Memorandum - Medicaid Workforce Referral Program Update (October 14, 2020)
Summary
A memorandum dated October 14, 2020 from Karen Kimsey, Director of the Virginia Department of Medical Assistance Services (DMAS), to Janet D. Howell, Chair of the Senate Finance Committee, Luke E. Torian, Chair of the House Appropriations Committee, and Mark D. Sickles, Vice Chair of the House Appropriations Committee, with the subject Medicaid Workforce Referral Program Update. It transmits a report to the Virginia General Assembly dated October 1, 2020, submitted in compliance with HB30 Item 313 KKKKK, which directs DMAS to develop a referral system connecting current and newly eligible Medicaid enrollees to employment, training and education assistance. The report states that DMAS administers Medicaid and CHIP programs for more than 1.6 million Virginians.
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“Memorandum - Medicaid Workforce Referral Program Update (October 14, 2020).”
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COMMONWEALTH of VIRGINIA
Department of Medical Assistance Services
KAREN KIMSEY SUITE 1300
DIRECTOR 600 EAST BROAD STREET
RICHMOND, VA 23219
804/786-7933
October 14, 2020 804/343-0634 (TDD)
www.dmas.virginia.gov
MEMORANDUM
TO: The Honorable Janet D. Howell
Chair, Senate Finance Committee
The Honorable Luke E. Torian
Chair, House Appropriations Committee
The Honorable Mark D. Sickles
Vice Chair, House Appropriations Committee
FROM: Karen Kimsey
Director, Virginia Department of Medical Assistance Services
SUBJECT: Medicaid Workforce Referral Program Update
This report is submitted in compliance with the Virginia Acts of the Assembly – [HB30
Item 313 KKKKK], which states:
The Department of Medical Assistance Services, in collaboration with the Virginia Department of Social
Services, state workforce agencies and programs, and appropriate stakeholders, shall develop a referral
system designed to connect current and newly eligible Medicaid enrollees to employment, training,
education assistance and other support services. The department shall review current federal law and
regulations that may allow through State Plan amendments, contracts, or other policy changes, the
department to support such a referral program. The department shall provide new enrollees in the
Medicaid program, that have been identified as being potentially unemployed or underemployed with
information on all available state and federal programs available to them that offer training, education
assistance or other types of employment support services. The department shall work with its contracted
managed care organizations to facilitate referrals to employment related services. To the degree that
resources are available in other state agencies or from federal grants to support the referral program
and existing authority permits such use, the department shall coordinate the use of such programs to
provide assistance to Medicaid enrollees. 2. The department shall report on development of the referral
program and make recommendations to the Chairs of the House Appropriations and Senate Finance and
Appropriations Committees by October 1, 2020.
Should you have any questions or need additional information, please feel free to contact
me at (804) 786-8099.
KK/KAM
Enclosure
Pc: The Honorable Daniel Carey, M.D., Secretary of Health and Human Resources
About DMAS and Medicaid
Medicaid Workforce Referral Program Update
A Report to the Virginia General Assembly October 1, 2020
DMAS’s mission is to improve the
Report Mandate: health and well-being of Virginians
through access to high-quality
1. The Department of Medical Assistance Services, in collaboration with the health care coverage.
Virginia Department of Social Services, state workforce agencies and
DMAS administers Virginia’s
programs, and appropriate stakeholders, shall develop a referral system
Medicaid and CHIP programs for
designed to connect current and newly eligible Medicaid enrollees to more than 1.6 million Virginians.
employment, training, education assistance and other support services. The Members have access to primary
department shall review current federal law and regulations that may allow and specialty health services,
through State Plan amendments, contracts, or other policy changes, the inpatient care, behavioral health as
department to support such a referral program. The department shall provide well as addiction and recovery
new enrollees in the Medicaid program, that have been identified as being treatment services. In addition,
potentially unemployed or underemployed with information on all available state Medicaid long-term services and
supports enable thousands of
and federal programs available to them that offer training, education assistance
Virginians to remain in their homes or
or other types of employment support services. The department shall work with
to access residential and nursing
its contracted managed care organizations to facilitate referrals to employment home care.
related services. To the degree that resources are available in other state
agencies or from federal grants to support the referral program and existing Medicaid members historically have
authority permits such use, the department shall coordinate the use of such included children, pregnant women,
programs to provide assistance to Medicaid enrollees. parents and caretakers, older adults,
and individuals with disabilities. In
2. The department shall report on development of the referral program and 2019, Virginia expanded the
make recommendations to the Chairs of the House Appropriations and Senate Medicaid eligibility rules to make
health care coverage available to
Finance and Appropriations Committees by October 1, 2020.
more than 400,000 newly eligible,
low-income adults.
Medicaid and CHIP (known in
Summary Virginia as Family Access to Medical
Insurance Security, or FAMIS) are
The General Assembly tasked DMAS with collaborating with the Department of jointly funded by Virginia and the
Social Services (DSS) and state workforce agencies to create a system to federal government under Title XIX
and Title XXI of the Social Security
facilitate Medicaid Expansion member access and referrals to employment and
Act. Virginia generally receives a
workforce development resources. Through this process, DMAS was
dollar-for-dollar federal spending
introduced to the new statewide Workforce Data Trust and Referral Portal match in the Medicaid program.
platform that DSS is utilizing to meet requirements of their Supplemental Medicaid expansion qualifies the
Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Commonwealth for a federal funding
Families (TANF) populations. Seeing that this existing resource could be of match of no less than 90 percent for
benefit to the Medicaid population and address the intent of this mandate, newly eligible adults, generating cost
DMAS met with the Office of the Chief Workforce Advisor to discuss savings that benefit the overall state
opportunities for collaboration. budget.
1 | Medicaid Workforce Referral Program Update
Workforce Data Trust and Referral Portal and workforce development resources and create
infrastructure to proactively support members through
The Workforce Data Trust and Virginia Career Works system navigation and case management.
website (www.virginiacareerworks.com) was created as
a centralized hub for a variety of statewide employment Medicaid Programs and Expansion
resources. Through a streamlined intake form, Population Overview
individuals are referred to all applicable programs and
services and are also assessed for barriers to As of the August 15th, 2020 over 450,000 Expansion
employment such as a lack of reliable transportation. adults are enrolled in Virginia Medicaid, with 320,000+
being below 100% of the federal poverty line. Most of
As of August 2020, participating agencies include: these Expansion members are young adults between
the ages of 19 and 34 (45%), with adults between the
• Virginia Department of Social Services
ages of 35 and 54 (38%) making up the next largest
• Virginia Department for Aging and Rehabilitative subgroup. The majority of these individuals are enrolled
Services in the Medallion 4.0 program.
• Virginia Economic Development Partnership
• Virginia Department for the Blind and Vision Through its managed care contracts for Medallion 4.0
Impaired and Commonwealth Coordinated Care (CCC) Plus
• Virginia Employment Commission programs, DMAS requires that its six MCOs assess the
• Virginia Department of Labor and Industry needs of its members for employment assistance,
• Virginia Community College System housing, and access to healthy food options. Currently
• Virginia Department of Education there are no formalized requirements beyond this initial
• Virginia Department of Veteran Services assessment, though MCOs are asked to annually submit
their policies and procedures to address these social
DMAS Collaboration with the Department of determinants of health (SDOH). Systems integration with
Social Services the Workforce Data Trust and Virginia Career Works
portal would allow DMAS to go beyond assessing
The Department of Social Services (DSS) Division of member employment needs to actively addressing these
Benefit Programs is in the process of developing an needs through referral support and data analysis.
integration with the Workforce Data Trust and Referral
Portal that is set to be completed in 2021. This COVID-19 and Escalating Employment
technology will enable DSS to track individual Support Needs
engagement with workforce resources for SNAP and
TANF populations and monitor individual compliance In July of 2020, DMAS surveyed our MCOs to better
with benefit program requirements. understand changes to member needs as a result of the
COVID-19 pandemic. Five of the six health plans noted
Seeing the potential for this existing tool for Medicaid a marked increase in demand for employee assistance
members and Medicaid managed care organizations services over the past few months. Anthem reported a
(MCOs), DMAS reached out to the Office of the Chief two-fold increase in employment referrals for their
Workforce advisor for a demonstration. Beyond the members during the months of April and May 2020
diversity of state resources available through the compared to 2019. MCOs report that members are
website, the platform also allows for ongoing data encountering increased barriers to services including
matching to better understand the prevalence and needs challenges navigating overwhelmed employment
of Medicaid members within workforce development assistance programs and the closure of resources such
systems. Additionally, MCOs would gain tools to support as public libraries that provide access to computers and
member workforce needs and monitor and track the internet.
referrals.
Manatt Insight on Voluntary Employment
The Office of the Chief Workforce Advisor recommended Support Initiatives in Other States
that DMAS collaborate in this statewide initiative by
investing in a Medicaid interface on the platform. DMAS worked with Manatt, a public healthcare
Through this integration, DMAS would be able to consulting firm, to learn about voluntary workforce
understand member needs and utilization of employment development initiatives in other states. In comparing
2 | Medicaid Workforce Referral Program Update
employment and workforce programs in other Medicaid
managed care states, Manatt noted West Virginia as an
example of a state requiring that MCOs assist members
identified as actively seeking workforce resources and
help make referrals on behalf of members to designated
workforce offices. Additionally, Arizona, Delaware, and
Texas require that MCOs have dedicated staff to serve
as employment liaisons and/or employment and
vocational program administrators.
Though not a Medicaid managed care state, Montana
provides a model for supporting a voluntary workforce
referral system by proactively targeting and providing
outreach and supports to enrollees who do not have
disabilities or similarly severe barriers to work, but are
restricted from the labor market due to limited skills, lack
of access to transportation, or lack of childcare. This
initiative included a data sharing component between the
Department of Labor and Medicaid that highlighted a 6-
9% increase in labor market participating within the
state’s Medicaid population. Specifically, of the 29,000
Montana Medicaid recipients who received some type of
workforce training, 81% were employed within the
quarter following the completion of their training, and
approximately 71% experienced wage increases in the
first year after their participation in the program.
DMAS Next Steps and Budget Request
DMAS is coordinating a demonstration of the Virginia
Career Works portal with its contracted MCOs so that
MCO care coordinators, case managers, and SDOH
leads can understand how integration with the portal
could help demand for employment referrals and
support as well as the financial requirements for such an
integrated system and program. By partnering with this
statewide resource, DMAS could:
1) Align with existing statewide workforce initiatives
and resources;
2) Enhance data collection and reporting on
Medicaid member utilization of workforce
development resources, referral outcomes,
member needs, and gaps in services;
3) Provide targeted outreach to members as a
result of data sharing; and,
4) Better understand and troubleshoot barriers that
members face in achieving employment and
workforce development goals.
3 | Medicaid Workforce Referral Program Update
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