Yesterday I was reading the report that was posted 9/12/19 on the state townhall site about pending legislation. I found many of their conclusions alarming and indicative of their complete misunderstanding of how consumer directed services work. One the state is admitting they know EVV will close down many of the 600 small businesses that run agency directed care. The state assumes bigger business will pick up the slack; what they aren't taking into consideration is attendant services are already such a low profit margin and staff is already so difficult to get most likely no one is going to pick up these businesses. Secondly, the assumption that just because the fiscal agents paid for EVV services that the whole issue with consumer directed services is settled is extremely wrong. The way consumer directed services work is something called the employer of record EOR must hire, fire, schedule the attendants. The pay is coordinated through the fiscal agent. Numerous EOR are having attendants quit over EVV. Celltrak the largest smart device application will only let one attendant for each device. They cannot share the free Medicaid phone even if everyone was able to get it, like DMAS is claiming they can. Numerous people can't get the free Medicaid phone. CMS sad consumers should not have to purchase a device or service to access consumer directed care under their guidance for EVV. This is resulting in numerous people being able to not have staff. Attendant care is by far the cheapest care option. Nursing homes, ICFs, group homes, sponsored residential homes, in home support all cost thousands and thousands of dollars more. The implementation of EVV will cause people to place loved ones in these facilities or use higher cost services such as nursing or inhome support. Inhome support is $25.61 an hour... attendant care is $9.40. The millions the economic impact report says it will save by not being fined the 1% EVV fine, will be lost when numerous people are placed in facilities because of the loss of attendant care services due to EVV. It would be really interesting if Virginia would track the number of people who stop using attendant care and end up in higher cost placements. Again Virginia still has time to put in for a good faith effort waiver and exempt live in providers. The line we are being fed that Virginia can't file the good faith waiver is incorrect because this was in the 2017 budget too and didn't happen. Also, not that anyone seems to care, Virginia didn't inform the consumers and EORs of the upcoming EVV change during stakeholder meetings in 2018. The fiscal agents have no idea what the tens of thousands of individual consumers go through to hire people for a no benefits job at low pay. They do not speak for us. The elected official would have heard from many more of use when this started if we were aware of what was going to happen and that our loved ones will inadvertently be institutionalized over EVV so some tech companies could make some money