The Medicaid waiver is not portable, so those who have it cannot go to another state for services without going to the end of a hopelessly long waitlist there.  We are trapped in a despair created by a politics which considers us an ignorable minority of need.  This problem is readily soluble with rule changes and the insistence that the loving philosophy of the state human services boards be put into practice by expanding waiver slots and funding caregivers at a wage commensurate with their responsibilities.  This could be done now by using ARPA funds to value our direct service providers in Virginia.