12VAC30-120-920. Individual eligibility requirements - B. 2. a. (1) AND B. 2. B. (1) – Pages 2384 and 2385

Please delete the eight hour employment per week minimum for disregarding earned income.

Background: The regulations specify that “Virginia shall reduce its payment for home and community-based services provided to an individual who is eligible for Medicaid services under 42 CFR 435.217 by that amount of the waiver individual's total income (including amounts disregarded in determining eligibility) that remains after allowable deductions for personal maintenance needs, deductions for other dependents, and medical needs have been made…” However, with the consideration that “working individuals have a greater need due to expenses of employment” the regulations state: “Earned income shall be deducted within the following limits: (i) for waiver individuals employed 20 hours or more, earned income shall be disregarded up to a maximum of 300% of SSI and (ii) for waiver individuals employed at least eight but less than 20 hours, earned income shall be disregarded up to a maximum of 200% of SSI.”

Why is it okay to disregard income for persons working less than 8 hours per week? They have the same employment expenses as persons working 8 to 20 hours per week.

My daughter, Virginia Casey has approximately 4 hours per week of paid work. Therefore, all of her earned income is taken away and she has NO FINANCIAL INCENTIVE TO WORK.

This regulation seems arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same expenses of employment as those who work 9-20 hours? 

Please delete “at least eight <hours>” as follows:

“Earned income shall be deducted within the following limits: (i) … (ii) for waiver individuals employed less than 20 hours, earned income shall be disregarded up to a maximum of 200% of SSI.”

Why is it okay to NOT disregard earned income for persons working less than 8 hours per week? They have the same employment expenses as persons working 8 to 20 hours per week.

Question- if personal care aides in adult day settings have taken a similar course, which was listed as an approved curriculum prior to this addendum, are they grandfathered or will another 40 hours curriculum be mandated?  Specifically, I am referring to the Adult Day Care Aide Certification that was created by the National Adult Day Health Care Association and approved by DMAS to meet the curriculum.

Section 3. e.:

(3) Personal care aides who shall be responsible for overall care of waiver individuals such as assistance with ADLs, social/recreational activities, and other health and therapeutic-related activities. Each program aide hired by the provider shall be screened to ensure compliance with training and skill mastery qualifications required by DMAS. The aide shall, at a minimum, have the following qualifications

(e) Have satisfactorily completed an educational curriculum as set out in clauses (i), (ii), and (iii) of this subdivision E 1 c 3 (e). Documentation of successful completion shall be maintained in the aide's personnel file and be available for review by DMAS' staff. Prior to assigning a program aide to a waiver individual, the center shall ensure that the aide has either (i) registered with the Board of Nursing as a certified nurse aide; (ii) graduated from an approved educational curriculum as listed by the Board of Nursing; or (iii) completed the provider's educational curriculum, at least 40 hours in duration, as taught by an RN who is licensed in the Commonwealth or who holds a multi-state licensing privilege.

Thank you,

Michael DiGeronimo

When referencing volunteer requirements- does this mean ALL volunteers or only those that count in the staffing ratios?  Specifically- there are different levels of volunteers:

•  Those that may come with a school group to do a performance or special project
• Volunteers that are always in the presence of staff and do not provide any personal care, ie sets up dining room, assists staff with an activity, etc.
• Volunteers that act as staff and count in the ratio- per licensing, they must have ALL the requirements of paid staff.

My concern, if the requirements for back ground checks, reference checks, etc- our volunteer pool will drop.  Certainly, a background cannot be done on an entire choir from the local elementary school.  Another example- we work with "volunteers" that have developmental/intellectual disabilities that would like to learn skills.  Typically, they help set up our dining room and socialize with clients during non activity time.  Again, they are supervised- how do the requirements apply to them?  Much of our involvement with community would decline and limit our person centered approach.  Volunteers may not be able to encure the fees for the checks and smaller non-profits will be unable to accomodate that cost either.

If we have paid vendors that come in for entertainment, what are the requirements regarding background checks and such?

Thank you,

Michael DiGeronimo

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours? 

Here is the code element for reference:

(ii) for waiver individuals employed at least eight but less than 20 hours per week, earned income shall be disregarded up to a maximum of both earned and unearned income up to 200% of SSI. However, in no case shall the total amount of income (both earned and unearned) that is disregarded for maintenance exceed 300% of SSI.

I would recommend a review of the above section to have the minimum moved from 8 hours to one hour per week... as this would capture more individuals within the spirit of which I believe the original authors of this policy intended.

Many of the individuals who fall into this demographic who are willing to work, can only practically work a few hours a week due to medical or other circumstances. It is important to note the costs for the parent(s) or caregiver associated with the individual working for one hour, is the same as those able to work 8 or more hours. These individuals should not be denied the same consideration as those given to those working 8 or more, when in fact they are only given the opportunity to work 8 or fewer hours a week.   

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours? 

Please delete the eight-hour employment per week minimum for disregarding earned income.  Earning income is  for most persons an invaluable and I would suggest inviolable incentive to be reliable, conscientious, and productive members of a community work force whether for one hour or forty per week.  

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours?

Thank Tou

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work over eight hours.?

 Please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours? It gives no satisfaction for work accomplished, removing the incentive for those who already encounter many obstacles to gainful and meaningful employment.

over this text and enter your comments here. You are limited to approximately 3000 words.

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours?

n 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income. The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours?

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours? 

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours?

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income. The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours?

In 12VAC30-120-920, Sections B. 2. a (1) and B. 2. B (1), please remove the eight hour minimum employment per week for disregarding earned income.  The eight hour minimum is arbitrary and unfair.  Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours?

If a person is attempting to work whatever hours they can to supplement, it makes no sense to penalize them if they can only work less than 8 hours a week.  This requirement needs to be changed to eliminate the 8 hour minimum.  It is only logical.

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum apears arbitrary and not balanced with those working more then 8 hours a week. Why should a person who works less than 8 hours per week ( common for many in this demographic) have earned income deducted when they have the same employment expenses as those who work 8-20 hours? Thank you for reveiwing the above mentioned code adjustment.

It does not make any sense that when adults reach the age of 27, they lose "points" on the wait list and they most likely will lose Priority 1. These individuals do NOT have fewer needs as they age (and their parents/caregivers age). They will have more needs. My son has been on the "Urgent Wait List"- then the "Priority 1 Wait List" for years. The state of Virginia has failed him. Just because he did not receive the waiver by the "magic age" of 27, his chance of receiving it now are practically non-existant. This is so unjust and illogical. I would love to know who thought this up. Of course people exiting the public school system need the waiver support to move into adult activities, but if one does not get the waiver by age 27- the need does not disappear. It gets greater.

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income. The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours?

Regarding 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1),

Please delete the eight-hour minimum employment per week for disregarding earned income. Having an eight hour minimum is arbitrary and unfair. Should not employment of any hours be encouraged as opposed to only 8 or better?  Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours? The state of Virginia should respect and encourage those with disabilities who are attempting to be responsible citizens and contribute to society.

It is my understanding that the purpose of disregarding earned income is to encourage the employment of the people receiving SSDI.  This should serve several purposes simultaneously, one is the improvement of self esteem of the person doing the work as they see a check with an actual amount stating that they did something worthwhile with themselves that week, another is a feeling of contributing to society rather than draining it.  WHy should these positive results be restricted to only those who work between 8 and 20 hours?  Did the person working five hours over five days have to take fewer trips to work over the five days?  Did they need fewer clothes over the five days?  Yet this theoretical person is 'rewarded' by a zero paycheck resulting in zero incentive to even attempt to grow, learn, or assimilate into our working cutlure. 

Therefore, I would request that the minimum eight hour employment per week specified in 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1) is actually a detriment to those unable to work 8 hours and in order to encourage those who cannot meet the 8 hour minimum, it should be abolished in favor of a zero to twenty hour employment week.

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours?

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours? 

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income. The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours? Thanks for your consideration.

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income. The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours?

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours? Please consider the impact that this has on individuals with disabilities. Working provides a sense of pride and purpose. Would you want that taken away from you?

CIn 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours?

TIn 12VAC30-120-920, Sections B. 2. a (1) and B. 2. B (1), The eight hour minimum rule doesn't make sense.  Why should a person who works less than 8 hours per week have earned income deducted when they have the same kind of travel and employment expenses as those who work longer?  You are taking away their incentive to work.  I hope you'll rethink this ridiculous restriction.

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours? This is very important for many of our young adults who are working.  Your immediate attention to helping us make this change, would be very much appreciated!  Sincerely, Gail Hadley-Goggin parent to Ashlan Hadley- Goggin, who is a 26 year old young adult, with Down Syndrome and Autism.  Looking forward to your support!

In 12VAC30-120-920, Sections B. 2. a. (1) and B. 2. B. (1), please delete the eight-hour employment per week minimum for disregarding earned income.  The eight hour minimum is arbitrary and unfair. Why should a person who works less than 8 hours per week have earned income deducted when they have the same employment expenses as those who work 8-20 hours? 

Thank you.

In 12VAC 30 - 120 - 920 section B .2 .a 1 and B. 2. B. 1 please delete this 8-hour employment per week minimum for disregarding earned income. The 8- hour minimum is arbitrary and unfair why would a person who works less than 8 hours per week have the same earned income deducted when they have the same employment expenses as those who work 8 to 20 hours?

 Regarding 12VAC30-120-930A13:

General requirements for home and community-based

participating providers.

 13. Furnish information on the request of and in the form requested to DMAS, the

Attorney General of Virginia or their authorized representatives, federal personnel, and

the state Medicaid Fraud Control Unit. The Commonwealth's right of access to provider

agencies and records shall survive any termination of the provider agreement.

Please add Office of the State Long-Term Care Ombudsman to A 13. (The LTCOP was previously included in 1700 A 1 5 and aligned with code.)

 Regarding 12VAC30-120-920 (5):

Please add to “rights” section “person-centered planning.”

Regarding 12VAC30-120-930H1 and H5:

Please add language ensuring that when waiver individuals are notified of a termination of waiver services or a change in level of services, they are not only notified of appeal rights, but also made aware of the availability and contact information of the independent ombudsman/advocate to request assistance in understanding and exercising their rights relative to the action/decision.   

 Regarding 12VAC30-120-924 21.L 3 3 E 1 c (1)

 Please add a clear definition of the term “care coordinator” that is referenced in this section.

Delete the 8 hour work minimum... the individuals involved have the same employment expenses no matter the hours work..