The COVID-19 pandemic has presented great challenges including economic downturn. In 2020, funding for initiatives were eliminated or paused in response to the crisis. The Senate Finance Committee on the House Appropriations introduced recommendations and changes to the governor’s budget proposal on February 10. Here is a breakdown of the proposed budget and an opportunity to take action to ensure children and families are prioritized.

Expanding Healthcare Access to the Immigrant Population

Extend FAMIS MOMS Prenatal Care for Eligible Undocumented Women

The COVID-19 pandemic has put a sharp emphasis on longstanding inequities in health care coverage and access across the nation. Every policy decision must be intentional in eliminating these gaps. Extending prenatal coverage produces $2.3M in net savings in Virginia. The House and Senate both proposed to amend the Children’s Health Insurance Program (CHIP) State Plan for the Family Access to Medical Insurance Security (FAMIS) program. The program would provide prenatal coverage to eligible pregnant women through the program, regardless of a pregnant woman’s immigration or citizenship status. The amendment provides $11.1 million from the general fund and $20.7 million from federal matching funds.

In addition, the Senate also included language to expand healthcare coverage options for undocumented children. This would direct the Secretary of Health and Human Resources to convene a workgroup with the appropriate state agencies and other stakeholders to conduct research and recommend strategies for funding healthcare services for undocumented immigrant children.

Decreasing Maternal & Infant Mortality Disparities

Home Visiting Medicaid Benefit Not Included

We were disappointed that neither the House or Senate included the request to included a Medicaid-funded benefit for home visiting. Our state home visiting programs support pregnant women, families, and low-income parents of children birth to age five through an evidence-based model proven to improve overall child health and well-being. Instead of including the reimbursement, the Senate included budget language to convene a workgroup and make recommendations on a Medicaid home visiting benefit. The Department would report recommendations from the work group to the Chairs of the House Appropriations and Senate Finance committee by December 1, 2021.

Fetal & Infant Mortality Review Team

The National Vital Statics Report found that Black women died at 2.5 times the rate of white women from pregnancy-related causes. This is attributed to a combination of limited access to quality prenatal care, existing health disparities like obesity and hypertension, as well as racial bias in pain assessment. The House and Senate both proposed $51,146 from the general fund the second year for the Office of the Chief Medical Examiner to convene a work group to develop a plan to establish a Fetal and Infant Mortality Review Team at the Virginia Department of Health upon the passage of House Bill 1950.

Other complimentary items were included:

• Analysis of Medicaid/FAMIS Coverage on Maternal & Child Health Outcome: The House included $850,000 the first year from the general fund and $850,000 from non-general funds to the Department of Medical Assistance Services (DMAS) for a contractual analysis of payment, authorization, and provider requirements to assess the outcomes of Medicaid and FAMIS-covered pregnancies and births in collaboration with DMAS and contracted Manage Care Organizations.
• Medicaid Funded Doula Provider Training & FTE: The House included $67,660 from the general fund and $67,660 in federal matching Medicaid funds the second year and one position for the Department of Medicaid Assistance Services to develop and implement a provider training for doula service providers to learn how to explain patient access and bill Medicaid for benefits.
• HB 1953 Fund New License Category for Certified Midwives: The House included $66,000 from non-general funds and one position in the Department of Health Professions for the establishment of a new license category for certified midwives (CMs), pursuant to House Bill 1953 introduced during the 2021 Session.
• Medicaid Doula Provider Training & Resources: The House amendment adds $67,660 from the general fund and $67,660 in federal matching Medicaid funds the second year and one position for the Department of Medical Assistance Services to develop and implement a provider training program for Doula service providers to learn how to explain patient access and bill for Medicaid benefits.
• Certification Program for Doulas; Language Only: The House included language to direct the Department of Medical Assistance Services (DMAS) to implement an orientation program for Medicaid personal care attendances and to direct the Virginia Department of Health’s (VDH) Commissioner of Health to establish a task force to assist with the doula regulation and certification process. The task force would include private provider organizations and VDH agency representatives.
• Fund New License Category for Certified Midwives & FTE: The House included $66,000 from non-general funds and one position in the Department of Health Professions for the establishment of a new license category for certified midwives (CMs), dependent upon House Bill 1953 introduced during the 2021 Session.

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