Summary of Major I/DD Items in the Conference Committee Report

 

The Budget Conference Committee completed its work on Virginia’s Budget Bill this week and posted their amendments on Wednesday evening.  The House and Senate members now have 48 hours to review, which means the final vote on the budget bill will take place this evening or tomorrow morning.

Once the General Assembly has its vote on the conference committee report, the Governor will have the opportunity to review all budget items, suggest amendments or veto an item.  The General Assembly will convene again on April 20 to vote on the Governor’s amendments to the final budget bill.  The state budget is to take effect July 1.

Major I/DD Items in the Conference Committee Report:

  • Provides additional funding for the Early Intervention- Part C program ($1.7M in FY17  and $2.5M in FY18).

 

 

  • Provides additional I/DD Waiver slots.  Supports the Governor’s proposal to provide 855 Waivers required by the DOJ agreement, but eliminates the 100 proposed “reserve” Waivers that the Governor recommended.  Instead, the Conference Committee provides 355 I/DD Waivers above the DOJ agreement in FY17 for individuals and families on the I/DD Waiver waiting lists ($5.2M GF total).  200 of these Waivers are reserved for the first 200 people on the DD Waiver waiting list as of June 30,  2016. The total I/DD Waiver allocation will be as follows:
                              I/DD Waivers Included in the Budget Bill FY17 FY18 Total

 

 

Community Living (CL)Waivers for Waiting List

 

 

300

 

325

 

625

 

Individual and Family Support (IFS) Waivers for Waiting List

 

 

340*

 

25

 

365

 

Community Living (CL) Waivers for Individuals Leaving Training Centers

 

 

90

 

90

 

180

 

Reserve Waivers for emergencies, transitions from other institutional settings  and movement between waivers

 

 

40

 

40

 

  • Limits the hours a single consumer-directed attendant works to no more than 40 hours per week per employer. This would affect individuals and families receiving consumer-directed respite, personal care and companion services.  Attendants would not be allowed to work more than 40 hours per week for an individual/family.

 

  • Moves forward with I/DD Waiver Redesign, but includes some amendments.  In total, provides $34M SGF to increase I/DD waiver reimbursement rates and implement new waiver services as part of the redesign: 
FY17 FY18
General Fund $11.8M $22.2M
Non-General Fund $11.8M $22.2M
Total $23.6 $44.4M

 

The Conference Committee report includes the following amendments for Waiver Redesign:

 

  • Accepts the rates and models proposed in the Burns study (available here), with the exception of the following:

 

  • The rate increase for   skilled nursing offered in I/DD Waiver will be 25%.

 

  • Private duty nursing  offered under I/DD Waiver, EPSDT  and Tech Waiver will receive a 11.5% increase (rate increase for private duty nursing in I/DD Waiver was originally 40%).

 

  • Provides a 24.5% Northern Virginia rate differential for Sponsored Residential services effective January 1, 2017.
  • Initiates the following services as of July 1, 2016:  Shared Living Residential, Supported Living Residential, Independent Living Residential, Community Engagement, Workplace Assistance Services, Private Duty Nursing Services, Crisis Support Services, Community Based Crisis Supports, Center-based Crisis Supports, and Electronic Based Home Supports;
  • Delays implementation of the following services until July 1, 2017:  Community Guide and Peer Support Services, Community Coaching, Benefits Planning, and Non-medical Transportation (for a description of all NEW services available in the redesigned I/DD Waiver, click here).

 

  • Requires DMAS and DBHDS, in collaboration with sponsored residential providers and family home providers, to collect information and feedback related to payments to family homes and the extent to which changes in rates have impacted payments to the family homes statewide.

 

  • Requires an independent review of the Commonwealth’s options for continued operation of Central Virginia Training Center in the event that sufficient community capacity is not available or is insufficient to meet the care needs of individuals.  (Note-the DOJ agreement requires the Commonwealth to ensure community-based care meets the needs of Training Center residents).

 

  • Requires that expenditures from the Behavioral Health and Developmental Services Trust Fund be appropriated through an appropriations bill passed by the General Assembly.  The budget also allows funds to be carried forward to the subsequent fiscal year and authorizes funding to build community capacity in FY16 and FY17.

 

  • Authorizes $750,000 in FY16 for one-time capital and transition cost associated with the development of community-based waiver group homes and/or community-based intermediate care facilities for individuals with intellectual disabilities who are transitioning to community living from Southwestern Virginia Training Center and who choose to remain in Southwest Virginia.  The housing options shall be located in Virginia no farther than 100 miles from the Southwestern Virginia Training Center.  The Department of Behavioral Health and Developmental Services shall give preference to projects involving existing Virginia Providers to expand service capacity.

 

  • Authorizes $4 million in FY17 for one-time expenses related to developing housing options and specialized services, and making capital improvements to enhance and expand services for individuals intellectual and developmental disabilities.  A minimum of 60 percent of the funding will be used to build community capacity in NOVA and the remaining funding will be used to build community capacity for individuals who are transitioning from the community from SWVTC.  Language specifies that projects addressing SWVTC are to be located in VA within 100 miles of the facility.  DBHDS is required to give preference to projects involving existing VA providers to expand capacity.  Language also requires the  agency to report on expenditures from the Trust Fund by 12/1/2016

 

  • Provides rental assistance programs for people with intellectual and developmental disabilities.   Provides funds for the 300 rental vouchers and provides ongoing funds for Rental Choice VA subsidy program
  • Provides DBHDS with 35 new staff positions.  Provides funds for 10 prior authorization specialists, 5 prior authorization team leads and one administrative assistant to support the prior authorization team for the new I/DD Waiver program.   15 additional positions are created to facilitate compliance with the DOJ.
  • Provides $9.6M to strengthen crisis programs for children and adults with I/DD.  Provides funds to build two, eight bed therapeutic homes, in additional to funds for mobile crisis services, respite services for children and crisis coordinators in each region.  Funds are included for three crisis specialists to work in state mental health facilities to reduce unnecessary institutionalization.  The Independent Reviewer charged with monitoring the state’s compliance with this agreement has noted that the state continues to be noncompliant in this area particularly as it applies to children.
  • Requires a review of CSA to increase integration of children with disabilities into their home school districts. Requires the CSA State Executive  Council to review and develop a robust set of options for (i) increasing the integration of children receiving special education private day treatment services into their home school districts, including mechanisms to involve local school districts in tracking, monitoring and obtaining outcome data to assist in making decisions on the appropriate utilization of these services and (ii) funding the educational costs with local school students whose placement in or admittance to state or privately operated psychiatric or residential treatment facilities for the non-educational reasons has been authorized by Medicaid.  The SEC shall continue its review with the assistance of relevant stakeholders including representatives of the ODE, DMAS the Office of Comprehensive Services, DBHDS, local school districts, local governments and public an private service providers.  The SEC shall present a robust set of options and recommendations that include possible changes to policies, procedures, regulations and statues, including any fiscal impact for consideration by the Governor and the chairmen of the House Appropriations and Senate Finance Committees by November 1, 2016.
  • Provides $375,000 from the general fund each year for the Long Term Employment Support Services (LTESS) program to support individuals with disabilities.
  • Requires DOE to convene an interagency workgroup to assess the barriers to serving students with disabilities in their local public schools.   The workgroup shall assess existing policies and funding formulas including school divisions’ program requirements, localities’ composite indices, local CSA match rate allocations, local CSA rate setting practices, the impact of caps on support positions, policies for transitioning students back to the public school, and funding for local educational programming based on models which are collaborative and create savings for both local and state government while providing youth an educational option within their communities. Membership shall include a balance of local and state representatives, all impacted state agencies, local education agency (LEA) representatives, local CSA representatives, local government officials, local special education administrators, stakeholder organizations, parent representatives, the Arc of Virginia, the Coalition for Students with Disabilities, and members of the Virginia General Assembly. The workgroup shall make recommendations to the Virginia Commission on Youth prior to the 2017 General Assembly Session.”

 

For a full summary of all I/DD related budget items, including a side-by-side comparison of Governor, House, Senate and Conference Committee budgets, Side by Side 2016 Budget Bill- Conference Committee Report FINAL

 

The House briefing on the Conference Committee report, which includes an overview of all major items in the budget bill, can be found here.

One Reader Comment

Leave a Reply

You can use these tags: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>