RD199 - U. S. Department of Justice Implementation Update Pursuant to Code of Virginia § 37.2-319 (HB2533/SB1486, 2011) and Item 315.V.1. of the 2013 Appropriation Act for the Period January 1 - June 30, 2014


Executive Summary:
This report was developed to meet the requirements set forth in both Virginia Code § 37.2-319 (HB2533/SB1486, 2011) and Item 315.V.1 of the 2012 Appropriation Act. Specifically, Item 315.V.1. addresses the management of the general fund appropriation for the expansion of community-based services in accordance with the settlement agreement with the U.S. Department of Justice (DOJ), and states:

"The Department of Behavioral Health and Developmental Services shall provide updates on July 1 and December 1 of each year to the Governor and the Chairmen of the Senate Finance and House Appropriations Committees regarding expenditures and progress in meeting implementation targets established in the agreement."

The enactment clause associated with § 37.2-319 addresses the plan to transition individuals with an intellectual disability from state training centers to community-based settings, and states:

"The Secretary shall submit reports on the development and implementation of the plan to the Governor and the Chairmen of the House Committee on Appropriations and the Senate Committee on Finance on the first of July and December of each year beginning July 1, 2011."

This report addresses Virginia’s progress in meeting the milestones in the settlement agreement for the period of January 1, 2014 – June 30, 2014 and describes expenditures associated with the agreement for FY 2012, FY 2013, and projected for FY 2014.

• A TOTAL OF 405 INDIVIDUALS MOVED FROM TRAINING CENTERS TO THE COMMUNITY BETWEEN NOVEMBER 2011 AND JUNE 2014.

The dramatic decrease in the census of the training centers includes the successful closure of SVTC in May 2014. This is the first closure of a training center in the Commonwealth. Although the process was lengthy and encountered multiple barriers, DBHDS was able to address those challenges resulting in a very successful effort from which many lessons have been learned and will be used in future closures.

MY LIFE, MY COMMUNITY WAIVER REDESIGN: The Department of Behavioral Health and Developmental Services (DBHDS) and the Department of Medical Assistance Services (DMAS) retained Human Services Research Institute (HSRI) in July 2013 to study the existing Medicaid waivers supporting individuals with intellectual and developmental disabilities and make recommendations regarding redesign. The study is being conducted in two phases. The first phase, which concluded in December 2013, provided recommendations for how to transform Virginia’s waivers to better support individuals. These recommendations were based on extensive input from over 1,000 stakeholders statewide.

Phase 2 of the study, which is the Medicaid waiver redesign and rate study, began in January. As a result of the recommendations submitted by HSRI, DBHDS leadership established an advisory committee and five (5) related subcommittees to provide input on the new waiver design and how to enhance system processes.

- Waiver Design Advisory Committee

* Eligibility Subcommittee
* Waiting List Subcommittee
* Case Management Subcommittee
* Services Array Subcommittee
* Provider Advisory Subcommittee

These workgroups are facilitated by DBHDS leadership and staff. Their work is crucial to ensuring transparency and a well vetted rate methodology as the two new waivers are under development. To ensure a broad view of the current services system, it is critical that the members represent the diverse character of the Commonwealth. The advisory committee and subcommittee membership is composed of ID and DD self-advocates, family members, representatives from CSBs, provider agencies, and advocacy and parent groups. The responsibilities of the committees and a membership list can be found at: http://www.dbhds.virginia.gov/MLMC.htm.

IMPLEMENTATION OF CASE MANAGEMENT REPORTING REQUIREMENTS: Data collection of the frequency, type and duration of face-to-face case management visits by the ID Case Mangers continues. In January of 2014, the CSB began submitting data on quality of life issues that are included in individuals’ service plans. This data is being analyzed and will be published in the July Dashboard.

HOUSING INITIATIVE: On May 9, 2014, the Virginia Department of Housing and Community Development, in collaboration with the Department of Behavioral Health and Developmental Services, the Virginia Housing Development Authority and the Virginia Department of Medical Assistance Services, submitted a HUD Section 811 application for rental assistance to support 130 rental units for individuals with I/DD and serious mental illness. Individuals in the target population of the settlement agreement will have the highest priority for rental units.

DBHDS is also managing a rental assistance pilot, Rental Choice VA, with one-time funding totaling $800,000 to provide rental assistance for approximately 20 individuals who currently reside in a congregate setting (e.g., an institution, group home) and wish to move to their own homes or apartments. In April 2014, the Secretary approved an amendment to the project expanding it to cover individuals living with their family and receiving ID or DD Waiver supports who wish to live independently. The project is managed at the local level through contracts with the Virginia Beach CSB and the Fairfax-Falls Church CSB. The rental assistance bridges the gap between 30% of an eligible individual’s income and the fair market rent for a unit which, on average, ranges from $944 - $1,500 per month. As of May 31, 2014 there are approximately 11 individuals interested in the program with eight (8) residing in Fairfax-Falls Church and three (3) residing in Virginia Beach.