There are now new rules in Virginia for parents, otherwise referred to as legally responsible individuals (LRIs), who have been getting paid by the state to take care of their kids with developmental disabilities.
I've been covering this story for months as advocates pushed for the General Assembly to make changes to the state’s disability waiver program. Now, I’m circling back as Governor Glenn Youngkin signed new legislation into law.
Watch previous coverage: Virginia's Medicaid program pauses changes for parents acting as paid caregivers
During the pandemic, when caretakers weren't going into homes, the Department of Medical Assistance Services (DMAS), the organization that oversees Virginia’s Medicaid, allowed parents to get paid for taking care of their kids with severe developmental disabilities.
It impacted families like Antonio Mauro's in Virginia Beach. His son, Giovanni, is nonverbal.
"If you don't have the right person taking care of them, negative things will happen," he says.
The rules for the waiver program, which include limits on who the employer of record could be, were extended until March 1, 2024. However, advocates say families still needed more time to implement the rules in their day-to-day lives post-pandemic and also didn't agree with the regulations.
Watch previous coverage: Va. parents paid to take care of kids with disabilities set to see new rules in March
Lucy Cantrell is with the Arc of Virginia. News 3 met her in January in Richmond when we were attending a General Assembly session.
"We want the most qualified people possible taking care of children with significant disabilities and not putting them in harm," she says.
Advocates from several organizations attended sessions and in support, Senator Lashrecse Aird (D-Richmond) sponsored Senate Bill 488.
"The fact of the matter is families have been experiencing this current structure," she told me in March. "They know what works [and] they know what hasn't worked, and they have given us that feedback and we have a responsibility as a General Assembly to make this process easier."
The General Assembly approved the bill, which incorporates SB 149 and is identical to HB 909, and Governor Youngkin signed it.
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The Department of Medical Assistance Services (DMAS) and the Department of Behavioral Health and Developmental Services are now directed to seek federal authority through the necessary state plan amendments under Titles XIX and XXI of the Social Security Act to modify the program rules for certain 1915(c) Home and Community Based Services Medicaid Waivers.
- Modify the 40-hour-per-week work limit to allow legally responsible individuals with more than one waiver-receiving child to receive reimbursement for 40 hours of work per week per child receiving a waiver.
- Eliminate the requirement that, in order for a legally responsible individual to receive reimbursement for personal care services, no one else be available to provide services to the member.
- When a member under the age of 18 receives personal care through consumer direction, as defined in 12VAC30-122-20, modify the program rules to allow a legally responsible individual or stepparent to be the employer of record.
"I think that families led the charge on this, you know, I was just happy to be alongside them," said Sen. Aird.
According to the law, "DMAS shall submit its recommendations, cost estimate, and methodology used for obtaining the cost estimate to the Chairmen of the House Committee on Health and Human Services and the Senate Committee on Education and Health no later than November 1, 2024."
DMAS shared the following statement after Youngkin signed the bill into law:
"Currently, all of the LRI provisions included in the bills passed by the General Assembly are active due to an extension of temporary flexibilities that DMAS requested and CMS approved in March. After the state budget has been finalized, DMAS will submit DD and CCC Plus waiver amendments to CMS to make the LRI reimbursement guideline changes permanent. This step with CMS is necessary in order to remove the provision passed in a previous state budget that requires legally responsible individuals to be reimbursed only as the last resort."
