Comments Regarding NOIRA to Publish Consolidated Waiver Regulations
Blue Ridge Behavioral Healthcare would like to express serious concerns about the proposal to consolidate the regulations on Virginia’s HCBS Waivers. Of particular concern are the regulations affecting the Mental Retardation Waiver and the Mental Retardation Day Support Waiver, which have evolved since 1990 as the primary sources of supports for individuals with mental retardation who choose to live in our communities. Freestanding regulations have served recipients and professionals well over this period. Cooperative efforts between DMAS and DMHMRSAS have successfully developed and maintained an array of services that meet consumer needs. Specialized assessment instruments have been developed and refined over the years. A preauthorization process is in place and operating with a great deal of success. In addition, a unique system for developing, managing and maintaining a statewide-but-locally-driven Waiting List has been established and tested over the past 18 years, and this has proven essential in securing Waiver services in one of the scarce “slots” made available to individuals and families in need. At the CSB level, local Case Managers play a unique role in providing information to potential Waiver recipients. The majority of potential consumers are concerned with only one Waiver, and Case Managers, individuals and families would not be well served by the need to scan a consolidated regulatory document in order to “tease out” the details on these and other unique technical issues and requirements.
While at first glance it seems that common elements in Virginia’s Waivers might make consolidation of the regulations a defendable approach, we believe that this need to highlight the critical differences through freestanding regulatory sections should prevail. We are hopeful that the comments of those working daily within the regulatory boundaries will inform the process and curtail change that is not in the best interest of those most affected. Thanks for the opportunity to comment on this important proposal.