The original estimate which generated the budget of $7.4M for this program was that approximately 250 individuals would need and qualify for this exceptional rate to be successful in a community residential setting. The rates were approved for use on November 1, 2014; in the first 11 months there were only 56 provider applications of which 37 were approved and only 41 individuals had been approved for funding.

Given the delay from the authorized implementation of July 1, 2013 until the actual implementation of November 1, 2014  (16 months), one would have expected a far larger number of applications based on pent up demand.  The modest response indicates to us several things:

• The conditions imposed on the providers (12VAC30-120-1012) are excessive and costly to the point of making the added funding far less attractive
• The conditions imposed on the providers subject the providers to increased risk of being found non-compliant with some aspect of the requirements if audited
• Providers have been successfully supporting individuals who meet all of the qualifying conditions in the community, but can not demonstrate compliance with the conditions described in 12VAC30-120-1012 B.2. because of the structure of the existing funding system.

We recognize that the “exceptional rate” will extend only through the individual’s conversion (either in July 2016 or January 2017) to the revised rate structure; we felt obligated, however, to make these few points as there seems an inclination to make similar “rules” about individuals on SIS Levels 6 or 7 and the providers who support them.  We hope that is not the case!