56 hour soft cap for waivers is dehumanizing, goes against DMAS policy, creates poverty for families of individuals with disabilities and leads to institutionalization of people with disabilities  in Virginia. 

From DMAS website: The Family and Individual Support (FIS) Waiver provides care in the home and community rather than in an Intermediate Care Facility for Individuals with Intellectual Disability (ICF/IID) or other specialized care medical facility. 

1. The 56 hour cap does not represent the need of the individual.  

Since the member qualifies for a nursing facility and nursing facility level care, it is shocking that DMAS claims that the person only needs 56hours a week of care.  We understand that we will not get reimbursed for all 168 hours of the care we perform and our constant vigilance and constant availability (although many of other professions do). However reducing the 112 hour per week care that we offer to a 56 hour cap is shows how little DMAS really thinks about live-in caregiver. 

2. 56 hour cap  goes against DMAS policy 

According to "Chapter 122. Community Waiver Services for Individuals with Developmental Disabilities.  12VAC30-122-10. Purpose; legal authority; covered services; aggregate cost effectiveness; required individual and provider enrollment; individual costs. The Waiver Supports individuals with developmental disabilities to live integrated and engaged lives in their communities;"   BUT if you limit the hours to 56 a week, that does NOT support the individual, rather it  tells us that DMAS sees every person on the waiver in the same light. Everyone is cookie cutter same, rather than distinct individuals and distinct needs. We become standardized rather than individualized. 

3. 56 hour cap goes against the reason the waiver exists. 

Waivers are supposed to be based on individuals needs and not EORs work.  However 56 hours is covers EORs 40 hour week plus some hours for commute and shopping and does NOT reflect the needs of the individual. 

4. 56 hour cap creates poverty in Virginia. 

 56 h per week on a pay that is 13.88 per hour (with no overtime for live-ins)  comes to $777 a week, which is $38,000 a year. That is slightly below poverty line. https://www.vdh.virginia.gov/content/uploads/sites/97/2025/01/2025_FederalPovertyGuidelines.pdf

For families who are under tremendous mental, emotional and medical duress, this is an added burden.  We can not change our jobs we have our children till we, or they die. This is often the ONLY solution we have, till DMAS forced us to place our children in Group Homes. 

5. 56 hour cap will create a problem of repeated institutionalization. 

We as families are worn so thin with medical appointments, emotional stress that our children will die, will worsen, will be in constant pain that we are at a brink of quitting! How is DMAS prepared to handle thousands of individuals with disabilities who will not be cared for by their loved ones, because we simply can’t do it anymore???? What options does DMAS provide? What supports?  Rather than help family members we are being bombarded with constant new laws, new regulations, changing rules. Rather than being supported we are being punished. 

Thank you for reading my comment.