Voices’ Blog

Details of the Proposed House and Senate Budget Deal, Including Medicaid Expansion

Posted:  -  By: Emily Griffey

The House Appropriations Committee shared the details of the proposed House and Senate FY19 & FY20 budget deal on May 21, 2018, before the Senate was scheduled to vote. However, on May 22, the Senate postponed its expected vote on the budget and moved to convene the Senate Finance Committee on May 29 and vote as a full Senate after that meeting. While this extends the vote for one more week, it is helpful for children’s advocates to know what was included in the budget proposal and to signal support to your state delegate and senator.

Medicaid Expansion

Similar to the House proposal at the end of session, the proposed budget deal includes the two-step process to cover the uninsured by seeking a state plan amendment to begin to draw down federal dollars, while simultaneously seeking a waiver from the federal government to expand Medicaid with additional eligibility requirements. This version of the budget deal includes the hospital provider assessment and invests in reimbursement increases for hospitals and improvements to the behavioral health system. Michael Martz of the Richmond Times-Dispatch provides a comprehensive look at what is included in the budget here.

Mental Health

The proposed budget deal includes significant investments in mental health, including these Voices’ priorities:

  • Rolling out a statewide system of alternative transportation for adults and children under a temporary detention order at $2.5 million in FY19 and $4.5 million in FY20.
  • Implementation of the STEP-VA plan to ensure a more comprehensive and consistent array of behavioral health services at each of the 40 community services boards (CSBs), including: finish implementing same-day access to services at all 40 CSBs, implement primary care health screenings at all 40 CSBs, and begin adding capacity for outpatient treatment ($15 million) and detox services ($2 million) in FY20 at some CSBs.

State Policy Approaches for Childhood Trauma

We are encouraged by policymakers’ interest in creating trauma-informed systems. The budget proposal includes these priorities from Voices’ policy agenda:

Improvements to the Virginia Preschool Initiative (VPI)

The proposed budget includes a total of $11.1 million over the biennium to invest in VPI.

  • An increase of $2.3 million each year to increase the VPI per pupil rate by $201 per student
  • Funding to school divisions to help provisionally licensed teachers in VPI programs obtain their license ($2.3 million each year)
  • Additional resources for VDOE to develop a plan for quality improvement in VPI including classroom observations and student assessments
  • Additional funds to conduct classroom observations in all VPI classrooms by the end of the 2019-20 school year
  • An additional $1 million over the biennium to work with UVA CASTL to provide professional development for VPI teacher
  • Clarification that the VPI local match requirement can be met with private funds
  • Clarification of language about reallocating VPI slots to communities that use their entire allocation

Early Childhood System Improvements

Beyond VPI, the signature public preschool program, the proposed budget takes some steps to improve Virginia’s other early childhood systems.

  • Invests $850,000 of TANF funds over two years to strengthen Early Impact Virginia as the home visiting umbrella organization
  • Expands the scope of the Joint Subcommittee on the Virginia Preschool Initiative to include exploring Virginia Quality improvement system, Head Start and other recommendations of the JLARC report on early childhood
  • Includes a new requirement for all school divisions to participate in the Virginia Kindergarten Readiness Project (VKRP) student direct assessment by the end of the 2019-20 school year. Some of the funds for expansion include training on how to use the tool to improve instructional practices. Language also directs the VKRP to be expanded as a post-assessment given at the end of the kindergarten school year.
  • Provides $1.25 million in CCDBG funds over the two years to implement a pilot project through UVA CASTL for private and faith-based child care programs
  • Asks VDOE to work with the departments of social services, health and planning and budget to create a workgroup, facilitated by the Virginia Early Childhood Foundation, to explore leveraging and aligning existing early childhood funding streams

In addition, the budget proposal also includes funding to support the implementation of previously enacted legislation, including:

  • Funding of $47,000 each year for staff at the Department of Health to collect data and information on the plan of services for substance-exposed infants
  • Funding for the implementation of KinGAP, financial resources for kinship caregivers when children are not eligible for other foster care placements
  • An additional $28 million in FY19 and $43 million in FY20 of non-general funds to accept the federal increase in child care assistance funds enacted by Congress in February 2018

Contact your delegate and senator before Tuesday 5/29 asking for support of this budget proposal. Click through for a email template you can use and edit to make your own.

Read More Blog Posts