Virginia Disability Commission

July 20, 2010

The first meeting of the Virginia Disability Commission for the 2010 interim was held in Richmond. Delegate Robert D. Orrock, Sr. and Senator Yvonne Miller were elected chair and vice-chair, respectively.

Purpose/Legislative and Budget Updates

Staff provided an overview of the purpose and activities of the Disability Commission. Section 30-232 of the Code of Virginia directs the Disability Commission "… to identify and recommend legislative priorities and policies for adoption or examination by the General Assembly in order to provide ongoing support in developing and reviewing services and funding related to Virginians with physical and sensory disabilities." Section 30-236 of the Code provides that the Disability Commission shall:

• Serve as the primary forum in the Commonwealth where the needs and issues of people with disabilities are addressed through the collaboration of members of the legislative and executive branches of state government, and citizens of the Commonwealth.
• Evaluate and advance budget proposals and policy issues oriented towards a service system that maximizes the self-sufficiency of Virginians with disabilities.
• Develop and review recommendations for service program changes and funding related to services for persons with physical and sensory disabilities.
• Advise on local, state, and federal policies and programs relevant to citizens with disabilities.

Staff also provided a brief overview of budget actions adopted during the 2010 Session of the General Assembly that affect services for persons with disabilities, budget actions that were recommended by Governor McDonnell that were not adopted, and information on legislation considered by the General Assembly during the 2010 Session that may affect or be of interest to persons with disabilities.

Health Reform

Damon Terzaghi, National Association of State Medicaid Directors/American Public Human Services Association
Mr. Terzaghi spoke on the Patient Protection and Affordable Care Act of 2010. His presentation included a summary of the major provisions of the legislation, potential impacts on services for persons with disabilities, and potential opportunities for states to maximize services for persons with disabilities included in the legislation.

He discussed the impact of expansion of Medicaid to new eligibility groups, and the potential impact that such expansion may have on states' ability to provide services for persons with disabilities. He also mentioned that changes in income calculations may affect who is eligible for Medicaid and the composition of the population served by state Medicaid programs. Mr. Terzaghi also noted that Medicaid expansion is oriented more toward provision of acute care services, and that states will have to plan carefully to ensure that long-term services are provided for those who require ongoing assistance.

Mr. Terzaghi identified several issues for states, including aligning state eligibility systems with required health insurance exchanges, establishing benchmark packages of services that meet the needs of enrolled persons, prioritizing nonmandated activities, and succession planning for the future.

In closing, Mr. Terzaghi stressed that eligibility is not necessarily the same as access, and that states will need to pay close attention to ensuring that services are available and accessible to persons who are or become eligible for Medicaid and other types of assistance. Mr. Terzaghi then responded to numerous questions from the Commission.

Department of Rehabilitative Services: Overview of Commission Initiatives

Jim Rothrock, Commissioner, Dept. of Rehabilitative Services (DRS)
Commissioner Rothrock gave an overview of activities of the DRS related to past Disability Commission initiatives. Commissioner Rothrock described the Department's community-based programs including brain injury services, community rehabilitation case management services, independent living services, and personal assistance services. He stated that funding for brain injury services had been reduced by the General Assembly in 2010, but that additional sources of funding may have been secured to make up the difference. Funding for independent living services had also been reduced, but the 16 Centers for Independent Living and the four satellite centers continue to provide services. An infusion of federal funds in 2009 provided some assistance in meeting current needs. Funding for personal assistance services has remained essentially level over the years, but Commissioner Rothrock reported that increased demand has resulted in a waiting list of 94 persons.

Commissioner Rothrock also described changes at the federal level that will likely affect the Medicaid Works program. He noted that statutory changes may allow individuals enrolled in the program to earn more in wages while continuing to receive medical assistance. This change is expected to increase the number of persons who are interested in participating in the program.

Finally, Commissioner Rothrock provided some information on AbilityOne employment programs and the impact these programs have in the Commonwealth. He highlighted programs that provide services for the federal government and employment for a number of persons with disabilities. He encouraged the Commission to become aware of how these programs benefit people with disabilities and to look at ways to increase jobs for persons with disabilities through similar programs in Virginia.

Virginia Housing Expansion Task Force

Bill Fuller, Sr., Virginia Housing Development Authority; Teri Barker, VA Board for People with Disabilities
Mr. Fuller and Ms. Barker, representing the Virginia Housing Expansion Task Force (Task Force), presented an update on past activities and identified issues that the Task Force continues to track, including:

• Development of EasyLiving Homes®.
• Efforts to secure additional U.S. Department of Housing and Urban Development Non-Elderly Disability Housing Vouchers.
• Activities of the Money Follows the Person project.
• Implementation of the Transportation and Housing Alliance Toolkit Project that assists localities in planning housing and transportation services.
• Expansion of sponsored residential services.
• Development of VirigniaHousingSearch.com.
• Impacts of the Southeastern Virginia Training Center rebuild and development of community housing for residents.

The Task Force has also identified several emerging issues that it will continue to follow, including:

• Development of accessibility standards and standardized nomenclature for housing developers.
• Impacts of the loss of certain housing options for persons receiving services through the state Individual and Family Developmental Disabilities Support Waiver.

Mr. Fuller and Ms. Barker noted that a shortage of accessible, affordable housing continues to be a problem for persons with disabilities, that lack of capacity to develop accessible affordable housing and serious financial limitations of many people who need accessible housing contribute to the problem, and that lack of community alternatives often lead to institutionalization even when individuals could remain in the community if sufficient housing were available.

In closing, Mr. Fuller and Ms. Barker advised that the Task Force has identified several strategies for meeting these challenges, including:

• Expanding the Livable Homes Tax Credit to allow developers to take advantage of the credit and increasing the amount of the credit.
• Facilitating collaboration between agencies and stakeholders to capture data on housing needs and choices of persons with disabilities.
• Continuing to promote aggressive pursuit of Housing Choice Vouchers for persons with disabilities.
• Supporting efforts of the Department of Medical Assistance Services and the Department of Behavioral Health and Developmental Services to increase community living options and decrease the institutional census.
• Participating in a work group to identify and enumerate housing accessibility standards and standard nomenclature.

Discussion of 2010 Work Plan

Members of the Disability Commission discussed a work plan for the 2010 interim. Three work groups were established to study specific issues in greater detail. These include:

Work Group #1: Review of the name and purpose of the Virginia Disability Commission, including the option of expanding the scope of the Disability Commission to include policies affecting persons with disabilities of all types; and determine, with input from stakeholders and citizens, if the name or the scope and purpose of the Disability Commission should be revised.

Work Group #2: Evaluation of funding for current services; determine projected cost of needed services and identify potential sources of funding for such services; and perform cost-benefit analysis of various program options.

Work Group #3: Work with stakeholders and citizens to determine needs related to housing and transportation for persons with physical and sensory disabilities and develop recommendations for change.

Next Meeting

The Disability Commission will meet on September 8 at the General Assembly Building in Richmond and also in October with another meeting in November if necessary. The Commission will also meet during the first week of the 2011 Session to receive information about the Governor's proposed budget and its impact on services for persons with disabilities and to develop recommendations related to the proposed budget.

Chairman:
The Hon. Robert D. Orrock

For information, contact:
Sarah Stanton, DLS Staff