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McAuliffe administration seeks $110 million to boost services for disabled McAuliffe administration seeks extra $110 million to boost services for disabled
(35 minutes later)
Virginia Gov. Terry McAuliffe’s administration is seeking an extra $110 million over the next three years to provide more services to residents with severe disabilities, in order to comply with a federal court settlement. Virginia Gov. Terry McAuliffe’s administration is seeking an extra $110 million over the next three years to provide more services to residents with severe disabilities to comply with a federal court settlement.
The money would intensify the state’s efforts to move people off a waiting list for services that currently has about 10,100names. It would fund 855 Medicaid waivers for residents who do not currently have them, and pay for an overhaul of the way the state awards those waivers to better prioritize services for people in immediate need of aid. The money would intensify the state’s efforts to move people off a waiting list for services that currently has about 10,100 names. It would fund 855 Medicaid waivers for residents who do not have them and pay for an overhaul of how the state awards those waivers to better prioritize services for people in immediate need of aid.
The state Department of Behavioral Health & Developmental Services (DBHDS) also plans to expand the services it offers to families of the disabled who are in crisis; shut down four state-run institutions; and finance the construction of more homes or apartments for the disabled in communities where such facilities are in short supply. The state Department of Behavioral Health & Developmental Services (DBHDS) also plans to expand the services it offers to families of the disabled who are in crisis; shut four state-run institutions; and finance the construction of more homes or apartments for the disabled in communities where those facilities are in short supply.
“This will be a really significant step forward,” said Jack Barber, interim commissioner of the state agency for people with disabilities. “It will be very significant in moving us into compliance with the settlement agreement, but more importantly, providing the kinds of services in integrated settings that we want to provide.”“This will be a really significant step forward,” said Jack Barber, interim commissioner of the state agency for people with disabilities. “It will be very significant in moving us into compliance with the settlement agreement, but more importantly, providing the kinds of services in integrated settings that we want to provide.”
Virginia has struggled to comply with the terms of a 2012 federal court settlement that, based on the Americans With Disabilities Act, requires the state to offer more opportunities for people with disabilities to live and work in community environments, rather than institutional settings. Virginia has struggled to comply with the terms of a 2012 federal court settlement that, based on the Americans With Disabilities Act, requires the state to offer more opportunities for people with disabilities to live and work in community environments rather than in institutional settings.
[Justice Dept: Virginia not trying hard enough to reform disabilities services][Justice Dept: Virginia not trying hard enough to reform disabilities services]
Last fall, U.S. District Court Judge John A. Gibney threatened to appoint a receiver to take over the state’s role in making the changes, after federal attorneys highlighted several areas in the 10-year settlement agreement where the state is far behind. Those areas included finding ways to move severely disabled children out of large institutions into smaller group homes or back to their families, with appropriate support. Last fall, U.S. District Court Judge John A. Gibney threatened to appoint a receiver to take over the state’s role in making the changes after federal attorneys highlighted several areas in the 10-year settlement agreement where the state is far behind. Those areas included finding ways to move severely disabled children out of large institutions and into smaller group homes or back to their families, with appropriate support.
State and federal attorneys have since agreed to a series of timelines for program reforms that hinge largely on the McAuliffe administration’s new funding request, the Justice Department said in a court filing earlier this month. State and federal attorneys have since agreed to a series of timelines for program changes that hinge largely on the McAuliffe administration’s new funding request, the Justice Department said in a court filing earlier this month.
That means the state’s ability to comply rests mostly with the Republican lawmakers who control both houses of the General Assembly, and whose leaders say they have been waiting for the McAuliffe administration to unveil its reform plan so they can move forward. That means the state’s ability to comply rests mostly with the Republican lawmakers who control both houses of the General Assembly and whose leaders say they have been waiting for the McAuliffe administration to unveil its reform plan so they can move forward.
[Va. lawmakers, McAuliffe poised for fight and compromise this session][Va. lawmakers, McAuliffe poised for fight and compromise this session]
Legislative leaders say they support the Democratic governor’s proposed changes, and are pushing to fund even more Medicaid waivers for people with disabilities — possibly at the expense of other state programs that McAuliffe also favors. Legislative leaders say they support the Democratic governor’s proposed changes and are pushing to fund even more Medicaid waivers for those with disabilities — possibly at the expense of other state programs that McAuliffe also favors.
“I’ll push for this to be a priority, and I think some of the other items we’ll look at will obviously be a lower priority for me,” said House Majority Leader Kirkland Cox (R-Colonial Heights). “I’ll push for this to be a priority, and I think some of the other items we’ll look at will obviously be a lower priority for me,” said House Majority Leader M. Kirkland Cox (R-Colonial Heights).
As an example, he said, the state could take at least $10 million that McAuliffe wants to use to address food deserts in Virginia and reallocate it to fund the request for disability services. As an example, he said, the state could take at least $10 million that McAuliffe wants to use to address food deserts in Virginia and reallocate it to fund the request for disability services.
McAuliffe has proposed spending $86 million over two years on revamping the state’s system of Medicaid waivers, which currently covers about 12,000 people with disabilities. McAuliffe has proposed spending $86 million over two years on revamping the state’s system of Medicaid waivers, which currently covers about 12,000 people with disabilities.
DBHDS officials are preparing to roll out a new system for awarding Medicaid waivers in July, and want to expand the number of people covered by waivers to about 16,000 slots by 2021 — about 2,000 more than what the court settlement mandates. In July, DBHDS officials are preparing to roll out a new system for awarding Medicaid waivers, and they want to expand the number of people covered by waivers to about 16,000 by 2021 — about 2,000 more than what the court settlement mandates.
The redesigned waivers will cover a wider array of services than the existing waivers, making it easier for people to receive care at home or in smaller group settings, DBHDS officials said. They’ll also offer reimbursement rates that are on average 5.4 percent higher than what’s currently paid to care providers. The redesigned waivers will cover a wider array of services than the current waivers, making it easier for people to receive care at home or in smaller group settings, DBHDS officials said. They’ll also offer reimbursement rates that are, on average, 5.4 percent higher than what care providers are now paid.
The agency plans to whittle down the waitlist of people seeking Medicaid waivers by dividing that group into three tiers of need. Until now, the list has largely been first-come-first served. The agency plans to trim the waitlist of people seeking Medicaid waivers by dividing that group into three tiers of need. The list has largely been first come, first served.
First priority under the new system would go to the roughly 3,100 people who require services right away, many of them former students who’ve recently finished school and therefore aged out of other state-provided subsidies. Next, would come about 2,500 people who would need Medicaid-funded services in the next two-to-five years. First priority under the new system would go to the roughly 3,100 people who require services right away, many of them former students who’ve recently finished school and therefore aged out of other state-provided subsidies. Next would come about 2,500 people who would need Medicaid-funded services in the next two to five years.
Final priority would go to the 4,100 people, many of them children, who don’t anticipate needing a waiver for at least five years — but whose families have put them on the waitlist just in case. Final priority would go to the 4,100 people, many of them children, who don’t expect to need a waiver for at least five years but whose families have put them on the waitlist just in case.
Local government community service boards, which facilitate services for the disabled, will determine who falls into which tier, DBHDS officials said.Local government community service boards, which facilitate services for the disabled, will determine who falls into which tier, DBHDS officials said.
“We need to consolidate this into a better system,” Barber said. “Assuming all the slots in the next five years come on, we’ll be a lot closer to taking care of who needs a waiver when they need it and have a much better idea of what the future needs may be.”“We need to consolidate this into a better system,” Barber said. “Assuming all the slots in the next five years come on, we’ll be a lot closer to taking care of who needs a waiver when they need it and have a much better idea of what the future needs may be.”
Advocates for people with disabilities argue that more should be done to deal with the wait list problem — and some Republican lawmakers agree. Advocates for people with disabilities argue that more should be done to deal with the waitlist problem — and some Republican lawmakers agree.
Jamie Liban, executive director of The Arc of Virginia nonprofit group, and other advocates point out that since the settlement was signed, about 3,000 more people with disabilities have been added to the state’s waitlist for Medicaid vouchers. Diagnoses for autism and other ailments are becoming more common, advocates say, and people with disabilities are living longer, which adds to the need for vouchers.Jamie Liban, executive director of The Arc of Virginia nonprofit group, and other advocates point out that since the settlement was signed, about 3,000 more people with disabilities have been added to the state’s waitlist for Medicaid vouchers. Diagnoses for autism and other ailments are becoming more common, advocates say, and people with disabilities are living longer, which adds to the need for vouchers.
“If they only do the minimum of what the settlement requires, the waiting list will continue to grow,” Liban said.“If they only do the minimum of what the settlement requires, the waiting list will continue to grow,” Liban said.
Republican state legislators introduced a series of budget amendments Thursday that would offer several thousand new Medicaid waivers over the next two years to people on the waitlist who are able to live alone or with family or friends. Republican state legislators introduced a series of budget amendments last week that would offer several thousand new Medicaid waivers over the next two years to people on the waitlist who are able to live alone or with family or friends.
One amendment — sponsored by state Senate Finance Committee co-chairman Sen. Emmett W. Hanger Jr. (R-Augusta) — would create 5,000 Medicaid waivers for functionally independent people on the waitlist who are either already receiving aid from another state program or near the top of the list. One amendment — sponsored by Sen. Emmett W. Hanger Jr. (R-Augusta), co-chairman of the Senate Finance Committee — would create 5,000 Medicaid waivers for functionally independent people on the waitlist who are already receiving aid from another state program or near the top of the list.
State Sen. Adam P. Ebbin (D-Alexandria,) is among a handful of Democrats who signed on to co-sponsor that amendment, which estimates that about $42 million would be needed to fund the new waivers. State Sen. Adam P. Ebbin (D-Alexandria) is among a handful of Democrats who signed on to co-sponsor that amendment, which estimates that $42 million would be needed to fund the new waivers.
Ebbin said he is unsure of how the new waivers could be financed, but argued the money should come from new taxes for yacht owners or people who buy e-cigarettes — ideas that Republicans have opposed. Ebbin said he was unsure of how the new waivers could be financed but argued that the money should come from new taxes for yacht owners or people who buy e-cigarettes — ideas Republicans have opposed.
“This is a serious matter that needs to be funded,” Ebbin said. “These are families who need help, and the backup is too great.”“This is a serious matter that needs to be funded,” Ebbin said. “These are families who need help, and the backup is too great.”