2001 Session

Budget Amendments - SB800 (Committee Approved)

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Revised MR Waiver Language-Sub. (language only)

Item 319 #40s

Item 319 #40s

Health And Human Resources
Medical Assistance Services, Department of

Page 319, strike lines 21 through 28 and insert:
"SS.1.  The Department of Medical Assistance Services (DMAS) shall enter into an inter-agency agreement with the Department of Mental Health, Mental Retardation, Substance Abuse Services, which provides DMHMRSAS with the policy-making, daily management, and operational responsibility for implementing and managing the home and community-based waiver for mental retardation services.  The agreement shall establish DMHMRSAS as operational administrator, to the maximum extent allowable under federal law and regulation of this waiver, charged with responsibilities that shall include, but not be limited to, developing policy, service definitions, provider requirements, service-related recipient eligibility criteria, and preauthorization of service plans; and participating with DMAS in the internal drafting of applicable regulations and State Plan amendments.   DMHMRSAS shall request and manage the funds for start up costs for services not otherwise covered by Medicaid Waiver reimbursement.  The agreement shall charge DMAS with the responsibilities of revenue forecasting for the waiver, requesting appropriations to meet the forecast, claims processing, provider enrollment, utilization review, and publishing rules and regulations.  DMAS, as the single state Medicaid agency for Virginia, shall support the policy and operational efforts of DMHMRSAS with the Health Care Financing Administration (HCFA).
2.  Any revisions to the current MR Waiver or any new MR waiver application submitted to HCFA after January 1, 2001, shall specify that the MR Waiver shall be administered by DMHMRSAS; that DMHMRSAS shall establish criteria for a waiting list that meets HCFA criteria and requirements, but accommodates and reflects regional variations in Virginia's diverse service delivery system to the greatest extent possible.  Community services boards and behavioral health authorities shall manage the waiting list at the local level using these criteria in order to facilitate planning with other providers for service needs of consumers.  Community services boards and behavioral health authorities shall remain the single point of entry for waiver services and have the sole responsibility for targeted case management and care coordination, consistent with Item 323, paragraph J of this Act
As the local managers of services, community services boards and behavioral health authorities shall ensure local accountability for publicly funded services, continuity of care, census management and discharge planning with state facilities, the health and safety of consumers that they serve, consumer choice, and whenever possible, the involvement and participation of private providers.  Services provided directly by community services boards or behavioral health authorities shall remain a choice for consumers.
3.  In preparing the revised home and community-based waiver application, consideration shall be given to the key values of the consumer and the family in their choice of services and providers; providing flexibility to best meet the needs of the consumer; protecting the health, safety and well-being of the consumer; and providing supports that are self-directed whenever possible.
4.  DMHMRSAS, with cooperation from DMAS, shall review the draft HCFA report on the current waiver.  Throughout the waiver revision or development process, DMHMRSAS and DMAS shall work with representatives of the following: consumers of mental retardation services and their families, The Arc of Virginia, Parents and Associates of the Institutionalized Retarded, the Coalition for Mentally Disabled Citizens of Virginia, the Board for People with Disabilities, the Virginia Association of Community Services Boards, the Virginia Network of Private Providers, vaACCSES, Virginia Municipal League, and Virginia Association of Counties.
5.  Before submission to HCFA, the revised home and community-based waiver proposed application and an implementation plan shall be submitted to the Governor and Chairmen of the
Senate Finance Committee, House Appropriations Committee, and the Joint Behavioral Health Care Commission no later than September 15, 2001.  The implementation plan shall include strategies for provider development, rate-setting methodologies, impact of major systems changes, and transition from the current waiver to the revised waiver.  DMAS revenue forecasts for the new waiver will be included in this plan."

(This amendment specifies elements to be included in any revision to the current home- and community-based waiver for mental retardation services. It retains elements of the waiver that have contributed positively to the administration of the program in the past such as providing DMHMRSAS operational responsibility for the waiver and retaining the community services boards as the single point of entry. It also provides for submission of the proposed waiver to the Governor and Chairmen of the Senate Finance Committee, House Appropriations Committee, and Joint Behavioral Health Care Commission prior to submission to the federal government for approval.)