Caregiving in District of Columbia— the questions adult children actually ask.

DC has an estate tax but not an inheritance tax. The DC estate-tax exemption is approximately $4.873 million per individual (2024-25), well below the federal exemption (approximately $13.99M in 2025). Estates falling between the DC and federal exemptions can owe DC estate tax even without federal liability — a common surprise for DC residents with material home equity and retirement assets. There is no DC inheritance tax.

DC applies the standard SSI-based asset limit for long-term care Medicaid: $4,000 for a single applicant (DC uses a slightly higher figure than the federal $2,000 minimum). The primary home is exempt up to the federal $752,000 equity cap (2026). One car is excluded. A community spouse can retain up to the federal maximum CSRA (approximately $157,920 in 2026). DC eligibility rules track federal floor closely but with some DC-specific generosity at the asset threshold.

The Elderly and Persons with Physical Disabilities (EPD) Waiver is DC Medicaid's primary home- and community-based services waiver. It pays for personal care services, adult day services, case management, home modifications, and other supports that allow a Medicaid-eligible older adult to remain in the community rather than enter a nursing facility. To qualify, the individual must meet financial Medicaid eligibility and the nursing-facility level-of-care threshold. The waiver is administered by DHCF and assessed through the DC Department on Aging and Community Living.

Yes, generally — through the DC EPD Waiver's personal care services benefit, which permits family-member caregivers (excluding spouses, who are typically excluded under federal Medicaid rules) to be hired and paid. Hourly rates are set by DHCF and the contracted personal care agency, typically in the $14-$20/hour range in 2026. The caregiver must be enrolled with a DC-certified personal care agency. Outside Medicaid, private-pay arrangements are also common in DC's dense home-care market.

DC's Universal Paid Leave Act provides up to 12 weeks of paid family leave per benefit year to care for a family member with a serious health condition. Wage replacement is among the highest in the country at lower wage levels (approximately 90% of weekly wages up to the program threshold, with a lower replacement rate above that threshold). Family members include parents, parents-in-law, spouses, domestic partners, children, siblings, grandparents, and grandchildren — broader than federal FMLA. Apply through the DC Department of Employment Services (DOES) PFL portal.

Call DC Adult Protective Services at 1-202-541-3950. APS is operated by the DC Department on Aging and Community Living (DACL). For emergencies, call 911 first. DC's mandatory-reporting framework appears at D.C. Code §7-1901 et seq. Reports may be made anonymously, and reporters acting in good faith have civil immunity. APS investigates and connects victims with services; criminal cases are referred to law enforcement.

Yes, partially. The DC Superior Court Probate Division administers an abbreviated process for small estates with total value under approximately $40,000 (excluding the family allowance and certain exempt property). Many DC families avoid probate entirely using revocable living trusts, beneficiary designations, joint tenancy, or transfer-on-death registrations where available. Real estate in DC generally requires probate or trust administration unless held jointly or in trust.

DC assisted living is among the more expensive markets in the country. Monthly costs run approximately $7,000-$10,000 for private rooms in 2024 dollars (Genworth Cost of Care Survey). Memory care adds approximately 25-40% on top of standard assisted living. DC has fewer than 20 licensed assisted living facilities within DC proper, with most DC families also looking at facilities in nearby Maryland (Bethesda, Silver Spring) or Northern Virginia (Arlington, Alexandria) where pricing is similar but inventory is larger.

Generally yes. DC adopted the Uniform Power of Attorney Act effective in 2015 (D.C. Code §21-2601.01 et seq.), which recognizes out-of-state POAs validly executed where signed. DC banks and brokerages may scrutinize older or unusually drafted POAs, but the Uniform Act framework eases recognition. For a parent now residing in DC, a DC-drafted POA reduces friction at the moment of need. A DC-licensed attorney can review or replace an existing POA for typically $300-$600.

DC has a higher concentration of federal employees and retirees than any other US jurisdiction, and the coordination of Federal Employees Health Benefits (FEHB) with Medicare is a major topic at DC SHIP. Most federal retirees keep FEHB after age 65 and add Medicare Part B as primary coverage. FEHB typically becomes secondary, covering deductibles and copays. The Office of Personnel Management (OPM) and a SHIP counselor at the DC Health Insurance Counseling Project can help model the right combination. Federal retirees generally do not need to add a Medigap policy since FEHB serves a similar function.