Case Study: Virginia Department of Medical Assistance Services (DMAS) Division of Long Term Care
Virginia Department of Medical Assistance Services (DMAS) Division of Long Term Care
Fiscal/Employer Agent (F/EA) services to Medicaid recipients receiving participant-directed services.
A number of Virginia programs allow for provision of care in a community setting rather than in an
Intermediate Care Facility (ICF/MR) or nursing facility. These programs include Virginia’s:
- Individual and Family Developmental Disabilities Support (DD)Waiver;
- HIV/Aids Waiver;
- Elderly Disabled with Participant-Directed Support (EDCD) Waiver;
- Early and Periodic Screening, Diagnosis and Treatment (EPSDT).
Virginia DMAS had been operating the programs internally for three years, but realized that its
operations were inadequate to meet a growing demand and that an experienced F/EA provider
could run operations more efficiently. Public Partnerships, LLC (PPL) was contracted to provide F/EA
The PPL Approach:
PPL took a number of steps to streamline project operations, including:
- Published statewide business rules for all participants and staff;
- Transitioned the program to new, more efficient technology platforms;
- Enforced program requirements based on the Medicaid Waivers;
- Customized PPL’s information technology platforms to the State’s unique program requirements;
- Provided a state-wide launch of PPL services with on-site participant information sessions across the State to explain the transition, program requirements, and tax requirements to participants, their employees, and service facilitators;
- Created a statewide advisory group comprised of participants, attendants, service facilitators,
and State staff.
- The initial launch was very difficult; participants and their attendants were not accustomed to
following specific business rules;
- After about four months, participants and employees began to use the new system and were
- Since inception, the program has grown from 1,390 to more than 5,000 enrolled participants;
- In a recent survey of program participants, 97 percent of respondents reported satisfaction with the ability to recruit their own attendant. Some 94 percent of respondents reported satisfaction with service and 93 percent would recommend participant-directed services to a friend or family member.