As HHS Investigates Care Delays for Virginia Medicaid Beneficiaries with Mental Retardation, Local Papers Weigh In

The HHS Office of Civil Rights is investigating complaints that Virginia is violating a 1999 Supreme Court decision requiring services for the mentally retarded to be delivered in a reasonable time period (AP/Newport News Daily Press, 5/31). As reported May 29 in the Kaiser Daily Health Policy Report, more than 1,300 Virginia families are on a waiting list for services under a Medicaid waiver program that pays for in-home, residential and day placement in lieu of institutionalization for people with profound retardation or disabilities. As a result, people with "emergency cases" received funds, but many eligible individuals have been "forced to wait," sometimes as long as five years, to receive care (Kaiser Daily Health Policy Report, 5/29). After receiving complaints from families on the waiting lists, HHS also opened an investigation into whether the state is violating the Americans With Disabilities Act by using the waiting lists to deny services. However, officials with the state Department of Medical Assistance Services, which administers the Medicaid program, have responded to the complaints by explaining that many of the system's problems were "fixed" last year during an agency restructuring. In addition, state officials have said that they are "developing a more efficient waiver" and will cease denying services based on state financial concerns (AP/Newport News Daily Press, 5/31).

Editorial Response
In response to the federal investigations, an editorial in the Washington Post notes that despite a 160% increase in Virginia's Medicaid spending during the 1990s, the state still ranks 36th nationally in Medicaid spending per beneficiary. In addition, the Post points out that the state "lags behind" others in reducing the number of residents in institutions. While noting that Virginia has "taken specific steps" to address the waiting list problem, the editorial says the state should "put more resources" into its Medicaid programs. However, this will prove difficult once the state's car tax is fully repealed -- a pending move that is expected to cost about $1 billion in annual revenue, or a sum equal to a "whole new Medicaid program." The editorial concludes: "Tossing away that tax without any plan to replace the revenue will come back to haunt the state in many ways, not least of which may be curbing its ability to do more for those who most need its help" (Washington Post, 6/1). The Norfolk Virginian Pilot also ran an editorial on the issue, calling the state's situation "disgraceful" and telling Virginians "to be ashamed." Writing that placing people with mental retardation on waiting lists for care is "inexcusable," the editorial says the problem is less about a funding shortage than about a "commitment" to providing services. The editorial notes that the state has a "longstanding tradition" of bordering on noncompliance with federal policies regarding care for the mentally retarded. While state officials "like to complain" about federal interference in state issues, the editorial concludes that for those needing services, "indifference and ignorance in a state compelled kicking and screaming toward compliance have too often been the hallmarks of the Virginia Way" (Norfolk Virginian Pilot, 5/31).