Virginia
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Comprehensive Person-Centered State Work Incentive Initiatives:

A Resource Center for Developing & Implementing Medicaid Buy In Programs
and
Related Employment Initiatives for Persons with Disabilities


Virginia


I. Overview of a State’s Comprehensive Person-Centered Employment Initiatives

The state of Virginia through a Medicaid Infrastruture Grant (MIG) is in the process of devisng a Medicaid Buy-In program. The state legislature in 2003 directed the state Medicaid agency to seek a waiver under Section 1115 of the Social Security Act to establish a Medicaid Buy-In program.

The MIG project is also involved in developing a pilot project in the northern Virginia area to improve utililization of the Section 1619 work incentives provisions for SSI recipients.
(See a description of the Section 1619 Pilot Project under Section VI Comprehensive Employment Initiatives.)

Link to the Medicaid Infrastructure Grant Project Web site
http://www.dmas.state.va.us/mb-home.htm

NewDownload file of Summary chart of State’s SSI and Other Medicaid Income Standards for Adults with Disabilities


II. What’s New and Persons to Contact

The state legislature in 2003 has directed the state Medicaid agency to seek a waiver under Section 1115 of the Social Security Act to establish a Medicaid Buy-In program.

Persons to Contact
Jack Quigley
MIG Project Manager
Virginia Department of Medical Assistance Services
600 E. Broad Street, Suite 1300
Richmond, VA 23219
Phone: 804-786-1300
E-mail: jquigley@dmas.state.va.us

 

III. Program Development - Past and Present

  • Executive Branch Leadership, Cross Disability Coalition Leadership and Interagency Working Groups
  • Initial Planning, Information Gathering and Program and Fiscal Estimates

    Link to MIG Project Web site on studies and surveys related to use of Section 1619 in Virginia
    http://www.dmas.state.va.us/mb-1619(b).htm

 

IV. State Legislation - Adopted and Pending

The state legislature has directed the state Medicaid agency to seek a waiver under Section 1115 of the Social Security Act to establish a Medicaid Buy-In program.

 

V. Current State Policies and Program Descriptions

  • State Policies: State Plans, Regulations and Waiver Requests to Federal Agencies - Pending and Adopted Programs
  • Ensuring Informed Choice and Person - Centered Programs: Benefits Counseling, Work Force Investment Act Implementation and Related Educational Services
  • Descriptions for Consumers and Staff Training Activities

 

VI. Program Data and Impact

  • Medicaid Buy-In Data
  • Consumer Surveys and Evaluation Studies

 

VII. Comprehensive Employment Intiatives

The MIG project staff has provided the leadership in developing a pilot project in the northern Virginia area to improve utililization of the Section 1619 work incentives provisions for SSI recipients.
The following is the explanation of the development of the Pilot Project from the MIG Project Web Site :

“Purpose of the 1619(b) Pilot.
Over the course of beginning work under its Medicaid Infrastructure Grant, DMAS staff discovered serious difficulties in the state with the application of Section 1619(b), a work incentive allowing persons with disabilities receiving SSI to work above the Substantial Gainful Activity (SGA) level, lose their cash benefits, but still maintainaccess to critical Medicaid services up to a ceiling.

DMAS staff have noted the following issues: a) lack of understanding within local and regional
Departments of Social Services (DSS) who move individuals found 1619(b) eligible by the local and regional SSA offices into 1619(b) Medicaid status; b) consumers are not aware of the provision and/or do not understand the provision; and c) possible problems in the exchange of
information between SSA and DSS offices.
The aims of the pilot are to:

1.Identify tools and mechanisms to provide ongoing training and education to staff attached
to DSS offices and other germane public entities (case managers, etc.).
2.Develop tools to educate consumers, their families, and front line providers about 1619(b)
and other similar work incentives.
3.Analyze the current process of identification of eligible 1619(b) individuals by SSA,
referral and notification of DSS and subsequent enrollment in the appropriate Medicaid
covered group. Such an analysis would then be used to target problem areas and make
corrections.

At the 1619(b) Pilot, the participants of the OneSource Project of the Northern Virginia Workforce Investment Board work group serve as a forum for development and/or to solicit input on draft tools and mechanisms aimed at educating stakeholders about 1619(b) and possibly other work incentives. These tools and educational events will provide information about 1619(b) in an easy to understand language and would offer detailed information on how the process works in Virginia. Fact sheets and other resources would be developed in more than
one version – one for consumers and families and one for professional benefits staff.

As part of the pilot, worksheets would be developed on how to determine the likelihood that an
individual is 1619(b) eligible. Again, these would be two versions – one lay and one professional. Information items to be contained in the worksheets would include: a) a description of 1619(b); b) a description of the identification, referral and enrollment process in Virginia, possibly a flowchart; c) a glossary with acronyms; and d) contact phone numbers and agencies. Such tools could be linked and run parallel with a Web site that could offer more detailed information on 1619(b) and other key work incentives at both lay and professional levels. Additionally, Virginia DMAS staff in conjunction with the pilot workgroup will develop and coordinate pilot training on 1619(b) both for consumers and professional staff. These trainings will be evaluated by participants and enhanced before being operationalized in other parts of the state. Recipients of the training would include local DSS eligibility workers, local SSA staff, providers and consumers.

Once a preliminary set of educational tools, educational forums, and provisional remedies to
1619(b) operational issues are developed, the tools will be piloted in a real world environment
through its consumers, their families, case managers, rehabilitation specialists, and other
organizations in the pilot area.”

Link to background data and complete description of Section 1619 Pilot Project
http://www.dmas.state.va.us/mb-1619(b)_pilot.htm

Link to access to Virginia Olmsted Report
See Employment Recommendations beginning on page 37 of the report
http://www.vadrs.org/whatsnew.htm


Center for the Study and Advancement of Disability Policy and Center for Health Services Research and Policy at George Washington University

Supported by a grant from the Robert Wood Johnson Foundation with additional support provided by NIDRR of the US Department of Education through the RRTC on Workforce Investment and Employment Policy at the Law, Health Policy and Disability Center at the University of Iowa. (#H133B980042) 

Website created and maintained by the Law, Health Policy and Disability Center at the University of Iowa College of Law. The opinions and analyses set out in the articles on this website are those of the authors and do not necessarily reflect the positions of the Robert Wood Johnson Foundation, the US Department of Education, George Washington University or the University of Iowa.