I am the parent of a child who receives consumer-directed services through Virginia’s CCC Plus Waiver. I am very concerned about the proposal to eliminate independent Services Facilitation and replace it with the statewide Support Broker model.

Our family has firsthand experience with why choice in Services Facilitation matters. We previously worked with a service facilitation provider that was not meeting our family’s needs. Because the current system allows us to choose our provider, we were able to leave that company and select another one. We now have a Service Facilitator we trust who communicates with us, understands our child’s needs, and provides accountability when problems arise.

The proposed system takes that choice away.

I am especially concerned that the Support Broker will be involved in assessing needs, developing the Plan of Care, and submitting documentation used to request consumer-directed services, while the managed care organization ultimately determines what services are authorized.

Families need someone in this process who is truly independent and whose role is to accurately represent the individual’s needs. Centralizing these functions under a contracted Support Broker system reduces that independence and creates legitimate concerns about accountability.

If a Support Broker fails to adequately document my child’s needs, minimizes those needs, fails to request appropriate hours, or simply is not a good fit for our family, what meaningful ability will we have to choose someone else? Who independently advocates for the member when the family disagrees with the Support Broker or the managed care organization?

Consumer direction should increase the individual’s and family’s control over care, not reduce it.

I strongly urge DMAS to preserve independent Services Facilitation or, at minimum, allow families the choice between an independent Service Facilitator and the proposed Support Broker model. Families should also have a clear right to change Support Brokers and access independent advocacy when disputes arise.

Please do not remove a system of choice and independent accountability without providing families an equally strong protection in its place.