Dear Members of the Virginia General Assembly and Kathy K.L Tran,

I am asking you to oppose HB 1495 and to reconsider the proposed changes to Virginia's consumer-directed Medicaid system, particularly the elimination of Services Facilitation.

For Virginians who rely on consumer-directed services, the ability to receive care in their own homes can make the difference between living in the community and being placed in an institutional setting. These services are not merely administrative conveniences. They are an essential part of the support structure that allows individuals with significant needs to live with greater independence, stability, and dignity.

Services Facilitators play an important role in making that system work. They provide individuals and families with a consistent point of contact who understands their circumstances and can help them navigate the complexities of Medicaid, coordinate their services, address problems, and respond when their needs change. This individualized assistance is particularly important when a person's care involves multiple requirements or when maintaining services is critical to remaining safely at home.

I am concerned that eliminating Services Facilitation and moving toward a more centralized model could weaken this support system. A process that may appear more efficient from an administrative perspective does not necessarily provide the same level of personal attention or continuity of care. The people affected by these decisions should be considered not simply as recipients of a government program, but as individuals whose ability to live safely in their communities may depend upon these services functioning properly.

There is a very real risk that making community-based care more difficult to navigate could have life changing consequences. If individuals are unable to obtain or maintain the supports they require, some may ultimately be left with institutional care as their only viable option.

That would be a serious outcome for both the individuals involved and the Commonwealth. Moving a person from their home into an institution can mean losing familiar surroundings, established routines, relationships, community involvement, and a degree of independence. For individuals who are capable of remaining safely at home with appropriate support, community-based care should be protected rather than made more difficult to access. The financial implications also deserve careful consideration. Any projected administrative savings should be weighed against the possibility that reductions in effective community-based support could result in greater reliance on institutional services. A policy that reduces administrative expenditures while increasing the number of Virginians requiring institutional care would not necessarily represent a long-term savings for taxpayers.

I recognize that Virginia must be responsible of Medicaid funding and that oversight and accountability are necessary. However, reforms should strengthen the delivery of care rather than create additional obstacles for the people who depend upon it. I urge you to consider the practical consequences of this proposal before moving forward. Please maintain a meaningful Services Facilitation option and ensure that Virginians who rely on consumer-directed care have access to individualized assistance that allows them to remain safely in their homes and communities.

The people affected by this legislation deserve a system that recognizes their individual circumstances and supports their ability to live as independently and safely as possible.

Thank you for your consideration of this important issue.

Sincerely,