What’s Actually in the Budget?

December 17, 2021

Governor Northam released his final budget today for the coming biennium.  It is not the document that Governor Youngkin will sign in April, but we know from hard experience that it is easier to keep items in the proposed budget than to amend it during the Session.  Some of the highlights are:


Medicaid:

  • 5% increase in rates for dental services and a review of issues related to access
  • an ongoing $15/day payment for nursing facilities (had been $20/day during the PHE)
  • 1.6% increase for personal care, respite, & companion services in January 2023 to accommodate the minimum wage increase
  • co-payments for Medicaid enrollees eliminated (April 2022 or at the end of the PHE); this item is also in the “caboose” budget bill
  • language in support of expansion of “telehealth” and allowance for a variety of virtual services for DD Waivers to equal those allowed during the PHE
  • 1,200 new DD Waiver slots (500 FIS and 100 CL each year) 
  • roughly $294M in new funding for DD Waiver rates – of the options considered the one selected was to use the Burns & Associates study as the base and fund the minimum wages increases for all services and fully fund those most integrated services that will promote compliance with the Settlement Agreement:
    • Group Homes, 4 beds or fewer – 30.3% (increases are from the rates prior to the temporary 12.5% increase currently in place)
    • Sponsored Residential – 12.8%
    • Supported Living – 61.6%
    • Independent Living – 52.2%
    • In-Home – 33.2%
    • Community Engagement – 30.5%
    • Community Coaching – 23.9%
    • TC – 7.4%
    • Private Duty & Skilled Nursing – 71.4% 

You will note, and we discussed on the Member Call this morning, that this list does not provide the increases necessary to maintain the workforce for Group Day, Group Supported Employment or for the majority of the Group Home Residential programs.  The Board met earlier today and decided to request an amendment to the budget which is more fully described here.


DBHDS:

  • Multiple projects to reduce admissions or promote discharges from State Hospitals
  • Small increase for Part C Services
  • Significant increase for rental assistance for DD individuals
  • Funding essentially as requested for STEP-VA

There do not appear to be expected items “missing” though a more in-depth review will be needed.

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