The Pogge Post

2014 General Assembly Update: Week 4

96th District, Virginia House of Delegates     January 31, 2014
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During Session:

General Assembly Building

Room 403

Capitol Square

Richmond, VA 23219



Please send mail to:

P.O. Box 196

Norge, VA 23127
Legislative Aide
Amanda Johnston
While many Virginians enjoyed snow days this week, the members of the legislature reported to work on time. Very rarely does the General Assembly cancel committee meetings or session. In fact, I am only aware of one instance of closure--back in February of 2010.

One of the biggest issues facing the General Assembly members this year is the decision regarding Medicaid expansion. Throughout the past few weeks, I have received countless emails from constituents who are concerned about this issue. If you've written to me about this matter, you have likely received my response that I do not support Medicaid expansion. I'd like to share some details guiding my decision.

According to the Virginia Secretary of Health, Dr. Hazel, thirty percent of all healthcare spending is waste, fraud and abuse. Of greater concern, nearly thirty percent of all physicians refuse to see Medicaid patients. As a result of this limited access, studies in other states have indicated that Medicaid enrollees are 40% more likely to visit emergency rooms, thereby driving up costs. For this reason, Virginia's Democrats and Republicans agreed last year to implement reforms prior to expansion. 


To this end, the Medicaid Innovation and Reform Commission (MIRC) was established in 2013 and has been working to draft reforms to improve Virginia's Medicaid system.  Some of these reforms include the implementation of a quality payment and incentive program and a coordinated-care program for individuals who are dually eligible for Medicare and Medicaid. Additionally, the Joint Legislative Audit and Review Commission (JLARC) has been directed to perform a comprehensive audit of Medicaid and to make recommendations about additional reforms. As you may recall, the 2010 audit of VDOT revealed over $1.5 billion in unspent funds. Similarly, in Illinois, an audit determined that more than half of the state's Medicaid population should not have been enrolled in the program.


Because Medicaid currently constitutes 21% of Virginia's general fund spending and has grown by 1600% over the past thirty years, a lack of significant reform could leave Virginia in a precarious financial position.  With 30% of every healthcare dollar wasted and the Medicaid system growing at an annual average of 8% in Virginia, the audit is an important first step in guaranteeing a more efficient and effective system.


As the discussion about Medicaid continues, I hope you find these facts helpful. I appreciate all of you who have provided feedback about this issue, especially those who completed my survey. Tellingly, 94% of survey respondents opposed the expansion of Medicaid in the Commonwealth.

February 18: District Day with special guest
Speaker of the House William Howell
Please take this opportunity to watch the General Assembly at work! On Tuesday, February 18, I will host a District Day in Richmond. If you are a resident of the 96th District and desire to learn more about the legislative process, please mark your calendar. The day will run from 9:30 a.m. until 1:30 p.m.  In addition to touring the capitol and viewing committee meetings and session, attendees will also hear from Speaker Howell. Lunch will be provided, and there is no charge to attend this event.  Attendees are limited to the first twenty respondents from the 96th District, so please reply promptly!  To RSVP, call 804-698-1096 or email  A detailed agenda will be provided as the date approaches.  
2014 Budget Amendment: Efficient & effective delivery of Medicaid services for individuals with mental health challenges
Because Medicaid reform and mental health care are top priorities of the General Assembly, I am excited to share information about a budget amendment that I submitted this year.  If adopted, the amendment will require adults seeking Medicaid services for mental health to undergo a face-to-face evaluation. This process, entitled the Virginia Independent Clinical Assessment Program (VICAP), ensures that individuals receive a personal assessment of their needs so that the correct services are provided.  

To share some history, in 2011, the General Assembly budget implemented VICAP screening for children seeking Medicaid services for mental health.  As a result, children and families were provided with a licensed clinical independent assessment and diagnosis. Following this evaluation, recommendations were made for the correct level of intervention and treatment--not the level of service that a provider happened to deliver (and bill to Medicaid). Also, families were required to participate in the delivery of services to their children, whereas prior to VICAP, parents could avoid participation in their children's behavioral health treatment.  Over the course of two years, $109 million in Medicaid funds were saved as a result of the implementation of VICAP for children. 

Respondents to my session survey listed "cut government spending" as their top priority. Ranked a close second was the option to "streamline government programs and services." If adopted in the budget, a requirement for VICAP screening for adults will accomplish both of these goals. Simply stated, the program provides higher quality mental health services while cutting costs.
Visitors in the General Assembly Building
Although the wintry weather deterred a few visitors, I am happy to share that the following folks were not dissuaded by the snow:

Brian Wise
Deanne Deschenes
Anthony Bavuso
Annete Parsons
Angela Karaktin
Reverend Charles Swadley
Visitors Welcome!
As always, if you are in Richmond during the upcoming weeks, please stop by my office in Room 403 of the General Assembly Building located at the corner of 9th and Broad Streets. 
Delegate Brenda Pogge

Paid for and Authorized by Brenda Pogge for Delegate