HHS Investigates Use of Waiting Lists for Medicaid Benefits for the Disabled in Virginia

More than 1,300 families are on a waiting list in Virginia for a Medicaid waiver program that pays for in-home, residential and day placement so people with profound retardation and disabilities can avoid being institutionalized, the Washington Post reports. Last year, the state discovered it had "run out of slots" in the program and lacked funds to create additional spots. As a result, people with "emergency cases" received funds, but many eligible families were "forced to wait," sometimes as long as five years, the Post reports. Although the state "acknowledge[s]" that the families should not have to pay for in-home care, officials with the state Department of Medical Assistance Services, which operates the program, attribute "much of the problem" to an increase in the number of people who are eligible for the benefits. Currently, 5,100 people are in the waiver program, up from 3,100 in 1998. State officials say they are drafting a "more efficient" waiver and will stop denying the benefit based on "monetary grounds." Leah Hamaker, spokesperson for the medical services department, said, "We feel very confident that this new waiver will address the needs of people on these waiting lists."

Federal Law Violations
People who are on the waiting lists either have been found eligible for benefits or have not had their claims processed yet. Advocates, lawyers and social workers maintain that if the state has found a person eligible for the program, that "service is guaranteed" and any "obstacles" people face in accessing the benefit "violate federal law." The Post reports that Virginia has faced several lawsuits that made such charges. In addition, the HHS Office of Civil Rights is investigating whether Virginia has violated a 1999 Supreme Court decision that found that the mentally retarded must receive services in a "reasonable time." HHS also is investigating whether the state has violated the Americans with Disabilities Act by using waiting lists to "delay services." David Braddock, a professor at the University of Illinois-Chicago, said that "all states have had to face" similar situations, adding, "What Virginia is now realizing is that it takes an overwhelming commitment to make these services work" (Jenkins, Washington Post, 5/29).