Please Preserve the Live In Attendant Exemption for Virginia Families

To the Virginia Department of Medical Assistance Services:

I am writing as the mother of a child with significant disabilities and as a Virginia family directly affected by the proposed changes involving the live in attendant exemption for Electronic Visit Verification.

My family currently relies on a live in attendant. Our attendant is my retired sister in law, who lives in our home and provides care and support for our son. This arrangement is not simply convenient for our family. It provides consistency, stability, familiarity, and dependable care for a child who requires significant support.

Having a trusted family member living in our home and serving as his attendant allows our son to receive care from someone who knows him, understands his communication, recognizes his needs and behaviors, and is familiar with his daily routines. That knowledge cannot be reduced to a clock in and clock out transaction.

The current live in exemption recognizes something important: when an attendant lives in the same household as the individual receiving services, caregiving does not function like a traditional workplace arrangement.

Requiring live in attendants to comply with Electronic Visit Verification requirements designed for attendants traveling into and out of a participant’s home would add an administrative requirement without improving the quality, safety, or accountability of the care our son receives.

I am particularly concerned about policies that could make it more difficult for families like mine to maintain stable attendant arrangements. Finding reliable caregivers for individuals with significant disabilities is already difficult. We are fortunate to have a retired family member who has made a substantial commitment to our son and our household. Virginia should be supporting arrangements like ours, not creating additional barriers that could discourage family members from serving as attendants.

For families caring for children and adults with disabilities, continuity of care matters. Trust matters. Familiarity matters. And the ability to maintain a caregiver who understands the individual as a whole person matters.

I respectfully ask DMAS to preserve the live in attendant exemption for EVV and carefully consider the real world impact that removing it would have on Virginia families who depend on consumer directed services.

Please do not create additional administrative burdens for families who are already doing the complicated, demanding work of ensuring that their loved ones with disabilities can live safely and successfully in their homes and communities.

Our family values Virginia’s Medicaid waiver services and the independence and flexibility they provide. We want those services strengthened, not made more difficult to use.

Thank you for considering the experiences of families like mine as you evaluate these proposed changes.

Sincerely,
Lijah Smith Nicholson
Virginia Parent and Family Caregiver