Virginia Medicaid
Menu

What is HNS?

The High Needs Supports (HNS) program, which DMAS expects to implement on July 1, 2022, will provide critical housing and employment support services to the Commonwealth’s high need Medicaid members. DMAS is committed to addressing the social and environmental needs of Virginians that impact health, wellbeing, and medical expenditures. The HNS benefit will be targeted to Medicaid members age 18 or older who are eligible under the Medicaid State Plan and those who are eligible under the out-of-state FFY component of the Section 1115 Medicaid demonstration age 18 up to 26. Housing and employment supports will be available to certain high needs individuals enrolled in the managed care delivery system, including those with a behavioral health need, need for assistance with activities of daily living, or a complex physical health need. Qualifying beneficiaries must be expected to benefit from supports necessary to obtain and maintain stable housing or employment. Now that DMAS has received CMS approval for the new HNS benefit, this webpage will provide public access to the latest implementation updates, opportunities for public comment, program and operational policy development, and upcoming public meetings.

The purpose of this document is to describe the preliminary operational design for the High Needs Supports benefit for interested stakeholders, including sister agencies, managed care organizations (MCOs), healthcare providers, policymakers, and advocates, among others. This paper also serves as a roadmap for DMAS and the Commonwealth more broadly, identifying the necessary implementation planning still required for 2020 and beyond. While the program design decisions memorialized below reflect substantial input from the Commonwealth’s partners, DMAS will continue to engage stakeholders and recognizes that the operational and implementation design of the High Needs Supports program will evolve.

HNS Public Comment Period

https://townhall.virginia.gov/L/ViewNotice.cfm?gnid=1164

October 14, 2020 begins a HNS 30 day public comment period, as stipulated in the recently approved HNS Special Terms and Conditions. Within six (6) months of the demonstration's approval date, DMAS will afford the public the opportunity to provide meaningful comment on the progress of the demonstration. DMAS welcomes public comment on the entire High Needs Support benefit delivery system design as memorialized in the HNS Policy Paper . All comments received on the Virginia Regulatory Town Hall website in addition to comments received during the HNS Virtual Town Hall held on October 14, 2020 will be considered. DMAS expects to utilize the feedback received to inform future implementation and operational planning, stakeholder workgroups, and provider training. To share your comments or inquiries, use the link above which will take you to the Virginia Regulatory Town Hall/General Notices, webpage.

HNS Follow-Up Session for Members & Families Presentation

DMAS recently presented a High Needs Support program overview targeted to Medicaid members and their families/advocates. The presentation can be found here: HNS Session for Members and Families presentation [pdf]

HNS Virtual Town Hall Presentation

DMAS hosted a virtual Town Hall on October 14, 2020 to provide details on the HNS program and operational design. That presentation can be found here: HNS Virtual Town Hall Presentation 10.14.2020 [pdf]


July 2020 – Waiver Changes

On July 1, 2020, DMAS submitted a formal withdrawal request letter to the Centers for Medicare & Medicaid Services (CMS) that formally requested removal of the work and community engagement requirements, monthly premiums, and other “healthy behavior” requirement provisions from Virginia's 1115 demonstration waiver. Passage of the Commonwealth’s 2020 - 2022 biennium budget on May 21, 2020 included the formal elimination of these COMPASS provisions.

On July 9, 2020, CMS notified DMAS of their approval of Virginia’s request, to add the High Needs Supports benefit to its section 1115 demonstration waiver. CMS also accepted the proposed Section 1115 demonstration name change from “Addiction and Recovery Treatment Services (ARTS) Delivery System Transformation” to “Building and Transforming Coverage, Services, and Supports for a Healthier Virginia” that better encompass the current ARTS and former foster youth coverage provisions, the new High Needs Supports program and any potential future programs.


DMAS is excited to implement this new benefit, scheduled for July 2022. The program will improve member health outcomes by providing critical supports targeting individuals with complex physical or behavioral health needs who are at risk for housing or employment instability and will soon be communicating next steps to stakeholders and the general public. Please stay tuned to this page for announcements, meetings, and updates on the High Needs Supports program.

Virginia Medicaid Approved for Housing and Employment Supports


Previous Updates

On June 7, 2018, Governor Northam signed the 2018 Virginia Acts of Assembly Chapter 2 (2018 Appropriations Act) directing the Department of Medical Assistance Services (DMAS) to submit a Medicaid Section 1115 Demonstration Waiver seeking federal approval for new Medicaid program features “designed to empower individuals to improve their health and well-being and gain employer sponsored coverage or other commercial health insurance coverage, while simultaneously ensuring the program's long-term fiscal sustainability.”

On December 30, 2019, CMS approved the extension of the existing Addiction Recovery and Treatment Services (ARTS) and former foster youth coverage provisions of the waiver through December 31, 2024. CMS also accepted DMAS' request, submitted on December 3, 2019 at the Governor’s direction, to pause finalizing negotiations of the waiver provisions related to work and community engagement requirements, monthly premiums, and other healthy behavior requirements. The approved ARTS Delivery System Transformation waiver extension can be found on the CMS website at this link.


HNS Overview Presentation and PowerPoint

A recorded HNS presentation is available at the link above to provide an overview of the HNS program and upcoming opportunities for stakeholder input.


HNS Policy

The purpose of this document is to describe the preliminary operational design for the High Needs Supports benefit for interested stakeholders, including sister agencies, managed care organizations (MCOs), healthcare providers, policymakers, and advocates, among others. This paper also serves as a roadmap for DMAS and the Commonwealth more broadly, identifying the necessary implementation planning still required for 2020 and beyond. While the program design decisions memorialized below reflect substantial input from the Commonwealth’s partners, DMAS will continue to engage stakeholders and recognizes that the operational and implementation design of the High Needs Supports program will evolve.

Read the HNS Policy Paper

Contact

For questions about the High Needs Support Program