Medicaid, Waivers, Wait List and Public Health Emergency(PHE)
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Sept. 20, 2023 Update
Virginia's Budget Update
On Sept. 15, 2023 The Governor signed the Budget. Here are a few highlights:
Medicaid Waivers: 70 DD Community Living Waiver slots and 430 Family and Individual Services Waiver slots to be available January 1, 2024.
Waiver Reimbursement Rates: DD and CCC Plus Medicaid Waiver Consumer-Directed and Agency reimbursement rates for Personal Care, Companion and Respite will increase 5% effective January 1, 2024.
The Consumer Directed Rate for Northern VA increases to $17.27/hour and the Rest of the State Rate increases to 13.34/hour on January 1, 2023.
Early Intervention Services rates will increase by 12.5% increase on January 1, 2024.(Does not apply to case management).
The K/Now Newsletter has more detail. Did you get your September K/Now? If not click here.
Parents of MINORS and Spouses with Waivers as Paid Personal Care Providers
Are you signed up for the Medicaid Webinar on Friday, Sept. 22?
On July 31, DMAS (Dept. of Medical Assistance Services) submitted changes to the Centers for Medicare and Medicaid (CMS), to the previous CCC Plus, FIS and CL Medicaid Waiver applications' amendments. Based on feedback, DMAS removed the Electronic Visit Verification requirement.
CMS will review the revised applications within 90 days from July 31 and either approve or disapprove the applications. DMAS expects that CMS will respond in less that 90 days.
Once approval from CMS is received, DMAS will hold sessions for all interested to learn about the waiver requirements and next steps that will need to be taken to ensure care continues without disruption. If you want to provide personal care, pay attention to all communications from DMAS, your managed care organization and fiscal-employer agent to avoid delays or disruptions.
The updated waiver applications and a fact sheet will be posted on the DMAS website. (not currently posted - stay tuned).
Qualified parents of MINORS and spouses (Legally Responsible Individuals) may be paid personal care/assistance providers when no one else or no other services options are available to provide care. The parent(s) or spouse must also be in the best interest of the waiver participants This applies to those with waivers only. It does not apply to the Medicaid EPSDT services.
Parents and guardians of Minors and Spouses may use the Consumer or the Agency-Directed models.
Parents of Minors and Spouses who want to be paid personal care attendants need to make sure that they have objective written documentation demonstrating that there are no other service options and that it is in the best interest of the waiver person that the parent or spouse is paid to provide personal care services. Do not delay in obtaining the documentation necessary.
Parents of Minors and Spouses as Paid Personal Care Providers (Medicaid Waivers)
Parents of Minors and Spouses are allowed to be paid to provide personal care services due to the COVID 19 Public Health Emergency. This flexibility will end on November 10, 2023.
This does not apply to adults with waivers whose parents are paid provider(s).
Developmental Disability(DD) Medicaid Waiver Program "Slots" Fiscal Year 2024
In January 2024 the following new DD Waivers will be available to those on the Waiver Wait List:
Community Living Waiver -70
Family and Individual Services Waiver 430
In July 2023 the following new DD Waivers were available to those on the Waiver Waitlist:
Community Living Waiver - 100 waivers
Family and Individual Support - 500 waivers
Additional DD Waivers may become available anytime. They are available when a person no longer qualifies for a DD waiver, when someone moves out of state or no longer wants to use their waiver, when someone dies of the VA General Assembly funds additional waivers.
Funding Opportunity for People on the DD Waiver Wait List
DD Waiver Waitlist as of Sept. 2023
Total # on Waitlist: 14,904
Of the Total, 53% are under 18 years of age.
Of the Total, 3,385 are in Priority Level 1.
What to do if YOU are on the DD Waiver Wait List:
If you are on the DD Waiver Waitlist make sure that your DD Waiver application documents accurately reflect your current situation.
Request the following application documents from your Community Services Board:
VIDES - Everyone on the DD Waiver Wait List
Priority Level - Everyone on the DD Waiver Wait List
Critical Needs Summary - Everyone on Priority Level 1
Waiver Slot Assignment Review Form - those who are going to be reviewed by the DD Waiver Slot Assignment Committee
Review the information on the forms for accuracy. Call your Support Coordinator/Case Manager if updates are needed.
For the documents and more information about the DD Waiver application process click here.
Medicaid Eligibility Redetermination - Can they contact you?
During the Public Health Emergency, the Departments of Social Services(DSS) did not re-determine if people with Medicaid were still eligible for Medicaid. In March 2023 the Departments of Social Services(DSS) started re-determining if people are eligible.
If you have Medicaid and want to keep it, make sure that your local DSS has your current address and contact information. To update your contact information and to find out when your Medicaid renewal date is you may:
Go Online at commonhelp.virginia.gov, or
Call Cover Virginia at 1-855-242-8282 or
Call your local Department of Social Services.
The Arc of Virginia will provide updates as information becomes available. Facebook is the first place we alert readers to changes. Or you may check this webpage anytime.
If you need information about Virginia public resources for people with or at risk of disabilities contact The Arc of Virginia ([email protected], (804)649-8481 x 104)
If you have questions about Medicaid/Cardinal Care you may email:
Question and Answer:
Q: Where can I get information about advocacy for the DD Waitlist and other information?
A: We are glad you asked! Sign up here.
If you have other questions please submit them to
[email protected] or call 804-649-8481 x 104.