RD385 - My Life, My Community: Medicaid Intellectual and Developmental Disability Waiver Redesign - November 2015


Executive Summary:
*This report was replaced in its entirety by the Department of Medical Assistance Services on December 2, 2015.

The Department of Medical Assistance Services (DMAS) and Department of Behavioral Health Developmental Services (DBHDS) have worked diligently for two years, engaging the expertise of consultants as well as stakeholders across the Commonwealth, to redesign Virginia’s Home and Community Based Services waivers (HCBS) for individuals with intellectual and other developmental disabilities. The redesign combines the target population of individuals with both intellectual disability and other developmental disabilities and offers services that promote community integration and engagement.

The agencies intend to amend the three existing waivers into three distinct waivers that will support all individuals who are eligible and have a developmental disability. Once the elements of waiver redesign detailed in this report are implemented, the Commonwealth’s Medicaid HCBS waiver system will:

• Better support individuals with intellectual and/or other developmental disabilities to live integrated and engaged lives in their community,

• Standardize and simplify access to services,

• Offer services that promote community integration and engagement,

• Improve the capacity and quality of providers by increasing their compensation as they increase their expertise,

• Align with current research to achieve better outcomes for individuals supported in smaller community settings, and

• Meet the Commonwealth’s obligations under the community integration mandate of the ADA, the Supreme Court’s Olmstead Decision, and the 2012 DOJ Settlement Agreement requirements to create a community system of care.

Significant input throughout the redesign process has been collected from individuals, families, providers, advocates and stakeholders as well as national experts. Extensive data has been collected to design a waiver system that more closely links needs with costs. For individuals with developmental disabilities and their families, the system will be simplified with a single point of entry through the CSBs and include an array of meaningful service options.

Virginia will better serve individuals and families due to improved provider reimbursement rates, choice and flexibility, improved understanding of needs, preferences, and service utilization. The new system will allow the Commonwealth to decrease the waiver waiting list by getting the right services at the right time to the right people.