To the Virginia Department of Medical Assistance Services (DMAS):

I am writing as a resident of Rockingham County and a user/representative of Medicaid Consumer-Directed Services. I would like to formally express my concerns regarding the proposal to eliminate independent Service Facilitation (SF) and transition these duties to a centralized Support Broker model managed by the fiscal agents.

My primary concerns and questions regarding this change are the following:

1. Loss of Independent Advocacy: I am deeply concerned that because the new Support Brokers will be directly employed by the fiscal agents (such as CDCN or PPL), they will lose the independence required to truly advocate for the user's best interests within the system.

2. Impact on Continuity of Care: In Rockingham County, we rely on service facilitators who know our families and our specific needs deeply. The mandatory transition starting in March 2027 risks disrupting established relationships of trust and care.

3. Lack of Consumer Choice: A cornerstone of the consumer-directed model is the right to choose. Consolidating these services entirely under the fiscal agencies drastically reduces our freedom to select the professional who best fits our home and situation.

I respectfully request that DMAS reconsider this structure or implement strict safeguards to ensure that families in our region continue to receive personalized, unbiased, and high-quality support.