Our View of the Legislature: Virginia’s Budget and Developmental Disability Services

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Every other year, Virginia adopts a two-year budget. The budget determines how state revenues are expended and reflects the priorities of Virginia’s elected leaders. The process begins with a proposed budget submitted by the Governor of Virginia. Then, Virginia’s Senate and House of Delegates each adopt amendments to the Governor’s proposed budget. Finally, differences between the budgets passed by the House and the Senate have to be worked out by a Conference Committee made up of selected members of each house. The following are just a few of the highlights from the proposed budget and proposed amendments to that budget that may be important to people with disabilities in Virginia. (This is far from an exhaustive list, but is just a sampling of the issues that we will be monitoring as the Budget process moves forward this year):

  1. Medicaid Waiver slots for people with Developmental Disabilities (DD Waiver Slots): The Governor’s proposed budget would add 1200 DD Waiver slots over the biennium (2023-2024), at a cost of $39,000,000 in State General Funds. A budget amendment patroned by Senator Dunnavant would fund an additional 3,500 DD Waiver Slots (1,750 per year) over the Biennium at an additional cost of $294,200,000.
  2. Medicaid rates: The proposed budget includes a total of $294,200,000 in General funds over the Biennium to increase the rates of select DD Wavier services impacted by increases in the minimum wage and other cost increases, as well as to ensure access to providers. A number of proposed amendments would increase these rates further or increase rates for services that were not increased in the Governor’s budget. An Amendment patroned by Senator Favola, for example, would add $35,400,000 in General Funds over the biennium to increase rates for Group Day Services by 25.62% and Group Supported Employment Services by 21.86%. Another amendment patroned by Senator Hangar would add $93,700,000 in general funds over the biennium to increase rates for Group Day, Group Supported Employment, and Group Homes with five to eights beds. Other amendments would increase rates for Supported Living Residential services (Senator Hangar); Group Day and Group Residential rates (Senator Peterson); Respite (Delegate Bell); and Personal Care, Respite, and Companion Services (Delegate Carr, Delegate Head), and Delegate Wilt.
  3. Ability of Parents to provide personal assistance services: Several Amendments would make permanent a pandemic-related rule allowing parents of minor children to act as paid personal care attendants for their minor children. This is sometimes referred to as an Appendix K wavier, after the authority under which this temporary rule was adopted. While its purpose was to alleviate strain on the personal care workforce during the pandemic, many families have found this flexibility to be life-changing for their families and have advocated for its continuation after the public health emergency ends.
  4. Additional Waivers and services: Several budget amendments would direct DMAS to explore options for adding additional Medicaid Waivers or Medicaid Services to Virginia’s Medicaid program. One amendment, for example would direct DMAS to conduct a feasibility study of an additional waiver that would provide specified services to people with developmental disabilities on the DD Waiver Waitlist who do not meet nursing facility level of care (Senator Hangar and Delegate Gooditis). Other amendments would direct DMAS to develop a plan for a state plan amendment to provide limited home and community-based services to older Virginians who are not currently eligible for a Medicaid HCBS Waiver (Senator McLellan and Delegate Adams).

We strive to advance independence, choice and self-determination; protect legal, human and civil rights; and eliminate abuse, neglect and discrimination of people with disabilities, including those with mental illness, through zealous and uncompromising legal advocacy.  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.