Over a month ago, the federal government announced it would start accepting emergency Medicaid waiver applications from states seeking extra support for providers during the pandemic.
Twenty-seven states have already received approval from the federal government for emergency Medicaid waivers that extend flexibility to providers of people with developmental disabilities.
Virginia’s Medicaid agency just submitted its request this week. According to the agency’s director Karen Kimsey, the application was submitted to the feds Tuesday night.
Kimsey said the department is seeking flexibility “to allow parents of minor children, spouses and legal guardians to receive payment for providing respite care,” in the case that in-home personal care attendants are unable or unwilling to continue providing services during the pandemic.
“One of the things I'm actually hearing more of is that aides are actually sheltering in place with Medicaid members, and they're working additional hours,” Kimsey said. “So we're working hard at the agency to make sure we open up authorizations to allow people to get the care that they need.”
In a letter sent to Kimsey a month ago, a group of disability rights advocates urged the department to seek additional flexibility and support to help residential providers in small group homes and day providers weather the pandemic.
A copy of Virginia’s waiver application was not provided to VPM by deadline Thursday. Kimsey told VPM that these additional requests are “currently under review from the administration.”
“I don’t think Virginia took full advantage of the opportunity here,” said Teri Morgan, Executive Director for the Virginia Board For People with Disabilities.
Morgan said she hasn’t received a copy of the application yet, but conversations with state officials suggest there’s “very little” that will directly help providers to individuals with disabilities stay afloat. For example, if an individual in a group home needs to be hospitalized, Medicaid won’t pay for a staff member from the group home to go with them and support them. That’s just one thing she would’ve liked to see included in Virginia’s waiver submission.
“Every single provider is scrambling every day to keep it together,” said Jennifer Fidura, executive director of the Virginia Network of Private Providers, Inc. “But it won’t take much to push us over the edge.”
Fidura said the federal emergency waiver allows for retainer payments to be made to support smaller group homes and day services providers. And while she was glad to see Governor Ralph Northam announce pay raises for nursing home staff, she hoped similar attention would be paid to other small group providers.
Advocates like Colleen Miller, executive director for the Disability Law Center of Virginia, worry that if community-based programs can’t survive, “people are at risk of being institutionalized” in nursing homes and other state facilities.
Tonya Milling, executive director for the Arc of Virginia, says a lot of smaller providers have closed programs for now because they’re not able to get flexibility to continue serving clients through alternative means.
“My big fear is we’re going to come out of this with only large, for-profit providers surviving,” Milling said. “You want to protect small providers, you want to protect non-profits who often are able to be more individualized and provide more inclusive services.”
