FMAP as a “bridge” to the “rates rebase” which will, at the earliest, be available July 2022 (six months after the next minimum wage increase)
This provision as part of ARPA, on its face, seems very straight forward. And while there may be a variety proposals for the funds, VNPP is strongly recommending the following:
Require documentation of the appropriate use to be confirmed in a subsequent QMR review; utilize the guidance to be provided by CMS as the options for appropriate use.
This methodology recognizes several realities:
While the CSBs do hold a unique position of both statewide “coverage” and direct accountability, the private sector provides the vast majority of the services in the community in both the behavioral health and developmental disability arenas. In very simple terms, meeting the needs already identified and those exacerbated by the COVID19 pandemic will be addressed only by building (and in some cases – maintaining) capacity
Building and/or Maintaining the Workforce
80-85% of the cost for any provider is for personnel (payroll, benefits, taxes, etc) and currently there are multiple factors which are driving that cost up in an unsustainable way:
And, most critically, the impact of the long overdue increases in the minimum wage which are not funded in the Medicaid rates structure.
The workforce, at all levels including professional staff, is key to building and/or maintaining the capacity of the system. Lacking that, the next steps will not come to fruition and Virginia’s most critical needs – reducing the pressure on the state hospital system and reducing the waiting list for DD Waiver Services – will not/can not be addressed.
This funding will be a "bridge" to the rebase of the rates which may not be possible until July 2022.