August Newsletter

Virginia Medicaid Waiver Reform

Because Waiver reform is such an important issue for developmentally disabled, this edition of the newsletter concentrates on latest developments.

For Virginia residents who are developmentally disabled the Medicaid Waiver program is the basic benefit program that provides ongoing care and support for such individuals and their families. After years of advocacy from the developmentally disabled community, Virginia has decided to reform its Waiver program. The Virginia Department of Behavioral and Developmental Services (DBHDS) started by hiring an expert advisor the Human Services Research Institute (HSRI). HSRI recommends two needs-based waivers referred to as a:

  • Comprehensive waiver which provides more intense services as individual needs increase and
  • Support waiver which provides supplemental services that allow an individual to live independently with family/friends.

DBHDS then formed stakeholder subcommittees to make recommendations on further structure. The stakeholder subcommittees were formed with mostly volunteers. The three subcommittees are: Eligibility; Case Management and Waiting List.

The following are the initial proposals:

Eligibility recommends a single eligibility criteria for the two new waivers. The criteria will be more functionally based.

Case Management recommends a single point of entry for both new waivers through the Community Services Boards (CSBs). The CSBs would contract with private case management providers to offer individuals on either waiver their choice of case management provider.

Waiting List recommends one set of criteria for both waivers; design the new waivers to allow movement between them as necessary. Assignment on list based on urgency of need rather than chronologically. There needs to be a transitional and fair process to align those now on the waiting list with the new criteria.

What is Next? These are only proposals. The Virginia Department of Behavioral Developmental Services and the Virginia Department of Medical Assistance Services (DMAS) are jointly responsible for developing waiver reform. The new waiver plans must be submitted to the federal government for final approval. We expect a plan with rules and regulations to submitted for public comments. DBHDS advises to check its website for updates: www.dbhds.gov.

Speaking Event: Edward Zetlin will be presenting at the Langston-Brown Community Senior Center located at 2121 N Culpeper St, Arlington, VA 22207 on August 12, 2014 at 1:00 pm. His topic will be on understanding the probate process.

Contact us at (703)379-0442; ed@zetlinlaw.com



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