On Thursday, June 7 – several months later than scheduled – Governor Ralph Northam signed the budget bills that dictate how state dollars will be spent in Virginia for the next two years. The delay was caused by the prolonged controversy over whether Virginia should expand Medicaid coverage to adults – including parents – who earn too much to qualify under the existing program, but not enough to afford private insurance. The General Assembly adjourned in March deeply divided; there was bipartisan support in the House to expand Medicaid, but most Senate Republicans, who maintain a slim majority, were opposed.
A compromise on the budget emerged in late May, brokered by Republican Senator Emmett Hanger, co-chair of the Senate Finance Committee, Republican Delegate Chris Jones, chair of the House Appropriations Committee, and Governor Northam, a Democrat. The final budget includes an expanded Medicaid program with certain conditions, which allows Virginia to draw down millions in additional federal dollars to cover most of the cost of insuring the expanded population, as well as invest in other priorities that impact the health and well-being of children.
What follows is a recap of the significant investments in the state budget for children.
Early Childhood Education
The state’s public preschool program for at-risk 4-year-olds, the Virginia Preschool Initiative (VPI), receives a boost. Currently serving approximately 18,000 children, VPI is funded through a combination of state and local dollars. The budget increases the amount of the state share for each pupil by $201, and clarifies that the local portion of funding can be met through private funds. Both of these measures are aimed at increasing participation in the program so more at-risk children can arrive at kindergarten on equal footing with
their peers.
Mental Health
The final budget includes $7 million to support an alternative system of transporting children and adults experiencing a mental health crisis to a psychiatric hospital. Currently, when someone is committed involuntarily to a psychiatric hospital for evaluation, he or she is driven there by law enforcement, often handcuffed and shackled. Parents are not allowed to travel with children, and the ordeal often exacerbates the mental health crisis. These funds will allow Virginia to develop a more appropriate, safe option for transporting people in these circumstances.
The budget also continues to roll out the plan, called STEP-VA, to transform Virginia’s behavioral health system. The goal is to ensure that children and adults in every community can access a consistent array of high-quality services at their community services board (CSB). The budget includes funding for all forty CSBs to provide same-day access to a clinical assessment, screening for primary care health issues for all CSB clients, and provides initial funding to add outpatient mental health services.
Kinship Care
The state budget funds the Kinship Guardianship Assistance Program (KinGAP) to allow certain relative caregivers to receive assistance from social services for taking children out of the foster care system to raise them. Currently, unrelated foster families receive financial assistance and ongoing case management, but grandparents and other relatives do not.
Medicaid Expansion
Medicaid expansion has a direct benefit for many children in Virginia. While children themselves who live in lower-income families already have insurance through Medicaid and CHIP, many of their parents do not. Parents making more than half the federal poverty level (FPL), which is $24,600 for a family of four, do not qualify under Virginia’s current Medicaid plan. With expansion, they will now qualify if their income is up to 138 percent FPL. When parents are not insured, families are often one accident or illness away from financial devastation. Parents who have insurance are more likely to take their children to the doctor for preventative and sick care, adding to overall health and well-being of families in Virginia.
Stay tuned for additional details about the General Assembly’s 2018 actions in future columns.
