We were very much a part of the decisions that The Post's May 15 editorial attributed solely to committee chairwoman Sandy Allen.

We find it unfortunate that The Post chose to personalize the decisions -- which were made by all of us -- in writing about "Sandy Allen's parade of power," "her decision to reroute $9.5 million . . . to her favorite services" and in saying that "this is Ms. Allen's show, and she's going to run it her way."

The Human Services Committee agreed unanimously that the budget proposed for Medicaid was larger than would be necessary, especially based on recent years' experience. This judgment ultimately was shared, after explicit debate on the matter, by all the consensus-budget partners. To be clear: The decision to reroute $9.5 million was shared by the mayor, the control board and the council.

If The Post chooses to disagree with the Medicaid cut or with the other public health programs that benefited from the reallocation, fine. But it is not fair to blame one council member when we and the entire spectrum of policymakers shared in this decision.


Member (D-At Large)

Council of the District of Columbia


The D.C. Council's astonishing decision to pass up $22 million in federal Medicaid money to gain $9 million for other purposes is pure folly ["D.C. Medicaid Deficit Predicted," Metro, May 14]. This action will hurt our most vulnerable citizens, the frail elderly and disabled who rely on nursing homes for their care 24 hours a day, seven days a week.

More than 90 percent of nursing facility care in the District is funded by the city's Medicaid program, yet the D.C. Council's action will reduce Medicaid rates to nursing homes by 7.5 percent. The rates paid now barely cover the costs of caring for nursing home residents. Most of the care delivered in nursing homes is by certified nursing assistants who work long hours helping residents eat, dress, bathe and use the toilet.

The vast majority stay on the job only a short time; it takes a special person to perform these difficult tasks over long shifts for relatively low pay. By reducing Medicaid reimbursement, the council ensures that it will be even more difficult to attract and retain dedicated, caring individuals to perform these essential functions.

At the same time, the council has ordered the Department of Health to adopt different nursing facility licensure regulations to replace the current, detailed D.C. licensure scheme that mirrors federal regulations. The resulting need to comply with two separate and distinct sets of rules will drive nursing home costs up while conferring no real new benefits on nursing home residents. To increase costs at the same time the reimbursement is being slashed is another example of public policy being made without adequate thought or data.

If the D.C. Council truly cares about these most vulnerable citizens -- residents of nursing homes -- it needs to back up that concern with the resources needed to deliver care, not hamstring providers by slashing Medicaid payments.


Executive Director

District of Columbia Health Care Association