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Virginia GAP and ARTS Delivery System Transformation - Extension Request

Dec 8th 2018 8:56 am Response: #388541 Iii
Dec 12th 2018 3:09 pm Response: #388565 It's about time. Much needed services and coverage.
Dec 12th 2018 3:53 pm Response: #388569 Please note that I support the following services to be added due to the needs of many Virginia individuals suffering from MH:-Add Supported Employment Services: These are services that are proven to help individuals with serious mental illness get and maintain competitive employment. I support the goal of employment, and recognizes that people with mental illness are disproportionately unemployed. Medicaid reimbursement for these services would ensure more people with serious mental illness could access them.
-Add Housing Support Services: These are new, innovative services designed to assist individuals with complex medical conditions, including those with serious mental illness, to obtain and maintain housing in the community. Many people with serious mental illness cycle in and out of homelessness and institutionalization because they lack safe and stable housing in their communities. Low income, poor health and housing instability are interconnected, and the Housing Support Services proposed in Virginia COMPASS would assist individuals with medical complexities to remain stably housed. These services are greatly needed in Virginia, and are not widely available.
-Create the Training, Education and Employment Opportunity Program: This program comprises the "work requirement" provision of Medicaid expansion. It would require able-bodied, low-income adults, with certain exceptions detailed in the application, to participate work and community engagement in order to maintain Medicaid coverage. The goal of this provision is "to improve Medicaid enrolled adults' health, well-being, and financial stability, and provide those subject to the requirement with assistance in finding and maintaining work and community engagement."
-Create the Health and Wellness Program: This program would require Medicaid enrollees with incomes between 100% and 138% of the federal poverty level (between about $20,700 and $28,000 per year for a family of three) to pay monthly premiums of between $5 and $10 per month, depending on income, and pay co-payments for non-emergency medical services. It would also reward members who regularly pay their premiums and participate in certain healthy behaviors by creating a "health and wellness account." The health and wellness account would be in the form of a limited-use Health Rewards gift card which could be used to pay for non-covered medical or other health related services such as eyeglasses or vitamins
Dec 12th 2018 4:40 pm Response: #388573 Having a son with mental illness, I can see where these Medicaid provisions can help the mentally ill in particular.
Dec 12th 2018 5:30 pm Response: #388577 As a volunteer at the peer run non-profit for 12 years, i have seen the miracle of successful recovery from serious mental illness and from substance abuse. I have seen many others go to state hospital, the streets, and frequently to death.Many lives will be transformed into productive citizenship through the GAP and ARTS delivery system advocated by COMPASS. Other volunteers and I provide companionship, support and hope and life planning to several hundred people a year, but they can only recover if they have the essential services required for them to make it. Many individuals and their loved ones will be saved, and so will huge costs in hospital and jail costs.. There will be a huge Return on this investment.
Dec 13th 2018 6:31 am Response: #388581 These services are desperately needed in Richmond. Since moving here 2 years ago, I’ve seen a significant number of patients who have not been able to access appropriate mental health or medical care due to lack of insurance. Of these clients 80% also have housing and employment needs. Without being able to meet their basic needs of housing and employment, it’s newrly impossible to stabilize their mental health and/ or prioritize mental health wellness/treatment. These deificits also lead to burnout in mental health professionals who struggle to help their patients improve.
Dec 13th 2018 6:50 am Response: #388585 I think the COMPASS (Medicaid) is a great opportunity for people with mental illness and others.
Dec 13th 2018 10:36 am Response: #388593 I have attached information on aspects of the waiver request that I feel are essential.
Dec 13th 2018 2:47 pm Response: #388597 I submit to you the following comment on Virginia’s Medicaid Waiver application, called Virginia COMPASS (Creating Opportunities for Medicaid Participants to Achieve Self-Sufficiency). COMPASS includes the Medicaid “work requirement” attached to Medicaid expansion, and also adds certain NEW Medicaid services to benefit individuals with serious mental health conditions.

I very strongly support the following elements of the COMPASS application:

Supported Employment Services: These services are proven to help individuals with serious mental illness get and maintain competitive employment. People with mental health conditions are disproportionately unemployed. These services are available in some areas of the state but not everywhere they are needed and Medicaid reimbursement would ensure more people could access them.

Housing Support Services: Lack of access to safe and stable and affordable housing in their communities for those with complex medical conditions, including those with serious mental illness, causes a cycle of homelessness, institutionalization and long-term inappropriate incarceration .All of these problems are also quite costly to the state to deal with. Supported housing would save a lot of taxpayer money. Low income, poor health and housing instability are interconnected, and the Housing Support Services proposed in Virginia COMPASS would ensure that people with complex medical conditions remain stably housed. These services are not widely available in Virginia but are greatly needed.

Addiction Recovery Treatment Services. In addition to the services mentioned above, the Virginia COMPASS application also requests the federal government's approval to continue the delivery of essential Addiction Recovery Treatment Services (ARTS) to Medicaid enrollees. ARTS provides a full continuum of treatment needed to address the urgent, costly substance use crisis and reverse the opioid epidemic in Virginia. These are essential services for many individuals experiencing substance addiction, including those with mental health conditions.

Medicaid services for youth transitioning out of foster care could also be continued until age 26 if this application is successful.

I appreciate the opportunity to submit my comments on the COMPASS application. I urge you to approve these provisions of the application.
Dec 13th 2018 8:15 pm Response: #388601 Please consider the following concerns surrounding the waiver for the VA Medicaid program. Virginians insisted on expanding Medicaid so we could help families and individuals when they are going through tough times. It should not be taken away for failure to follow through on red tape and bureaucracy. The working poor not only are short on money they are often short on time because they are working many hours at low-paying jobs to make ends meet.
To create a major administrative cost to implement and monitor a requirement that the most people are complying with already is a poor use of taxpayer dollars. There is no benefit from this expenditure for Virginia or the people the Medicaid program serves. Please take my comments and those of others seriously.
This rule could cause people to lose work instead of finding it! That's the effect it's already having in Arkansas.
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