Our Voices, an organization of Southeastern Virginia self-advocates requests:  1) DMAS leverages enhanced HCBS funding available through the American Rescue Act to make significant investments in Assistive Technology to bridge gaps experienced by people with disabilities uncovered during the COVID pandemic, and 2) this funding is made directly available to people with developmental disabilities outside of the dysfunctional Medicaid waiver assistive technology funding process.

1. We ask that technology funding be made available in the following areas:

1. Smart-Home Technology helps people with developmental disabilities to live more independently in their own homes and lessens the need for support from paid staff.  This fact was made more apparent then ever as the pandemic exacerbated staffing shortages and agencies struggled to meet the needs of the people they supported.

1. 1. • Amazon/Alexa & Google Home:
        • Control of the home environment: Voice activated door opening/closing, turning on and off of lights and controlling TV functions, access to information, games and entertainment.
        • Safety:  This technology provides voice activated access to staff for people who may be at risk of falling or have limited dexterity.
        • Health: To keep track of and remind about medications.
      • Ring doorbell:
        • Safety & Control: provides security, especially for people with limited mobility, to see who is at the door before opening via voice activation.  

2. 2. Smartphones, computers and tablets make the world and personal connections accessible to people with limited mobility.  As the world went virtual during the pandemic technology helped many people with disabilities greater access than ever.
      • Facetime and other 1:1 video communication applications kept us in contact with friends and family while staying safe in our homes (communication is many times as visual as it is audible)
      • Zoom and other video conferencing applications connected us to self-advocates across the state and country and have helped us meet new people and become involved in new groups, activities & projects.  
      • Text to talk, talk to type and Dragon software (full voice control computing) and other functionality provide us the ability to fully interact with limited support or no support at all.
      • Virtual classes became the norm providing much greater access to education, personal and professional development.

3. 1. Wearable Technology is portable, convenient, and always accessible.
      • Mightier wristband: connects to an individual to healthcare professionals to help self-manage emotional episodes.
      • Smart watches: Provide for the availability of alarms and next step instructions in community, work and medical settings when integrated with compatible tablets and computers.   Note: In many  cases Apple products are necessary for this integration but unavailable due to lowest cost requirements via Medicaid waivers.  Smart watches also provide tracking and location support via GPS.

2. This funding must be made available directly to people with disabilities, outside of the existing dysfunctional process for the distribution of Medicaid funding for technology for the following reasons.
   1. The annual per person cap of $5,000 is an insufficient sum for many technology solutions.
   2. The “least expensive” mandate results in low quality solutions, requiring frequent, costly maintenance, decreasing the lifespan of technology solutions while many times not fully addressing needs.
   3. Medicaid requires the use of approved contractors. However low Medicaid rates, requirements for usage of the cheapest materials, cumbersome processes and lengthy payment cycles are a disincentive to quality contractors in this lucrative field with widespread demand.  Thus, approved contractors either do not exist or perform subpar quality work.
   4. The requirement of needs assessments are in many cases unnecessary.  All people need access to technology to stay connected and to access an ever more virtual world, especially people with limited mobility.
   5. The process for obtaining technology is dysfunctional and takes too long for technology that people need NOW.  Individuals are at the mercy of support coordinators to submit paperwork- in many cases this can take up to 6 months.   We are then at the mercy of support coordinators to make purchases, which can take another 6 months. In fact, The agency that provides us support devoted the necessary resources to obtain a grant which placed tablets in our hands within weeks.  Thus, we were immediately provided access to virtual events, resources, and connections that many of us would still be waiting for otherwise.  Additionally, some of our requests have been denied due to lack of assessments.  Meanwhile, those assessments were unavailable due to COVID!!

We appreciate this opportunity for comment and hope you will devote a significant portion of available funding to technology so that Virginians with developmental disabilities may gain greater independence in our own homes and have the opportunity to participate in an ever more virtual world.

Sincerely,

Jesse Monroe, Executive Committee, Our Voices

Grace Feazelle, Executive Committee, Our Voices