Before you cast your vote please take a minute to walk in our shoes. We did not choose these shoes they were chosen for us. Consider how your life would be impacted if your adult child was suddenly unable to live independently and you had to figure out how to make it all happen. Where would you even start? You need to figure out what agency does what, what services you need, how to find people to do the services, what are the timelines for keeping it all going. Don't forget you are probably also working. Service facilitation and hours of support are not frivolous needs. They are essentials for keeping our kids at home in a safe and loved environment, wouldn't you want that for your child?

I am writing to strongly oppose the proposed 1915(c) waiver amendments that seek to implement a 56-hour "soft cap" on consumer-directed Personal Assistance (PA) and eliminate Service Facilitation by transitioning to Support Brokers. These changes will severely threaten the health, safety, and independence of Virginia’s most vulnerable citizens.

1. Opposition to the 56-Hour Cap on Personal Assistance

Limiting care to 56 hours per week does not reflect the real, everyday needs of individuals with significant developmental disabilities. My adult son relies on these authorized hours for critical daily needs, requires, shopping, meal preparation, hygiene, dressing, laundry, medication, entertainment, transportation, emotional and behavioral support etc., and he would not be able to live in a private home with family members without the needed hours of support. He also requires constant supervision to ensure his safety. Capping his care at 56 hours a week forces him down to just 8 hours of care per day. He is able to have a part time job in the community because of his hours of support. This change would prohibit him from working, living with family and being a member of his community, he deserves all of those things. Cutting his hours to 8 hours per day leaves 16 hours every single day where he is completely unsupported and this is not safe and would lead to him having to move into an institution setting which would cost the system a lot more money and would be totally unfair to him as a young man.

Even though this is labeled a "soft cap," forcing families into a high-stakes "exception request" process creates unnecessary bureaucratic barriers, strips away independence, and will inevitably lead to institutionalization for individuals who can no longer be safely cared for at home under a standard 56-hour limit especially if at the same time you remove the support of a service facilitator who help guide us through all of these endless hoops.

2. Opposition to Eliminating Service Facilitation

The proposed elimination of Service Facilitation by May 31, 2027, is a dangerous disruption to our care system. Service Facilitators are our frontline advocates. They understand the consumer-directed model and ensure that our payroll, electronic visit verification (EVV), and service plans run smoothly. Transitioning families to an unproven "Support Brokerage" system while simultaneously cutting hours will leave families entirely unsupported. Removing  Service Facilitators completely removes our only remaining safety net.

I urge DMAS and the General Assembly to halt these amendments. Virginia should be expanding community-based care to keep individuals with developmental disabilities safe in their homes, not restricting their hours and removing the professional advocates who help them survive.