The Arc of Virginia
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The Arc of Virginia
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Advocating for persons with mental retardation and related developmental disabilities and their families
CRITICAL ISSUES
I. ELDERLY CAREGIVERS/TRANSITION FROM SCHOOL TO ADULT SERVICES - Each year students with MR age out of Public School Special Education Programs and wait for Employment/Day Support services. Consequently, the costly training received through the special education programs is wasted and the students must be re-trained again once funding is available for Day Support/Employment services. Each year there are over 200 emergencies where the caregivers are no longer able to provide the supports needed to keep their family members at home or where individuals have aged out of Comprehensive Service Act (CSA) services. And yet, we do not allocate funding annually to provide a safety net for these individuals. Further, because of the lack of waiver and non-waiver funding, individuals with MR and their families are unable to access services until they are in a crisis. This is contrary to good planning, causes emotional turmoil, and is a shameful way to treat families who can no longer provide care for their loved one with a disability. The Comprehensive State Plan has the numbers of individuals who need services now and in the near future. Therefore, The Arc recommends the following in order to provide services in community settings:
· ANNUAL BUDGETED FUNDS FOR THOSE IN CRISIS
· ANNUAL BUDGETED FUNDS TO REDUCE WAITING LISTS
II. LIMITED ACCESS TO WAIVER SERVICES - The MR Waiver rate structure has not changed significantly since the implementation of the Waiver in 1991. Our private sector community system is currently undergoing a rapid turnover of personnel and because of low unemployment it is very difficult to hire qualified staff. In addition, many providers are going out of business because they cannot provide the services at the current rates. It should be noted that when the MR Waiver is used it is unlike any other provider group that DMAS oversees. Medicaid is the only funding source whereas other health care providers, such as nursing homes, doctors, hospitals, can obtain fees from other sources. For community MR services, Medicaid is the only funding source; there is no private sector or other insurers that subsidize the low state Medicaid rate. In addition, there is no rate differential for areas with a high cost of living. In order for delivery of services in community settings, The Arc recommends the following:
· ADEQUATE MEDICAID RATES ü Rates should cover the cost of doing business ü Rates should be simplified ü Rates should include automatic cost of living adjustments
· WORKFORCE CRISIS STUDY ü Implement recommendations of current DMHMRSAS Workforce Task Force
III. SERVICE SYSTEM IMPROVEMENTS
· SELF-DETERMINATION - Self-determination and person-centered planning are concepts being used in many states to provide more individualized services for people with mental retardation. These concepts have also proven to be more cost-effective. To be successful, a critical component of Self-determination requires that it be free from state agency regulations that prevent creative approaches that work best for individuals and families. Therefore, The Arc's recommendations are to:
ü Implement pilots around the state ü Allow flexible use of public funds to ensure successful implementation of the pilots
· IMPROVEMENTS FOR THE MR WAIVER - Although through the MR Waiver Task Force, the MR Waiver was rewritten in October 2001, it had to be cost neutral and hence, needed services could not be added. If Virginia is moving from institutional services to community-based services then it is essential that supports be enhanced and designed for individuals who have significant behavioral and physical health care needs. In addition, regulations and policies should be implemented that streamline the flow of paperwork and allow time to be more appropriately spend on providing support services rather than documenting them. The Arc recommends the following be implemented:
ü Equity with the Institutions: Dental and Behavioral Services ü Reduction of paperwork and cumbersome regulations
Updated 06/24/07
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