Mr. Speaker and Members of the House, yesterday you heard from Chairman Putney, and Delegate Cox on a number of steps the Appropriations Committee is taking to address specific concerns raised by Members over the past five weeks related to providing relief to local governments, increasing funding for public education, shoring up the health safety net, and addressing the long-term structural balance of Virginia’s finances.

Today I would like to elaborate on some of the actions related to health and human services that the Committee will be addressing in its recommendations on Sunday.

First, we listened to the concerns of the members of this body related to the funding for the health care safety net. Safety net organizations provide some of the most cost effective health care to thousands of sick uninsured Virginians who rely on them for life-saving treatment and medications. Last year alone, these organizations provided care to more than 198,000 uninsured Virginians. Consequently, we will put forth recommendations to restore funding to free clinics, community health centers, and dental services provided through local health departments. We will also propose additional support for mobile crisis services for children with serious mental health disorders.

We also heard your concerns about Medicaid funding of our hospitals and nursing homes, who are not only important partners in caring for the sick, aged and disabled, but are major employers, sustaining the local economy in many parts of Virginia.. It is only fair to expect that payments to these providers are “adequate” to ensure access to services and the delivery of quality care for low-income, vulnerable Virginians. While we applaud the Governor for restoring funding for nursing home capital improvements, we believe it is imperative to fund the reasonable cost of providing direct care to the elderly and disabled in these facilities, as well as our hospitals who receive an average of 64 cents on the dollar for care provided. The amendments we propose will provide fiscal relief to these providers.

Finally, let me address the concerns that many of you have shared with us related to services to individuals with intellectual and developmental disabilities. As many of you know, expanding the availability of home and community based services through Medicaid waiver programs has been a high priority of the Committee and this body over the past decade. Even in the toughest economic times, we have led the charge to increase these services and have had your full support along the way. Since 2002, we have provided funding to add:

• 3,081 community intellectual disability (ID) waiver slots,
• 300 ID Day Support slots, and
• 450 developmental disability (DD) waiver slots.

Last year alone, we provided 275 additional community ID waiver slots and 150 additional DD waiver slots for individuals on the waiting lists.

In the wake of U.S. Department of Justice findings that Virginia was not providing services in the most integrated and appropriate setting and that our discharge process at the state training centers was flawed, we judiciously set aside $30 million in a trust fund in FY 2012 to be used to transition individuals from our state training centers in the community. That funding is providing a critical down payment for the services needed to move Virginia forward to a more comprehensive system of community-based care for disabled individuals and their families.

I want to applaud the Governor for adding an additional $30 million to the trust fund in FY 2013 to address the DOJ Settlement Agreement. This along with the $30 million we provided this year will provide the core funding to add:

• 160 new ID waiver slots each year of the biennium to transition individuals from state training centers to the community
• 225 new ID waiver slots each year to address the community urgent care waiting list,
• 25 new DD waiver slots each year, and
• serve 1,000 individuals through a new individual and family support program designed to keep them at home and avert the need for institutional care.

Nevertheless, many of you have asked whether we can do more to alleviate the long waiting lists for community-based services. Today our ID urgent care waiting list grows by about two individuals per day. Many individuals are in desperate need of services, as their parents and caregivers become elderly and frail, and their needs become too great to be sustained by the family alone. At this rate of growth, we will fail to achieve our objective to eliminate the community waiting lists by the 2020-2022 biennium.

We continue to place a high priority on responding to the needs of this vulnerable population, therefore on Sunday you will see recommendations by the Committee to add additional community-based waiver slots for individuals with intellectual and developmental disabilities.

Mr. Speaker, I want to associate myself with the Chairman’s and Delegate Cox’s remarks yesterday that the amendments will reflect a bi-partisan approach, reflective of the comments and concerns we received from all the members of this body.