Thank you for inviting any and all to offer advice and solid "real-life" information to help guide your decisions on how to best use the ARPA funding.

As you are well aware, the COVID-19 crisis has only exacerbated an already ongoing (for YEARS) crisis situation in the Commonwealth of Virginia in regards to a shortage of qualified attendant care workers for people with Developmental Disabilities, the elderly and their families.  Having personally experienced (and still am) this need and frustration for many years ( I have a son, age 42 with a genetic developmental disability who still lives with my husband and I ), I can personally attest to the stress, frustration, worry, burn-out, and dire need of trying to find appropriate and qualified individuals to help us care for our son so that we could be functional as a family unit.  At times, through the years, we had a few individuals through agencies that were appropriate but more who were NOT. 

We have not been able to find anyone for the past five years, to even help part-time, neither through agencies nor soliciting on our own.  It is very understandable. The low wages tells the story because the wage has not been raised as the inflation rates have constantly risen through the years.  The last few caretakers/clinicians that we had, who loved working with our son and being a part of our family, shared that they just couldn't afford to work any longer at such low wages, no reimbursement for mileage and no benefits.

Our son's needs are mild compared to most others with disabilities that we know. He is upbeat, fun to be with, no behavior issues and ambulatory and can do a lot for himself.  Everyone who has worked with him said he and our family are such a joy to work with.  If WE cannot find people to work for us now, imagine how much MORE DIFFICULT it must be for those families who have adult children with much higher needs and are medically fragile!!  "Those families" are our friends!

The wage rate desperately needs to be raised again especially for those attendants/clinicians who are hired under Consumer-Directed and In-Home Residential Services.  In addition, training, support and benefits need to be brought up to a competitive level.  We need a pool of trained individuals to respond to families for the care of the adult child when the parents themselves have a medical emergency or emergency of other family members.  We and our friends who are aging have already had these terribly stressful experiences and could not be with our spouses in the ER when they needed us because of not having someone to stay with our child.

This crisis is only getting progressively worse as the years go by.  The ARPA funding truly could help this situation create a new way for Virginia to serve those who cannot help themselves and their overburdened families.  Some states do better than others.  Let's try to model after some of those who choose to do better for their special citizens.

I have read many of the other comments posted here and I agree wholeheartedly with every one of them.  They speak the truth to what the needs are here in Virginia. 

My hope is that you take these comments seriously as you make these decisions and how to best utilize this funding.  

Thank you for your time to read and contemplate all of our comments here in this forum. I wish you the best in trying to prioritize so many needs.