Comment on 90 day reserve requirement
Lutheran Family Services of Virginia has been providing services in Virginia for more than 130 years. Since 2011, LFSVA has been providing a full array of services to upwards of 600 people with developmental disabilities annually, at multiple locations around the state.
The language in the Guidance Document proposed by the DBHDS Office of Licensing is extremely concerning, as it will no doubt place an incredible, if not impossible burden on the vast majority of providers. The re-imbursement rates paid by Medicaid already makes it difficult to be a provider and maintain qualified help much less add the extra burden of this 90 day resources. We agree with the other providers who have commented that "projected revenue", as specified in the actual regulation, 12VAC35-105-210, should be considered as valid financial resources to cover operating expenses.
The Guidance Document states "Therefore, both applicants for licensure and licensed providers must be able to provide proof, at any time when requested by a representative from the department, that they have sufficient funds for 90 days of operating expenses, whether in cash or a line of credit". This statement does not reflect the language of the regulation for which the document purports to provide guidance: 12VAC35-105-210 states "The provider shall document financial arrangements or a line of credit that are adequate to ensure maintenance of ongoing operations for at least 90 days on an ongoing basis. The amount needed shall be based on a working budget showing at least 90 days on an ongoing basis. The amount needed shall be based on a working budget showing projected revenue and expenses".
The language in the Guidance Document does not include projected revenue. This is a significant omission which has the effect of going beyond regulations and will have dramatic implications for providers, individuals being served, and the system at large.