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Hi I am writing to you on behalf of The Well Connection UK, a media and publishing company. We could easily get virginia.gov featured in various publications such as magazines, online blogs and news sites. This would undoubtedly help virginia.gov with publicity, reputation, domain authority and organic search engine rankings. We have a wide range of options including completely free collaborations, sponsored posts, guest posts and banner ads. If this sounds of interest, please reach out to the senior business development manager, Anita at info@thewellconnection.co.uk and whatsapp +447395206515 (GMT) Kind regards Clifton Junior Outreach Assistant

Alexandria is a vibrant city based on history, culture, a waterfront and lots of tourism. If Virginia has money and space to build an arena then you have money and space to build new schools. Our school system is deplorable. It’s overcrowded. Think of your citizens before thinking about your quick money grab that eventually leads to an inevitable loss. We don’t want or need an arena. This is pure greed.

My name is Donald Benson, and my wife and I recently adopted my almost 4 year old daughter that was severely abused and traumatized by her bio-father and left with injuries that will affect her for the rest of her life. She is a bright, loving, and amazing miracle and I would not trade her for anything, but due to the trauma she has had it is very hard for her to trust others and especially with her personal care. My daughter is one of many disabled children and families that are being affected by the proposed changes which are scheduled to go into effect on March 1, 2024. • ‘new guardrails’ that will compel many parents of minors to become employees of agencies and demonstrates a bias in favor of agencies and institutions. This makes a mockery of consumer directed service option. • Modify the 40-hour-per-week work limit to allow legally responsible individuals (LRI) with more than one waiver-receiving child to receive reimbursement for 40 hours of work per week per child receiving a waiver; Soft Cap of 56 and this still penalizes families with multiple waiver children • Eliminate the requirement that, in order for a legally responsible individual to receive reimbursement for personal care services, no one else be available to provide services to the member; No other state agency makes the Parent the last option and to be honest if it wasn’t for the fact that many parents step up to provide care for their family member- the system would collapse. Even though the system does not function correctly without these parents, these guardrails seem to assume the worst of intentions on the part of these same parents. • Allow a legally responsible individual or stepparent to be the employer of record when a member under the age of 18 receives personal care through consumer direction. EOR is an unpaid position that also has significant access to personal information and details of attendants and the person receiving waiver services. EOR is vital to the safety of the individuals that are involved, and I could not think of anyone that would be able to put the best interests and care for these children further to the forefront than their parents and forces families to disclose personal information and also takes away their right to act in their loved one’s best interests. • DMAS has stated that CMS is requiring these new ‘guardrails’ in order to continue to allow parents of minors and spouses to provide personal care. o In recent public communications as well as Emails from Directors Alissa DeBoy and Curtis Cunningham with CMS stated “CMS continues to encourage states to use the array of flexibilities allowable under existing Medicaid authorities to incorporate reimbursement of legally responsible individuals into HCBS programs on a longer-term basis. While there are no federal barriers in place, it is ultimately at the state’s discretion” • the guardrails proposed by DMAS are their proposals- and unfortunately, they place an undue burden upon families and in the eyes of many treat these families as guilty until proven innocent.

My name is Donald Benson, and my wife and I recently adopted our almost 4 year old daughter that was severely abused and traumatized by her bio-father and left with injuries that will affect her for the rest of her life. She is a bright, loving, and amazing miracle and I would not trade her for anything, but due to the trauma she has had it is very hard for her to trust others and especially with her personal care. My daughter is one of over 1700 disabled children and families that are being affected by the proposed changes which are scheduled to go into effect on March 1, 2024. Unfortunately, DMAS is making it much more difficult for parents (of minors) to be reimbursed for providing personal care for their child. DMAS is enacting ‘new guardrails’ that will compel parents to become employees of agencies. This makes a mockery of consumer directed service option and demonstrates a bias in favor of agencies and institutions. DMAS has failed to address significant problems with these guardrails such as the finding and enrolling of new consumer directed providers due to shortages and delays in the processing of forms needed to hire attendants. To be honest, if it wasn’t for the fact that many parents step up to provide care for their family member- the system would collapse. It seems strange to me that even though the system does not function correctly without these parents, DMAS would rather assume the worst of intentions on the part of these same parents. I understand that there may be bad actors but to implement a system where parents are treated as guilty of this until proven innocent is absurd. This is not the assumption with the any other state agency. Honestly no parent is making a living off of the under $13.50/hr. that most of the state is reimbursed for this care. Teenagers working in fast food make more than that. DMAS is also making it impossible for parents to be the EOR (Employer of Record). The EOR is an unpaid position that also has significant access to personal information and details of attendants and the person receiving waiver services. This role of the EOR is vital to the safety of the individuals that are involved, and I could not think of anyone that would be able to put the best interests and care for these children further to the forefront than their parents. With that being said, expecting families to have a friend or neighbor act as an EOR (instead of a parent or guardian) forces families to disclose personal information and also takes away their right to act in their loved one’s best interests. I DMAS has stated that CMS is requiring these new ‘guardrails’ in order to continue to allow parents of minors and spouses to provide personal care. However, in recent public communications as well as emails from Directors Alissa DeBoy and Curtis Cunningham with CMS stated “CMS continues to encourage states to use the array of flexibilities allowable under existing Medicaid authorities to incorporate reimbursement of legally responsible individuals into HCBS programs on a longer-term basis. While there are no federal barriers in place, it is ultimately at the state’s discretion”. These guardrails proposed by DMAS are their proposals- and unfortunately, they place an undue burden upon families.