Virginia Regulatory Town Hall
Department of Medical Assistance Services
Board of Medical Assistance Services
Waivered Services [12 VAC 30 ‑ 120]
Action Omnibus Waiver Regulatory Changes
Comment Period Ended on 7/9/2008
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7/7/08  11:59 am
Commenter: Crossroads Community Services Board

NORIA Omnibus Waiver Services

The MR Waiver and MR Day Support Waiver regulations should remain separate beginning with 12 VAC 30-120-211 through 12 VAC 30-120-249 and 12 VAC 30-120- 1500 through 12 VAC 30-120-1550.


These Waivers have many unique and significant features that must be retained.  Additionally, these two Waivers have figured highly in public policy discussions and decisions made by Virginia’s elected officials since the MR Waiver was first developed in the early 1990’s. 


Among the very unique features of the waivers include the assessment process and instruments used in assessment, the preauthorization process and authority, and the criteria used in developing and managing the waiting lists.


Unique is the MR case management system and roles played by the Case Managers.  If any citizen is seeking information regarding the MR Waiver or the MR Day Support Waiver, a separate set of regulations is going to be most helpful and will assist in that citizen’s understanding of the Waiver features.


The oversight of the MR Waiver and the MR Day Support Waiver is unique.  The Virginia General Assembly mandated a secure partnership between DMAS and DMHMRSAS.  Each agency has roles specific to these Waivers and which are outlined within the DMAS-DMHMRSAS Interagency Agreement.  Such roles have been affirmed time after time by Virginia’s elected leaders.


Since responsibility is shared for the implementation, administration, and oversight of the MR Waiver and the MR Day Support Waiver, integration of the Waivers into Omnibus regulations would result in all sections of these Waivers being opened each time the agency needed to suggest changes to any Waiver.  Such a continuous regulatory process would result in a burden upon the agencies, consumers, advocates, families, and providers.  Instead of streamlining anything with regards to these Waivers, the result would be increased process and work for everyone involved, including the very DMAS staff proposing such a move.  As the regulations are constructed at present, changes needed in one Waiver can occur with no need to open all sections of 12 VAC 30-120.


While there may be exceptions, most families are concerned with only one Waiver and separating those Waivers by section would appear to be the most informative and user-friendly way to accomplish information sharing.


The history of the MR Waiver and MR Day Support Waiver, with its legacy of strong interest and affirmation by Virginia’s elected leaders, should indicate that the very features that have made them vital and effective Waivers, whether they are phrased as “inconsistencies” or by any other term, cannot be lost if the Waivers are to remain strong systems of support for citizens of Virginia and their families.


Although these Waivers are complex, they can and are being managed as is. 

Thank You for the opportunity to Comment on this intended regulatory action.

CommentID: 1810