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Advocates seek additional Medicaid reimbursement, access for those with disabilities

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The Arc of Virginia and other groups part of a coalition for the developmentally disabled have criticized budget reports from the Virginia General Assembly.

Advocates say higher Medicaid reimbursement for service providers for the disabled are needed — especially reimbursement for wages paid to direct support professionals for groups like The Arc of Virginia, which includes The Arc of Southside in Danville.

In addition, the state Senate has proposed cutting the previous governor’s recommended 1,200 waiver slots in the second of the proposed biennial state budget down to 600. Those waiver slots include developmentally disabled people who are most in need and waiting to be able to receive support services under Medicaid.

Tonya Milling

Tonya Milling

“We are hoping they restore those 600,” said Tonya Milling, executive director of The Arc of Virginia.

There are more than 13,000 developmentally disabled people across the state waiting to receive community-based services, including 3,000 in immediate need, Milling said. Of the 13,000, there are 314 in Danville and Pittsylvania County, with 38 in urgent need of services, she said.

“People with disabilities and families are disappointed, and we are angry,” The Arc of Virginia Board President Kim Goodloe said in a prepared statement. “These budget proposals will ultimately move Virginia backward.”

Following a court settlement with the U.S. Department of Justice, Virginia moved from an institution-based system of care for the developmentally disabled to a community-oriented one about 10 years ago.

in 2012, the department had found Virginia in violation of the Americans with Disabilities Act due to a failure to provide services to those with intellectual and developmental disabilities in the most integrated setting appropriate to their needs.

Virginia remains under a decade-long, court-monitored settlement agreement with the U.S. Department of Justice.

“Here we are, 10 years later, and there are still 13,000 people waiting for those [community-oriented] services,” Milling said.

Over the last 10 years, the commonwealth has been transitioning away from institutional care and segregated living and working environments. The Arc of Virginia, as part of a coalition of self-advocates, families, member organizations and service providers proposed a DD System Rescue Plan to legislators for the 2022 General Assembly session to more thoroughly uphold the intent of the settlement agreement.

“Both of the budget reports that were passed miss the mark for moving Virginia closer to building a viable community-based system of support and services for people with developmental disabilities,” Milling said.

The Rescue Plan calls for:

Reimbursement rate increases for waiver services for developmentally disabled people at a sustainable 75th percentile;

Investing in innovation via one-time spending initiatives to build community capacity;

Continue address those in most urgent need by supporting the introduction of 1,200 new waiver slots in the second fiscal year;

Building a core services model to offer select essential services to individuals in need.

Milling said advocates are hoping for $5,5 million to build more community capacity for services. Nothing is in the proposed budget for that item, she said.

In addition, service providers need much higher reimbursement for those services, including reimbursement for wages to address workforce shortages in the system, she said.

“We want higher reimbursement rates that have high reimbursement for wages because we need to attract quality employees, especially now that we’re operating in an unusual wage market,” Milling said. “In the current workforce crisis, providers are closing, people are displaced because we can’t pay a wage to attract high-quality staff. We recognize that is a big jump, we would just like to see lawmakers move wages up to ensure that the DD System can compete in the labor market where the common, if not yet required, minimum wage is $15 per hour.”

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