The Virginia Assisted Living Association (VALA) represents assisted living communities from across Virginia with varying resident capacities, organizational structures, and funding resources. There is a continued need to have assisted living as an option for long-term care housing as the number of senior citizens and adults with disabilities in the Commonwealth continue to increase significantly. While we would welcome the Commonwealth to create a Medicaid waiver specifically for providing assisted living housing, we encourage the Commonwealth to at least improve the current Medicaid waiver programs to not discriminate against residents of assisted living communities. 

Many states allow for Medicaid waivers to be used for residents of assisted living facilities. Virginia needs to remove the restriction in 12VAC30-120-920 to provide home and community-based care services to individuals residing in assisted living facilities (ALFs) licensed by the VDSS. Having this restriction in place has resulted in many of Virginia's citizens being forced to reside in inappropriate housing that may not be optimal for their care needs and wants. Individuals on Medicaid waivers should have the right to choose their housing situation. This restriction prohibits individuals otherwise eligible for Medicaid that choose to reside in an ALF from being able to receive assistance such as with non-medical transport and aide services not already provided by the ALF. 

ALFs are just one component on the continuum of care that is needed and provided for Virginia’s older citizens. It is crucial that supports are provided for each level of care to make sure that the right placement and the right accessibility is provided to Virginia’s residents to ensure personal choice, quality of life, security, and independence of older Virginians. We need Virginia to support the assisted living communities that are caring for some of Virginia’s most vulnerable individuals by including ALFs specifically in the available programs. By doing so, Virginia will be recognizing the potential for programs and services that may be implemented or expanded that would advance the aging services in Virginia. 

In addition to ensuring right placement, we also recommend that Virginia change the DMAS rule to require persons who attend day programs to attend for at least 6 hours. (12VAC30-120-924) Individuals with brain injuries or other ailments may not have the physical stamina to stay in a program for 6 full hours. This rule prevents those persons from having access to day support programs. 

We thank you for considering these comments and invite you to contact VALA at information@valainfo.org or (804) 322-2111 should we be of assistance. 

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