Health care insiders review Virginia special session


Nicole Pasia


The passing of the budget bill during Virginia’s special legislative session this month will bring over $3.1 billion in federal American Rescue Plan Act (ARPA) funds to the Commonwealth over the next year. State leaders shared their thoughts with State of Reform on the success of the special session and next steps.


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Delegate Kathy Tran (D-Fairfax), applauded the election of eight new judges to the Court of Appeals, which was the other main purpose of the session along with allocating ARPA funds. 

“We have the most historic, diverse slate of judges, both in terms of personal, lived experiences, professional backgrounds, geography, sitting on our Court of Appeals for the first time and it’s really exciting to have a court that looks more like Virginia.”

Tran also highlighted a section of the budget that provides one-time $1000 bonuses and a temporary 12.5% reimbursement rate increase to home health care workers. 

“This increase, for the first time, puts our consumer directed homecare workers over $15 an hour here in Northern Virginia … that’s just really important both for the families that depend on these caregivers, and for the caregivers themselves and their own families.”

Originally, ARPA provided $4.3 billion to Virginia. However, a significant portion of those funds weren’t allocated during the special session.

Department of Health (VDH) Director of Public Health Planning and Evaluation John Ringer says this will provide flexibility for future projects. 

“From a budget planning perspective, it does make sense to leave some money unallocated so they can see additional needs as they come along and where resources might be needed.”

Scott Johnson, a partner at Hancock Daniel and health care lobbyist, says the underallocation is relatively conservative.

“Virginia has changed a whole lot, but it’s still very fiscally conservative in spending, and cautious, and they wanted to make sure too, during this past special session, that whatever they spent was generally viewed as a one time expenditure as opposed to ongoing expenditures.”

He says in the future, providers will push for the funds to go towards higher Medicaid reimbursement rates, especially for telemedicine in light of the pandemic.

Behavioral health funding was a major component of the special session budget, with a staffing shortage crippling state hospitals. Johnson says while the additional funds are helpful in bolstering behavioral health services, there’s still a long way to go.

“The last two governors we’ve had, both have had to deal with challenges in behavioral health … whoever the next governor is is going to have to deal with that. [Addressing behavioral health] is like an aircraft carrier. You can’t redirect it overnight.”

One budget provision that doesn’t have a dollar amount, but Johnson says is worth noting, will allow temporary nurse aides (TNAs) to register through the Board of Nursing to prepare for the National Nurse Aide Assessment Program exam. This was only possible under a state public health emergency waiver, which expired June 30. However, the provision allows TNAs to continue registering under a federal 1135 public health emergency waiver, which was extended another 90 days on July 19.

The Virginia Heath Care Association-Virginia Center for Assisted Living (VHCA-VCAL) applauded the provision. April Payne, MBA, LNHA, chief quality & regulatory affairs officer and executive director of VCAL, said in statement: 

“In the face of significant workforce shortages in long term care, VHCA-VCAL applauds the General Assembly for including language in the budget to reinstate eligibility for temporary nurse aides (TNAs) … TNAs have played an important role in caring for nursing home residents during the pandemic by expanding our pool of caregivers.” 

See the full special session budget, which includes allocations for the 2022-2024 biennium, here.