Legislative Plan for 2026 Has Been Released!

November 18, 2025

The VNPP Legislative Plan is available today on our website here and below!  And because we hope that you will share it with your legislators, we have made a “one pager” available – click on the link in the “title” on the webpage!  If you have questions, hop on the Member Call this Friday!

Legislative Plan 2026

  • In order to provide high quality supports and services accessible to individuals across the Commonwealth, providers must be able to demonstrate consistent and predictable ability to operate in a sustainable business environment.
  • Factors which contribute to the provider’s ultimate success, and therefore to the successful support and treatment of the individuals they serve, are:
    • Adequate rates of reimbursement to allow staff compensation, which is competitive in the market,
    • Timely and complete payment made for claims properly submitted, and
    • A regulatory, development and business environment that minimizes the administrative burden on providers, while ensuring compliance and quality.


Specifically for the 2026 General Assembly Session:

  • Based on the assumption that HB1 which would require an increase in the minimum wage from $12.77 (which begins January 2026) to $13.75 (proposed to begin January 1, 2027) passes and is signed by the Governor, request an increase of 3% in the rates paid from July 1, 2026 through December 31, 2026  and an additional 4.6% for rates paid from January 1, 2027 for critical DD Waiver Services which were not included in the DOJ mandate for review.   The expected GF cost is ~$23.8M.

Note: The cost is based on FY 25 utilization/cost data from DMAS and the increase is identical to that included in the FY24 & FY 25 budgets and  approximates CPI annual increase reported in September plus the projected increase in minimum wages.  

  • Request the Department of Medical Assistance Services shall have the authority to amend both the Community Living and Family and Individual Supports 1915c Developmental Disability Waivers and the associated regulations needed to implement the provisions of the provision which allows, in limited circumstances, payment for a designated support staff person in an acute care setting.. Cost estimates are based on the following assumptions:
    • 7% of the members in the identified services are admitted to an acute care setting for an average of 15.63 days in a year;
    • 80% of the individuals will require specific supports up to 8 hours in a day;
    • Services will be reimbursed at the same rate as personal care to providers who assign designated support staff able to implement the supports identified in the individual’s plan, identify other needs which arise where support is required, facilitate the acute care treatment plan and communication among all service providers. The expected GF cost will be ~ $.8M
  • Request language in support of raising the ICF/IID rate cap to equal the highest as-filed rate paid to a state ICF-IID institution. The expected GF cost will be minimal as most ICF-IIDs do not reach the current cap and the cost, if any, would begin in FY28.
Other issues of concern and discussion:
  • Pause the BH Redesign Efforts to allow both the needed time for implementation, but also more careful consideration of the proposed requirements.
  • The increasing difficulty in obtaining and/or the cost of obtaining liability insurance.
  • Clarify that DBHDS licenses “providers” not services and limit inspections to be in advance of the requested renewal of the license rather than annually by service.
  • Payment of leave benefits for PRN/Relief staff which would add an administrative burden for providers.

 

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