Current Actions

Virginia--Medicaid Personal Care In Crisis

Fri, 27 Feb 2026 05:00:00 GMT

Virginia’s Labor Cost Increase at least 22.5%

A number of new labor mandates are about to reach the Governor’s desk, two of which she has promised to sign, and one she seems inclined to support as well.

What does this mean?

Over the next two years many businesses can expect to see labor cost increases

around 22.5%.

Minimum wage increase of 7.5% for January 1, 2027
Minimum wage increase of 9% for January 1, 2028
New mandated sick leave adds another 3.3% to labor cost
New Paid Family Leave Act adds 1% to labor cost

Ripple Effect

When the minimum wage goes up, employers often increase pay for workers who were previously earning just above the new minimum to maintain morale, experience differentials, and internal hierarchy. At higher earnings levels, the cost of covering absentee employees is also higher. And, as the added costs of paid sick leave and paid family and medical leave are applied to the higher salaries, even more money will be drained from Virginia’s businesses.

Medicaid Personal Care Industry Entering a Crisis

Despite our efforts and years of advocacy work it feels like our industry has gone unheard.

The cost of delivering care is going up and coupled with a 10% drop in CCC+ enrollment and a 41% drop in the average annual reimbursement per person for of care the future for Medicaid personal care providers is grim at best.

These mandated came despite being told by their own staff what the cost would be on Virginia's businesses.

Opposed Increased Mandates on Virginia's Home Care and Hospice Agencies

Fri, 30 Jan 2026 05:00:00 GMT

Labor Issues

Many of the proposed legislative mandates will have a negative impact on Virginia’s small businesses in particular home care organizations that provide care under Medicare and Medicaid. The proposed mandates include increases in minimum wage which has a ripple effect on all wages, mandatory paid sick leave, mandatory overtime for personal /private duty care, and mandatory paid family medical leave.

I ask that you please oppose legislation that will increase the cost of care such as HB1, HB5, HB27, HB238, SB1, SB2, SB28.

Virginia Issuee --Support Recommendations of the GuideHouse Report to Increase Personal Care Reimbursement

Fri, 23 Jan 2026 05:00:00 GMT

Personal Care Rate Increase

Pursuant to the Appropriation Act of the 2025 Regular Legislative Session – Item 292 OO the Virginia Department of Medical Assistance Services (DMAS) was instructed to conduct an outside rate study in accordance with Civil Action No. 3:12-cv-59-JAG.

DMAS engaged GuideHouse to conduct a comprehensive rate study of 11 services under the Commonwealth’s Medicaid 1915(c) Home and Community-Based Services (HCBS) waivers for individuals with intellectual and developmental disabilities (I/DD). These services include Community Coaching, Community Engagement, Companion Care, Independent Living Supports, In-Home Support Services, Personal Assistance, Private Duty Nursing, Respite Care, Skilled Nursing (including Congregate Nursing), Therapeutic Consultation, and Workplace Assistance. Services included in this study were identified in the Permanent Injunction (Civil Action No. 3:12-cv-59-JAG), which outlines compliance expectations for Virginia’s DD service system.

In alignment with the injunction’s requirements that “the rate study shall be in accordance with best practices and designed to target rates necessary to ensure sufficient capacity to reach the goals of paragraphs 33 [therapeutic consultation services], 37 [day/community engagement services], 38 [private duty nursing services], 39 [skilled nursing services], and 48 [training and competency of direct support professionals]," the study aimed to assess the adequacy of current reimbursement rates and develop benchmark rates that appropriately reflect the cost of delivering high-quality services. Key findings that informed the development of State Fiscal Year (SFY) 2027 proposed benchmark rates were not included in Governor Youngkin’s proposed budget.

Table 25: SFY 2027 Proposed Benchmark Rates

Procedure Code	Service Description	Location	SFY 2026 Current Rate	SFY 2027 Proposed Benchmark Rate	Unit	Percent Change
T1019	Personal Assistance	NOVA	$23.81	$34.42	Hour	44.6%
T1019	Personal Assistance	ROS	$20.23	$29.48	Hour	45.7%
T1005	Respite	NOVA	$23.81	$34.42	Hour	44.6%
T1005	Respite	ROS	$20.81	$29.48	Hour	45.7%
S5135	Companion Care	NOVA	$23.81	$34.42	Hour	44.6%
S5135	Companion Care	ROS	$20.23	$29.48	Hour	45.7%
T1002	Private Duty RN Care	NOVA	$21.65	$24.74	15 minutes	14%
T1002	Private Duty RN Care	ROS	$18.90	$21.19	15 minutes	12.1%
T1003	Private Duty LPN Care	NOVA	$16.83	$19.77	15 minutes	17.5%
T1003	Private Duty LPN Care	ROS	$13.89	$16.93	15 minutes	21.9%

Table 28: SFY 2027 Proposed Benchmark Rates (State Share Only

Service Category	SFY2024 State Only	SFY 2026 Calculated Expenditures State Only	SFY2027 Benchmark Expenditures State Only	Fiscal Impact State Only	Percentage Fiscal Impact State Only	% of SFY 2027 Total Expenditures State Only
Personal Assistance	$123,217,902	$128,210,335	$180,011,859	$51,801,525	40.4%	42.9%
Private Duty Nursing	$42,697,359	$45,294,772	$53,694,200	$8,399,428	18.5%	12.8%
Companion Care	$9,915,316	$10,316,959	$14,452,836	$4,135,876	40.1%	3.4%
Respite	$9,751,316	$10,146,864	$14,211,800	$4,064,939	40.0%	3.4%

Support West Virginia's Certificate of Need Program

Wed, 05 Feb 2025 05:00:00 GMT

A Certificate of Need (“CON”) is a formal permit issued in West Virginia that monitors and controls the development of home care organizations. CON programs started rolling out nationwide starting in the 1970s with the passage of Section 1122 of the Social Security Act, in response to concerns about both the potential over saturation of the supply of healthcare, as well as the potential to incentivize unneeded hospital care. Among other objectives, CON programs encouraged building of healthcare facilities in rural areas by limiting competition and providing stable revenues and returns on investment.