I am the parent and legal guardian of an adult son with disabilities who receives services through Virginia's Family and Individual Supports (FIS) Medicaid Waiver. I strongly oppose the proposed elimination of the current Service Facilitation model and its replacement with a Support Broker model administered through Fiscal-Employer Agents.

My opposition is based on firsthand experience, not speculation.

For years, our Service Facilitator has been an essential part of helping our family navigate an already complicated Medicaid waiver system. Our facilitator visits our home, knows my son, understands our family's needs, and is someone I can actually contact when I need assistance.

This relationship has been built on years of trust, communication, and personalized support. Our facilitator is not simply someone who handles paperwork. They help us understand requirements, resolve issues, and ensure that my son continues receiving the services he depends upon.

My greatest concern is that Virginia plans to transfer these responsibilities to organizations that already struggle to provide timely and reliable customer service.

I currently deal with Consumer Direct Care Network Virginia (CDCN), which handles the administration and payment of my son's attendants. Based on my personal experience, I have serious concerns about this organization taking on additional responsibilities currently handled by our Service Facilitator.

When I call CDCN, I frequently reach a voicemail system promising that someone will return my call. I am still waiting for a return call regarding an issue I contacted them about in April 2026. It is now October. I ultimately had to resolve the issue myself.

If an organization cannot reliably return a phone call concerning its existing responsibilities, why should families be expected to trust it with additional responsibilities that directly affect the care and services of individuals with disabilities?

This is not simply an inconvenience. When families are managing attendants, Medicaid requirements, service authorizations, and the daily needs of a loved one with disabilities, timely assistance is critical.

Under the current system, I have a Service Facilitator I can call directly, someone who knows my family's circumstances and can help us work through problems. Under the proposed system, will I be forced to leave another voicemail and hope someone eventually calls me back?

I also strongly object to taking away families' ability to choose their own Service Facilitators.

Families have different needs. Some require significantly more guidance than others. A centralized, one-size-fits-all approach cannot automatically replace the individualized relationships that families have spent years building.

Why should families who are satisfied with their Service Facilitators be forced to give them up? What problem is Virginia actually solving by eliminating a service that families rely upon?

I believe DMAS owes Virginia families clear answers to several important questions:

1. What evidence demonstrates that the proposed Support Broker model will provide better service than the existing Service Facilitation model?
2. How will DMAS guarantee that families can reach a knowledgeable person when assistance is needed instead of being directed to voicemail?
3. What response-time requirements and accountability measures will be imposed on these organizations?
4. How will continuity of care and established relationships be protected?
5. Why aren't families being given the option to retain their existing Service Facilitators?

Families like mine already carry enormous responsibilities. We coordinate care, manage attendants, navigate Medicaid requirements, and advocate constantly to ensure our loved ones receive the services necessary to remain safely in their homes and communities.

We should not have to fight the administrative system simply to maintain the services our loved ones depend upon.

I understand that Virginia may be seeking administrative efficiencies or cost savings. However, those objectives should never come at the expense of accessibility, accountability, and personalized support for individuals with disabilities and their families.

Before eliminating a system that works for many families, DMAS should first demonstrate that the proposed replacement can provide equal or better accessibility, reliability, and continuity of service.

Do not eliminate a trusted support system and expect families to accept an unproven replacement without meaningful assurances or accountability.

I strongly urge DMAS and Virginia policymakers to reconsider these proposed changes, preserve independent Service Facilitation, and protect families' ability to choose the professionals who support them.

Please listen to the families who actually depend on these services. We are the ones who will live with the consequences of these decisions.

Our loved ones deserve continuity of care. Families deserve reliable, accessible support. And our voices deserve to matter.