Please give serious consideration to passing this bill. I deeply wish that pediatric extended care centers existed when my son George was still alive. George was born 10 weeks premature with a congenital heart defect; he has his first open heart surgery at UVA when he was barely five pounds! Due to complications from his surgery he required a trach and g tube. We were overjoyed to bring him home and he thrived but acquiring reliable home nursing was always a challenge. I remember hearing about these centers when I was crying about having lost another nurse to turnover and wondering how I would meet productivity quotas at my job and thinking "Why cant Virginia have something like this?" We were blessed to be able to work from home during this time so we got by but other parents are not so lucky and they shouldn't be precluded form taking their children home because of the severe home nursing shortage. Also, these centers would allow children to have access to a whole staff or nurses and therapists to aid in their development and in case of emergencies. We were not so lucky. Our son had an emergency at home while I was in the hospital delivering his baby brother. His home nurse did not realize his trach was actually out the whole time and he passed away because he was without oxygen for too long. He was two weeks shy of his second birthday. If he was in another setting (like one of these care centers) with a staff of nurses and respiratory therapists, the outcome likely would have been different. These centers could bring peace of mind to families during the day and allow these incredible children to be in a safe setting with their peers.

How is this - My name is Thomas LoBianco, and I’ve seen firsthand the impact that Prescribed Pediatric Extended Care centers (PPECs) have on medically fragile children and their families—not just as someone who operates these centers, but also as a parent of a special needs child. My family opened Florida’s first independently owned PPEC center in 1988. Since then, we’ve expanded to six centers in Florida and are now opening one in Texas because we have seen both the need for and the impact of our services. PPEC centers provide an essential alternative to private duty nursing, offering high-quality, skilled nursing care at a significantly lower cost. With ongoing nursing shortages, many families struggle to secure reliable in-home care, leaving them without options. PPECs bridge that gap, providing consistent, specialized care in a structured setting that not only supports a child’s medical and developmental needs but also improves long-term health outcomes. Beyond that, PPECs help reduce the burden on hospitals and emergency services. When children receive proper daily care, they are far less likely to experience medical emergencies that require ambulance transport, ER visits, or hospital stays—events that drive up healthcare costs for the state. PPECs are a proactive solution that improve health outcomes while significantly reducing Medicaid expenditures. Other states, including Michigan and Ohio, have recently moved to implement PPEC regulations, recognizing the benefits for both families and state healthcare budgets. Virginia now has the opportunity to do the same by passing this bill and ensuring access to a proven, effective model of care. I appreciate your time and consideration. This is a solution that works—not just for families, but for the state as a whole. Thank you, Thomas LoBianco Vice President Tender Care PPEC