The District of Columbia is home to 572,069 residents, the District’s population consists of 60% African American, 30.8% White, 7.9% persons of Hispanic or Latino origin and 2.7% Asian. The most significant growth over the past ten years has been the increase of children who are Hispanic/Latino, which has grown by almost 50%. 17.7% of the population is in poverty: one District resident in seven and one child in three lives in poverty (U.S. Census Bureau, 2000)

The District’s Mental Retardation and Developmental Disabilities Administration (MRDDA) reported that in 2000 it provided services to approximately 1500 individuals with mental retardation and developmental disabilities. The child count conducted in that same year indicated that 11,634 students received special education services, representing 17% of the population of school-age children and youth 3-17 years of age. (Georgetown University Center for Child & Human Development, 2002)

Low- and moderate-income households are unable to access adequate and affordable housing, leading families to double- and triple-up with family and friends. Poor families are displaced in response to initiatives to revitalize communities and enhance economic development. Critical supportive services to children, youth and families that serve as the safety net for prevention of homelessness are stretched to their limits, leaving many homeless. Housing for people with physical disabilities is severely under-resourced. (GU CCHD, 2002)

The status of the District’s service delivery systems for individuals who experience developmental disabilities and their families has been greatly impacted by court orders placing agencies under receivership, impacting services in several ways: (1) significant fiscal resources going to court supervision and not to the development of services and capacity building; (2) system changes and lack of leadership stability has made it difficult to build capacity and knowledge to effect systems change; (3) these factors have impeded effective collaboration among District agencies. (GU CCHD, 2002)

In a study by UDC’s Center for Applied Research and Urban Policy (CARUP, 2002) that assessed current services related to family support, the following was highlighted:

• problem in identifying the availability of specific services and methods for accessing those services;
• lack of respite care services, case management services, counseling services, coordination, after school services;
• inadequate pre-transitioning counseling services from one level or component of service to another;
• transportation inefficiencies impact ability to keep medical and other appointments;
• no automated management information system to follow children with special health care needs throughout the system to assure needs are being met;
• Medicaid reimbursement caps for specialty services result in withdrawal of most expert medical care for Medicaid clients;
• infrastructure characterized by staff shortages, lack of service providers in critical areas, cumbersome procurement processes, and bureaucratic multi-layered decision-making processes; and
• lack of cultural competence and staff diversity.

Although this study focused on children with special heath care need, most, if not all of the abovementioned issues, are pervasive throughout the lifespan for residents of the District.