Our View of the Legislature: Budget

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dLCV is here to educate policy makers, and especially to advance independence, choice and self-determination; protect legal, human and civil rights; and eliminate abuse, neglect and discrimination of people with disabilities through zealous and uncompromising legal advocacy and representation.

On Monday, March 1, the 2021 Special Session of the General Assembly (GA) formally adjourned “sine die,” a Latin term meaning it has adjourned “without a day” to reconvene.  Despite this designation, however, the GA actually will reconvene on April 7 for the “veto session.”  During the six-week period between adjournment sine die and the reconvened veto session, the Governor will review the many bills and the state budget passed by the GA during both the 2021 Session and the Special Session.  The Governor can amend or veto the budget and any bills, and during the reconvened “veto session,” the GA will consider and take action on the Governor’s amendments to bills and the budget.  Unlike the President at the federal level, Virginia’s Governor has what’s called a “line item veto,” meaning he can strike any item from the budget that he wishes without vetoing the entire budget.  The GA can overturn any of the Governor’s vetoes with a two-thirds vote of both houses.

The following are some budget items approved by the GA that may be important to people with disabilities. Clicking the hyperlinks below will take you to the page on the state budget website where you can find more information about that particular budget item.  As a reminder, the budget currently under consideration is to amend the state’s operating budget for the balance of the current state budget year, Fiscal Year (FY) 2021, which ends on June 30, and also the next budget year, FY 2022, which begins on July 1.  To view the full budget, member amendments and the money committees’ reports, check out the House budget bill, House Bill 1800, and the Senate budget bill, Senate Bill 1100.

Medicaid Budget Amendments

  • Expand Waiver Slots to Address the Priority One Waitlist The final GA-approved amendment, item 313 #19c, adds 435 slots at a cost of $14.18M (M here means million).
  • Workgroup on Developmental Disability Waiver Waiting List and Provider Rates: Item 320 #9c is a language-only amendment, meaning no funding is required. This amendment requires the Department of Behavioral Health and Developmental Services (DBHDS), in collaboration with the Department of Medical Assistance Services (DMAS) to convene a workgroup of stakeholder to review issues with existing rates and issues with rates, and make recommendations on needed changes.  The amendment also requires the workgroup to conduct an analysis of current DD Waiver waitlists and develop plans for reducing the waitlist.  The report, along with projected costs, must be submitted to the Chairs of the House Appropriations and Senate Finance and Appropriations Committees by November 1, 2021.
  • Permanent Continuation of Developmental Disability Waiver Telehealth Services: Item 313 #16c is a “language-only” amendment which requires DMAS to submit a waiver modification request to the federal Center for Medicare and Medicaid Services for approval to continue supporting telehealth and virtual learning options in the Community Living, Family and Individual Services and Building Independence Waivers. This amendment is designed to seek federal approval to make those services available permanently.
  • Increase Reimbursement Rates for Consumer-Directed Personal and Respite Care: Item  313 #17c combines the language from Senate Amendment 313 #1s and House Amendment 313 #11h to increase the Medicaid reimbursement rates for agency- and consumer-directed personal care, respite and companion services in the home and community-based services waivers and the Early Periodic Screening, and Diagnosis and Treatment (EPSDT) program.  The amendment also ensures compliance with the state’s minimum wage in reimbursing for these services.  Provides $6.15M for FY21 and $123.7M for FY 22.
  • Paid Sick Leave for Personal Care Attendants: Item 313 #8c provides $6.88M in FY22 to provide paid sick leave to Medicaid providers of consumer-directed personal, respite or companion care, pursuant to the passage of House Bill 2137.  That bill passed the House and Senate.
  • Increase the Income Eligibility Limit for Medicaid Works: Item 313 #2c provides $114K in FY22 to increase the income eligibility for participation in the Medicaid Works Program to 138 percent of the Federal Poverty Level (FPL). Current eligibility for the Medicaid Works Program is 80 percent of the FPL and was not adjusted to 138 percent of FPL when Medicaid Expansion was implemented.
  • Support Payments for Medicaid Developmental Disability Waiver Providers Affected by COVIDItem 313 #24c is a language-only amendment indicating that “it is the intent of the General Assembly” that a portion of any additional federal funding provided to the Commonwealth to offset the economic impact of COVID-19 be provided to Medicaid Developmental Disability Waiver providers that “have experienced a significant disruption in operations and revenue” as a result of the pandemic.

Behavioral Health and Developmental Services Budget Amendments

  • Services for Individuals with Dementia to Prevent Psychiatric HospitalizationItem 340 #1c combines the provisions of Senate Amendment 340 #1s and House Amendment 321 #3h. This amendment provides $150,000 in FY22 to the Department of Aging and Rehabilitative Services to support interdisciplinary dementia care management for 50 Virginia residents diagnosed with dementia who are hospitalized in the state psychiatric hospitals operated by the Department of Behavioral Health and Developmental Services (DBHDS). The amendment also requires the workgroup evaluating at services for adults with dementia in state psychiatric hospitals to evaluate the Northern Virginia Regional Older Adult Facilities Mental Health Support Team (RAFT) to determine the feasibility of replicating the RAFT model elsewhere the state to support persons living with dementia and co-occurring behavioral health conditions.
  • Development of a Program to Implement Supported Decision-making Agreements:  Item 320 #10cprovides $300,000 in FY22 for DBHDS to hire a staff person to implement the provisions of HB 2230, which passed the House and Senate.  That bill requires DBHDS to develop a program to educate individuals with intellectual and developmental disabilities, their families, and others regarding the availability of supported decision-making agreements.  (If you are interested in learning more about supported decision-making, visit dLCV’s Supported Decision-Making Resources page here!)
  • Restore Funding for Pilot Programs for State Facility Census Reduction: Item 320 #5c restores $3.7M funding originally allocated in FY22 budget for “alternative inpatient options” to state psychiatric hospital care through the establishment of two-year pilot projects to reduce census pressures on state hospitals. These funds were eliminated from the budget in April 2020 due to the fiscal impact of COVID.
  • Reduction of Funds for Additional Beds at the new Central State Hospital (CSH): Item C-66.10 #1c eliminates $58.5M in debt authorization from the state’s Capital Projects budget to maintain the new CSH at 252 beds.  This debt authorization proposed by the Governor would have allowed DBHDS to construct a new CSH facility of 300 beds.

Brain Injury Services Amendments

  • Expand the Availability of Brain Injury Services: Item 339 #2c combines House and Senate budget amendments to provide $1.2M in FY22 for an adjustment to state-funded contracts with brain injury services providers. Current contracts have not been adjusted to account for cost increases in some time.

Other Amendments

  • Increase the Auxiliary Grant Rate: Item 353 #1c provides $4.4M in FY22 to increase the monthly rate in the Auxiliary Grant Program by 10%, or by $142 per month.  The Auxiliary Grant is a monthly supplement for older adults and adults with disabilities who are Supplemental Security Income (SSI) recipients.  Individuals enrolled in the program use the monthly Auxiliary Grant supplement to support the cost of residing in an assisted living facility, adult day care home placement, or the person’s own housing through the DBHDS Permanent Supportive Housing Program.

Please let us know of any legislative proposals or budget issues that you think we should be following.  Contact us at info@dlcv.org or by calling 1-800-552-3962 or 804-225-2042.   Please continue to check back here for regular updates on developments in the legislature.