My son (14) has Autism and a myriad of other neurological and medical challenges. The system of gaining assistance approval, and then, IF one can access those services is sorely, and sadly, very broken. It takes a tremendous amount of a parent's time with paperwork, calls, evaluations for, frankly, most of the time, something goes 'wrong' in 'the system' and we have to perform the same work multiple times, simply to end up not being able to access benefit for which our children qualify, like care providers and direct service personnel. My son's mental health and medical conditions have deteriorated (as well as mine) while services and supports remain unavailable throughout Covid, and were minimally accessible prior. We NEED for parents of minor children (especially those who cannot otherwise work DUE to their medical needs) to be able to be paid caregivers. The paperwork and calls alone could use 2 full time secretaries in my son's case, then there are the constant doctor and/or hospital visits, medical tests, traveling to and from appointments AND the high care needs my son has such as with all ADLs. Most recently, 'the sytem' messed up his health insurance SO badly, that I have spent multiple FULL days, over months to try to fix something that should be simple, yet months later, my son is not even on the proper health plan. The proper, reasonably accessible support in any way for children with complex is far too overwhelming and needs to be overhauled, simplified, and a process that actually works the vast majority of the time. The millions saved in more reliable, efficient, non-duplicative processes could go towards the needs of the children and families which are largely inaccessible not only prior to Covid, but most certainly since. Mental Health in NOT having help, and having to spend hours and hours on the phone waiting for someone to answer with several state departments just for the system to cut off at 45 minutes of hold time is simply unacceptable. I have a plethora of suggestions which can simplify and highly improve the 'system' to ease the burden on families truly needing the resources and assistance for which our children qualify, but repeatedly go without. There is too much human error and too many systems touching too many things required in the entire process in all arenas that need to be addressed and improved. It's simply not worth going through ALL of the trouble, over, and over, repeatedly, while children and families suffer without approved, required supports and assistance. Wendy Little - 804-909-3639

Virginia's DD System has been UNDER FUNDED for too long. The families we serve depend on services and support for someone with a developmental disability. For these families the DD Waiver is a life saver and makes their lives possible. However, with years of waiting for services and no available providers, the system is dysfunctional because it cannot even serve those with the most urgent needs. With Virginia's wealth, there is no reason for the Commonwealth to continue to rank in the bottom quarter of state's for disability services. The DD waiver rate increases proposed in the introduced budget are a good start, but additional funding for home and community-based services is critically needed - and needed now. Please invest in the DD System Rescue Plan proposed by The Arc of Virginia and vaACCSES

Today I urge strong support of the following four funding elements of Virginia’s proposed 2022 budget: • Funding over two years to ensure the Department of Forestry can help localities and residents protect and enhance the Commonwealth’s tree canopies, to include: Trees for Clean Water program; Urban & Community Forestry to help localities plant and maintain trees; the New Kent nursery that produces hardwood seedlings; water quality grants. • Stormwater Local Assistance Fund (SLAF). • Funding for stopping sewage overflows from combined sewage systems into the James and Potomac Rivers. • Virginia Agricultural Cost-Share and related programs. At first glance, these are “Natural Resource” elements, and as such are justified from that perspective alone. However, I am further commenting on these same elements for their critically valuable contribution to the – in the minds of many of us – even more important areas of: 1) economic development, to include job creation and wealth creation; and also the area of: 2) public health. My mixed background – as Virginia native, award-winning NASA engineer, entrepreneur, and economic development leader across almost all the States in the Chesapeake Bay watershed – provides the parallel lenses through which I see these areas as I do, and therefore why I’d like to particularly highlight their vast importance today. I have over and over experienced firsthand, from the economic development and job creation perspectives, how the condition and management of a region’s – or State’s – forests and trees; water treatment, sewer/septic systems; and agricultural/farm conservation practices – absolutely HAVE to be healthy, even state-of-the-art, for that region to prosper economically, for sustainable jobs to be created and maintained, and for public health measures (and COSTS!) to be at acceptable, and certainly better-than-acceptable levels. Furthermore, it is because of our bounty of interior water – our creeks, streams, rivers – that these funding areas of trees, human waste management, and agricultural conservation practices come to affect much larger Virginia regions outside their points of origin so considerably. Sadly, our treasure the Chesapeake Bay, has suffered tremendously, literally to the point of near death, owing to pollutants flowing in to the bay through contaminated water because of poor and underfunded forest and tree, waste management, and agricultural practices. Urgently, as well, these four funding elements will significantly mitigate the looming dangers of climate change, an aspect that furthermore makes them critically essential. Importantly, I’d like to point out that these four elements must all be passed with full funding as they work together. Each of the elements either adds to or importantly enables the other so that the impact they can and will produce critically requires all four. Should you wish further explanation or comprehensive data that substantiate the claims I assert today, I am happy to oblige. My sincere thanks and congratulations if you make the leadership decision to support these critically needed tree, sewage and waste, and agricultural conservation FY2022 budget items. Best wishes to all.

Comments Document

I am writing to address school funding being considered by the House and Senate Appropriations Committees. My concerns are explained in the attached letter in support of the legislative priorities of Fund Our Schools.

I have a son with a DD waiver and i have been trying to get him a job and it has been all but an act of God. Please support the DD System Rescue Plan and address the issue of people with disabilities being able to work with the raise in minimum wage not affecting their SSI benefits. Thank You Laurie Midkiff

Please support the proposed budget item for $27.4 million to address gun violence in Virginia. The funds will establish the Center for Firearm Violence Intervention and Prevention at the Department of Criminal Justice Services (DCJS), which will work across public safety and public health sectors to collect data and publish reports on violence caused by firearms. The information will be shared with state and local agencies, higher education institutions, research institutions, hospitals and other medical care facilities, and community-based organizations. The center will also establish model policies for law-enforcement personnel. Senator Jennifer McClellan is submitting legislation with Delegate Marcia Price to establish the center.

Throughout the pandemic, our schools and the people who work in them have kept our commonwealth going. From delivering food and school supplies, learning and inventing entirely new methods of instruction during remote learning, and helping to reacclimate and process the stress of the past year, education workers across Virginia have never stopped showing up for their students, whether our schools were physically open or not. I am a public school teacher in Richmond, and I can wholeheartedly say the past 22 months have been both the most challenging and the most rewarding of my life. They've been challenging because the existing racial and socioeconomic inequities in our education system and society have only been exasperated by the pandemic. But, they've been rewarding because it has been so powerful to see the way ordinary students, parents, community members and education workers show up and take care of each other when we are in need. Now, it's past time for the general assembly to do their part. It is time to lift the cap on school support positions and invest in our crumbling school infrastructure. It's time to meaningfully attack the teacher and staff shortage with bold investments in pay and benefits so that those who invest their lives in the education of our most precious resource, our children, are paid a living wage. And it is finally time to fully fund the Revised Standards of Quality. Often times I hear politicians talk about "our failing schools" and use this as an excuse for why we need more charters and a voucher program. But, I challenge this body to consider; who's really failing our students? The education workers that invest their time, energy, love and support to do their best in a situation that seems impossible, or the politicians, from both political parties, that repeatedly fail to adequately fund our schools? The answer to that is clear to me, and I would hope it is to this body. You can deliver justice by the people of this commonwealth and fund our schools.

Dear House Appropriations Committee and Senate Finance and Appropriations Committee, I am a parent and educator, and I support budgetary provisions proposed by Governor Northam for education funding in the new budget. In particular, I am asking that you: 1. Fully fund the revised Standards of Quality 2. Support a more robust funding stream and system for school infrastructure. 3. Raise teacher and K-12 educational staff pay. Provide matching funding for raises for ALL public PK-12 schools employees. Localities cannot provide raises for one group of employees and not another 4. Lift the cap that limits funding for school support positions. 5. Increase state funding for our public institutions of higher education and HBCUs. 6. Oppose voucher and back door voucher tax credit programs. Thank you.

I am the Executive Director of Resources for Independent Living, My agency is one of 17 Centers for Independent Living across Virginia provides support, education and advocacy to individuals with physical and / or sensory disabilities. There are several areas in the state that do not have access to a Center for Independent Living and a Center for Independent Living is needed in every Planning District to ensure individuals with disabilities have access to information and services to ensure independence in their communities. Our central averages approximately 1,100 direct care services per year with an additional 2,200 community and I&R contacts. CILs assist in securing housing, accommodations and modifications, identify support services, transition services, and provide critical information and referral to ensure individuals with significant disabilities have access to their community and live a fulfilling and engaged life. I urge you to include funding for Centers for Independent Living in this years budget cycle that will provide statewide coverage and allow individuals with disabilities in unserved areas the opportunity to receive supports and education to enable them to remain independent in the community. As we look to meeting the needs of individuals with disabilities equally across the state, I thank you for your consideration and support.

Do NOT shift investments to voucher and tax credit programs. Instead, fully fund VA Board of Education recommendations for updating the Standards of Quality, including new spending for support staff and funding for high poverty districts. Also, remove the arbitrary cap on support staff funding. Invest in higher pay for teachers and staff. VA has the least competitive teacher salaries in the country! Invest in school infrastructure with the billions of dollars in budget surplus. It’s time!

Please support the proposed budget item for $27.4 million to address gun violence in Virginia. The funds will establish the Center for Firearm Violence Intervention and Prevention at the Department of Criminal Justice Services (DCJS), which will work across public safety and public health sectors to collect data and publish reports on violence caused by firearms. The information will be shared with state and local agencies, higher education institutions, research institutions, hospitals and other medical care facilities, and community-based organizations. The center will also establish model policies for law-enforcement personnel. Senator Jennifer McClellan is submitting legislation with Delegate Marcia Price to establish the center.

Comments Document

We support funding in the introduced budget to make Virginia’s Earned Income Tax Credit refundable. Improved household financial security has proven to reduce the risk factors for child abuse and neglect. Policies that strengthen family financial security can go a long way toward reducing childhood adversity and enhancing the relationships that help children thrive. When families face financial hardship, it sets the stage for more stress and less tuned-in interaction with children. Boosting family incomes through direct payments, and tax credits can relieve pressure, helping to head off childhood adversity before it happens. We support funding to boost salaries and hire additional child welfare caseworkers so that child-welfare and foster-care cases are managed appropriately and effectively. Children’s lives are at risk because the child welfare system is critically understaffed. High caseworker turnover rates (40% before 18 months) interfere with stability, safety, and permanency efforts for families and children. More caseworkers are required in local communities to protect children, reduce caseloads, and protect and supervise children who are no longer with their parents. We support amending the budget to add $3.5 million over the biennium to fund randomized controlled trials for CHIP’s evidence base. Virginia has been funding its own homegrown home visiting program, CHIP, for many years with great outcomes. Now is the perfect time to provide additional funding to help CHIP become an Evidence Based Program so that it can leverage its current Virginia funding with national funding streams.

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The complete statement from Sakina Jackson, Deputy Director of Child Care Aware of Virginia. This statement includes additional statistics on the need for additional funding to support families in need of child care assistance across the state as well as wage improvements for child care providers. I was unable to share all of these important details and statistics during the three minutes allotted during the public hearing. Thank you for your time and consideration. Sakina Jackson

Good morning distinguished Senators and Delegates, It is an honor to have the opportunity to participate in the legislative process with you, my name is Richard Bagby and I’ve come before you today as a lifelong Virginian and the Executive Director of the United Spinal Association of Virginia to ask for your support in amending the Medicaid budget in the state of Virginia to cover custom power and manual wheelchairs which are medically necessary pieces of equipment that promote independence and prevent secondary medical complications, most notably, bed sores (aka Pressure Injuries). Currently Virginian’s living in nursing facilities do NOT have access to these prescribed wheelchairs while those who live in the community do, this gap in care is determined solely by an individuals’ place of residence and needs to be addressed. If you need a custom wheelchair, you need it no matter your living situation. Adopting the proposed budget amendment would not only drastically improve the quality of life of many Virginians, it would also save taxpayers a significant amount of money. The cost of medical complications, such as bedsores is MUCH higher than the cost of providing these wheelchairs as they are proven to be able to prevent these issues. Since the day I suffered a traumatic spinal cord injury 13 years ago resulting in complete quadriplegia, I have been fortunate enough to have access to custom wheelchairs and cushions due to the support which allows me to remain in the community as opposed to a skilled nursing facility. However, many are not as fortunate. I became aware of this issue through United Spinal’s peer mentoring program where I met Mr. Christopher Turpin soon after he suffered a traumatic sci which also resulted in complete quadriplegia. Mr. Turpin believed he would be discharged to his home with his wife following his stay in an acute physical rehabilitation facility, so a custom power wheelchair was ordered to his medical needs. Unfortunately, it was determined that Mr. Turpin needed to go to a skilled nursing facility for a brief stay in order to make his home accessible for him at the wheelchair level…so he could not receive his custom wheelchair. Due to 2 pressure sores and a related stroke stemming from autonomic dysreflexia triggered by the sores…Virginia taxpayers via MCAID have paid for many weeks of hospital stays, 2 surgeries, subsequent wound care, and continuing skilled nursing facility costs for the past 4 years…much of these costs and a great deal of Mr. Turpin’s suffering could have been avoided if he was able to access the equipment which was prescribed and ordered for him. Alas, his chair remains collecting dust in a warehouse. I appreciate your time and consideration of this important issue and look forward to working with you to rectify it. Thank you!

Comments Document

Child Care Aware of Virginia's 2022 Policy in Brief document attached. We have provided recommendations to improve the access, availability, and affordability of child care options. Our goals are to support families by assisting with child care search and providing consumer education services as the state's Resource & Referral Agency. We also support quality improvements in child care while supporting providers by offering professional development opportunities and technical assistance services to support child development and strengthen provider business practices to increase sustainability. We respectfully request the Committee review as this year's session begins. Thank you, Sakina Jackson

On behalf of the James River Association, I urge your support for the historic investments in natural resources funding included within the Governor’s proposal. With this budget, the next two years will be transformative not just for the Chesapeake Bay and tributaries like the James River, but for the health of our communities and our local economies, supporting Virginia’s thriving forests and farmland as well as our vibrant tourism and outdoor recreation industries. Across the Commonwealth, and across the aisle, Virginians value our natural resources, and these budget items can deliver cleaner water, cleaner air, and healthier landscapes to all Virginians: full funding for the Virginia Agricultural Cost-Share Program; $165 million in FY2023 to address combined sewer overflows; $100 million in FY2023 for the Stormwater Local Assistance Fund; $290,000 in FY2023 for an American shad recovery plan; as well as funding for urban forestry, multi-use trails, and land conservation.

Comments Document

The legislature should create and fully fund an independent prison ombudsman's office to perform inspections of Department of Corrections facilities and investigate recurring complaints from incarcerated people and staff. A recent study shows that an independent prison ombudsman's office could operate for approximately $3.4 million in annual appropriations. An independent prison ombudsman's office will prevent costly lawsuits and settlements for taxpayers and provide these committees with essential information needed to establish a sound and sensible DOC budget.

The Hopewell Tree Stewards have been trying to increase their group since it was started in 2019. We have planted many trees with the assistance of the Chesapeake Bay Foundation. The Hopewell Recreation and Parks have been a tremendous help with our planting events and maintenance of the trees throughout our independent city. We have been trying to build the tree canopy in Hopewell City within church, park, and school grounds, especially a City Orchard. More funding would benefit groups and cities like ours trying to grow. The funds would allow us to be able to purchase proper equipment for tree maintenance for trees that have already been placed in the ground. The funds would allow us to have printed materials to train more active volunteers and to help promote our efforts for future years. Please consider providing more support and funds towards those trying to beautify and increase tree canopies throughout our Virginia State.

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I am Keri Ayres, the owner of Moms In Motion, a HCBS Waiver Provider. We provide Service Facilitation (SF) to over 9,000 people with disabilities receiving Personal Care & Respite via VA Medicaid Waivers. SF is a unique service line to what you are used to hearing about/working with: It is a service that is exclusive to Medicaid. All of our revenue is from Medicaid. Without Medicaid Rate increases, we have no way to increase our revenue for this service. It is also unique in that it spans the DD and CCC+ waivers (like Personal Care and Respite (and now AT, EM, & EHBS) - the only services to span both waiver groups. Don’t use that as a reason to leave us out of Rate Rebases again as we were in 2016. I am asking that you Support the DD System Rescue Plan! As you are aware, the VA Medicaid Waiver System is in crisis! Without immediate action, thousands of Virginians with developmental disabilities who rely on a provider network for essential supports will be facing a loss of community-based services. Others who were recently approved for funding, will continue to go unserved due to lack of capacity as a result of the worsening workforce crisis. Providers across VA are not able to hire and retain staff at the current reimbursement rates and this is magnified further in Northern VA. Much work has been done recently to illustrate that the Medicaid Waiver System has been chronically and significantly underfunded in VA since its advent. To that end, the General Assembly in special session approved a temporary BRIDGE increase of 12.5% for community-based services. Thank you for that! The need for significant increases for all services is further supported by the Burns & Associates (B&A) study mandated by the General Assembly. Call To Action - We desperately need your support for: Rate Rebase – Provide funding to implement the recommended B&A study rates for ALL community-based services. If the recommended rates are not adopted, at a minimum, do not allow the temporary increase of 12.5% to be removed in July 2022. This was meant to be a stop gap measure until new rates were implemented. The Governor recognized the critical importance of increased funding for some services in his proposed budget, just 8 of the 30 DD services, but the DD system is a continuum of services, one affects another, they are inter-connected. The entire system is critical and needs immediate funding support. And I want to point out that Service Facilitation is unique in two more ways. It is one of the only waiver services to not receive an increase in rates since inception (pre 2010). This means we uniquely cannot: Attract and Retain qualified and dedicated staff. We cannot provide services at the level of quality people on the Waivers deserve. We cannot sustain this business. And 2, our service is the only one that is paid based on physical in-home visits to the individual. The current regulations allow no flexibility to provide this service in alternate settings, or periodically or exclusively via telehealth. Under current regulations we are only paid when we can physically drive to and get into the person’s home. This is the pre-2010, pre-Zoom, pre-Pandemic way of doing things. Please bring SF into 2022 with all the other services (Primary Care, OT, Case Management) and allow telehealth options for the delivery of our services. And allow us to hire and retain staff with sustainable and reasonable (and B&A recommended) 2022 rates.

My name is Blair St. Ledger-Olson, and I’m an electric vehicle advocate based in Charlottesville, VA, and I represent the national nonprofit organization, Climate Cabinet. I’m writing to support pro-electric vehicle policies such as the state level EV rebate. In 2021, the General Assembly codified the most equitably designed financial incentive for electric vehicles in the country, but a funding mechanism has not yet been identified. I want to underscore that this program is VERY different from the federal EV tax credit. This proposed program instead applies to both new and used vehicles, and because it is a point of sale rebate rather than a retroactive tax credit, it truly lowers the upfront cost of an EV. Furthermore, the program structure provides additional financial support for low-to-moderate income Virginians, which is the opposite of the federal tax credit that rewards those with a higher tax liability. This structure is proven to drive EV sales and expand the accessibility of this technology. While every new electric vehicle on Virginia’s roads benefits our environment and public health, transportation pollution disproportionately impacts black and brown communities in Virginia. Furthermore, expanded EV adoption will have significant positive economic benefits, - as Virginians spend 25 million dollars every single day on imported fossil fuels. Combined with expanded public transit and safer bikeable and walkable communities, EVs are a critical component to tackling the climate crisis and safeguarding a prosperous and resilient future. I ask the committees to support electric vehicle adoption in the Commonwealth by funding this important program, and I thank you for your time.

On behalf of the membership of the Virginia Association for Home Care and Hospice I am respectfully requesting your consideration for introduction of a budget amendment. Personal care and skilled nursing services offered to Medicaid recipients are an important component of Virginia's long-term care services. These wavier services are an alternative to institutional care and save tax-payor resources. The value of home care is not only the 2:1 savings it is where Virginian's want to receive care. Low Medicaid reimbursement rates and a booming economy have created a workforce shortage that is rapidly becoming a crisis for home care providers. The Department of Medical Assistance Services has estimated that current rates for these services are approximately 66% of the established benchmark/cost of care. The cost of insurance, travel, health care, and regulatory compliance have also increased the cost of delivering care. Significant rate increases for waiver services are critical to sustaining a stable workforce our staff deserve to be paid a competitive wage. Current reimbursement rates are inadequate and unfair to our workers. Without workers services cannot be delivered. Frail and disabled Virginian's will be forced to receive care in more costly nursing facilities and hospitals. On July 30, 2021, the Virginia Department of Behavioral Health and Developmental Services released proposed rate models for Medicaid waiver services. The report was prepared by Burns & Associates and recommended current rates for Medicaid personal care should currently be $31.21 for the rest of the state and $33.89 for Northern Virginia. I ask you to please support improving waiver rates for personal care and skilled nursing services. Home care providers must be able to hire and pay workers. Immediate action must be taken - it is a matter of survival for home care agencies, our workers, patients and communities.

Mr. Chair and members of House Appropriations and Senate Finance, thank you for the opportunity to express my concerns with the Governor’s proposed budget. I am ______Aziz Nawabi_______. I am the Co- Owner of __________Senior Homecare Services LLC.___________ and I employ 25-27 caregivers caring for the most vulnerable part of our population in the community. I cannot stress enough of the challenges we are facing, our Patients are also extremely stressed due to las off caregivers available due to the pandemic, and increase in overall worker shortages, currently Walmart and other retailers are paying more than $17 an hour for entry level position, we are paid $18.09 as an agency for personal care hours, how are we to compete with any other company for employees if we are only paid $18.09 an hour for services. No one wants to work for less than $16 an hour. There is no profit margins for providers caring for the most vulnerable part of the commonwealth and as a result many of these patient end up not receiving services which in turn end up in hospitals or nursing homes costing the commonwealth much more in the long run. Current rates are not sufficient and coupled with an increase in Virginia’s minimum wage it is impossible to hire staff. Under the proposed budget there are no increases for Medicaid personal care. Personal care and skilled nursing services offered to Medicaid recipients are an important component of Virginia's long-term care services. These waiver services are an alternative to institutional care and save tax-payor resources. The value of home care is not only the 2:1 savings, it is where Virginian's want to receive care. Low Medicaid reimbursement rates and a booming economy have created a workforce shortage that is rapidly becoming a crisis for home care providers. The Department of Medical Assistance Services has estimated that current rates for these services are approximately 66% of the established benchmark/cost of care. The cost of insurance, travel, health care, and regulatory compliance have also increased the cost of delivering care. Significant rate increases for waiver services are critical to sustaining a stable workforce. Our staff deserve to be paid a competitive wage. Current reimbursement rates are inadequate and unfair to our workers. Without workers, services cannot be delivered. Frail and disabled Virginians will be forced to receive care in more costly nursing facilities and hospitals. On July 30, 2021, the Virginia Department of Behavioral Health and Developmental Services released proposed rate models for Medicaid waiver services. The report was prepared by Burns & Associates and recommended current rates for Medicaid personal care should currently be $31.21 for the rest of the state and $33.89 for Northern Virginia. I ask you to please support improving waiver rates for personal care and skilled nursing services. Home care providers must be able to hire and pay workers.

I'm writing on behalf of the Virginia Recovery Advocacy Project (VA-RAP). We are a non-profit organization focused on evidence-based solutions to Virginia's overdose crisis. I am retired public health professional and a new resident in Virginia, coming from the Maine, where overdose death rates far exceed those in Virginia. The State of Maine was very slow to respond to rising overdose deaths in the 2010s, waiting until 2020 to significantly fund syringe exchange programs, evidence-based overdose prevention interventions, immediate access to treatment, and recovery support services like recovery residences. The result is a full-blown disaster, with far too many deaths, a demoralized public, and devastated families. Now that state funding is available in Maine, service providers are playing catch-up every day and the deaths continue. It doesn’t have to be this way, and I sincerely hope we can prevent this situation in Virginia. As I understand it, the budget includes at least two important provisions which would contribute to preventing overdose deaths. The budget seeks to add funding for recovery residences through the Virginia Association of Recovery Residences. This evidence-based recovery support service is critical to keeping Virginians safe in early recovery, and I urge you to support this part of the budget. I also understand that the budget would provide funding to repair Virginia's mental health and substance use treatment system, which in theory includes same day access to treatment services. VA-RAP urges support for same-day service that means just that: same-day service, not same-day assessment. Waiting for days or weeks for services results in clients dropping out and losing access to life-saving services. Indeed, that window of time when a person is ready to change and reaches out for help can be as short as 24 hours, and appropriate services must be available immediately. I cannot stress enough the importance of acting NOW, with as much funding and support as is humanly possible. The State of Maine failed miserably in this area, and now Maine families are paying the cost. Thank you for your consideration.

Please support the proposed budget item for $27.4 million to address gun violence in Virginia. As with many public health issues, change does not come until the public is educated on the dangers of whatever is harming society be it car crashes without seatbelts, driving under the influence of alcohol, the addictive and harmful effects of cigarettes, the addictive nature of opioids. We need to lift the veil on gun violence in our state. The 2.4 million will be used to establish the Center for Firearm Violence Intervention and Prevention at the Department of Criminal Justice Services (DCJS), which will work across public safety and public health sectors to collect data and publish reports on violence caused by firearms. The information will be shared with state and local agencies, higher education institutions, research institutions, hospitals and other medical care facilities, and community-based organizations. The center will also establish model policies for law-enforcement personnel. Senator Jennifer McClellan is submitting legislation with Delegate Marcia Price to establish the center.

Comments Document

I thank you for the opportunity to speak about the Virginia General Assembly 2022 Legislative Session Priorities for the American Federation of Teachers Virginia. My name is Tyvon Bates, and I am the Political Director with American Federation of Teachers - Virginia. I proudly represent more than 5,000 members from Fairfax County and the cities of Norfolk and Hampton. I would like to share some of our union’s priorities for the 2022-2024 Biennial State Budget. First, we stand with the Fund our Schools Coalition and share their 5 priorities: ● Fund the Fund Our Schools Coalition’s 2022 legislative priorities: ○ Fully fund the Virginia Board of Education’s revised Standards of Quality. ○ Lift the support staff cap that has limited funding for support positions including psychologists and social workers since 2009. ○ Make bold investments to start providing adequate teacher and staff pay. Provide funding to school divisions to support a substantial raise for educators so that Virginia can reach the national average for teacher pay as soon as possible. Virginia currently has the steepest teacher wage penalty of any state and is more than 10% below the national average for teacher pay despite being in the top 10% of median household income. ○ Invest in school infrastructure ○ Stand against cuts and repurposing of K-12 public schools funding. Avoid vouchers and tax credit programs that would direct money away from Virginia’s public schools. ● Ensure that all school divisions can take advantage of state money for educator raises by lifting the requirement for districts to match the remaining amount of the state raise before paying the LCI-determined state-portion. In districts like Fairfax County where the LCI requires the local government to fund around 82% of school staff raises, the requirement to fund the remaining amount before receiving the state portion has meant that districts like Fairfax have not been able to take advantage of state money at all. We urge the General Assembly to pass a bill that would allocate the LCI-determined amount for educator salaries to each school division regardless of that division’s ability to fully fund the remaining amount. ● Continue to hold districts harmless for enrollment losses as we are dealing with the impacts of the 3rd school year impacted by the COVID-19 pandemic. ● Oppose repealing the grocery tax, which would negatively impact localities’ ability to fund necessary public services including education. ● Support Delegate Coyner’s bill to develop a statewide literacy plan for Virginia aligned with the science of reading.

I am asking that you amend the Virginia Medicaid budget to cover medically necessary equipment needs for people living in nursing facilities. Currently people in these facilities do not have the same coverage for necessary equipment as those who live in a more traditional home setting. Appropriately fitting wheelchairs and related equipment can make a huge impact for many people living in these facilities, and it is shocking to families when they find out they can not get it when they are in their greatest time of need. These people need to be able to get out of bed and many of them require a custom fitted wheelchair to do so. Their health suffers without this equipment and caring for them is much more difficult and expensive otherwise. I work with many individuals across Central Virginia who come into one of the many hospitals due to an illness or injury who I tell that they have no coverage for an appropriate wheelchair because they need to be discharged to a nursing facility. Whether you can get a medically necessary wheelchair should not depend on where you are living. I encourage you to amend the budget to include funding for durable medical equipment for people in skilled nursing facilities who have complex equipment needs.

We are writing on behalf of Southside ReLeaf in support of the proposed $14 million for the Virginia Department of Forestry (VDOF) and the impact it will have in creating healthier communities across the commonwealth, especially in localities like the City of Richmond. As a community and volunteer-driven organization, we are committed to environmental justice in South Richmond. The reality is that many localities in Virginia don’t have the personnel, resources or infrastructure to manage an urban forestry program. Often, this work is left up to volunteers and community groups because localities are cash strapped. Virginia has a substantial funding gap for maintaining these green spaces and we are not reaping the intended benefits trees provide. Almost all funding for Virginia’s urban and community forestry initiatives comes from the U.S. Forest Service and is at the mercy of Congress. Taking the necessary step to provide funding ensures VDOF will be able to help localities and residents protect and enhance the Commonwealth’s tree canopies. Funding will support the creation of new staff positions to assist with outreach and project implementation, provide training and technical assistance for many cash-strapped localities. Additionally, this work will go towards helping localities achieve long-term canopy goals, build climate resilience and improve water quality based on their unique needs. Our organization and other community groups in Richmond have benefitted immensely from the Urban and Community Forestry Program thanks to available grants and hands-on support for planting projects. Community foresters not only provide ground support and expertise on what to plant, but also leadership in how volunteers groups can improve the overall environmental ecosystem of green spaces in neighborhoods. This is a very big deal for us as we fight to undo decades of disinvestment in our communities due to redlining and urban renewal. Richmond’s urban heat islands create extreme heat in neighborhoods with little or no canopy cover. Temperatures can be up to 20 degrees hotter due to a lack of trees and green spaces. Excessive heat is recognized as the greatest weather-related cause of death in the United States and unfortunately, Richmond continues to see more and more residents end up in emergency departments and die at greater rates than individuals in areas that have more canopy cover. The life expectancy of Southside Richmond residents is approximately 20 years shorter than other parts of the city due to poor housing conditions, air pollution, lack of access to fresh foods and health services. Everyone deserves to live a full and healthy life, no matter where they live. Having a healthy, thriving urban forest is key to making that happen. The work of the Urban and Community Forestry Program is crucial in improving the quality of life and health of residents. As members of this Committee, you have an opportunity to make a historic investment that will save lives. We are counting on you to make this historic investment. Sheri Shannon and Amy Wentz Co-founders, Southside ReLeaf

I am writing in support of the budget that enables the Virginia Trees for Clean Water program to be possible. On behalf of my neighborhood civic association, a small group of neighbors successfully applied for this grant twice and planted a total of 53 trees over the last two years. Our neighborhood rests right in the intersection of interstate 95 and interstate 64 and sits adjacent to Joseph Bryan Park. This park has two in-line stormwater management ponds that are fed by three tributaries of the Chesapeake Bay Watershed. These feed into the Chickahominy River which feeds into the James River, one of the largest tributaries of the Chesapeake Bay Watershed. The Virginia Trees for Clean Water program allowed us to plant 53 trees which will capture and slow the runoff entering this system from our neighborhood in addition to capturing carbon dioxide, decreasing the heat reflected by paved surfaces in the neighborhood, and increasing the ecological health of the neighborhood through only native trees. Please continue funding for programs such as these that empower citizens to protect the environment and fight climate change from their communities.

Virginia's schools are ranked 4th in the Country. Let's make the investment to be 1st. We can do that by fully funding the SOQ's, improving teacher and staff pay, removing the cap for support positions, replacing crumbling buildings, and last but not least, directing education funding to our public schools. We should not fund a second education system if we have not fully funded the first, and we should model our schools after states with lower rankings. All schools receiving public funding should have the same requirements, standards, pay, and should not segregate students. I recommend members of the Education Committees read Raynard Sanders "Jim Crow Schools: The Impact of Charters on Public Education" and make equitable public schools a priority.

Please support the proposed budget item for $27.4 million to address gun violence in Virginia. The funds will establish the Center for Firearm Violence Intervention and Prevention at the Department of Criminal Justice Services (DCJS), which will work across public safety and public health sectors to collect data and publish reports on violence caused by firearms. The information will be shared with state and local agencies, higher education institutions, research institutions, hospitals and other medical care facilities, and community-based organizations. The center will also establish model policies for law-enforcement personnel. Senator Jennifer McClellan is submitting legislation with Delegate Marcia Price to establish the center.

In order for our students to succeed, Virginia must fully fund our public education institutions and make full investments in our students and educators. Please fully fund the Standards of Quality and bridge the gap left in the wake of COVID. Additionally, educators of our children need to be appropriately paid and the teacher shortage addressed in order to retain the best teachers. Quality teachers determine the success of our students, not the number of tests.

Please support the proposed budget item for $27.4 million to address gun violence in Virginia. The funds will establish the Center for Firearm Violence Intervention and Prevention at the Department of Criminal Justice Services (DCJS), which will work across public safety and public health sectors to collect data and publish reports on violence caused by firearms. The information will be shared with state and local agencies, higher education institutions, research institutions, hospitals and other medical care facilities, and community-based organizations. The center will also establish model policies for law-enforcement personnel. Senator Jennifer McClellan is submitting legislation with Delegate Marcia Price to establish the center.

For 3 long years I lived in fear of a repeat violent felon who obtained a firearm via a "straw man" purchaser, a relative, who knew well the danger he was contributing to. Despite law enforcement awareness of the situation, sadly, one of the bullets I believe was meant for me shattered the leg of a five year old, another narrowly missed her brother's head as they huddled in terror behind a locked bathroom door. Stories like this are all too common and they can be prevented but only when adults have the political courage to take a stand for public safety. We all know of brave law enforcement officers, soldiers, sailers, and Marines suffering post traumatic stress from gun battles. Imagine the impact on an innocent child. Please support the proposed budget item for $27.4 million to address gun violence in Virginia. The funds will establish the Center for Firearm Violence Intervention and Prevention at the Department of Criminal Justice Services (DCJS), which will work across public safety and public health sectors to collect data and publish reports on violence caused by firearms. The information will be shared with state and local agencies, higher education institutions, research institutions, hospitals and other medical care facilities, and community-based organizations. The center will also establish model policies for law-enforcement personnel. Thanks goes to Senator Jennifer McClellan and Delegate Marcia Price for submitting legislation to establish the center.

Please vote yes to the proposal to amend the budget of Virginia Medicaid to cover custom wheelchairs and related equipment for individuals with disabilities that are living in nursing facilities in the state of Virginia. Currently Virginian’s living in nursing facilities do NOT have access to medically necessary wheelchairs while those who live in the community do, this is a gap in care that needs to be addressed. If you need a custom wheelchair you need it no matter your living situation. Lack of access to these wheelchairs leads to decreased independence and self efficacy, increases burden of care and makes them at higher risk for secondary medical complications such as bed sores, blood clots, respiratory diseases and death. The cost to the health care system of the secondary medical complications associated with lack of access to this equipment costs significantly more than the cost of providing these wheelchairs. I am a physical therapist and I run a wheelchair clinic at a large inpatient rehabilitation hospital. The patients that I work with on a daily basis have suffered brain injuries, spinal cord injuries, stroke and amputations. When they are unable to transition to their home environment due to lack of support system I then have to tell them they are also unable to receive the wheelchair that they require to allow them functional mobility independence, access to social and recreational outlets and prevention of secondary medical issues related to immobility and poor positioning. Imagine recovering from a catastrophic life altering event and fighting for your recovery to be unable to return to your home environment and then be told you also would not be able to have the wheelchair that allows you independence. I urge you to make this essential change, as 22 other states have already done, to improve the lives of these marginalized individuals.

I have been a paraplegic for 9 years and use a manual wheelchair as my only means of personal mobility. I am also heavily involved with United Spinal Association of Virginia, a nonprofit organization that provides resources to others in our Commonwealth living with paralysis. It has come to my attention that there is a gap in Medicaid coverage that impacts people in my community: paralyzed Virginians relying on Medicare that live in skilled nursing facilities don't have access to wheelchairs, but those that live in the community do. My personal wheelchair was custom made, both to give me as much independence as possible for my situation and to help prevent bed sores, which can be exacerbated by poorly fitting mobility equipment. Denying wheelchairs to Medicaid recipients in nursing facilities not only diminishes their quality of life, but increases the incidence of skin breakdown issues. In fact, denying these wheelchairs is more costly to the Commonwealth than granting coverage because the cost of treating the medical complications associated with bedsores is extremely high, involving long hospital stays and significant monitoring. Considering my comments above, I ask that you vote yes to amend the Medicaid budget to cover manual and power wheelchairs for those living in skilled nursing facilities.

VOCAL is a peer-driven, statewide organization that supports the community of people recovering from challenges in behavioral health. We believe in transformative personal recovery, and that people can achieve their personal best when affordable, accessible community supports and services are available. Please prioritize funding for community-based, effective, and timely services to ensure that citizens have access to appropriate mental health care.

After two years of a pandemic that has disrupted learning, deepened pre-existing inequities, and challenge the mental health of students and school officials alike, this moment calls for robust funding for our public schools. On behalf of MENTOR Virginia, an agency dedicated to expanding quality mentoring opportunities to youth across the Commonwealth, please consider the following requests: 1) Fully fund the revised standards of quality--These updates include nearly $813 million in new state spending for essential positions like school counselors, social workers, instructors of English learners, reading specialists, funding for high-poverty divisions, and more--all of which is needed right now to ensure students with the highest needs have the resources to succeed in school and life. 2) Lift the support cap, which limits funding for school support positions--Between 2009 and 2019, support staff in Virginia schools has declined by 2,800 positions due to implementation of the support cap while student enrollment increased by more than 57,000 students. Our schools need robust support personnel to help our youth recover from the pandemic, and the cap impedes positive progress in this regard. 3) Provide adequate teacher and staff pay--According to the Economic Policy Institute, Virginia has the least competitive teacher salaries in the country compared to professions with similar education levels, and the staffing crisis in our schools can't be solved without increased investments in staffing. Virginia will also struggle to recruit new teachers to the field without adequate compensation for a challenging role. 4) Invest in school infrastructure--Virginia has identified around $24 billion in needed K-12 school infrastructure updates, which need to be made in order for our schools to be able to meet the demands of pandemic and post-pandemic learning needs. Students can't learn in crumbling or under-resourced schools. 5) Don't cut or repurpose K-12 public school spending--With students and schools still recovering from the setbacks of the pandemic, we can’t afford to shift investments to voucher and tax credit programs that redirect public K-12 funding and have track records of hurting student outcomes. Please invest in teacher pay, standards of quality, and lifting the support cap instead of redirecting funds outside the public school system. Thank you for your consideration of these requests to help ensure our public schools can be responsive, proactive, and equitable in recovering from the challenges of the COVID-19 pandemic. Sincerely, Sarah Wilkinson Programs Manager MENTOR Virginia

Please support the proposed budget item for $27.4 million to address gun violence in Virginia. The funds will establish the Center for Firearm Violence Intervention and Prevention at the Department of Criminal Justice Services (DCJS), which will work across public safety and public health sectors to collect data and publish reports on violence caused by firearms. The information will be shared with state and local agencies, higher education institutions, research institutions, hospitals and other medical care facilities, and community-based organizations. The center will also establish model policies for law-enforcement personnel. Senator Jennifer McClellan is submitting legislation with Delegate Marcia Price to establish the center.

Please support the proposed budget item for $27.4 million to address gun violence in Virginia. The funds will establish the Center for Firearm Violence Intervention and Prevention at the Department of Criminal Justice Services (DCJS), which will work across public safety and public health sectors to collect data and publish reports on violence caused by firearms. The information will be shared with state and local agencies, higher education institutions, research institutions, hospitals and other medical care facilities, and community-based organizations. The center will also establish model policies for law-enforcement personnel. Senator Jennifer McClellan is submitting legislation with Delegate Marcia Price to establish the center.

Please support the proposed budget item for $27.4 million to address gun violence in Virginia. The funds will establish the Center for Firearm Violence Intervention and Prevention at the Department of Criminal Justice Services (DCJS), which will work across public safety and public health sectors to collect data and publish reports on violence caused by firearms. The information will be shared with state and local agencies, higher education institutions, research institutions, hospitals and other medical care facilities, and community-based organizations. The center will also establish model policies for law-enforcement personnel. Senator Jennifer McClellan is submitting legislation with Delegate Marcia Price to establish the center.

Please support the proposed budget item for $27.4 million to address gun violence in Virginia. The funds will establish the Center for Firearm Violence Intervention and Prevention at the Department of Criminal Justice Services (DCJS), which will work across public safety and public health sectors to collect data and publish reports on violence caused by firearms. The information will be shared with state and local agencies, higher education institutions, research institutions, hospitals and other medical care facilities, and community-based organizations. The center will also establish model policies for law-enforcement personnel. Senator Jennifer McClellan is submitting legislation with Delegate Marcia Price to establish the center.

Good morning, Please support the proposed budget item for $27.4 million to address gun violence in Virginia. The funds will establish the Center for Firearm Violence Intervention and Prevention at the Department of Criminal Justice Services (DCJS), which will work across public safety and public health sectors to collect data and publish reports on violence caused by firearms. The information will be shared with state and local agencies, higher education institutions, research institutions, hospitals and other medical care facilities, and community-based organizations. The center will also establish model policies for law-enforcement personnel. Senator Jennifer McClellan is submitting legislation with Delegate Marcia Price to establish the center. Thank you, Ruthann Litchford

We would like to thank you for allowing us to express our concerns, as it is deeply appreciated. My name is Sonya Majkovic, representing AAA+ Home Health Care which provides Personal Care and Respite Care services since 2014. The current rate of 17.22 we are receiving is causing many difficulties in our company. Medicaid is currently offering Long Term Services to more patients than ever before. This is a great thing, but there are no employees looking to work. Currently, individuals are making more money receiving unemployment funds than being employed. We are spending our time posting ads and advertising that we are hiring, but no individual is looking forward to a pay of 11.00$ when daily life expenses have increased. As an agency, we are not able to provide more than 11.00$ due to having to cover expenses such as EVV compliance, daily adverting, management, office space, supplies, employer tax's, etc. Our rate is 17.22 and minimum wage is currently 11.00. From your point of view, it may seem as if we are receiving 6.22 of income but after we pay all our overhead expenses it comes down to 2$ or even no income. DMAS has also mandated more compliance requirements, which is more labor for our management and hiring more staff. We believe if the reimbursement increases for Personal Care and Respite Care services, we are able to compensate our caregivers and management more which will make a difference! The reimbursement increase will give motivation to our staff and look forward to their job. This will also assist with more individuals willing to work in this field. If more Medicaid participants are being approved for this service everyday, but there are a lack of caregivers how will the participants receive the assistance they need? Please see the proposed rates. Should the proposed rates be approved, it will help the whole community but most importantly it will help our patients receive the assistance they deserve.

Mr. Chair and members of House Appropriations and Senate Finance, thank you for the opportunity to express my concerns with the Governor’s proposed budget. I am _Jazmin Budd__. I am the Administrator of Angels on Earth Home Care and I employ 25 Personal Care Aides caring for the elderly and disabled in the community. We are not able to provide care to as many individuals that are in need to low staffing which is a direct cause of staff leaving to gain employment and other companies like Chic fil a and Amazon who can pay a more flattering hourly wage. Our staff have to supplement income with food stamp benefits and section 8 housing to survive. We have had to discontinue taking any more than 50% 0f Medicaid clients to avoid ant more negative effects on our businesses bottom line. We had to stop accepting Private Duty cases in 2020 due to Medicaid inability to pay nursing staff adequately. Current rates are not sufficient and coupled with an increase in Virginia’s minimum wage it is impossible to hire staff. Under the proposed budget there are no increases for Medicaid personal care. Personal care and skilled nursing services offered to Medicaid recipients are an important component of Virginia's long-term care services. These waiver services are an alternative to institutional care and save tax-payor resources. The value of home care is not only the 2:1 savings, it is where Virginian's want to receive care. Low Medicaid reimbursement rates and a booming economy have created a workforce shortage that is rapidly becoming a crisis for home care providers. The Department of Medical Assistance Services has estimated that current rates for these services are approximately 66% of the established benchmark/cost of care. The cost of insurance, travel, health care, and regulatory compliance have also increased the cost of delivering care. Significant rate increases for waiver services are critical to sustaining a stable workforce. Our staff deserve to be paid a competitive wage. Current reimbursement rates are inadequate and unfair to our workers. Without workers, services cannot be delivered. Frail and disabled Virginians will be forced to receive care in more costly nursing facilities and hospitals. On July 30, 2021, the Virginia Department of Behavioral Health and Developmental Services released proposed rate models for Medicaid waiver services. The report was prepared by Burns & Associates and recommended current rates for Medicaid personal care should currently be $31.21 for the rest of the state and $33.89 for Northern Virginia. I ask you to please support improving waiver rates for personal care and skilled nursing services. Home care providers must be able to hire and pay workers.

Comments Document

Solitary Confinement, also known as "restorative housing," "restrictive housing." or "general detention" in Virginia's prisons is the practice of keeping an incarcerated individual isolated in a cell alone or with one other person for 20 or more hours a day. The United Nations and medical community recognize that after 14 consecutive days in solitary confinement long term severe mental and physical health harm occurs and they call it torture. In Virginia we still use this practice in our state prisons. According to the Department of Corrections last year they kept someone in extended solitary confinement for more than 14 days 3672. In recent years Virginia has spent millions of dollars in settlements and legal fees to defend the practice of keeping people in solitary confinement. Every state that has eliminated long term solitary confinement has also seen either a cost savings or no long term increase in costs. I am asking you to support the budget amendment for the Senate bill being introduced by Senators Morrissey and Vogel that will end extended solitary confinement in Virginia. It is worth spending some money upfront to end the practice of torturing Virginians in our prisons.

To Committee Members, The Bryan Park Civic Association has been part of the Virginia Trees for Clean Water grant program in 2020 and 2021. This program is run very efficiently and thoughtfully by VDOF. Over these two years, our neighborhood was able to give 36 trees to citizens to plant in their yards and 4 which volunteers planted in our "pocket parks." These native trees will increase canopy, help with storm runoff, clean water and provide benefits to the local ecology. Nature on all levels is at a higher risk than ever because of the actions of man. Mankind needs to give back to benefit nature in every way we can. Please vote for full funding for these essential programs. Regards, Peg Mohar Tree Chair Bryan Park Civic Association I am chair of the Tree Committee and speak only for myself. Please