8/23/24

Department of Medical Assistance Services

ATTN:  Andrew Greer/Senior Policy Analyst – Office of Community Living

Suite 1300

600 East Broad Street

Richmond, VA 23219

RE: Proposed Changes to Medicaid Waivers

The disAbility Law Center of Virginia (dLCV) is Virginia’s designated protection and advocacy system. We advance the rights of Virginians with disabilities under several federally funded programs, including the Protection and Advocacy for Assistive Technology (PAAT) and Protection and Advocacy for Individuals with Developmental Disabilities (PADD) programs.

Thank you for this opportunity to comment on proposed changes to the FIS, CL, BI, and CCC + Medicaid Waivers. dLCV strongly supports the following proposed changes:

1. Combining the annual service limits for Assistive Technology and Electronic Home-Based Services into one annual $10,000 limit to be shared between the two services.

This change will allow greater flexibility for Waiver members who rely on Assistive Technology and Electronic Home-Based Services to live independently in the community. The current limits of $5000 per service are unduly restrictive and unnecessarily limit the usefulness of these services to many individuals. We are hopeful that after studying the financial impact of this change, the Department will further expand this flexibility by additionally combining the Environmental Modification service limit into this combined budget limit, allowing for a total of $15,000 limit shared between the three services. This would allow for an even more flexible and individually tailored approach supporting individuals with unique technological and environmental modification needs in the community.

2. Permit allowance for individuals offered a Developmental Disability Waiver slot to delay enrollment into the waiver for up to 1 year.

This change in policy is necessary to ensure that Waiver members do not unnecessarily lose their Waiver slot simply because of delays in their ability to access Waiver services that may be out of their control. As the Commonwealth expands the number of DD Waiver slots in the coming years, the provider network will need to expand available services in order to accommodate the influx of these newly enrolled Waiver members. We already hear from individuals and families who have difficulty accessing services in their communities, because of provider shortages. This amendment will allow some buffer time for individuals and the provider community to adapt and protect newly enrolled Waiver members from unnecessarily losing their long-awaited Wavier slots.

3. Disregard Social Security Disability Insurance (SSDI) benefits above the maximum Social Security Insurance (SSI) benefit limit as determined by the Social Security Administration for purposes of pre-eligibility treatment of income.

This crucial amendment will ensure that Virginians with developmental disabilities are not penalized simply because they are recipients of SSDI benefits. Medicaid Waiver long term services and supports are a crucial lifeline for these individuals, and this amendment will remove one more barrier to individuals to access this lifeline.

Sincerely,

Colleen Miller

Executive Director