The Problem
Council research conducted in 2021 found that the Virginia Department of Health was behind in certifying approximately one-third of intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs). Certification is an important mechanism for ensuring compliance with Medicaid requirements related to health, safety, and quality of care. The Council’s research also identified process challenges that limited the timeliness and effectiveness of the certification system.
Action
Since 2021, the Council has continued to analyze certification data and share its findings with policymakers, advocates, state agencies, and other stakeholders. The Council engaged in discussions with key organizations, including the state’s Protection and Advocacy agency, to increase awareness of the findings and potential approaches for addressing identified challenges. The Council also identified a recommendation regarding improved access to certification data that was reflected in a 2022 legislative proposal and published a policy brief in 2025 providing updated information on the certification backlog and related trends.
Results
The Council’s research and dissemination efforts increased awareness among key stakeholders of challenges within the ICF/IID certification process and opportunities for improvement. The certification backlog declined from affecting 95% of ICF/IIDs in February 2025 to 56% in March 2026. In addition, new leadership at the Virginia Department of Health has identified this issue as an area of focus and is providing periodic progress updates. The Council continues to monitor developments and share information to support informed decision-making.
Unique Role of the Council
The Council played a unique role by identifying and documenting systemic challenges in Virginia’s ICF/IID certification process through independent research and data analysis. By collecting and disseminating information, publishing policy recommendations, and fostering dialogue among stakeholders, the Council helped build a stronger evidence base for understanding the issue and informing consideration of potential system improvements.