Changes to Virginia’s Medicaid program paused for parents who are paid caregivers

On March 1, 2024, the implementation of new regulations in Virginia Medicaid was temporarily halted by the overseeing program.

Since the start of the pandemic, parents, also known as Legally Responsible Individuals (LRIs), have been serving as paid caretakers for their children with severe developmental disabilities. The recent decision has an impact on these parents.

Back in February, I informed you about the ongoing efforts of advocates in Virginia to halt certain changes. Today, I am circling back to share an update on this matter. Recently, the Virginia Department of Medical Assistance Services (DMAS) received last-minute federal approval to extend certain existing processes.

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Parents paid to care for kids with disabilities set to see new rules in March

“I was just happy to be alongside them,” says Senator Lashrecse Aird, acknowledging the pivotal role that families played in leading the charge.

Senator Aird expresses a sense of pride and relief as the General Assembly takes steps to improve the lives of 1,700 families in Virginia.

Three bills, including SB 488, which she sponsored, are now on their way to Governor Glenn Youngkin’s desk after receiving approval from both the House and Senate.

According to her, families have firsthand experience with the current structure and are well aware of what has been effective and what hasn’t. They have provided valuable feedback on the matter. As a General Assembly, it is our duty to simplify this process and address their concerns.

Amid the pandemic, Virginia implemented a policy that enabled parents (LRIs) to receive compensation for taking care of a child with significant developmental disabilities.

The program, like many others during the COVID era, was initially scheduled to conclude but ended up being extended. Originally, it was set to end on November 11, 2023, but another extension was granted. This time, the new deadline was moved to March 1, 2024.

Advocates and legislators, including Senator Aird, expressed the need for additional time, despite the extension provided. They also voiced their disagreement with certain new regulations, leading to their decision to push back.

Delegate Lashrecse Aird expressed her desire for the delay of the new regulations that were supposed to be implemented on March 1. She emphasized the need for the General Assembly to take action and formally approve the regulations from the federal government. Aird stated, “They wanted those delayed until the General Assembly took action and actually directed [DMAS] for formal approval from the federal government [CMS].”

DMAS ultimately paused the new rules, as mentioned. In their statement, they explained the decision, stating, “We have decided to temporarily halt the implementation of the new rules.”

“In order to support the families who are navigating the changing policies around paid family caregivers, the Governor’s Administration and DMAS worked with CMS to take the extraordinary step of extending the implementation date of some of the new LRI policies pending any potential General Assembly action.”

To access the complete statement, simply click on the link provided below.

The third day brought about some interesting developments.

DMAS full statement on LRI policies

According to Aird’s bill, the rules will involve getting rid of the need for parents to provide evidence that no one else can take care of their child. Additionally, there will no longer be restrictions on who can be considered the official employer.

However, there have been some changes that have been put into effect. A spokesperson from DMAS has informed me that due to the agency lacking budgetary authority, two regulations have been implemented. They have provided me with an updated implementation timeline:

    • March 1, 2024 – any parent currently being paid as an LRI can continue, with two new policies in place:
      • Family caregivers can be paid for up to 40 hours of personal care each week (a non-family caregiver can provide the remaining hours authorized by the plan of care)
      • Families with a paid family caregiver are not eligible for respite services, which is defined as a service for unpaid caregivers
    • Summer/fall 2024 – additional policies scheduled to go in place, subject to General Assembly action
    • Family caregivers can be paid for up to 40 hours of personal care each week (a non-family caregiver can provide the remaining hours authorized by the plan of care)
    • Families with a paid family caregiver are not eligible for respite services, which is defined as a service for unpaid caregivers

In February, Antonio Mauro, a father from Virginia Beach, emphasized that the importance of legislation goes beyond its mere existence; it directly impacts the well-being of his son. According to Antonio, having the right person to care for your child is crucial in order to avoid any negative outcomes.

Mauro reveals that his son Giovanni, who has Down Syndrome and is nonverbal, is greatly affected by these regulations. According to him, these rules have a profound impact on every aspect of their daily lives.

“It’s challenging to truly grasp the experience of raising a child with a disability unless you have lived through it,” he emphasizes.

Aird believes that the General Assembly and DMAS are making an effort to comprehend the situation. The bills now await Governor Youngkin’s signature as the next course of action.

Aird expresses her desire for families and parents to feel listened to.

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