I oppose the proposed elimination of Services Facilitation.

Consumer-directed services are intended to give individuals with disabilities and their families choice and control over the supports that help them live safely and successfully in their homes and communities. A Services Facilitator is not merely someone who completes paperwork or assessments. For many families, that person is a trusted resource who understands the individual’s needs, attendants, Employer of Record, circumstances, and the challenges of navigating Medicaid.

I am particularly concerned about replacing the existing network of Services Facilitation providers with Support Brokers working through Fiscal-Employer Agents. Consumer direction should mean more choices for individuals, not fewer. Families should not be forced to abandon a qualified Services Facilitator they know and trust simply because the program is restructured. Continuity of care matters, especially for people whose daily lives depend on these services.

Provider choice also creates accountability. When individuals can choose among qualified providers, they have alternatives if a provider is unresponsive, provides poor service, has personality conflicts, or does not meet their needs. Families also benefit from having an independent and trusted person to help answer questions, resolve problems, understand requirements, and navigate the system.

Before eliminating an established service, Virginia should demonstrate that the replacement will provide equal or better service, adequate staffing, reasonable caseloads, timely responses, continuity of care, knowledgeable support, and meaningful accountability.

I support appropriate oversight of Medicaid services. If particular Services Facilitation providers fail to meet requirements, Virginia should strengthen standards, improve training, impose accountability measures, and remove consistently deficient providers. Problems with individual providers should not justify eliminating an entire model or taking provider choice away from every family.

Virginia can improve oversight while preserving choice. It can introduce Support Brokers without forcing families to abandon their existing Services Facilitators. It can modernize consumer-directed services without making them less consumer-directed.

I respectfully ask DMAS and Virginia policymakers to preserve Services Facilitation as an option and protect the right of individuals and families to choose among qualified providers. At minimum, existing qualified Services Facilitators and providers should have a meaningful pathway to continue serving the individuals and families who want to remain with them.

The consumer should have a choice. Please do not take that choice away.