[{"_1":2,"_112":-5,"_113":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6486119,"mediaKeyId","5901778-8c8b1a8b2292a6b98f913d672e1c85a3","parentId",5901778,"title","Virginia seeks input for competitive federal rural health transformation fund; $500M possible over five years","audioSeconds",612,"startMs",5084000,"endMs",5696000,"viewUrl","/Search/View?dp=1&key=5901778-8c8b1a8b2292a6b98f913d672e1c85a3&start=5084&end=5696","thumbnailUrl","https://assets.pipeline.soar.com/5901778-8c8b1a8b2292a6b98f913d672e1c85a3/thumbnail_5084000.jpg","articleUrl","/articles/6486119/Virginia/Virginia-seeks-input-for-competitive-federal-rural-health-transformation-fund-500M-possible-over-five-years","mediaUrl","https://secure.pipeline.soar.com/6486119-20fccd01f17245bfee6e10e0cd92319d/orig.mp4?Expires=1777610020&Signature=CBFwnGxKMmuIJIq52rq3bds-TJR5YbMgpAbChMkxnbpbBOpFRB0tKeddMmM7WazbJ12uCCo80dx5bFe3W59oP1hLkRIT~BkjBFILqt0dmbm9rjtfgru5~xzTXu6Xng4nfkdniyMb6oYDhFfMZu6B-eK8tgntgO5cc2TAuSE8hdTTF3udU8mXWmnazNU~uAeD~Xg4mPRxMV8MYCCLvRKEMqBlVllgdRD9NJn6pPKT9oR2Yhf8HnzEPRjKuNyWYtbhMSnPaEZ2vSVbQN6gNOEBM~zCASMDk6vsUpQGEIUcYnmJkkKz74iaxLK~VsfhHfSGfh~Il4npk1E0pcTDLjB2-A__&Key-Pair-Id=KUT5TJCACFTXG","author","Virginia Legislature","date","2025-09-10T00:00:00Z","article","RICHMOND — Virginia officials described plans to apply for federal funding intended to bolster rural health systems and said the state is soliciting stakeholder proposals while the U.S. Centers for Medicare & Medicaid Services finalizes the application guidance.

Background: The 2025 federal reconciliation law (H.R.1) created a $50 billion rural health fund over five years. CMS will allocate half of annual funds to every state equally (about $100 million per year), with the remaining half awarded competitively based on criteria the agency sets. States must submit applications, and CMS must make awards by Dec. 31, 2025, for federal fiscal 2026 funding to begin Oct. 1, 2025.

Virginia’s planning process: The Secretary of Health and Human Resources is conducting a statewide listening tour and collecting up to 10‑page stakeholder proposals to shape Virginia’s application. The administration engaged the Boston Consulting Group to synthesize stakeholder input and build the state application. The state must propose at least three permitted uses identified in the federal law; those uses include workforce recruitment and retention in rural areas, telehealth and technology investments, innovative care models, behavioral health and substance use services, and technical assistance to rural providers.

Why it matters: If Virginia submits an approved plan, the state would receive an equal share of the annual allotment (about $100 million per year) and could compete for supplemental funding. Over five years, that equal allotment amounts to roughly $500 million. States may use up to 10% of awards for administrative costs and must certify that funds will not be used to finance the non‑federal share of Medicaid obligations.

Timeline and constraints: CMS guidance and the application were expected to be released in late September or early October; Virginia’s application is due in early November 2025 and CMS will announce awards by Dec. 31, 2025. Any federal funds not spent or obligated within the program’s required timelines would revert to the U.S. Treasury.

Lawmakers’ questions and next steps: Committee members asked how “rural” will be defined, whether clinics, urgent care centers and mobile health units that serve rural residents would be eligible, and how multi‑facility health systems that include rural hospitals would fit the application. State staff said CMS guidance will clarify eligibility and that stakeholder input is central to deciding proposals. The secretary’s listening tour planned multiple regional meetings across September 2025 and invited legislative feedback.

Ending: State officials asked legislators and stakeholders to submit proposals during the abbreviated engagement window so the application can reflect Virginia priorities for workforce, technology and access in rural areas.","mediaType","Video","parentTitle","Joint Subcommittee for Health and Human Resources Oversight","oneSentenceSummary","The state is collecting stakeholder input and preparing an application for the federal Rural Health Transformation Fund; Virginia expects an initial $100 million per year allotment and could receive more from a competitive pool, totaling up to roughly $500 million over five years if approved.","taxTitle","2025 Legislature VA, Virginia","taxId",77687,"location","Virginia","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6486124,"Virginia outlines strategy to cut SNAP error rate as federal changes shift costs to states",1135,3737000,4872000,"/Search/View?dp=1&key=5901778-8c8b1a8b2292a6b98f913d672e1c85a3&start=3737&end=4872","https://assets.pipeline.soar.com/5901778-8c8b1a8b2292a6b98f913d672e1c85a3/thumbnail_3737000.jpg","/articles/6486124/Virginia/Virginia-outlines-strategy-to-cut-SNAP-error-rate-as-federal-changes-shift-costs-to-states","https://secure.pipeline.soar.com/6486124-a25a99d22d2c976be5ec48ca74dc3d4f/orig.mp4?Expires=1777610020&Signature=AgK~hxy8yW8Q5q3I9bdGx1ui1BJ5spKNd7WVZOCrT~AH-335S8rC3Cwa3T-EGNpx~CcEgvz-5QmXznuGA6osNRW3L2pWM~KiUb0DEwKWPjLdlgK7NkUoavQnp9-CYQSEmc2TXG4RRjcx9iIwwe0MxHzDFqK~BWzp6CZZqqgj3GUa6KKbD7CetcvQ~rPSI-rMiqEOAau38gBL7EXXmM9l26RFxdRyv6cZc4TLCd6mESQTMGyAEeHpIXg8pU0llwnDIYt5AchYU0k4aGz9foFI60LYfUq~58fjVDgm775p703kSUghKMHBqoqiXsUVFIv9t1Dwq1RedfRwTB3BdfYFig__&Key-Pair-Id=KUT5TJCACFTXG","RICHMOND — Virginia’s Department of Social Services briefed legislators on federal changes to the Supplemental Nutrition Assistance Program and a statewide effort to reduce SNAP payment errors after the 2025 federal reconciliation bill narrowed eligibility and shifted more administrative costs to states.

Acting VDSS Commissioner Erskine told the joint subcommittee that the federal law commonly called HR1 changes non‑citizen eligibility categories, tightens work requirements for able‑bodied adults without dependents and limits certain heat‑and‑eat program eligibility. The law also eliminates funding for the SNAP Education (SNAP‑Ed) grant program and phases a larger share of administrative costs to states: from a 50/50 federal‑state split to a 25% federal share and 75% state share beginning Oct. 1, 2026.

Why it matters: SNAP benefits are federally funded, but a higher state share of administrative costs and new penalty rules tied to the program’s quality control (QC) error rate could cost Virginia millions if error rates remain high.

What VDSS reported: Erskine said Virginia’s benefits (the federally funded benefit dollars) total roughly $1.8 billion annually and that administrative costs were $360 million in 2024. Under the new QC penalty schedule, if the state’s error rate remains above 10% the federal contribution to administrative costs could be reduced; VDSS said an error rate above 10% would trigger a 15% state share on a sliding scale. Erskine said a substantial share of the error rate historically has been overpayments (about 9.5 percentage points of a reported 11.5% error rate cited in testimony).

How errors occur and how they are audited: VDSS described errors as improper payments resulting from processing or data errors by local departments, missing household updates, incorrect income or household composition reporting and other non‑fraud mistakes. Data sources for the federal QC reviews are sampled after benefit issuance; federal reviews pick random case samples and calculate an annual error rate that determines the state’s penalty share. VDSS officials emphasized that QC results lag behind transactions and that the state will need to prevent errors proactively rather than react after federal sampling.

State strategy to reduce errors: VDSS listed a multi‑pronged plan that includes:
- Directive 13 (an administration directive) to develop incentives and penalties for local departments to adopt best practices and to require core training for benefit staff;
- Targeted reviews and technical assistance in high‑caseload local departments (a “Big 20” initiative) and support for understaffed smaller localities;
- Technology upgrades, including vendor procurement to provide instant policy guidance, improved automation and possible AI tools to detect anomalies before benefits are issued;
- Revision of guidance, micro‑trainings and mandatory core training for staff who determine or supervise SNAP eligibility; and
- A request to the federal government for quality‑control waivers and a standard utility allowance to reduce inadvertent errors tied to household‑reported expenses.

Lawmakers’ concerns: Subcommittee members pressed VDSS on why error rates have been difficult to reduce, the practical effect of gig‑economy income on verification, and the burden that increased state administrative costs would place on local departments that process applications. VDSS said the state will pursue vendor support, public‑private partnerships and targeted funding to local departments to sustain best practices.

Numbers cited in testimony:
- Annual SNAP benefits: about $1.8 billion (federally funded).
- VDSS administrative costs (2024): $360 million; projected incremental state share if the federal Medicaid/administrative split moves to 75/25 could add approximately $90 million for the Commonwealth.
- Recent QC error rate cited in testimony: roughly 11.5% overall, with approximately 9.5% from overpayments; VDSS said historical rates have sometimes been lower in earlier periods but that recent years have been higher.

Next steps: VDSS said it has engaged consultants, requested carry‑over funds to hire a national vendor to review best practices, and initiated targeted oversight and training. The department asked for state and local cooperation to deploy technology and training rapidly because federal QC penalties and the new work/eligibility rules will take effect in coming fiscal years.

Ending: VDSS officials said they would provide follow‑up details on waiver requests and vendor work and that the state intends to prioritize efforts that reduce errors before federal QC sampling.","Virginia Department of Social Services described outreach, technology and training initiatives aimed at lowering SNAP payment error rates after federal changes in HR1 shift administrative costs and penalty exposure to states.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6486128,"Virginia health agencies outline reforms after sharp rise in nursing home complaints",1952,53000,2005000,"/Search/View?dp=1&key=5901778-8c8b1a8b2292a6b98f913d672e1c85a3&start=53&end=2005","https://assets.pipeline.soar.com/5901778-8c8b1a8b2292a6b98f913d672e1c85a3/thumbnail_53000.jpg","/articles/6486128/Virginia/Virginia-health-agencies-outline-reforms-after-sharp-rise-in-nursing-home-complaints","https://secure.pipeline.soar.com/6486128-0af2e2a3c0cdf6dfe7b248ff7b471b25/orig.mp4?Expires=1777610020&Signature=CZfRkihRZ9LQKbpot0Ld~kjrauGPymT7zYK0x42J7BBjwKm6xScyZW8RkWg~~QpmW1yzIuHFNeTFAwzsT2PLME8y0lKQxLA~R9Au2e9PMuzzkiODGUZLcbGmQ6mQuST83OgwyR0daHoxSnHJpLKOiqcGa7ePZNqIAZ9iUXLYN5~r5gIEv9wbRQ7TpIBFkVFaiT5owNBLxBPvtS-nqUSY3RJ~MHocvWC1NAtBBqibPUv8eNQCD7qG~2PkIGGqCYy~Xu9Japh3~R-VJm79kCzH4ctHh58IRaB7hPRqBNmBPUQDY1u9AFJIZHHICTfSmxTl6Qt6qO88dO3G9Se1CwUz~Q__&Key-Pair-Id=KUT5TJCACFTXG","RICHMOND — The Virginia Department of Health and the Department of Medical Assistance Services on Tuesday told the General Assembly subcommittee overseeing health and resources that both agencies are pursuing staffing, process and payment changes to address rising complaints and uneven quality in nursing facilities across the commonwealth.

Christopher Lindsey, chief operating officer for the Virginia Department of Health, said the Office of Licensure and Certification is “reimagining” nursing home oversight after complaints surged from about 730 in 2023 to 1,246 as of Sept. 5, 2024, and a projected 1,800 by year end. Lindsey said high-priority complaints — immediate and non‑immediate jeopardy cases — have shown a similar increase.

The spike in complaints has coincided with long gaps between federally mandated surveys. Lindsey said VDH’s goal is to meet the federal target of 15.9 months between surveys. He reported a recent improvement from a much longer interval to roughly 22.4 months as of June 2024, but said the department remained “a bit off the mark.”

Why it matters: Nursing facility residents are vulnerable and oversight lapses have direct consequences for safety and care. VDH and DMAS briefed lawmakers on concurrent strategies — VDH on inspections, complaints intake and inspector recruitment; DMAS on how Medicaid value-based payments reward facility performance.

What VDH is doing: Lindsey attributed survey delays to vacancies and said the Office of Licensure and Certification (OLC) had a roughly 42% vacancy rate across its divisions, with long-term care inspector positions especially strained. He told the committee that of 47 authorized long-term care inspector positions, 23 were vacant as of the Sept. 5 slide cited in his presentation. To address that, VDH has:
- Created a Northern Virginia regional office to hire and pay at regional scales and deploy teams in Prince William County and other regions;
- Added recruiters and a new HR business partner dedicated to OLC hiring;
- Offered sign-on bonuses ($5,000) and up to 80 hours of upfront leave for outside hires;
- Posted leadership and supervisory vacancies and said many positions attracted multiple applicants, with at least one MFI (medical facilities investigator) supervisor offer accepted the week of the briefing;
- Established an interim leadership team including Jim Jenkins and Daryl Hellams and hired an executive adviser with hospital administration experience;
- Planned a dedicated training manager, preceptor programs and partnerships with CMS and neighboring states to accelerate onboarding.

Lindsey said the office is redesigning complaint intake — now largely a single‑line, mixed phone/fax/email workflow — toward an automated online portal with triage, dashboards and dedicated complaint-investigation teams so MFIs can focus on surveys and investigations rather than intake. He also referenced Governor Youngkin’s Executive Order 52, which established an advisory work group and directed work on workforce capacity, training, process redesign and accountability; Lindsey said the group’s first meeting was scheduled for Sept. 15, 2025.

What DMAS said: Jeff Leonardi, director of long‑term services and supports at the Department of Medical Assistance Services, described the Nursing Facility Value-Based Purchasing (VBP) program that pays nursing facilities a portion of Medicaid funds based on six performance measures: two staffing measures (including a per‑resident staffing hours metric and daily RN hours) and four quality measures (pressure ulcers, urinary tract infections, hospitalizations and emergency department visits). He told the subcommittee that FY 2025 was the first year the full VBP pot — roughly $184–185 million — had to be earned by providers.

Leonardi said the Medicaid program now funds roughly $2 billion in base nursing facility payments and added that the state’s VBP design was producing some unintended outcomes: facilities with low star ratings could still earn some payments because performance on some measures was self‑reported or based on CMS datasets the agency uses (minimum data set, payroll‑based journal and claims). He said the data sources include facility-submitted minimum data set reports, payroll-based staffing reports and Medicare claims for hospital/ED utilization.

DMAS’s concerns and planned changes: Leonardi told lawmakers that VBP was maturing but needed methodological changes to avoid rewarding persistently low performers. He said DMAS is:
- Considering revising metrics and weights and possibly sunsetting measures where statewide performance has improved;
- Working to change how payments respond to year‑over‑year backsliding (so a facility that declines in performance does not continue to receive the same payment);
- Exploring ways to incorporate licensure and inspection data from VDH into VBP eligibility or participation thresholds so facilities that fail to meet licensing standards cannot continue to receive incentive funds.

Lawmakers’ questions: Committee members pressed both agencies on timing and authority. Several asked why legislation enacted earlier had not yet produced implementable rules. Lindsey and Leonardi said recent statutes and rule packages were in process: VDH is drafting regulatory action to implement intermediate sanctions authorized by 2025 legislation and a licensing fee structure was scheduled for the Board of Health on Oct. 2. Lindsey said the regulations were “in process” and not yet effective.

Numbers and limits cited in testimony:
- Nursing home complaints: 730 in 2023; 1,246 as of Sept. 5, 2024; projected 1,800 for 2024 year-end (Lindsey’s projection).
- High‑priority complaints: 151 in 2024 baseline; 315 year to date; projected 426.
- OLC vacancy rates: about 42% overall; long‑term care and acute care divisions with high vacancy percentages; 23 of 47 long‑term care inspector positions vacant (as cited by Lindsey).
- Target federal survey interval: 15.9 months; reported interim interval: ~22.4 months.
- FY 2025 VBP funding: roughly $184–185 million; total Medicaid base payments for nursing facility services cited at about $1.98 billion for FY 2025.

What they did not decide: The agencies did not announce new regulatory changes that are already finalized; they described steps under way, recruitment incentives, organizational redesign and pending regulatory filings. Multiple speakers — including lawmakers and DMAS staff — said CMS approval is required for methodological changes to the VBP program and that some reforms require rulemaking or federal signoff.

Context and next steps: Both agencies signaled intensive recruitment and training campaigns and closer coordination. Lindsey asked legislators to refer qualified applicants quickly for posted OLC leadership and inspector roles; Leonardi said DMAS will propose changes to VBP methodology in coming rule cycles and work with VDH to prevent incentive payments to facilities out of compliance with licensing standards.

Ending: The committee did not vote on any measure during the presentations. Lawmakers scheduled additional questions and follow‑up on how licensure, inspection outcomes and VBP incentives will be aligned going forward.","The Virginia Department of Health and the Department of Medical Assistance Services described workforce, process and payment reforms aimed at strengthening nursing home oversight after a threefold rise in complaints and persistent inspection vacancies.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6486114,"Virginia health commissioner issues standing order to expand COVID vaccine access for older adults",286,6064000,6350000,"/Search/View?dp=1&key=5901778-8c8b1a8b2292a6b98f913d672e1c85a3&start=6064&end=6350","https://assets.pipeline.soar.com/5901778-8c8b1a8b2292a6b98f913d672e1c85a3/thumbnail_6064000.jpg","/articles/6486114/Virginia/Virginia-health-commissioner-issues-standing-order-to-expand-COVID-vaccine-access-for-older-adults","https://secure.pipeline.soar.com/6486114-55891e911576c0fc62db02b696c14d63/orig.mp4?Expires=1777610020&Signature=Nk4QuBG15CWU1E~zTTYjfDBboMITDN4McuCRoyF61iYzeufoec25yvlejmyAF3a-621eEmUDLbN1egTUattPLLPIuI1KsIzgFMeBVNZ5jndc-bPWMXp-avggADWLrBrjoq2ksrJEJV5lfHJZd-IHWw9ifWHs7v2Qd1RISldH1gVDaFVhnv0bJeLoZFzSzo84BsAJWv52nOPc7EsaMVn1GF5gkzZjFm1Aq4hjEe31HlkaP8t98m-PbbUQT3r~hWSznLFiXLws14aZIyQfBTsdWYHtcnjwDyDe6mYR67OTU4ogyO~IiN3GOd~~dNjbmxPAy3pfqv8pRDAjgUMMTeHWDA__&Key-Pair-Id=KUT5TJCACFTXG","RICHMOND — Virginia’s state health commissioner said a standing order will be issued to clarify pharmacy protocols for the 2025–26 COVID‑19 vaccine and expand access for adults at higher risk while federal advisory guidance is finalized.

Dr. Karen Shelton, Virginia’s state health commissioner, told the joint subcommittee that the Food and Drug Administration has authorized the updated 2025–26 COVID vaccine but the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control and Prevention had not yet issued their finalized seasonal schedule at the time of the briefing. Because about 70% of Virginians receive vaccinations at pharmacies, Shelton said some pharmacies were waiting for ACIP/CDC guidance before administering the new vaccine.

What the standing order does: Shelton said the department will issue a standing order — limited to FDA recommendations and adults — that will allow pharmacies to administer the updated COVID vaccination to people 65 and older and to adults 18–64 with qualifying medical conditions under the commissioner’s authorization, without requiring an individual prescription. She said the department planned to publish a press release and the standing order the next day so pharmacies and the public would know the protocol.

Clarifications from the Board of Pharmacy: Caroline Jeran, executive director of the Virginia Board of Pharmacy, added that obtaining a prescription remains an acceptable path and that some pharmacies may also use an alternative standing‑order approval route through the Board of Nursing; she said chain pharmacies were using different approaches before the commissioner’s order.

Flu vaccine: Shelton said the seasonal influenza vaccine protocol had been conferred in June and remained available at pharmacies per standard practice.

Ending: The commissioner said the standing order would reduce access variability across pharmacies and that additional guidance would be published by the department.","The state health commissioner said a standing order will allow adults 65 and older and adults 18–64 with qualifying medical conditions to receive the 2025–26 COVID vaccine at participating pharmacies without an individual prescription while ACIP guidance is finalized.","actionData","errors"]

Article not found

Virginia seeks input for competitive federal rural health transformation fund; $500M possible over five years

Virginia outlines strategy to cut SNAP error rate as federal changes shift costs to states

Virginia health agencies outline reforms after sharp rise in nursing home complaints

Virginia health commissioner issues standing order to expand COVID vaccine access for older adults