Medicaid Waivers


Support funding and expansion for Virginia’s Medicaid waivers that provide critical home and community based services for qualified individuals.

Medicaid funds both physical and mental health care services for people in particular categories (low income children and parents, pregnant women, older adults, persons with disabilities).  It is financed by the federal and state governments and administered by the states.  Federal funding is provided based on a state’s per capita income – the current federal match rate for Virginia is 50 percent.  Because each dollar Virginia puts into the Medicaid program draws down a federal dollar, what Medicaid will pay for is a significant factor in guiding the direction of state human services spending.   However, states set their own income and asset eligibility criteria within federal guidelines; Virginia’s requirements are so strict that although it is the 12th largest state in terms of population, it is 48th in per capita Medicaid spending.

Virginia offers fewer optional Medicaid services than many other states (in addition to federally mandated services), though Medicaid beneficiaries in Virginia may also receive coverage through home and community-based “waiver” programs, which allow states to “waive” the requirement that an individual must live in an institution to receive Medicaid funding.  Waivers result in less expensive, more beneficial care.  In addition, the reduced financial eligibility requirements make waiver slots especially important for lower income families with older adults, people with disabilities or significantly ill family members in Virginia, where Medicaid eligibility is highly restrictive.

The number and type of waivers is set by the General Assembly, and the extensive waiting lists for some demonstrate the significant unmet needs that exist in the Commonwealth (current Virginia waivers include AIDS, Alzheimer’s, Day Support for Persons with Intellectual Disabilities, Elderly or Disabled with Consumer-Direction, Intellectual Disabilities, Technology Assisted and Individual and Family Developmental Disabilities Support).  Fairfax County supports the following adjustments in Medicaid waivers:

  • Support automatic rate increases. Medicaid waivers for the Elderly or Disabled with Consumer Direction and the Individual and Family Developmental Disabilities Support should keep pace with rising costs, while maintaining existing funding and services available through these waivers. (Revises and reaffirms previous position.)

  • Support creation of dedicated waivers.  New waivers are needed for people with brain injuries, autism, or people who are blind, deaf/blind, or suddenly become blind. (Revises and reaffirms previous position.)

  • Support increased waiver funding.  Funding is needed for an additional 1200 individuals with intellectual disabilities to receive services in each of the next two years.  (Revises and reaffirms previous position.)

  • Support funding for an expansion of services.  Additional medical and behavioral services are needed under the Intellectual Disabilities Waiver, for individuals whose needs extend beyond the standard benefits available. (New position.)

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