Medicaid Waivers and Wait List 

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Medicaid Waiver Amendments 

There was a 31 day public comment period that ended on Sept. 6, 2024 for the Medicaid Waiver amendments. 

It is expected that the amendments will go into affect on Jan. 1, 2025 pending approval by the Centers for Medicare and Medicaid.

You may view the Waiver amendments below:

Building Independence(BI) Waiver Amendment 

CCC Plus Waiver Amendment 

Community Living(CL) Waiver Amendment 

Family and Individual Support(FIS) Waiver Amendment

To view the public comments submitted go to Virginia Town Hall

 

AMENDMENTS:

1. Combining the annual service limits for Assistive Technology and Electronic Home-Based Services into one annual 10,000 limit to be shared between the two services. (BI, CL, FIS Waivers)
2. Permit the allowance for individuals offered a Developmental Disabilities Waiver slot to delay enrollment into the waiver for up to 1 year. (BI, CL, FIS Waivers)
3. Disregard Social Security Disability Insurance (SSDI) benefits above the maximum Social Security Insurance (SSI) benefit limit as determined by the Social Security Administration for purposes of pre-eligibility     treatment of income. (BI,CL, FIS Waivers)
4. Amend the rules for when a Legally Responsible Individual (spouse or parent of a minor) is a paid aide/attendant for personal care/personal assistance. (CL, FIS, CCC+ Waivers)
5. Add nursing facilities and Program for the All-Inclusive Care for the Elderly (PACE) providers to screen individuals in the community for waiver enrollment (CCC+ Waiver)
6. Remove educational requirements for Services Facilitation providers (CL, FIS, CCC+ Waivers)
7. Update language to match with the newest version of the Supports Intensity Scale assessment instrument for service plans (BI, CL, FIS Waivers) 
8. Update language that the Virginia Individual Developmental Disability Eligibility Survey (VIDES) is used for level of care for both waiver and the alternative institution placement (BI, FIS Waivers)
9. Align quality measures across the Developmental Disabilities Waivers (BI, FIS, CL Waivers)
10. Update language for who is responsible for conducting the annual level of care review (CCC+ Waiver)

DD Medicaid Waiver Wait List - September  2024

Total # on Waitlist: 15,555        

Of the Total: 3,658 are in Priority Level 1

Of the Total: 53% are under 18 years of age.

 

In Case You Missed It!

The Budget was Approved!!!

On May 13, the Virginia Public Budget was approved  for July 2024 - June 2026! 

The most exciting and historic item in the budget is that 3,440 people in Priority Level 1 will receive a DD Waiver over the next two years!!! 

Add 3,440 Developmental Disability Waivers for Priority Level 1 

1,720 new DD Waivers in July 2024 and July 2025. There will be a total of 3,096 new Family and Individual Supports waiver slots and 344 new Community Living waiver slots funded over the two years.

Other highlights:

Retention of Waiver Slots
In response to the ongoing provider shortage, this allows children and adults struggling to find services to keep their waiver slot for up to one year while they are seeking service providers. This flexibility will end in June 2026.

Legally Responsible Individuals
Families are protected by ensuring that the waiver regulations regarding their ability to provide paid care for their children are reasonable and appropriate.

Increase in Peer Mentor Rates
This DD waiver service  increased after it had been left out of the larger rate increases a few years ago. 

Technology Funding
Increase funding limits for Assistive Technology(AT) and Electronic Home Based Services(EHBS) to a maximum annual total of AT and or  EHBS up to $10,000. 

Medicaid Works Eligibility
A study group will be formed to make recommendations.  

Rate Increases for DD Waiver Services    
A 3% rate increase effective July 2024 and July 2025 for these services: 

Community Engagement,  Community Coaching, In-home Supports, Supported Living, Independent Living Supports, Therapeutic Consultation, Private Duty and Skilled Nursing, Group Day, Group Supported Employment, Workplace Assistance, Benefits Planning, Group Homes, Sponsored Residential, and Community Guide. 

Medicaid Rate Increase for Personal Care, Companion and Respite
A 2% rate increase for agency and consumer-directed Personal Care, Companion and Respite effective July 2024 and July 2025. 

Special Education
Funding related to the implementation of IEPs, professional development, teacher coaching and eight additional state ombudsman positions. Funding total is $8 million over the two year budget.

 

MARCH 1, 2024 

LEGALLY RESPONSIBLE INDIVIDUALS (LRIs) INFORMATION

With new rules coming into effect on March 1, 2024 for LRIs, we have created 3 Resources for Families. These resources are meant to meet you where you are based on your knowledge. We have 3 levels of information:

1) Quick Start Guide - short basic steps to take now to get you started

2) Fact Sheet - one page with all the basic facts you need

3) Overview - 3-page full overview of the new rules and what to do

Click below to Download what you need

 

The Updated Rules required "LRI Forms" and training materials  are on the DMAS WEBPAGE 

Virginia's Budget

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, 2024.

Early Intervention Services rates will increase by 12.5% 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.


DEVELOPMENTAL DISABILITY(DD) MEDICAID WAIVER  "Slots" Fiscal Year 2024 

In January 2024 the following 500 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.  

 

DD Waiver Waitlist as of October, 2023
Total # on Waitlist: 14,941
Of the Total, 53% are under 18 years of age.
Of the Total, 3,395 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.

STAY INFORMED
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.

NEED HELP?
 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:

DD Waiver:  [email protected]
CCC+ Waiver:  [email protected]
General Inquiries:  [email protected]

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.