DARS Mission: To improve the employment, quality of life, security, and independence of older Virginians, Virginians with disabilities, and their families.

This service area aligns with DARS' mission to improve the employment, quality of life, security, and independence of older Virginians, Virginians with disabilities, and their families.

Accountability

Customer Service

Engagement 

Innovation

Diversity, Equity, and Inclusion

The Department for Aging and Rehabilitative Services (DARS) was created by legislation in 2012 to take the programmatic units of the Department of Rehabilitative Services and the Department for the Aging and create a new entity with a wider menu of service options. In 2013, the Adult Services, Auxiliary Grant, and Adult Protective Services units from the Department of Social Services became a part of DARS.

DARS’ programs support Virginians with disabilities and older Virginians to maximize their employment, independence and  full inclusion into society.  Virginia is also committed to having livable communities for aging Virginians and Virginians disabilities who wish to  live, work  with   the assistance of  long-­term supports and services in their communities.  DARS services also seek to enhance the safety and security of vulnerable adults and promote and protect the rights of older adults and people with disabilities.

Vocational rehabilitation (VR) services are provided through the Division of Rehabilitative Services, with local offices throughout the Commonwealth.  The VR program assists individuals with disabilities with employment and is a partner in the Commonwealth’s workforce system.  Disability Determination Services conducts disability determinations for the Social Security Administration and Medicaid, helping to provide access to services that provide additional financial security for individuals with disabilities.

The Division of Community Living includes the Office for Aging Services, the Office for Disability Programs, and No Wrong Door. The Office for Aging Services is designated by the federal government to oversee all state programs using funds from the federal Older Americans Act and the Virginia General Assembly.  The Office contracts with the 25 Area Agencies on Aging (AAA) and other community partners to provide services for older Virginians and their families in communities throughout Virginia.  The Office for Disability Programs administers multiple community based services programs that support individuals with disabilities in their communities and works with partners in the community such as Centers for Independent Living, Brain Injury Programs, Long Term Rehabilitation Case Management, and the Personal Assistance Services Program.  No Wrong Door Virginia is a virtual system and statewide network of shared resources, designed to streamline access to long-term services and supports. It supports older adults, family caregivers and individuals of all ages with disabilities.

The DARS Adult Protective Services Division administers the state Adult Protective Services, Adult Services and Auxiliary Grant programs formerly under the Department of Social Services. Direct services are provided by 120 local departments of social services (LDSS).

Specialized advocacy services for individuals receiving long-term care in Virginia are available through the Office of the State Long-Term Care (LTC) Ombudsman.  Ombudsman Program representatives across the state work to address problems encountered by long-term care facility residents and community long-term services and supports (LTSS) recipients, and their family members.  The Ombudsman program is client focused and seeks to resolve issues to the satisfaction of the client.  The program also partners with the Department of Medical Assistance Services (DMAS) to serve as an advocate for Medicaid managed care LTSS recipients.

DARS’ focus is on improving the lives of older Virginians and Virginians with disabilities.  The agency will work with its community partners to be more effective in strategic planning, budgeting, program monitoring and evaluation and training and technical support.

As the Commonwealth’s state unit on aging (SUA), DARS will continue to work to elevate aging within the Commonwealth, support our community partners, and look for ways to be innovative and raise the profile of aging issues.   The agency will be a key partner in the Commonwealth's workforce efforts, particularly the employment of individuals with disabilities and promoting independent living of individuals with disabilities.

The agency will continue to assist in the Commonwealth’s response to COVID-19 and support older adults and individuals with disabilities who are particularly vulnerable to the disease. DARS, through our community partners, has been instrumental in disseminating important and accurate information on COVID precautions and vaccines as well as in responding to the increased impact of social isolation faced by our constituents. With increased federal funding and through partnerships with federal and state agencies, DARS is supporting public health efforts, long-term care safety, workforce development, and social and community engagement through assistive technology and access to information and resources, among a myriad of other aging and disability services.

An efficient and effective human resource and management program remains critical in supporting the agency’s efforts to provide quality services leading to a higher quality of life for our consumers.

The Information Technology Division (ITD) provides management, administrative support and technical assistance to functional programs of the Department for Aging and Rehabilitative Services (DARS). In addition, the ITD provides administrative support and technical assistance to the Disability Services Agencies (DSA), which includes the Wilson Workforce and Rehabilitation Center (WWRC), Department for the Blind and Vision Impaired (DBVI), the Virginia Rehabilitation Center for the Blind and Vision Impaired (VRCBVI), the Department for the Deaf and Hard of Hearing (VDDHH), the Assistive Technology Loan Fund Authority (ATLFA), and the Virginia Board for People with Disabilities (VBPD).

All of the DARS technology services and procurements are managed and/or provided administrative oversight by the Virginia Information Technology Agency (VITA).  We have experienced a number of challenges (poor service and support, high costs, etc.) from VITA and their vendors, but the DARS IT Division staff help to ensure that the required technology, services, and support are provided to all DARS locations and staff.  In compliance with Executive Order (EO) 19, DARS working to migrate all appropriate enterprise applications and systems to VITA approved cloud platforms. Below are the three primary enterprise technology applications and systems that are utilized by DARS:

1. AWARE is our employment services case management system utilized by DARS, WWRC, and DBVI. It is a heavily customized COTS system used by Vocational Rehabilitation (VR) programs in 35 of 80 state VR programs.  Per EO 19, DARS IT is working with the vendor to migrate this application to the cloud.


2. DocFinity is our cloud document management and intelligent data capturing system, which is used by our DRS, HR and Fiscal divisions. DARS is expanding the use of electronic document management to improve business processes, and implement workflow and e-forms software.  Implementation of these tools improves content reliability and improves records access to end users, as well as migrating our paper documents into a digital format. 


3. PeerPlace is our customized cloud application, which provides client tracking, case management, and compliance data reporting features that helps us to annually submit required data and reports to the U.S. Department of Health and Human Services Administration for Community Living (ACL).

One main DARS information technology initiative, for the next biennium, is to decrease the footprint of our internally developed applications and migrate their functionality into existing or new cloud applications/systems (where possible).  In addition to moving towards cloud applications/systems, DARS IT has initiated a project to migrate all field office physical data servers to the VITA QTS data center, to become virtual servers.  Both cloud migration projects will improve application/system and data server security, reduce our technology ownership costs, and eliminate the need for additional IT positions within our agency. 

The DARS IT Division continues to focus on implementing newer technology and cost effective technology solutions, in order to meet the increasing needs of our internal divisions and programs and external customers and partners.

Over 12% of DARS workforce is eligible to retire with unreduced benefits. Within the next 5 years that number will increase to nearly 23%.  A large percentage of those eligible for retirement are in management and/or leadership positions possessing an abundance of both technical and institutional knowledge. In addition, there are ever increasing recruitment and retention challenges with vocational rehabilitation counselors within our Division of Rehabilitative Services (DRS) and Analysts working in the Disability Determination Services (DDS) division.

To address the inevitable upcoming retirements of employees in these critical positions, DARS is very active with implementing succession planning strategies and talent development programs.  Programs, including the DARS BOLD Institute, DDS Leadership Program, DRS Skills for Leadership, and numerous supervisor training sessions, have been instrumental in developing current staff to step into future leadership positions.

To implement more effective recruitment and retention plans, DARS places a strong emphasis on alternate and flexible work schedules, retention increases, and talent development.  In addition, DARS has expanded its recruitment sources and streamlined the screening process for all recruitments.

DARS will continue to develop and implement strategic initiatives to combat these and other important issues facing its workforce.

Strategically located, affordable, accessible and well maintained facilities are critical to DARS ability to provide effective services. DARS administrative headquarters are located in an office park in Henrico County which is convenient to our consumers and fully accessible for individuals with disabilities.

All DARS offices are in leased space. DDS and the VR program have offices located throughout Virginia; the VR program has thirty offices where direct services are provided to VR consumers. Two of the DDS offices, in Norfolk and Roanoke, are col­located with Social Security Administration Offices.

DARS continues to improve its transportation program, centralizing transportation services, request process. and vehicle management and established processes with DGS/DMV to insure that staff are properly licensed to operate state vehicles.

DARS has improved its facility security, beginning with enclosed reception areas   Throughout fiscal year 2020 and 2021 DARS completed a project to install a centralized security camera and badge swipe system, at DARS Central Office. Upon completion of the central office installation, in fiscal year 21 the second phase of this project began, which entailed the installation of the centralized camera/badge system at all DDS and VR field offices across the Commonwealth. At the end of fiscal year 22 all but 6 locations remained. The remaining DDS and VR locations are slated to be completed in fiscal year 23.

In fiscal year 23 DARS General Services will complete the implementation of a new centralized work order management system that will allow for tracking/reporting of all General Services requests and increase the department’s ability to better respond to and update all DARS office occupants on General Services-related requests and needs agency-wide.

The VR program receives about 79% of its Title I funding from the Federal government, with a required state match of about 21%.  For each dollar DARS spends for VR services, it receives $3.69 in federal funding. Between 2014 and 2016, DARS state general funds available for VR match increased by $1,000,000 (from $7,984,358  to $8,984,358).  Under Order of Selection, all categories have been open, leading to the elimination of the waiting list for VR services.  However, as costs increase, categories may need to be closed again.  Expenditures are closely monitored to determine when categories may need to be closed again.

WWRC and DRS are affected by DARS Order of Selection which impacts the number of consumers receiving services and the complexity of their disabilities. This, combined with a rapidly changing workplace along with economic factors causing shifts in types of available jobs, increases risks to successful employment outcomes for persons served. The increase in WWRC consumers with Autism Spectrum Disorders requires specialized programming to address unique barriers to employment and independence. Efficient rehabilitation team operations, flexible use of resources, and innovative programming, in collaboration with DARS, will be required for WWRC to address complex disability­ related challenges faced by these WWRC consumers to successfully prepare them for employment and offer a competitive edge.

In addition, the Workforce Innovation and Opportunity Act (WIOA) requires that 15% of VR funds be used to provide pre-employment transition services (Pre-ETS) for students with disabilities.  This is a positive investment in youth who are potential clients and those who are DARS clients now.  Pre-ETS are distinct services that must meet prescribed criteria and are designed to help prepare students for work.  However, this shift in the allocation of funds results in a reduction of available resources for traditional VR clients.

The demand for community rehabilitation programs and living options will grow as people with significant disabilities move from institutions into the community.

There are approximately 1.9 million Virginians age 60 or older, a number that will increase to 2.2 million in 2030. The Office for Aging Services distributes federal Older Americans Act and state general funds to the AAAs through an Intrastate Funding Formula. The Older Americans Act is not an entitlement program, so services may be curtailed due to lack of funding, increased inflation costs, supply chain issues, and increased wages or lack of sufficient workforce to provide services. Therefore, priority is given to serve older Virginians in the greatest economic and social needs. Further, Congress has provided an extensive investment in time-limited aging services in response to COVID-19. These funds, which have significantly increased the ability of AAAs to provide home-delivered meals and public health supports will end in FFY 2024 [, possibly setting up a funding cliff for many of these important community services. This is added to the fact that federal Older Americans Act has not kept up with the growing demand on aging services from the increasing population of older adults.

For the last several years, the Public Guardian and Conservator Program has had the capacity to serve 1,049 individuals. With new General Assembly funding starting July 1, 2022 DARS will be able to add 300 new slots. Getting those slots assigned to providers as well ensuring guardianship and conservatorship court orders are in place will take some time.

For  Adult  Protective Services (APS),  concerns  are:  (1)  the  continued  rapid  growth  in  the  number  and  complexity  of  APS  cases,  especially  financial  exploitation;  (2) the lack of affordable and accessible housing for older adults and individuals with disabilities;  (3) the lack of available guardians for incapacitated adults;;  (4)  the affordability and availability of in-home services to help adults “age in place”; ;  (5) the  absence  of  direct  federal  funding,  limited state funding for for LDSS to provide home­based adult services ; and (6) the declining number of Auxiliary Grant (AG) assisted living beds due to the low AG rate.

With a continued emphasis on electronic claims, DDS has instituted many changes to meet the increasing technology and claimant demands.  This requires ongoing training of staff.  The continual training needs combined with a fluid workforce creates staffing challenges that DDS continues to try and address through innovative approaches.

A key risk factor in the DARS IT Division, is that several staff are reaching retirement age and will most like choose to retire.  As these workers age and move into retirement, they will leave significant IT support experience and skills deficits behind.  To help mitigate this, DARS IT management is ensuring that knowledge sharing and partnering are occurring between all staff.

The appropriation for DARS is comprised of approximately 71% Federal and Special funding and 29% State funding. The budget for fiscal years 2023 and 2024 saw increases for the Long-Term Care Ombudsman Program, Adult Protective Services, Public Guardianship Program  Brain Injury programs, Senior Nutrition and Independent Living.  Additional increases were VITA costs.

The  vast  majority  of  the  non­general  fund revenues (92.3%) are  federal and  the  second largest non­general revenue stream (5.8%) is indirect cost which is  derived from federal sources.  These indirect cost revenues are  reported twice in  the  chart below because the  funds are  received as federal  funds  (from  which  they  are  derived)  and  then  transferred  to  indirect  cost  revenue  and  a  portion  to  general  fund  revenue  thereby  being reported twice.  The other non­general revenues are derived from fees for services to other agencies and revenue from the Department of Taxation for the Commonwealth Neurotrauma Initiative (CNI) Trust fund, transportation services for the elderly/disabled and special fund revenues from operating agreement with Disability Service Agencies to support back office operations. Federal aid in response to the pandemic provided a historic opportunity to make investments in our citizens and communities.  These same revenue supplemental payments may place future budgets at risk when the federal funding is exhausted, potentially triggering a fiscal cliff in 2024.

The following statistics provide a comprehensive snapshot of the Department for Aging and Rehabilitative Services during 2022.

• DARS has realigned policies and services to meet the requirements of the Workforce Innovation and Opportunity Act (WIOA).  Performance expectations and data requirements have changed with the implementation of WIOA.  There is an increased emphasis on longer-term sustainable employment.


• Over 50% of VR consumers are youth at transition age. Over the next several years this number is expected to grow exponentially with the targeted focus of the Workforce Innovation and Opportunity Act (WIOA) on youth with disabilities.  The increased attention and resources on younger students with disabilities is an investment in the future and should in the long run result in improved VR outcomes for this population.  However, shifting funds and service requirements will impact how services are delivered to adults in need of VR services.  This in turn changes the performance measures for the program in line with the new expectations of WIOA. s With fewer VR resources to support adults with disabilities and  the typically lower wages and  longer stay associated with youth with disabilities in the VR program DARS performance outcome measures will reflect the changing system.


• From FFY 2016 to FFY 2022, the VR program saw a 43% change in the number of clients with an Autism Spectrum Disorder (ASD). While the number of ASD clients is small in relation to other disabilities, the number is expected to increase. DARS will implement and expand new service delivery systems to address the needs of this population. This population is significantly more expensive to serve


• The VR Program will continue to see steady growth in the number of consumers from different ethnic backgrounds and will need to enhance its efforts to provide appropriate services to these individuals.


• Individuals with disabilities who also have a criminal background are increasing and pose challenges to the VR Program in assisting them in employment, requiring new service delivery approaches to address their needs.


• In cooperation with the DOE and local education agencies, DARS VR Program is participating in the implementation of 20 Project SEARCH programs across Virginia. These programs provide youth with significant disabilities with internship experiences in the real work world, primarily in large medical facilities. These internships often result in higher paying and more stable employment than would otherwise have been possible.


• The vocational rehabilitation program remains in Order of Selection, which is required by federal law when the program has insufficient funds to serve all eligible consumers. Order of Selection creates categories of consumers to be served based on the significance of disability. Wait lists are created for consumers whose category is not open for services. DARS has been in Order of Selection since July 1, 2004. Currently all categories of disability are open at DARS as of July 2022 and there is not a wait list for individuals to receive VR services from DARS.


• Increased funding for brain injury services allows expansion of the availability of brain injury services statewide.


• The demand for community rehabilitation programs and community living options will continue to grow as people with significant disabilities move from institutional settings, such as nursing facilities, or opt to stay in their homes and community-based settings.


• The Social Security Administration (SSA) projects that disability determination workloads will remain high nationally and in Virginia for several years.  The projected Continuing Disability Review (CDR), which are periodic reevaluations to determine whether beneficiaries are still disabled, workload for 2022 is 12,649 compared to 2021, which was 9,500. This denotes an 33% increase.
  
  
  
  • While adults 50+ still represent a growing number of applicants for disability, the reduction in CDRs and the growth of the economy has resulted in a decrease in the total workload goals for the Virginia DDS. The total workload goal for 2021 was 107,752 and the expected workload goal for 2022 is 99,077.
  
  
  
  


• There are approximately 1.9 million Virginians age 60 or older, a number that will increase to 2.2 million in 2030. This population phenomenon will be unlike anything DARS or our partner agencies have seen before.


• We have seen a reduction in Medicaid claims with the expansion of Medicaid benefits for Virginians.


• The Public Guardian Program Will again expand its services this year to serve an additional 300 individuals, bringing the total number of individuals that can be enrolled in the program to 1,349.


• Uncertainties in federal funding streams for Health and Human Services, Department of Labor, Department of Education, Housing and Urban Development and the Centers for Medicare and Medicaid Services will create uncertainties in funding for DARS. In addition, the one-time funding that DARS has received and passed through to our community providers will end, potentially setting up a funding cliff for many older adults and individuals with disabilities who have accessed services in the last several years.


• The launch of statewide Medicaid managed care has increased the volume of consumers seeking help from the Long-Term Care Ombudsman Program (LTCOP) to access services, understand their rights and benefits, and resolve problems.  Concurrently, increased public awareness of the availability and value of assistance through the LTCOP’s Managed Care Advocate services has heighten demands on the Program. .  Over SFY 2023, the Office of the LTC Ombudsman’s Medicaid Managed Care Advocate team anticipates a large expansion in the number of beneficiaries seeking the program’s assistance with complaint handling/ resolution as the  Department  of Medical  Assistance Services brings a large volume of additional beneficiaries under the umbrella of its Medicaid Managed Care Model as the Commonwealth transitions to Cardinal Care, expanding the member population from the current 225,000 to about 2.2 million. This will create a spike in demand for the unit’s services in providing critical beneficiary support. As long-term care facilities follow federal guidance that supports improved access to LTC residents by families/ visitors to mitigate the harmful effects of social isolation, an overall uptick in demand for the program’s services in investigating and resolving complaints is also anticipated.


• Over the past 5 years Adult Protective Services (APS) reports increased by 49% and substantiated financial exploitation cases increased 37%.  This trend is expected to continue into the next biennium.  For Adult Services, healthcare workforce shortage have affected the availability of long-term services and supports (LTSS) in both residential and in-home settings though demand remains significant. LDSS work force challenges and lingering effects of the pandemic combined with growing client demand have resulted in some regional delays in completing Medicaid funded LTSS screenings within 30 days. The lack of affordable and accessible housing and closures of assisted living facilities that accept Auxiliary Grant hinder successful placement of adults.

Vocational  Rehabilitation:  Provides  services  to  eligible  persons  with  disabilities  to  help  them  remove  barriers  to  employment  and  reach  an employment goal. Long-­term services needed by consumers for successful job placement include supported employment and extended services.

Disability Determination: Provides accurate, timely, efficient and cost­ effective evaluations of medical evidence related to claims filed by citizens for benefits under the Social Security Act; and to process claims filed for Medicaid based on disability.

Disability Programs: Improves the employability and independence of individuals with significant disabilities through independent living, personal assistance services, long­-term case management, brain injury programs, and local assessment and systems change.

Aging Services:  Helps citizens find information and services needed to lead healthy and independent lives as they grow older. The Area Agencies on Aging (AAA) administer aging services at the community level. Common AAA services include adult day care, homemaker, personal care, communication, referral and information, transportation, congregate (group) and home delivered meals, nutrition education and counseling, disease prevention/health promotion education, legal assistance, elder abuse prevention, Ombudsman and Virginia's Insurance Counseling and Assistance Program to Medicare beneficiaries. The Virginia Public Guardian  and  Conservator  Program  serves  adults  age  18  and  older, who are legally incapacitated,   cannot  pay  for  guardian  services,  and  have  no  one  else  to  provide  this service.  The  Office for   Aging Services has  15  local  public  guardianship  programs.

Adult  Protective  Services:  Develops,  maintains,  monitors  and  supervises  the  implementation  of  legislation,  regulations  and  policy  for  the  Adult Protective  Services,  Adult  Services  and  Auxiliary  Grant  programs  and  provides  technical  assistance  and  training  to  Local  Departments  of  Social Services(LDSS) that provide the services. Local services provided to eligible individuals include the receipt, investigation of reports of abuse, neglect and exploitation of vulnerable adults and provision of protective services; home­based companion, chore and homemaker services; assessments and  screenings for long-­term care placements; and eligibility determination for Auxiliary Grants to low ­income residents of assisted living facilities, supportive housing, or adult foster care homes.

State Long Term Care Ombudsman:  Identifies, investigates, and resolves problems and concerns on behalf of long-term care recipients in nursing homes, assisted living facilities, and in the community receiving home care supports.  Working statewide on behalf of recipients to help them understand and exercise their rights, access benefits, and make informed choices, Ombudsman Program representatives at the state and local levels ensure critical protections for the health, safety, welfare, and rights of vulnerable Virginians.  The Program monitors and makes recommendations regarding laws, policies, and regulations affecting long-term care recipients and works collaboratively with partner agencies to improve quality of care and quality of life for older Virginians and those with disabilities. The OSLTCO has significantly expanded its operations through creation of a unit, within the Office of the State LTC Ombudsman, dedicated to providing Beneficiary Support Services for Medicaid Managed Care beneficiaries receiving Long-Term Services and Supports (LTSS). Under terms delineated in DARS’ MOU with the Department of Medical Assistance Services (DMAS), the Medicaid Managed Care Advocate team provides navigation, advocacy, and problem-solving assistance to help beneficiaries understand and exercise their rights, and access the care and services they need. The member population served by the program will expand exponentially in the next year as the DMAS brings the full range of Medicaid beneficiary groups under a unified managed care umbrella called Cardinal Care.   

DARS had 2,206 successfully employed VR consumers in federal fiscal year (FFY) 2021All clients whose cases are successfully closed as employed must be working in competitive integrated employment (in an integrated setting in the community with wages at or above minimum wage). DARS productivity measure captures the employment rate of our VR consumers. This rate compares the number of consumers who exit the VR program after receiving services successfully employed versus those who are not employed.  For FFY 2021, the employment rate was 44%.  In addition, DARS is now measuring the percent of program participants who are employed during the fourth quarter after they successfully exited from the VR program. This measure  uses data from outside entities and agencies and is not yet complete for FFY 21.  However in FFY 20, 54% of DARS clients were employed at the 2nd quarter post closure.  Refinement of the data collection process will continue, as we seek to improve this important quality measure.

WWRC’s key performance metric is to deliver comprehensive vocational rehabilitation services that lead to employment and/or re-entry to the workforce. This is measured as the percentage of WWRC Vocational Training graduates who are employed. This measure supports the Commonwealth’s objective to enhance Virginia's economy by increasing employment among Virginians with disabilities. A stable trend is expected. Targeted strategies ensure a workforce driven curriculum that is responsive to industry demands, as well as shifting economic markets.

Ensuring a high accuracy rate of disability decisions is paramount, in order to provide an effective level of customer services to Virginians applying  for disability benefits under Title II (Disability Insurance), Title XVI (Supplemental Security Income), and Title XIX (Medicaid disability) of the Social  Security Act. The accuracy rate for Disability Determination Services for Federal Fiscal Year (FFY) 2021 was 95.6%.

DARS has a performance management process in place to monitor the services provided by our community partners who have contractual relationships with the agency and/or receive state or federal appropriations.  By monitoring and providing technical assistance, training, and guidance to these entities (Employment Service Organizations, AAAs, brain injury organizations, CILS, etc.), DARS helps ensure that their fiscal and administrative processes are in compliance with federal and state requirements and that they provide high quality services to customers.

Through our collaborative relationship with the AAAs, DARS ensures that older Virginians receive nutritional meals and transportation services to enhance their health and well-being.  Another key measure for DARS is the number of individuals receiving communication, information, referral and assistance (CRIA) through the No Wrong Door (NWD) system.  NWD is a statewide initiative, designed to help people navigate the complex system of public and private long-term services and supports, avoid unnecessary trips to the hospital and/or nursing home, and support individual choice.  In State Fiscal Year 2021, 54,031 individuals received NWD CRIA services.

Virginia benefits from the Department for Aging and Rehabilitative Services (DARS) vocational rehabilitation program because it enables individuals with significant disabilities to become employed or remain employed. Their employment helps businesses secure qualified workers, increases the tax base, and helps reduce dependency on public benefits. Virginians with disabilities also benefit from VR services by receiving educational and vocational training, and other services, to enhance their employment capabilities and to secure sufficient wages to provide for themselves and their families. In addition, Disability Determination Services (DDS) works to provide accurate and timely disability decisions for Medicaid and Social Security to enhance financial stability of individuals with disabilities.

Increase the employment of Virginians with disabilities who are consumers of the department's vocational rehabilitation program.

• Collaborate with One Stop Career Centers, schools, and Departments of Social Services and Behavioral Health and Developmental Services in providing referrals and services leading to competitive, integrated employment.

• Collaborate with the Virginia Assistive Technology System to enhance the availability of assistive technology for VR consumers and to educate VR counselors on identifying technology needs and accommodation solutions.

• Continue to collaborate with the Wilson Workforce and Rehabilitation Center (WWRC) to ensure that WWRC’s programs and services complement VR services, also resulting in increased referrals to WWRC and increased employment outcomes.

• Continue with initiatives (Cold Case and Intense Consumer Engagement) to further engage VR clients in their employment program.

• Develop a model of employment focused collaboration among VR staff and consumers to achieve effective communication, shared responsibility and accountability for employment outcomes.

• Develop recruitment and retention plans to address the anticipated vacancies in critical positions.

• Enhance education and outreach to school and community partners to foster a collaborative transition approach to service provision that includes involvement of transition stakeholders, including the student, family, school personnel and VR staff, leading to integration of the student's IEP and IPE and execution of services leading to employment.

• Continue to provide VR staff with the technology and other resources they need to work more effectively in mobile work environments.

• Support training programs to enhance the knowledge and skills of VR staff and to prepare employees to successfully move into leadership roles within the agency.

• Continue to train and support VR managers to more effectively utilize data in service delivery decision making.

• Collaborate with the Employment Service Organizations (ESO) and ESO Steering Committee to ensure utilization of long term employment support funding for consumers to work in competitive, integrated employment.

• Enhance our Business Development Services and vocational evaluation services to prepare consumers for competitive jobs in the workforce that also fulfill the needs of employers.

• Increase activities and focus on Students with Disabilities (SWDs) to prepare them for employment and careers through the provision of Pre-Employment Transition Services (Pre-ETS).

Ensuring a high accuracy rate of disability decisions is paramount, in order to provide an effective level of customer services to Virginians with disabilities. These customers apply for disability benefits under Title II (Disability Insurance), Title XVI (Supplemental Security Income), and Title XIX (Medicaid disability) of the Social Security Act.

• All SSA regions supporting the DDS will have access to the same proven practices to ensure the right disability decision is made at the earliest possible time. The resulting increase in staff productivity and decrease in processing time will save program dollars while enhancing customer service.

• Also referred to as “Q5” (5 dimensions of quality): maintaining high levels of accuracy, timeliness, productivity, and service while also providing cost savings to the public; SSA and DDS strives to continually improve on their goal of affording its customers the highest quality product possible.

• Continuous Improvement (CI) is a standard methodology that uses data to identify areas where changes to policy or processes will provide the most benefit to SSA, the DDS, and the public we serve. Once a problem has been identified, CI seeks to identify the root cause(s), determine the best solution(s), make the necessary changes, and measure the impact.

• New Continuous Improvement (CI) initiatives supports ongoing efforts of improving overall quality of the DDS product.

• The American public depends on SSA and the DDS to make certain their benefits are accurate. The partnership also has the responsibility to protect the trust funds and general revenues against unwarranted payments. Consequently, quality checkpoints are needed to guarantee that the work performed meets or exceeds these expectations. In addition, SSA and the DDS need quality information to operate as efficiently and effectively as possible.

• The federal review component in SSA has begun to randomly assign quality reviews to disability quality branches (DQBs) throughout the nation rather than assigning them to only the Philadelphia Region DQB. This is to ensure that policy is implemented the same way throughout all DDSs and will undoubtedly require greater use of the Review Policy Component to rebut assigned errors.

DARS is the lead agency in coordinating the work of state agencies on meeting the needs of an aging society. DARS promotes local participation in programs for older persons, evaluates and monitors the services provided for older Virginians and provides information to the general public. DARS also ensures the development of a continuum of long term care programs and services to enable older Virginians to remain in their own homes and communities for as long as appropriate and avoid unnecessary institutionalization. Services are targeted to older Virginians and their families, especially caregivers, to form a critical part of the Commonwealth’s continuum of long term care, including adult day care, chore, homemaker, personal care, nutrition, transportation, and other services and programs. DARS also coordinates and collaborates with partners to provide services to support individuals with disabilities in their communities. Some individuals with disabilities may need individualized services to live independently in their homes, become as self-sufficient as possible, or allow themselves or their caregivers to maintain their employment. DARS supports these efforts through a number of programs and community partners.
DARS also supports individuals seeking to retain or gain independence by providing timely and accurate information regarding a variety of programs and supports. Through the No Wrong Door Initiative, DARS provides information to Virginians of all ages to help them prepare for their retirement, pursue healthy lifestyles, fulfill their roles as family caregivers, and understand the choices available for preserving their independence or that of their relatives.

Home delivered meals involve the procurement, preparation, conveyance, and provision of nutritionally balanced meals that meet one­ third of the current Dietary Reference Intakes and follows the Dietary Guidelines for Americans. The meals must be delivered and received at the homes of the individuals. DARS contracts with Virginia’s 25 Area Agencies on Aging (AAAs) to provide the service.

• DARS would like to see an increase in federal funds for this program. Unfortunately, with rising costs and only marginal increases in funding, DARS encourages participating AAAs to continue to provide the same number of meals as provided in the previous fiscal year and to identify other fundraising opportunities to help stabilize the program.

Transportation services are provided to older persons to travel to congregate meals, socialization and recreation activities, shopping, and other services available in the community; individual transportation to needed services that promote continued independent living.

• Provide transportation best practices to Area Agencies on Aging and other significant program contractors.

Respite Care provides regular daytime supervision and care to frail, disabled, and institutionally at-risk older adults. Participants require a level of care that ensures their safety, and, with the provision of services ranging from socialization to personal care, may experience an enhancement in their quality of life and level of functioning.

• The Division for Community Living, Office of Aging Services, issues a Request for Proposal every five years to encourage providers to examine their respite care programs and ensure resources are appropriately deployed for caregivers of individuals with Alzheimer’s disease and other dementias.

DARS participates in the Senior Farmers’ Market Nutrition Program funded by the US Department of Agriculture. DARs issues coupons to participating AAAs to give to seniors that can be redeemed for fresh Virginia grown fruits and vegetables at local farmer’s markets.

• Provide education and technical assistance to farmers about the Senior Farmers’ Market Nutrition Program.

• Provide nutrition education and technical assistance to AAAs offering the Senior Farmers’ Market Nutrition Program.

Group (congregate) meals involves the procurement, preparation, conveyance, and provision of a nutritionally balanced meal that meet one­ third of the current Dietary Reference Intakes and follows the Dietary Guidelines for Americans. The provision of meals must occur at designated nutrition sites, which also provides a climate or atmosphere for socialization and opportunities to alleviate isolation and loneliness. DARS contracts with Virginia’s 25 Area Agencies on Aging (AAAs) to provide the service.

• DARS would like to see a substantial increase in the number of meals. Unfortunately, with rising costs and only marginal increases in funding, DARS encourages the AAAs to continue to provide the same number of meals at the same cost as provided in the previous year. Nationally there is a shift away from congregate (group) meals to the home delivered meals program.

The Community Rehabilitation Program is comprised of specialized programs that provide services and supports to Virginians with varying and significant disabilities that assist them to live as independently as possible in the least restrictive community setting. Two of these programs, Community Rehabilitation Case Management Services and Personal Assistance Services, provide direct services to consumers.

• Provide monitoring and oversight of programs and services to assure that funds are expended fully and appropriately in accordance with federal and state laws, regulations, and guidelines.

• Provide training and technical assistance to internal and external customers regarding the specialized needs of, and resources for, people with significant physical and sensory disabilities.

• Support an environment that promotes shared communication, responsibility, and accountability for consumer outcomes for participants served through Community Rehabilitation Programs.

• Support training programs and provide technology to enhance the knowledge, skills, and ability of Community Rehabilitation Program staff to effectively administer and manage programs and services.

• Work collaboratively with community partners and advocacy groups to assure adequate funding to meet the needs of Virginians with significant physical and sensory disabilities.

DARS provides education, consumer protection, crime and fraud prevention and public guardian and ombudsman services through contract in order to enhance the safety and security of vulnerable adults. DARS and the AAAs provide information and legal assistance to older Virginians and their families that will allow them to avoid becoming the victims of crime, fraud, abuse, or financial exploitation. Partners at the local level, through local departments of social services, investigate cases of abuse and neglect, including financial exploitation, of Virginians age 60 or older or who are age 18-59 and meet the definition of “incapacitated person.” Ombudsmen provide critical support to long-term care recipients that are the victims of abuse and neglect by providers, and work with providers, partner agencies, and other advocates to systemically identify and address the underlying causes of abuse and neglect experienced by vulnerable individuals who depend on long-term care services.

Through the Office of the State Long-Term Care Ombudsman long term care recipients and their families receive assistance in resolving problems with their care/services that affect their health, safety, welfare or rights. The program works with providers, policy makers, partner agencies, and consumers to promote improved quality in long-term care and to shape law, regulations, and practice in order to better protect vulnerable Virginians.

• Continue expanded Ombudsman program services to support Medicaid MLTSS recipients under Commonwealth Coordinated Care Plus (to become Cardinal Care in SFY 2023).

• Monitor and strengthen protections against conflict of interest in program operations at the state and local host agency levels.

• Provide ongoing training and technical assistance to enhance knowledge and skills of Ombudsman Program representatives statewide to resolve problems and improve care for long term care recipients.

• Expand strategies to promote awareness and access of long term care recipients and their families to the Program’s services.

• Support collaborative efforts with partner agencies and other stakeholder groups to promote improvements in the quality of long term care.

DARS seeks to promote and protect the rights of older adults and individuals with disabilities by providing legal assistance, public guardian and ombudsman services through and providing timely information through No Wrong Door in order to ensure individuals can make informed decisions. DARS and local partners such as the AAAs and local departments of social services (LDSS) provide information, legal assistance, and possible interventions to individuals with disabilities and older Virginians and their families that will allow them to avoid becoming the victims of crime, fraud, abuse, or financial exploitation. The Ombudsman Program intervenes to investigate and resolve complaints and protect the rights of long term care recipients, while working systematically to identify and address underlying causes that contribute to abuse and neglect. The Public Guardianship and Conservator Program seeks to provide person-centered services that support individuals in need of a surrogate decision maker.

The Virginia Public Guardian and Conservator Program provides guardianship services for indigent individuals in need of a surrogate decision-maker because a Virginia Circuit Court has found them to be incapacitated, provided that no alternative guardian can be found and no less restrictive alternative to guardianship can be established. Conservatorship can be provided if an individual meeting those criteria has financial assets that must be managed or sold. A guardian or conservator makes legal decisions on behalf of the incapacitated person. A guardian determines the individual’s appropriate care and placement, and seeks public assistance benefits for the incapacitated person.

• DARS will work with local programs to ensure person-centered practices and compliance with state regulations.

No Wrong Door is a network of partners and technology system supporting streamlined access to long-term services and supports using person-centered options counseling. Designed as a single point of entry system, providers and individuals gain access to an array of home and community based services through a collaborative technology, integrating an individual’s unique needs to a live search engine of local to statewide services and supports. The training for person-centered options counseling, partner certification and technology are standardized statewide. The technology includes a live database of over 27,000 statewide services and supports maintained and updated by VirginiaNavigator. CRIA (Communication, Referral, Information and Assistance) is the electronic tool powered real-time, within the No Wrong Door System technology, allowing partners to make automated referrals back and forth, securely share information (with consent), track progress of an individual over time, and run analytical and statistical reports of client-level, agency-level, and community-level progress. CRIA is one of a few modules available on the No Wrong Door System technology supporting fluid life transitions among community based settings, such as hospital to home, through automated processes historically accomplished by phone, fax or email. Consumers are able to make direct referrals to partner organizations on the technology via the public facing website Virginia Easy Access, using No Wrong Door Direct Connect tool. CRIA allows a client record to accurately develop over time, with input from multiple partners, providing an up-to-the-minute dynamic view of an individual’s needs, preferences, and circumstances.

The expanding No Wrong Door partner network currently includes 236 public and private certified providers. While some partners operate statewide, others vary from region to region based upon local to statewide partnerships developed by local Area Agencies on Aging, designated as No Wrong Door community leads. To date, over 509 programs and services have been “opted into” by No Wrong Door partner organization to receive direct referrals from consumers visiting the public facing websites looking for resource and supports on Virginia Easy Access or VirginiaNavigators suite of websites (DisabilityNavigator, SeniorNavigator, VeteransNavigator). Consumers can also be directed and supported in finding access to services via a real-time 24/7 live chat function on the Virginia Easy Access website, staffed by a live human. This 24/7 live chat is maintained through a partnership with Virginia 2-1-1 or via a toll free number accessible in 200+ languages.

• Expand the use of CRIA and NWD Direct Connect within the No Wrong Door system tools both in number of tools as well as the number of community partners that use them. This will be accomplished only with additional funding or sharing the cost with the participating agencies.

Through the Office of the State Long-Term Care Ombudsman long term care recipients and their families receive assistance in resolving problems with their care/services that affect their health, safety, welfare or rights. The program works with providers, policy makers, partner agencies, and consumers to promote improved quality in long-term care and to shape law, regulations, and practice in order to better protect vulnerable Virginians.

• Continue expanded Ombudsman program services to support Medicaid MLTSS recipients under Commonwealth Coordinated Care Plus (to become Cardinal Care in SFY 2023).

• Monitor and strengthen protections against conflict of interest in program operations at the state and local host agency levels.

• Provide ongoing training and technical assistance to enhance knowledge and skills of Ombudsman Program representatives statewide to resolve problems and improve care for long term care recipients.

• Expand strategies to promote awareness and access of long term care recipients and their families to the Program’s services.

• Support collaborative efforts with partner agencies and other stakeholder groups to promote improvements in the quality of long term care.

This service area provides comprehensive vocational rehabilitation services to eligible individuals with disabilities necessary for them to prepare for or retain employment

This service area directly aligns with DARS’ mission of empowering individuals with disabilities to maximize their independence and full inclusion into society.

The authority to operate this program comes from the Code of Virginia:

§51.5-118 Department designated as state agency for purpose of cooperation with federal government

§51.5-170 - §51.5-177 Vocational Rehabilitation

The Rehabilitation Act of 1973 as amended

34 CFR Part 361, 363, 397

Vocational Rehabilitation (VR): The VR Program provides services to individuals with disabilities in order that they may prepare for or retain  employment. Services are individualized and are designed to assist an individual to reach an employment goal that is consistent with the individual’s strengths, resources, abilities, interests and informed choice. Services that are provided to eligible consumers include: vocational evaluation, career exploration and vocational counseling, job development and placement, support for vocational training, support for physical and mental restorative services, rehabilitation engineering, and miscellaneous services required for participation in a rehabilitation program and business development services to employers. Supported employment services are provided to consumers with the most significant disabilities by Employment Service Organizations (ESO). The goal of supported employment is to maximize employment opportunities for these consumers who require support in order to work in integrated, competitive employment.  With funding and positions received from the Department of Behavioral Health and Developmental Services, DARS provides VR services to individuals with a substance abuse disability.

Follow Along Support Services: As an extension of the VR program, DARS administers the state funded Extended Employment Services (EES) and  Long Term Employment Support Services (LTESS) programs. These programs are the link between the time­limited services of the basic VR program and the on­going activities necessary to support individuals in employment after they leave the VR program. Individuals who choose not to purseue competitive integrated employment through the VR program may also be able to access LTESS and EES services.  Funding for EES provides services to  persons with significant disabilities who are employed by ESOs. Through EES, the ESOs provide extraordinary supervision, training, advocacy, and other supports necessary for these individuals to learn employment skills and maintain employment.

Grants Development and Implementation: Development of competitive external funding proposals (primarily grants and cooperative agreements) and the development, implementation, and management of externally funded service and systems development and change projects.

Virginia Assistive Technology System (VATS): The mission of VATS is to ensure that Virginians of all ages and abilities can acquire the appropriate, affordable assistive and information technologies and services they need to participate in society as active citizens. This is accomplished through an array of activities to include assistive technology (AT) device recycling, demonstration and loaner programs. In addition, VATS through its network of AT Regional Sites provides device specific training, technical assistance, public awareness, and coordination and collaboration with entities responsible for policies, procedures, or funding of AT devices and services.

Deaf and Hard of Hearing Services: The Deaf and Hard of Hearing (DHH) program provides comprehensive community ­based VR services through specialized VR counselors who are fluent in sign language. The program promotes DHH advocacy and awareness within the rehabilitation community, provides technical assistance and consultation to field staff, and develops and monitors interagency cooperative efforts on behalf of people who are deaf and hard of hearing. Program staff provide community education and technical assistance to entities involved with job training, job placement, and employment of persons who are deaf and hard of hearing. The DHH program currently includes one Program Coordinator and ten Rehabilitation Counselors for the Deaf. Additionally, there are five positions in the Special Populations Services Unit at the Woodrow Wilson Rehabilitation Center. There is also a Staff Audiologist at the Center, who functions as the Lead Audiology Consultant on cases related to hearing aid  technology.

Ticket ­to­ Work Administration: Under the Ticket Program, the Social Security Administration provides disability beneficiaries with a ticket they may use to obtain the services they need from Employment Networks (ENs) to become employed. DARS can receive reimbursements from the Social Security Administration for the costs of services provided to either Social Security Disability Income (SSDI) or Supplemental Security Income (SSI) recipients   who put their ticket in use with DRS and receive VR services leading to  employment.

Partnering in Virginia's Workforce Investment System: Under the federal Workforce Innovation and Opportunity Act (WIOA), VR is a mandated partner and anchor in the State’s Workforce Investment System. As such, there are designated VR staff who serve on the Local Workforce Investment Boards and the Youth Programs to assist in the design of the workforce development programs in the localities. DARS has a memorandum of understanding with each Board that describes the services and expectations of the various WIA partners. In some instances, VR staff are co­located in the One­Stop Career Centers, or visit the Centers on a routine basis, to provide services to individuals with disabilities looking for employment assistance. DRS also has partnered with other state agencies to assess the programmatic and physical accessibility of the One­Stop Career Centers so that they can better serve individuals with disabilities. 

The Vocational Rehabilitation Services' funding comes from federal funds (79%), general funds (20%) and Indirect Costs (1%).   

This service area encompasses an array of community-based programs and services that complement the agency’s vocational rehabilitation program. These programs address the longer-term needs of individuals with significant physical and sensory disabilities to enable them to live independently in the community.

This service area directly aligns with the Department for Aging and Rehabilitative Services' (DARS) mission to improve the employment, quality of life, security, and independence of older Virginians, Virginians with disabilities, and their families.

Authority for this program derives from the following sources:

Code of Virginia:

§ 51.5-119. Department designated as state agency for purpose of coordinating rehabilitative services.

§ 51.5-123. Community Rehabilitation Case Management System.

§ 51.5-162. Independent living services.

Budget Item 329 Brain Injury and Personal Attendant Service Program

DARS’ Brain Injury Services Coordination (BISC) Unit contracts with nine (9) state-funded Brain Injury Services (BIS) Programs to operate 14 programs statewide that provide one or more of three identified “core” services in brain injury: adult / pediatric case management, clubhouse / day program, and resource coordination (outreach, information and referral). The BIS contractors received a little over $6 million annually in state and federal funds for programs/services.  Nine (9) state-funded contractors operate 14 programs statewide.  BISC Unit manages the Brain Injury Direct Services (BIDS) Fund, which is a “fund of last resort” that provides specialized goods/services to individuals who have no other source of funding and who would benefit from this assistance to live more independently. Personal Assistance Services for People with Brain Injury (PAS/BI) referenced below under PAS.

The Long Term Rehabilitation Case Management Program formerly (Community Rehabilitation Case Management Program) provides case management services to individuals with significant physical and sensory disabilities and their families. Rehabilitation Specialists assist individuals and their families in developing strategies to match their rehabilitative needs with appropriate public and private service agencies, organizations, and individuals. 

 The Independent Living Program grants State General Funds and some Federal dollars, and provides technical assistance, program audits, oversight and compliance to Centers for Independent Living (CILs). CILs provide services and advocacy to promote the leadership, independence, and productivity of people with disabilities. CILs work with individuals, as well as the local communities, to remove barriers to independence and ensure equality of persons with disabilities.

The Personal Assistance Services (PAS) program serves individuals who have the most severe physical disabilities and who require assistance from another person to perform non­medical activities of daily living. These consumer­directed services might include transferring, bathing, eating, dressing, or other physical activities that the individual could perform if they did not have a physical disability. DARS manages three PAS programs: State­ funded  PAS, PAS for Individuals with Brain Injury, and vocational rehabilitation PAS (funded through Title I of the Rehabilitation Act) for individuals who are currently receiving or who may be eligible for vocational rehabilitation services provided through an Employment Plan.

The Community Rehabilitation Program (Community Based Services) funding came from federal funds (8%), general funds (87%), Special Funds (1%), and dedicated special revenue funds for the CNI Trust Fund from fees paid by citizens to regain suspended driver's licenses (4%).  The federal funding is primarily represented by SSA PI funding supporting the CIL and Traumatic Brain Injury Demonstration grant. 

The Office for Aging Services (OAS) of the Division for Community Living of the Department for Aging and Rehabilitative Services (DARS) contracts with 25 Area Agencies on Aging (AAAs) and other service providers throughout the Commonwealth to provide an array of services to support older Virginians and their caregivers. Also included in this Service Area are the agency’s directed appropriations including: Mountain Empire Older Citizens, Inc., Jewish Social Service Agency, Birmingham Green, and Senior  Navigator.

This service area aligns with DARS' mission to improve the employment, quality of life, security, and independence of older Virginians, Virginians with disabilities, and their families.

Authority

Code of Virginia §51.5-134-§51.5-143 Services for Older Virginians

Services include: Communication Referral and Information and Assistance, Adult Day Care, Options Counseling, Personal Care, Homemaker, Care Coordination, Checking (Reassurance), Chore, Disease Prevention & Health Promotion,  Emergency, Employment, Senior Cool Care, Legal Assistance, Money Management, Outreach and Public Information / Education, Residential Repair & Renovation, Respite Care, Socialization & Recreation, Transportation, the Virginia Insurance Counseling & Assistance Program (VICAP), Virginia GrandDriver, and Volunteer Services.

Federal funding is received through the Older Americans Act and grant awards.  Statefunding remained stable.

The Department for Aging and Rehabilitative Services contracts with 25 Area Agencies on Aging (AAAs) and other service providers throughout the Commonwealth to provide an array of services, which includes: the Virginia Public Guardian and Conservator Program, and Elder Abuse Prevention.

This service area directly aligns with DARS' mission to foster the independence and well­being of older Virginians and supports their caregivers.

Authority

Code of Virginia §51.5-134-§51.5-143 Services for Older Virginians

Services include the Public Guardian and Conservator Program and Elder Abuse Prevention.

Federal funding is received through the Older Americans Act and grant awards.  State funding remained stable.

The Department for Aging and Rehabilitative Services (DARS) contracts with 25 Area Agencies on Aging (AAAs) to provide meal and nutrition services throughout the Commonwealth in congregate (group) settings. These settings provide hot and cold meals, as well as nutrition education, to older persons

This service area aligns with DARS' mission improve the employment, quality of life, security, and independence of older Virginians, Virginians with disabilities, and their families.

Authority

Code of Virginia §51.5-134-§51.5-143 Services for Older Virginians

This service provides a meal, at a nutrition site, senior center or some other congregate setting. Each meal, which complies with the Dietary Guidelines for Americans, must provide a minimum of 33 1/3% of the Dietary Reference Intakes as established by the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences. The congregate nutrition site also provides opportunities for socialization and recreation that may alleviate isolation and loneliness

Federal funding is received through the Older Americans Act. State general funds are provided through ongoing appropriations.

The Department for Aging and Rehabilitative Services (DARS), through a grant funded by the United States Department of Agriculture, works with several Area Agencies on Aging (AAAs) to administer the Senior Farmers' Market Nutrition Program and the WIC Farmers’ Market Nutrition Program

This service area aligns with DARS' mission to foster the independence and well­being of older Virginians and supports their caregivers.

Authority

Code of Virginia §51.5-134-§51.5-143 Services for Older Virginians

Older adults living in poverty often struggle to balance paying for shelter, food, and medical needs ­ including prescription drugs. Often nutrition is neglected because of the cost or inability of these individuals to care for their own needs due to physical frailty, health issues, such as depression, or cognitive impairments.  The Seniors Farmers’ Market Nutrition Program provides access to low income ­older individuals to fresh Virginia grown fruits and vegetables when in season. Office of Aging Services (OAS) issues coupons to participating AAAs to give to seniors that can be redeemed for fresh Virginia grown fruits and vegetables at local farmer’s markets. Seniors benefit from eating fresh fruits and vegetables and nutrition education. Local farmers benefit from the purchases made by seniors.

Federal funds are received through a grant from the U.S. Department of Agriculture Food Nutrition Service program to support Seniors Farmer’s and WIC Farmer’s market programs

The Department for Aging and Rehabilitative Services (DARS) contracts with 25 Area Agencies on Aging (AAAs) to provide meal and nutrition services throughout the Commonwealth to older adults in their homes. These meals include hot and cold meals, as well as nutrition education, to older individuals. The delivered meal also provides an opportunity for someone to check on the well-being of the individual.

This service area aligns with DARS' mission to foster the independence and well­being of older Virginians and supports their caregivers.

Authority

Code of Virginia §51.5-134-§51.5-143 Services for Older Virginians

.

This service provides a meal at the individual's place of residence. The meal must comply with the Dietary Guidelines for Americans, providing a minimum of 33 1/3% of the Dietary Reference Intakes, as established by the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences. The individual must be homebound and unable to leave home to attend regular social activities such as a senior center or congregate nutrition site.

Federal funding is received through the Older Americans Act. State general funds are provided through ongoing appropriations.

This service area, in partnership with the Social Security Administration (SSA), processes claims filed by citizens of the Commonwealth of Virginia who have applied for disability benefits under Title II (Disability Insurance), Title XVI (Supplemental Security Income), and Title XIX (Medicaid disability) of the Social Security Act. These evaluations result in the adjudication or "determination" of claims at the initial claims stage, at the continuing disability review stage, and at other appellate points in the disability adjudicative process.

This service area aligns with DARS’ mission of providing services to individuals with disabilities to help them live independently by ensuring accurate, timely, and efficient determinations of eligibility for disability benefits.

 Authority

Social Security Act - Sections 221(a) and 1633

20 C.F.R. Subpart P, Sec. 404.1502 and 404.1503 and Subpart Q, and Subpart I, Sec. 416.902, 416.903 and Subpart J

TITLE II AND TITLE XVI DISABILITY DETERMINATIONS: The primary mission of the DDS is to provide residents of the Commonwealth of Virginia with accurate and timely disability determinations. Citizens of the Commonwealth applying for Title II and Title XVI disability benefits under the Social Security Act have a right to expect an accurate decision on their claim.

TITLE XIX MEDICAID DISABILITY DETERMINATIONS: Accurate and timely disability determinations for Medicaid applicants in the Commonwealth of Virginia are also critical. Citizens of the Commonwealth applying for Title XIX disability benefits under Medicaid have a right to expect an accurate decision on their claim.

TRAINING DEVELOPMENT: Outreach efforts throughout the local communities to educate citizens and advocates about the disability program. Incorporate new training technology into the training program to use with staff and external customers. A major segment of this initiative includes outreach and training within the medical/psychological/educational community about DDS informational needs. These efforts provide sources in the community with the tools necessary to correspond and submit information to the DDS electronically. A more efficient process facilitates increased accuracy and timeliness­ to serve the citizens of the Commonwealth of  Virginia.

COMPUTER SYSTEM UPGRADES: Implementing continuous enhancements to the SSA’s electronic case processing system allowing the DDS to enhance adjudicating disability claims in an electronic environment more quickly and efficiently. SSA is currently in the process of developing innovative ways to meet the challenge of increasing workloads. A single source Disability Case Processing System (DCPS) for all DDSs and other Social Security components was rolled out to Virginia in 2017..  The DDS completed training of all offices in 2021.  However, the DDS still has a minimum number of cases still pending in the old system.

CONSTITUENT CONCERNS: Provide information and direction to individuals seeking assistance as it relates to the Social Security Disability Program.  Act as a liaison for constituents with various governmental agencies to assist them in getting answers to their inquiries. Conduct outreach programs to inform and aid residents of Virginia of their rights as they relate to the Social Security Disability Program.

Social Security Disability Determination's funding comes from federal funds (97%) and general funds (2.7%) and less than half a percent from indirect cost funds recovered from federal grants. The general funds are allocated to Medicaid eligibility determinations and comprise 50% of Medicaid’s funding.

The Office for Aging Services (OAS) of the Division for Community Living of the Department for Aging and Rehabilitative Services (DARS) contracts with 25 Area Agencies on Aging (AAAs) and other service providers throughout the Commonwealth to provide an array of services to support older Virginians and their caregivers.

This service area aligns with DARS' mission to improve the employment, quality of life, security, and independence of older Virginians, Virginians with disabilities, and their families.

Authority

Code of Virginia §51.5-134-§51.5-143 Services for Older Virginians

Services include: Communication, Referral, and Information and Assistance, Adult Day Care, Options Counseling, Personal Care, Homemaker, Care Coordination, Checking (Reassurance), Chore, Disease Prevention & Health Promotion,  Emergency, Employment, Senior Cool Care, Legal Assistance, Money Management, Outreach and Public Information / Education, Residential Repair & Renovation, Respite Care, Socialization & Recreation, Transportation, the Virginia Insurance Counseling & Assistance Program (VICAP), Virginia GrandDriver, and Volunteer Services.

Federal funding is primarily provided by the Administration for Community Living grants, through the Administration on Aging, and other federal funding grants.  State funding remains stable, with a slight increase due internal reorganization of divisional responsibilities. The nongeneral fund change is due to administrative transfer with no impact on overall funding.

This service area prioritizes efforts to protect older adults and persons with disabilities from abuse, neglect, and exploitation. This area also provides services to support independence and self-determination and to avoid or delay placement in more restrictive and costly institutional care.

The Department for Aging and Rehabilitative Services (DARS), Adult Protective Services (APS) Division provides oversight to three programs: APS; Adult Services (AS), which includes home-based services, screenings for long-term care services and supports, annual guardianship report reviews, and assessments for assisted living facility (ALF), adult foster care (AFC), or supportive housing (SH); and eligibility determination for Auxiliary Grant (AG).  One hundred twenty (120) local departments of social services (LDSS) are responsible for eligibility determination and service provision of these programs.

DARS helps sustain and increase independence and self-sufficiency of older adults and people with disabilities and enhance the safety and security of vulnerable adults by:

• preventing and intervening to stop abuse, neglect, and exploitation of vulnerable adults


• supporting adults who wish to remain in their home setting for as long as possible; and


• ensuring certain aged, blind, and disabled, low-income adults have financial support to live in ALFs, AFC,  or SH.

Code of Virginia:

• § 51.5-145 – Responsibility of the Department for adult services.


• § 51.5-146 – Adult Services.


• § 51.5-148 -- Establishment of the Adult Protective Service Unit; powers and duties.


• § 63.2-1605 -- Protective services for adults by local departments.


• § 51.5-160 - Auxiliary grants program; administration of program.

Funding provided by state appropriations with an increase for state fiscal year 2020 for additional policy support to address ongoing needs of vulnerable adults.

The Long-Term Care Ombudsman Program identifies, investigates, and resolves problems and concerns on behalf of long-term care recipients in nursing homes, assisted living facilities, and in the community. Working statewide on behalf of recipients to help them understand and exercise their rights, access benefits, and make informed choices, the Office of the State Long-Term Care Ombudsman staff and its representatives at the local level ensure critical protections for the health, safety, welfare, and rights of vulnerable Virginians.  The Program monitors and makes recommendations regarding laws, policies, and regulations affecting long-term care recipients and works collaboratively with partner agencies to improve quality of care and quality of life for older Virginians and those with disabilities.  In recent years, the Program has expanded its role to serve as the beneficiary support system for Medicaid managed care (CCC Plus).  

This service area aligns with DARS mission to foster the independence and well-being of older Virginians and persons with disabilities.  It provides critical services that align with the agency’s strategic goals of enhancing the safety and security of vulnerable adults, and promoting and protecting the rights of older adults and people with disabilities.  

Authority

Older Americans Act - Title VII, Chapter 2, Sections 711-712

45 CFR Parts 1321 and 1324

Code of Virginia §51.5-139-142

Investigation, advocacy, education, and program oversight

COMPLAINT INVESTIGATION and RESOLUTION

The primary mission of the  Ombudsman Program is to investigate and resolve complaints on behalf of long-term care recipients that reside in nursing homes, assisted living facilities, or the community with the help of long-term services and supports.  A specific component under this role is the Program’s work in providing the beneficiaries support system under Medicaid managed care (CCC Plus, which transitions in SFY 2023 to Cardinal Care).   The Program must ensure timely access to its services for all long-term care recipients and provides extensive information counseling/support to clients/consumers to help them understand and exercise their rights and access benefits, make informed decisions about long-term care, and resolve problems. 

 EDUCATION

Program staff/representatives provide significant education and outreach, including community education (regarding long-term care options, regulatory protections and residents’ rights) and facility staff training on such topics as elder abuse and neglect, person-centered care principles, residents’ rights. In addition, program representatives provide training/support for resident and family councils, community groups, and partner agencies.

 ACCESS

The program’s local representatives regularly visit long-term care facilities to promote access for residents to the program’s services and to provide consultations as well as direct investigations/interventions with residents, families, and facility staff with regard to resolving problems and improving care. The OSLTCO works closely with partners at the Department of Medical Assistance Services (DMAS) on development of communications/ informational resources, outreach efforts, etc. to ensure that Medicaid recipients are aware of, and can easily access, Beneficiary Support Services provided through our Medicaid Managed Care Advocate unit.    

 PROGRAM OVERSIGHT AND TRAINING

The Office of the State Long-Term Care Ombudsman provides training, technical assistance, monitoring, and support to designated representatives of the program who work out of host agencies across the state.  Delivery of ongoing high quality training is critical to ensuring program consistency and integrity.

 SYSTEMS ADVOCACY

Per its federal and state mandates, the Office monitors and makes recommendations regarding laws, policies, and regulations that affect long-term care recipients.  Program staff participate in committees, task forces, and work groups to provide input, recommendations regarding long-term care issues.  The Program works with a wide array of stakeholder groups, resident and family councils, and partner agencies to raise awareness of long-term care issues, support residents’ rights, and promote improved care and services.

Funding for this program increased in state fiscal year 2023 to support Ombudsman programs. 

No Wrong Door (NWD) is a statewide initiative, designed to help people navigate the complex system of public and private long-term services and supports. As a network of public and private partners, NWD helps streamline access to long-term services and supports using person-centered practices. The System allows providers and individuals to gain access to an array of home and community based services through a collaborative web-based platform, integrating an individual’s unique needs to a live search engine of local to statewide services and supports. The training for person-centered options counseling, partner certification and technology are standardized statewide while local partners vary. CRIA (Communication, Referral, Information and Assistance) is the electronic tool powered real-time, within the No Wrong Door System, allowing partners to make automated referrals back and forth, securely share information (with consent), track progress of an individual over time, and run analytical and statistical reports of client-level, agency-level, and community-level progress. The CRIA tool supports fluid life transitions among community based settings, such as hospital to home, through automated processes historically accomplished by phone, fax or email. CRIA allows a client record to accurately develop over time, with input from multiple partners, providing an up-to-the-minute dynamic view of an individual’s needs, preferences, and circumstances. A comprehensive set of consent requirements, security documents, utilization and partnership agreements, and standardized protocols govern use of the technology tools and access to individual-level data. Consumers are able to utilize an electronic tool to self-refer to services and supports called NWD Direct Connect.  This electronic, self directed tool is available from public facing websites including: Virginia Easy Access and VirginiaNavigator’s suite of websites (DisAbilityNavigator, SeniorNavigator, and VeteransNavigator) and can be accessed 24/7.

This service area aligns with DARS mission to collaborate with community partners, provides and advocates for resources and services to improve quality of life and independence of older Virginians, Virginians with disabilities, and their families. NWD Virginia works to provide a high-quality, sustainable, person-centered, single statewide NWD system of long-term services and supports. No Wrong Door works to support individuals of all ages and disabilities in achieving their unique goals for community living; streamline access to community supports; and promote efficiencies.

Pursuant to Section 51.5-135(6), the Area Agency on Aging is designated as the Lead Agency in each respective service area for No Wrong Door, and responsible for leading its community toward achievement of the NWD Four Elements, as defined in the Contract Section 4.1 and in the Administration for Community Living Resource, Key Elements of  a NWD System of Access to LTSS for All Populations and Payers.

The four primary functions of a NWD statewide System include the following four elements: https://nwd.acl.gov/pdf/NWD-National-Elements.pdf

• State Governance and Administration


• Public Outreach and Coordination with Key Referral Sources


• Person-Centered Options Counseling (PC OC); and


• Streamlined Eligibility for Public Programs

 State Governance and Administration

• Uses a process for ensuring ongoing and meaningful involvement of key stakeholders, including consumers and their families in implementation of NWD System


• Responsible for overseeing agencies and organizations playing role in carrying out local NWD functions, including Person-Centered Options Counseling and Streamlined Eligibility


• Uses defined measures and business process for collecting information needed by entities in the NWD System to effectively manage, evaluate and continually improve performance of NWD System

 Public Outreach and Coordination with Key Referral Sources

• Proactively engages in education to ensure individuals are aware of NWD System as a visible and trusted source of information and supports for LTSS

 Person Centered Options Counseling

• Uses NWD System to implement person-centered planning statewide as part of a strategy for making its overall LTSS system more consumer-driven


• Uses NWD System to implement person-centered planning statewide as part of a strategy for making its overall LTSS system more consumer-driven


• Person Centered Options Counseling includes follow-up to ensure individuals are receiving services and supports needed

 Streamlined Eligibility

• Leverages NWD Person-Centered Options Counseling staff and information to facilitate streamline access to LTSS


• Maintains statewide website(s) to ensure information is accurate, timely and accessible.

Funding is primarily made up of federal grants from Administration for Community Living and state funding has remained.  The nongeneral fund increase in state fiscal year 2020 is an administrative adjustment with no impact on funding.

This service area provides management, administrative support and technical assistance to functional programs of the Department for Aging and Rehabilitative Services (DARS). In addition, via memoranda of agreement (MOA), much of this service area provides administrative support and technical assistance to the Disability Services Agencies (DSA), which include the Wilson Workforce and Rehabilitation Center, Department for the Blind and Vision Impaired, the Virginia Rehabilitation Center for the Blind and Vision Impaired, the Department for the Deaf and Hard of Hearing, and the Virginia Board for People with Disabilities. The MOA also describes technology support provided to the Assistive Technology Loan Fund Authority (ATLFA).

This service area directly aligns with DARS’ mission by providing management, administrative support and technical assistance for policy, personnel, technology, financial management, program evaluation and research and internal audit efforts to the program areas that provide and advocate for resources and services to improve the employment, quality of life, security, and independence of older Virginians, Virginians with disabilities, and their families.

Authority

Code of Virginia § 51.5-117 Declaration of purpose; Department for Aging and Rehabilitative Services created

Administrative Support Services coordinates and provides oversight for integration of activities and initiatives across all divisions and service areas as well as other state and local partners.

Human Resource Management Services (HR provides quality consultation and services to foster a positive work environment for DARS leadership and staff to fulfill its mission of providing high quality services to senior Virginians and persons with disabilities.  HR service areas include but is not limited to policy compliance, employee relations, talent acquisition, classification and compensation, benefits administration, talent development, employee processing, and employment file maintenance.  Significant changes to leave accounting, timekeeping, and attendance and leave tracking systems occurred in the spring of 2022.

 Financial Management Services provides financial services including budget, grants management, general accounting, financial reports, cash management, asset and lease tracking/management, purchasing and contracts, mail distribution services, and motor fleet and central supply management.

 Information Technology Services (IS) provides computer applications development and support, web services, and computer operations. Both in partnership with Virginia Information Technologies Agency (VITA) and the new vendor SAIC and independently for education, video teleconferencing and client related technology services, IS provides systems engineering services including voice and data communications networks, and hardware and computer support services. IS also collaborates with other agencies where possible to maximize staff, computer and financial resources.  They participate in planning and implementation of the Secretary of Health and Human Resources (SHHR) Information Technology Strategic Plan. An IT strategic plan for DARS and the DSA is developed about every 2 years.

Risk Management provides health and safety information to staff and consumers, tracks accidents, manages emergency response planning and continuity of operations planning (COOP), and assists Human Resources (HR) with the Workman’s Compensation and Return to Work programs. WWRC staff coordinates emergency response planning and COOP statewide.  Agency Risk Managers also collaborate on computer disaster recovery planning.

The Policy and Legislative Affairs Division provides legislative support, policy and regulatory development, support for several boards and commissions, as well as grants development. . The Division’s Program and Analytics unit provides management analysis and reporting including program evaluation, consumer satisfaction, and quality assurance.

Internal Audit helps business units ensure their operational, financial, and IT (Security) processes are sound by providing an indication of whether business units comply with relevant standards and / or regulations. This is accomplished through Internal Audit providing independent, objective assurance and consulting services designed to evaluate and improve the effectiveness of risk management, control, and governance processes as they relate to the Agency’s mission. In addition, Internal Audit investigates potential fraud, waste, and abuse at the Agency and at grant sub recipients when requested by the Office of the State Inspector General or by Agency Management.

The Administrative and Support Services' funding comes from federal funds (15%), general funds (2%), indirect cost funds recovered from federal grants (71%), and special funds (12%).

Administrative Support Services coordinates and provides oversight for the integration of activities and initiatives across all divisions and service areas as well as other state and local partners.

Human Resource Management Services (HR) provides quality consultation and services to foster a positive work environment for DARS leadership and staff to fulfill its mission of providing high quality services to senior Virginians and persons with disabilities.  HR service areas include but is not limited to policy compliance, employee relations, talent acquisition, classification and compensation, benefits administration, talent development, employee processing, and employment file maintenance.  Significant changes to leave accounting, timekeeping, and attendance and leave tracking systems occurred in the spring of 2022Financial Management Services provides financial services including budget, grants management, general accounting, financial reports, cash management, asset and lease tracking/management, purchasing and contracts, mail distribution services, and motor fleet and central supply management.  Cardinal Human Capital Management implementation occurred in 2022.

General Management and Direction Services are necessary for the administrative functions of the agency. Without these services other core functions of the agency would not be able to be completed.

This service area directly aligns with DARS’ mission by providing management, administrative support and technical assistance  to the program areas that provide and advocate for resources and services to improve the employment, quality of life, security, and independence of older Virginians, Virginians with disabilities, and their families.

Essential services such as administrative support, financial management and human resources are included.

Funding derived primarily from indirect cost recoveries on federal grants, memorandum of understanding revenue for back office responsibilities of the Disability Service Agencies and general fund revenue supporting statewide technology systems.

This service area provides Information Technology (IT) applications development and IT infrastructure support services to functional programs of the Department for Aging and Rehabilitative Services (DARS). In addition, via a memoranda of agreement (MOA), the Information Technology Division provides  the same services to the Disability Services Agencies (DSA), which include the Wilson Workforce and Rehabilitation Center (WWRC), Department for the Blind and Vision Impaired (DBVI), the Virginia Rehabilitation Center for the Blind and Vision Impaired (VRCBVI), the Department for the Deaf and Hard of Hearing (VDDHH), and the Virginia Board for People with Disabilities (VBPD)and the Assistive Technology Loan Fund Authority (ATLFA).

This service area directly aligns with DARS’ mission by providing Information Technology (IT) applications development and IT infrastructure support services to the functional program areas that provide and advocate for resources and services to improve the employment, quality of life, security, and independence of older Virginians, Virginians with disabilities, and their families.

Authority

Code of Virginia § 51.5-117 Declaration of purpose; Department for Aging and Rehabilitative Services created

DARS IT provides support to all DSA locations in the following areas: applications and systems development, website services, video teleconferencing, client related technology services, voice, data, and wireless networks, and network and computer hardware services.

Funding derived primarily from indirect cost recoveries on federal grants and memorandum of understanding revenue for back office responsibilities of the Disability Service.

Planning and evaluation services, including internal audit helps business units ensure their operational, financial, and IT (Security) processes are sound by providing an indication of whether business units comply with relevant standards and / or regulations and are complying or meeting recognized standards and benchmarks.   Internal audit provides independent, objective assurance and consulting services designed to evaluate and improve the effectiveness of risk management, control, and governance processes as they relate to the Agency’s mission.  In addition, Internal Audit investigates potential fraud, waste, and abuse at the Agency and at grant sub recipients when requested by the Office of the State Inspector General or by Agency Management.

This service area directly aligns with DARS’ mission by providing management, administrative support and technical assistance  to the program areas that provide and advocate for resources and services to improve the employment, quality of life, security, and independence of older Virginians, Virginians with disabilities, and their families

Funding derived primarily from indirect cost recoveries on federal grants.