The Virginia Network of Private Providers, representing more than 120 entities in Virginia who support more than 27,000 individuals with 12,000 staff, tries to look into the future and support legislative action which will provide stability and allow for growth. With that in mind, we have focused our attention on the planned increases in the minimum wage which will put all of our member organizations in a very difficult position by next January.
Both Behavioral Health providers and Developmental Disability Waiver providers are “Medicaid dependent” without any control of the reimbursement rates for services – that is solely within your control. So with that in mind, we support:
- Senate 320#1s which provides for a “rebasing” of the entire array of the DD Waiver services with an emphasis on updating rates to align with services as delivered, and the impact of the minimum wage increase.
- Senate 479.20#1s which provides (in the second priority) $20M GF to DMAS to increase the DD Waiver Provider Rates to Reflect Minimum Wage contingent upon the determination that revenue for FY21 exceeded the official forecast. And,
- The Behavioral Health Enhancement work which will provide not only a more robust continuum of services, but will afford an opportunity to look at the rate structure in light of the pressure from the increased wages and resulting wage compression.
Because there are more immediate needs, specifically due to the ongoing pandemic,
- We also support some version of Support Payments for DD Waiver Providers (Senate 314 #1s would allocate $15M GF); we do not think that the specific proposal in this item would accomplish the intended purpose! And,
- Senate 318 #1s which extends the existing Conditional DBHDS Licenses six months beyond the end of the Governor’s declared emergency.
We do not support the “clawback” of CARES Act moneys (Senate 479.10 #4s) on page 574, Line 1 or page 575, Line 5 as DMAS has released instructions for a second round of requests to utilize the remainder of the funds allotted by the Special Session
There are, of course, other items that we support, but want only to highlight those above for your consideration!Talking Points!
- We are worried that if the minimum wage goes up to $11/hour in January 2022, we won’t be able to compete with others to recruit and retain staff. We get paid by Medicaid and can’t raise our prices!
- Background – The minimum wage is scheduled to increase to $9.50 on May 1st 2021, and then again to $11.00 on January 1st 2022.
- While we do not think the first increase will be difficult, and we do support the concept of better wages for our DSPs and frontline behavioral health staff, we think that $11.00 will be difficult to manage – competition will increase and wage compression will make the costs far exceed our rates.
- We support many of the budget items delayed until July 2021 because of COVID that you agreed to last year! These are at the top of our list — complete the DD Waiver rate refresh, increase the Mental Health Provider rates, implement the Adult Dental benefit and increase the rates for Skilled and Private Duty Nursing.
- Background – The items above were all included in the Biennial Budget passed last winter, but were postponed because of the uncertainty due to the pandemic.
- These, among others, were approved again for delayed implementation during the Special Session and are included in the Governor’s budget – we really need them to stay!
Legislative Plan for 2021
Support the restoration of funding in FY 22as approved in the Budget signed on 18 November, 2020 for:
- Mental Health Provider Rates – $2.5M
- Adult Dental Benefit – $17.5M
- Rate Increase for Skilled and Private Duty Nursing – $6.2M
- Discharge Assistance Plans – $10M
- Permanent Supportive Housing – $17M
- Behavioral Health Redesign – $10.3M
- DD Waiver Rates for Community Integration Services – $3.7M
- Funding for 250 DD Waiver Slots – $4.1M
The detailed analysis from DMAS on the impact of minimum wage increases, delayed because of COVID, will not be completed in time to provide information necessary to affect the rates before the increase to $11.00/hour projected for January 2022. The increase should be delayed until July 1, 2022 to permit action by the General Assembly to adjust the rates.
Support Budget language to direct DBHDS to complete the DD Waiver Services rates “rebase” for submission for the Governor’s budget for FY22-FY24
Support the request for the authority to support the continuation of audio-only health services and new telehealth services after the expiration of the public health emergency.