I am writing as a Developmental Disabilities Support Coordinator serving individuals and families who rely on Virginia's Medicaid Home and Community-Based Services Waivers. I respectfully urge DMAS to carefully consider the potential impact of replacing the current Services Facilitation (SF) model with a Support Brokerage model.

In my role, I work closely with individuals who use Consumer-Directed services to remain safely in their homes and communities. I have witnessed firsthand the critical role that Services Facilitators play in helping individuals and families navigate a complex system of regulations, employer responsibilities, and service requirements. Services Facilitators provide ongoing guidance that many families depend upon to successfully manage consumer-directed services.

Many of the individuals and families I support face significant challenges, including intellectual and developmental disabilities, behavioral health needs, medical complexities, limited natural supports, and difficulties understanding the requirements associated with employing and managing attendants. Services Facilitators serve as trusted partners who help families understand their responsibilities, maintain compliance with waiver requirements, address staffing challenges, and prevent disruptions in essential supports.

The proposed change raises concerns that individuals and families may experience a reduction in the level of personalized assistance currently available through Services Facilitation. Families frequently report that their Services Facilitator is often the first person they call when questions arise regarding attendant management, service authorizations, documentation requirements, or accessing additional resources. This relationship is built over time and often provides families with stability and confidence in navigating the waiver system.

I am also concerned about the potential impact on participant choice. The ability to choose a Services Facilitation provider allows individuals and families to select an organization and professional who best understand their needs and circumstances. Preserving choice supports person-centered practices and promotes accountability and quality among providers.

As Virginia continues to expand opportunities for individuals with disabilities to live and participate in their communities, it is essential that any changes to the support structure strengthen, rather than diminish, the assistance available to families. Any transition away from the current model should be approached cautiously and with substantial input from waiver participants, family caregivers, Services Facilitators, Support Coordinators, and provider organizations.

I encourage DMAS to thoroughly evaluate the potential consequences of this proposal and ensure that individuals and families do not lose access to the guidance, advocacy, and individualized support that Services Facilitators currently provide. The voices of individuals with disabilities and their families should remain central to any decision affecting these vital services.

Thank you for the opportunity to provide feedback and for your continued commitment to supporting Virgini