HD64 - A Study of Virginia's 1915c Medicaid-Funded Home and Community-Based Waiver for Intensive Assisted Living Services


Executive Summary:
The 1999 General Assembly passed Item #335, #5c of the 1999 Appropriations Act which mandated the Department of Medical Assistance Services (DMAS) to review the current Medicaid assisted living waiver. The issues the General Assembly requested DMAS to review include:

I. The services covered by the assisted living payments and the extent to which payments reflect the services that need to be provided and the extent to which Medicaid finds could be used lieu of general funds to provide assisted living care;

II. Whether additional nursing facility patients can be safely and appropriately served through assisted living;

III. The adequacy of reimbursement for assisted living care and the appropriateness of the current two-tiered structure for assisted living payments;

IV. Best practices in other states; and

V. The adequacy of the current regulatory structure, if heavier care patients were to be cared for in adult care residences.

This report presents the options identified by the Department of Medical Assistance Services (DMAS) in relation to its review of the Medicaid home and community-based waiver that provides intensive assisted living services. The options outlined in this report are in no way intended to fully outline all the details which must be addressed in the revision of the Intensive Assisted Living (IAL) Waiver.