This SPA modifies the methods and standards for setting payment rates for inpatient hospital services furnished by hospitals in the District of Columbia. It also modifies the rate setting assumptions for children's residential treatment centers. Specifically, this SPA provides that effective October 1, 2009 the disproportionate share factor used in setting rates for inpatient hospital services in the District of Columbia will be reduced by two percent and creates a separate method for making payments to children's residential treatment centers beginning December 1, 2009.