DMAS should publicly disclose the complete fiscal analysis supporting the decision to eliminate Services Facilitation as a standalone service.
The proposed change does not eliminate the underlying functions currently performed by Services Facilitators. Instead, many of those responsibilities will be transferred to Support Brokers employed through the Fiscal-Employer Agents.
Therefore, the relevant question is not simply how much Virginia currently spends on Services Facilitation. The relevant question is how much Virginia will actually save after accounting for the cost of the Support Broker model, including Support Broker salaries and benefits, recruitment, training, supervision, management, technology, administrative overhead, and any additional compensation paid to the Fiscal-Employer Agents.
Before Virginia eliminates an established statewide network of Services Facilitators and disrupts longstanding relationships between individuals, families, and their chosen providers, DMAS should publicly disclose:
The current annual Medicaid expenditure for Services Facilitation;
The projected annual cost of the Support Broker model;
The additional amount that will be paid to the Fiscal-Employer Agents to administer Support Brokers;
The number of Support Brokers expected to be hired;
Expected Support Broker caseloads;
Projected implementation and transition costs;
The projected state General Fund savings;
The projected federal Medicaid savings; and
The projected net savings after all Support Broker expenses are included.
If the purpose of this restructuring is financial savings, the public deserves to know exactly how much Virginia expects to save and how those savings were calculated.
If the change is not expected to produce significant savings, DMAS should explain what measurable improvement in quality, accountability, access, or participant outcomes justifies eliminating an established provider network and removing participants' ability to choose their Services Facilitator.