Preliminary Report on Budget Recommendations from the “Money” Committees

February 21, 2016

Both the House Appropriations Committee and the Senate Finance Committee released their recommended changes to the Governor’s introduced budget for 2016-2018 (FY17 & FY18). As expected there are some significant differences in approach and the detail, particularly on the Senate side, is still lacking – all the amendments will be available by mid-week.  This brief report will tie the budget amendments to our Legislative Agenda for 2016. Agenda Item #1Support the goals for the Redesign of the ID/D Waivers which are jointly held by the individuals who are supported by the Waivers and their families, the providers who support them and agencies that develop the policy and fund the services. These goals are: 
  • To offer an array of service options to meet the diverse needs of the ID/D individuals who qualify for one of the three Waivers.
Both the House and Senate preserved the basic structure of the Waiver Redesign; the House is recommending delaying the start of some new services until July 1, 2017. One of those recommended for delay is an existing service and, therefore, a “delay” would cause a significant disruption. This will be a matter for discussion! The Senate is recommending greater specificity; in other words, they will include the details of the rates in the Budget which would insure that the plan is implemented as proposed. Both House and Senate tightened their control over the expenditure of the “Trust Fund” dollars, either by establishing very specific priorities or by requiring that funds be specifically appropriated by the General Assembly.  
  •  To encourage supports in the most integrated settings possible by adequately funding those services which will help achieve that outcome.
A rate increase is proposed by the Senate to correct the identified error in the calculation of the rate for Sponsored Residential in Northern Virginia; the rate published did not include the factor for the higher housing costs in that area of the state.Details of other small increases for Skilled Nursing, Private Duty Nursing, Personal Care and Adult Day Health will be reported later in the week
  • To plan, through the person centered planning process, supports that meet but do not exceed the needs and preferences of the individual.
Agenda Item #2 Work with our partners in the Executive Branch, VACSB, VaACCSES and other provider groups to identify the costs which will be associated with the likely implementation of the revised federal standard for overtime pay. No Budget impact in this cycle! However, on the subject of overtime, both the House and the Senate removed the funding requested to pay CD Services staff up to 16 hours of overtime per week; the result will be no overtime allowed! Agenda Item #3 -Request legislation that allows providers to obtain federal criminal histories for all adults providing support in either Sponsored Residential or Shared Living residential arrangements. No fiscal impact; no budget amendment required. Agenda Item #4Support the creation of viable community-based services in a sustainable business model, which includes an appropriate level of revenue over cost to meet quality standards, in advance of any reduction in functional capacity of a DBHDS state facility. We added this item in response to our concerns that DBHDS proposed $1Million develop a plan to close Catawba Hospital. Both House and Senate removed the funding and language and fashioned a study of psychogeriatric services as the alternative. Additionally, both the House and Senate require DBHDS to make efforts to recertify Hancock Geriatric Center at Eastern State Hospital! Both House and Senate increased the eligibility for the GAP program from 60% to 80% of FPL. This program is scheduled to expire soon it may not, in fact, be much help. Agenda Item #5 – Partner with other advocates to request funding to mitigate the concerns of the families who have waited the longest for a “DD Waiver slot” when the waiting lists for the Waivers are combined into one needs based list.   The slots in the Governor’s Budget that meet the requirements of the DOJ Settlement Agreement are not in jeopardy, but neither the House nor the Senate added many additional slots. The House added 150 to the DD Waiver, 100 of which are to be used for those who have waited the longest on the DD Waiver Wait List when the Lists are combined into one “needs based” list on July 1; the Senate added 400 DD Waiver slots (detail forthcoming).  The Senate also removed the requested reserve slots. We will provide more detail later in the week.