Thank you for the opportunity to submit ideas for use of the increased FMAP funding for the HCBS Waiver system. 

VA's system is bifurcated in ways that only complicate the system.

Recommend:

1. Establish a singular reimbursement rate for I/DD case management.
2. Match the Supported Living Rate to the Group Home rate. 

Increase the Waiver reimbursement rates so that providers are incentivized to:

1. Stay in business
2. Create inclusive residential waiver services rather than congregate adult residential services.
   
   

Make direct payments to DSPs to retain DSPs.