We respectfully request the 100 % FMAP For Medicaid HCBS be used for a rate increase for Medicaid Agency Directed Personal Care Providers as this waiver is not adequately funded to care foe the Commonwealth's most vulnerable population Agency Directed Personal Care Providers have already incurred the increase cost associated w/ Covid -19 and the loss of revenue and continued to be impacted by the minimum wage incrase which took effect May 1, 2021. Agency Directed providers are facing an additionally unfunded minimum wage increase January 1, 2022 which will further jeopardize our ability to continue to provide crucial community home based personal care at a tremendous cost saving to the Commonwealth over the same recipients care in a skilled nursing or rehab facility,

  In order to continue providing this invaluable home based community service to the Commonwealth's most vulnerable population , We recommend Virginia State policy makers:

 1.  Pursue a strategy which will maximize reimbursement for Personal Care Providers allowing them to provide personal care to Medicaid recipients in their home , train and hire staff to meet the need in localities.

2.  The rate increase should be retro -active to April 1, 2021

3. The directed payments provision of 42 C.F.R. &438.6 (c) should be invoked to ensure increased funds are indeed distributed to Managed Care and allocated to Personal care Providers.

Sincerely.

Tina Baker  Agency Manager -AmeriCare Plus - Alleghany