HD77 - The Medicaid Home and Community-Based Waiver for Persons with Mental Retardation


Executive Summary:
Pursuant to Item 302, TT of the 2006 Appropriation Act, the Department of Medical Assistance Services (DMAS), in cooperation with the Department of Mental Health, Mental Retardation and Substance Abuse Services (DMHMRSAS), the Virginia Association of Community Services Boards, The Arc of Virginia, and other stakeholders, was directed to jointly review the current Mental Retardation (MR) Waiver to determine how it can be improved to provide a person-centered, individualized support focus, assess the need to upgrade availability of therapeutic behavioral consultation, skilled nursing, medical and other specialized, and review successful models of waiver funded community supports used by other states. The responsibility to study the MR Waiver was transferred to DMHMRSAS from DMAS on August 29, 2006.

During this year, DMHMRSAS and DMAS reviewed the administrative process for the MR Waiver, making significant changes in lead responsibilities. DMHMRSAS has established a MR Waiver Study Steering Committee, developed a study design, and completed a review of current studies and system transformation activities that relate to the study of the Waiver. The Advisory Consortium On Intellectual Disabilities (TACID) and the MR Waiver Advisory Council will review the study design, all findings, and recommendations resulting from the study process.

Findings of the study, to date, indicate that the MR Waiver issues are complex, that DMHMRSAS and DMAS are in the process of major transformation efforts (with the MR Waiver as a central piece of the transformation), and the transfer of the lead responsibilities and study of the MR Waiver to DMHMRSAS has recently occurred. Therefore, it is recommended that the DMHMRSAS be given a one-year extension on the study to provide a more comprehensive review.