COVID-19 significantly impacted Medicaid members, including members receiving home and community-based services (HCBS). In order to reduce their risk of COVID19 exposure, certain flexibilities were identified and authorized by the Centers for Medicare and Medicaid Services (CMS), through an Appendix K amendment to the waiver application. This appendix was developed as a standalone appendix to be utilized by the state during emergency situations. It includes actions that states can take under the existing Section 1915(c) HCBS waiver authority in order to respond to an emergency.

Virtual support is a delivery model for accessing approved Medicaid services. It is synonymous with telehealth and must meet the pertinent requirements related to the Health Insurance Portability and Accountability Act (HIPAA). Since the term “Virtual Supports" is not recognized or defined, the term “Telehealth" (DMAS, n.d.) is used instead. Telehealth offers options and choice based on modernization of service delivery options and equity and is not intended to supplant integrated, community-based services.

Originally intended to be a temporary response to the pandemic, Virginia is now exploring permanent options for telehealth service delivery to enhance independence for individuals with intellectual and developmental disabilities (IDD). In 2021, as directed by HB2197, the Department of Medical Assistance Services (DMAS) convened a workgroup and reported options and recommendations on increasing access to telehealth and services for individuals with intellectual and developmental disabilities by promoting access to assistive technology (AT) and environmental modifications (EM). This year, HB990 directed DMAS to continue the workgroup and develop recommendations for the permanent use of telehealth and increased access to virtual supports and services by promoting access to assistive technology and environmental modifications for individuals with IDD.