I respectfully urge you to SUPPORT HB 915. This bill is essential to prevent unelected bureaucrats from establishing the school mandated immunizations in Virginia. This establishes an additional safeguard from regulatory capture/corruption. Thank you.

Dear Delegate, Protect religious freedom, vote YES for HB 306! Our religious freedoms do not end just because government bureaucrats declare a public health emergency. Our First Amendment rights apply at all times. Thank you, Kellie M. Good

Correction: Please vote YES for house bill 306! No one should be punished for exercising their right to religious freedom!!!!!

Please vote YES for house bill 106! No one should be punished for exercising their right to religious freedom!!!!!

This is an atrocious political power play. Virginia is going to drive out all their doctors. Increasing limits on Physicians while decreasing limitations on Nurse Practitioners is an egregious power play that will be to the detriment of the citizenry of Virginia. Physicians complete training with over 15000 hours of supervised clinical training. Nurse practitioners complete training with less than 500 hours and these days their less than 2 years of schooling is sometimes completely online with 100% acceptance rates. Hospitals and politicians love them because they cost less. Buyer beware.

I support these bills. Please move to report. Thank you.

Comments Document

Please see attachment.

NP Need more clinical practice time to work as Independent providers . This bill needs to be more thought off

I am really wanting you all not to pass this bill because Oxford House gives me a place to live at a price I can afford on disability it gives me stability Oxford House I would be homeless and if the bill does pass that means I rent would go up and I would be homeless again and I am doing very well I enjoy living in the Oxford House we have meetings once a week for our house and we have committee meetings and everything So please do not pass this bill I in begging you

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Let me introduce you to Nutritional Products International, a global brand management company based in Boca Raton, FL, which helps domestic and international health and wellness companies launch products in the U.S. As senior account executive for business development at NPI, I work with many health and wellness brands that are seeking to enter the U.S. market or expand their sales in America. After researching your brand and product line, I would like to discuss how we can expand your penetration in the world’s largest consumer market. At NPI, we work hard to make product launches as easy and smooth as possible. We are a one-stop, turnkey approach. For many brands, we become their U.S. headquarters because we offer all the services they need to sell products in America. NPI provides sales, logistics, regulatory compliance, and marketing expertise to our clients. We import, distribute, and promote your products. NPI for more than a decade has helped large and small health and wellness brands bring their products to the U.S. NPI is your fast track to the retail market. For more information, please reply to this email or contact me at MarkS@nutricompany.com. Respectfully, Mark Mark Schaeffer Senior Account Executive for Business Development Nutritional Products International 150 Palmetto Park Blvd., Suite 800 Boca Raton, FL 33432 Office: 561-544-071 MarkS@nutricompany.com

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Dear Sirs: Please consider passing the HB105 and HB1232 bills into law. There is a even greater need for treatment options due to both the Opioid Crisis and the pandemic. I wholeheartedly agree with VOCAL for the need to have citizen representation on the Behavioral Health Commision. Please know that the decisions you make will impact our future and the health and welfare of this great nation. Sincerely, Kattrell Lewis Peer Support Specialist

Protect our U.S. and Virginia Constitutions as they were written by our forefathers. Enough of this "woke" BS. Make laws that protect the citizens and not the criminal elements within our society. Guns don't kill!! Heartless and evil citizens who have no regard for our laws or for human life. Get these criminals off the streets and keep them there until such time as justice has been rendered.

Get the Commonwealth back on track! The US Constitution must be adhered to! No more Lobbyist intervention!

This essential to reign in an out of control federal government. This the only way!

I support this bill.

He is the right one

Q

Agaist anything that restricts my 2nd amendment rights

My name is Hannah and I am an undergraduate student at Virginia Tech who has helped advocate for HB105. Our team recognized the need for improved substance use disorder (SUD) recovery services in Virginia and we hope that this potential feasibility study will be a springboard for recovery and positive change in the lives of those affected by SUD. Transforming Catawba Hospital into a SUD recovery center, in addition to psychiatric services, would be life-changing for those in Southwest Virginia. It would provide long-term medical care and housing for individuals with SUD. It would also provide specialized services for expecting mothers, individuals with physical and intellectual disabilities, and individuals with co-existing health conditions. This transformation would positively affect thousands of lives who have been affected by this crisis. Please see Bently Wood's written testimony, as he discusses his personal experience with the SUD recovery community and as a peer recovery specialist. HB105 could benefit the entirety of the state of Virginia, as hopefully, the transformations applied to Catawba Hospital could be applied to other Virginia state behavioral health hospitals. Thank you for your time in listening to our bill. We are excited to provide additional programs to combat the opioid epidemic.

I urge you to pass this resolution

I urge you to pass this resolution

Many companies are known for their product development. That is their expertise. As senior account executive for business development at Nutritional Products International, I have worked with brands that have created and developed innovative products that consumers would want to buy. But these companies don’t have the staff or knowledge to successfully launch their products in the U.S. This is why many domestic and international health and wellness brands reach out to NPI. Launching products in the U.S. is our expertise. On a daily basis, I research companies in the health and wellness sectors, which is how I came across your brand. NPI, a global brand management company based in Boca Raton, FL., can help you. Through a one-stop, turnkey platform called the “Evolution of Distribution,” NPI gives you all the expertise and services you need when you launch your product line here. We become your headquarters in the United States. What does NPI do? We import, distribute, and market your product line. When you work with NPI, you don’t need to hire a U.S. sales and support team or contract with a high-priced Madison Avenue marketing agency. NPI, along with its sister company, InHealth Media, collaboratively work to market your products to consumers and retailers throughout the U.S. For more information, please reply to this email or contact me at MarkS@nutricompany.com. Respectfully, Mark Mark Schaeffer Senior Account Executive for Business Development Nutritional Products International 150 Palmetto Park Blvd., Suite 800 Boca Raton, FL 33432 Office: 561-544-071 MarkS@nutricompany.com

April should be Arab Heritage Month. Hi thanks for your consideration.

I wholeheartedly support Arab American Heritage month. I'm from a Jewish background, and I feel that Arab Americans have not been fully recognized or appreciated. I have met many of then in the past few years and have so appreciated getting to know their culture and history. Arab American Heritage month is a wonderful idea!

I support this bill because America should have de institutionalized over 60 years ago after Kennedy signed the Community Mental Health Act, but here we still are stuck in the dinosaur age. Virginia is still way too overreliant on institutional care and it's utterly shameful. Psychiatric institutions are traumatic, prison-like, and not therapeutic at all. They cost a fortune to operate and bleed funds from the community. They are harmful for patients and workers alike -- why you all can't pay people enough to work in these awful places, and why no one voluntarily wants to get help in them. So please, go ahead and study this but do it quickly. Honestly we don't need more studies to tell us what we should have done 60 years ago. Please just do what needs to be done create a full continuum of recovery supports at Catawba and in this state. Thanks.

Please support HB 509 - Until the second amendment is repealed, it must be respected.

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No anti 2A legislation please!!!!

I ask that you support HB105. HB105 provides access to wrap around recovery and recovery support services in a single location. The legislation is developed and written on sound research using evidence based approaches to provide treatment and support services to individuals with mental health and/or substance use disorder(s). Repurposing and modernizing an existing facility to provide these services makes sense. Please vote in favor of HB105. Recovery is possible when an individual is provided the treatment, services, support, accountability and resources. I am working in the recovery field today helping and supporting others instead of sitting in a prison cell. I was provided with the opportunity to receive help. I ask that you approve this feasibility study that will provide ways for others to find a new way to live and become a productive and responsible member of society. Vote to provide Virginian's who struggle with substance use disorders, other addictions, and mental health challenges a chance at a future and support HB105

I ask that you support HB105. HB105 provides access to wrap around recovery and recovery support services in a single location. The legislation is developed and written on sound research using evidence based approaches to provide treatment and support services to individuals with mental health and/or substance use disorder(s). Repurposing and modernizing an existing facility to provide these services makes sense. Please vote in favor of HB105. Recovery is possible when an individual is provided the treatment, services, support, accountability and resources. I am working in the recovery field today helping and supporting others instead of sitting in a prison cell. I was provided with the opportunity to receive help. I ask that you approve this feasibility study that will provide ways for others to find a new way to live and become a productive and responsible member of society. Vote to provide Virginian's a chance at a future and support HB105

VOCAL, along with its 2,000 members, supports the HB105 feasibility study to determine the services and supports that could be provided in a seamless continuum of care, including recovery services, at Catawba Hospital. One campus, where an individual can be served from the early stages of recovery to discharge and ongoing care, creates an environment that supports the needs of a person as they progress toward wellness. Additionally, the bill provides for other regions in the state that could also be served by a wellness campus. Please vote yes on HB105.

When i was first diagnosed with schizoaffective disorder there was no where for me to go except the hospital. It would have been nice to go to a place that I could stay and not out in 2 -3 days. To receive wrap around services instead of just changing medication would have been beneficial. Being able to have one on one counseling and groups would have helped me deal with mu issues much better.

HB1232, to add citizen members to the Behavioral Health Commission, achieves benefits for the commission and the public. Research shows that policy is better when the people affected provide input about services and supports based on their lived experience. VOCAL is an organization of more than 2,000 Virginians with lived behavioral health experience. We strongly support citizen membership on the commission. Doing so ensures that the voices of Virginia’s citizens are heard. The commission will benefit by having citizen members that will help them to craft policy that makes behavioral healthcare cost efficient, effective, high quality, and appropriate to the needs of the individuals served. VOCAL joins disability Law Center of Virginia, the Virginia Association of Community Services Boards, the National Alliance on Mental Illness Virginia, Partner for Mental Health, Robin’s Hope, SAARA, Mental Health America of Virginia, Voices for Virginia’s Children, and many other organizations and individuals who support this positive change to providing outstanding behavioral health care to all Virginians

I support the bill HB105. There should be more effort within the substance use treatment space and the behavioral health treatment space, to find and make connections with how the two correlate, and to base treatment on those connections. For substance use treatment there should be more hands-on and effective care provided, and mental health and behavioral health should be observed and taken into consideration when providing treatment. I feel this study will provide both.

Many companies are known for their product development. That is their expertise. As senior account executive for business development at Nutritional Products International, I have worked with brands that have created and developed innovative products that consumers would want to buy. But these companies don’t have the staff or knowledge to successfully launch their products in the U.S. This is why many domestic and international health and wellness brands reach out to NPI. Launching products in the U.S. is our expertise. On a daily basis, I research companies in the health and wellness sectors, which is how I came across your brand. NPI, a global brand management company based in Boca Raton, FL., can help you. Through a one-stop, turnkey platform called the “Evolution of Distribution,” NPI gives you all the expertise and services you need when you launch your product line here. We become your headquarters in the United States. What does NPI do? We import, distribute, and market your product line. When you work with NPI, you don’t need to hire a U.S. sales and support team or contract with a high-priced Madison Avenue marketing agency. NPI, along with its sister company, InHealth Media, collaboratively work to market your products to consumers and retailers throughout the U.S. For more information, please reply to this email or contact me at MarkS@nutricompany.com. Respectfully, Mark Mark Schaeffer Senior Account Executive for Business Development Nutritional Products International 150 Palmetto Park Blvd., Suite 800 Boca Raton, FL 33432 Office: 561-544-071 MarkS@nutricompany.com

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As an occupational therapist working directly with wheelchair users, I am in support of H.B. 241. I have worked with motivated and hardworking patients who have been done everything on their part to heal and recover from their injuries. Based on their needs, they qualified for custom equipment but this gap in care left them stuck with difficult decisions. They either had to languish in the hospital waiting for a placement that would accept them and their equipment needs or go to a facility with equipment that was not custom and not appropriate. Many times, both options led to significant harm for these people, both mentally and physically. I had one patient who passed away because of this gap in care. Please support H.B. 241, which will prevent this dilemma and make sure these patients no longer have to make unnecessary compromises in their health care.

I am writing in support of H.B. 241. It is my experience as a clinician working with patients with complex rehab needs that everyone should be able to get medical equipment made to their specifications no matter what insurance or aid they have or whether it is needed for home or a facility. It is a common for patients to discharge to a skilled nursing facility or similar initially after a significant injury as patients are attempting to organize the care or home modifications needed for home. Without being able to access the custom medical equipment that they need and are entitled to, these patients are at risk of developing secondary conditions further limiting their ability to return home. It is imperative to these patients life and wellbeing that they have access to the medical equipment they require to regain independence and mobility..

Thank you for the opportunity to provide comment on HB241 and the related Fiscal Impact Statement. We appreciate the hard work of the individuals at DMAS who work to ensure that this bill has the appropriate funding to close the gap in care. However, we are in disagreement of what the impact of the bill will actually be. 1. The average cost of a custom/specialty wheelchair is not $15,000. We believe the information provided by DMAS is simply an average of the MSRP of the most and least expensive equipment. This is not what the insurance company actually pays to the DME provider (they are reimbursed at a much lower rate than the MSRP and what is billed to the insurance company). Additionally, there are far fewer individuals who need the MOST expensive equipment than who need the least expensive equipment. While it is true that a power wheelchair with many accessories is costly, there are far fewer individuals who require this level of support from their wheelchair than who require a manual wheelchair. 2. We based our average of $5,800 to determine our average cost of a custom wheelchair on 2 years worth of data provided to use by one of the largest DME providers in the state. They provided us with total reimbursement for custom wheelchairs for over 300 pieces of equipment for 2 years and $5,800 was the average for an individual piece of equipment. We believe this is a more accurate reflection of what the average cost of a custom wheelchair will be as it reflects what was actually ordered and reimbursed for over a 2 year time period for individuals with TBI, SCI and CVA which reflect a large portion of the individuals that this bill intends to assist. This would lower the total fiscal impact statement by bringing the average cost from $15,000 to $5,800 per unit. 3. Our budget amendments also break the initial total cost into 2 separate years to catch up the back log of individuals that we believe to be eligible to receive a custom wheelchair. Which would divide the fiscal impact provided by DMAS in half lowering the overall fiscal impact. 4. After the first 2 years, individuals are only eligible for new equipment every 5 years. So once all of the current folks are caught up the fiscal impact would be a fraction annually of the first 2 years. We believe that our numbers provided to get to our budget amendment dollars request are accurate and would like to request that this information be brought to the attention of DMAS and the members of this committee for consideration. Thank you all for your service to our great Commonwealth of Virginia. We hope you support HB241 and associated budget amendments to help our friends with disabilities residing in nursing homes throughout our communities gain access to independent mobility.

Chairman Fariss, distinguished delegates… I appreciate the opportunity to request your support for House Bill 241 and its accompanying budget item. My name is Richard Bagby. I serve as the Director of the United Spinal Association and am representing a group of dedicated volunteers comprised of clinicians, effected Virginians with disabilities, and other compassionate stakeholders. This bill will close a critical gap in coverage for Virginians with disabilities who receive Medicaid and reside in nursing homes by giving them access to wheelchairs prescribed by their doctors which they would otherwise be able to get if they lived in the community. Increasing their health and quality of life. Additionally, it will save the Virginia taxpayer a substantial amount of money. First and foremost, the Fiscal Impact Statement forecast is grossly inflated beyond the ask of the budget item. For example it relies on an average cost of a wheelchair to be $15,000. We strongly believe that the ask reflected in the budget item is far more accurate based on the commonwealth’s largest durable medical equipment provider’s data, which shows the average cost of the relevant equipment to be $5,500. I suspect the impact statement mistakenly cites the amount billed as opposed to actual reimbursement amounts. Further, the impact statement forecasts the initial ask to be ongoing year over year until at least 2029. The reality is that our ask of $3.8 million divided over the next two years will clear the backlog of eligible Virginians currently living in nursing facilities. Beyond 2024, the budget would decrease exponentially as new beneficiaries per year would only amount to the number of new admissions, likely less than 300 people, as opposed to the 1,500 from the current ask. Finally, what is not addressed in the fiscal impact statement is the cost savings associated with this bill. Studies overwhelmingly show that properly fitted wheelchairs and cushions significantly decrease the likelihood of pressure sores and other secondary complications. The incident rate of pressure injuries in nursing facilities is 44%....each pressure injury costs DMAS on average $86,500. House Bill 241’s ask of $3.8 million over the next 2 years will take a significant bite out of the $200 million plus dollars DMAS currently has budgeted for treating pressure wounds…while also giving Virginians with disabilities a chance at realizing independence again. Thank you for your consideration of his incredibly important bill.

I am in support of H.B. 241. Everyone should be able to get medical equipment made to their specifications no matter what insurance or aid they have or whether it is needed for home or a facility.

As a wheelchair user, I support HB 241. Medical equipment- such as a prescribed/recommended wheelchair- is vital to human autonomy, independence, and overall health.

Save tax payers money by providing the necessary equipment in nursing facilities! Save patients from having residual health problems by giving them wheel chairs and other necessary equipment!

I have worked in the physical rehabilitation field for over 30 years and know how critical it is for individuals to have access to appropriate equipment to maintain a level of independence and quality of life . Decisions on funding of equipment needs for an individual has a direct impact on their long term outcomes . Access to appropriate equipment impacts physical health , mental health , quality of life , and level of independence . Appropriate equipment is a necessity wether living at home or in a facility .Please support HB241 to ensure equitable funding of equipment to meet the individual needs regardless of someone's living disposition . Finding a wheelchair that meets the needs of a patient and denying them access based on their disposition is detrimental to physical and mental well being . Adjustment to loss of mobility and physical functioning is challenging enough, but not providing the appropriate equipment to best meet the patients needs , level of independence , and mobility is detrimental.

Virginia Medicaid recipients who live in nursing facilities are denied wheelchairs prescribed by their doctors, solely because they live in nursing facilities. If they had the means/support to return home after an injury Medicaid would pay for their wheelchairs. If this legislation passes, it would cost Virginians about $3.8million…but would save the taxpayers 10’s of millions of dollars ATLEAST. While also giving people the chance to get: out of bed/out of the nursing facility/back to their homes/back to work/back to life.

As a retired physical therapist I repeatedly saw the inequity for Medicaid recipients forced to live in a nursing home for medically necessary supplies/ devices. There is no rationalization for denying the need for wheelchair payment when prescribed by the attending physician. How is the same chair an approved device at home but not approved in a more limited environment ( less assistance )? If anything, the nursing facilities are understaffed and not able to address the daily needs of residents. The wheelchair makes them more independent leading to fewer associated illnesses. Approval for payment should be a no brainer, please correct this injustice .

This bill should be passed. Providing these wheelchairs will have multiple positive effects. Having the ability to be mobile will decrease incidence of depression, provide a sense of independence and decrease medical care. With the use of the wheelchair you may even see some patients able to transition home. I urge all to vote for this bill

I support H.B. 241

As a medical professional I have seen many patients go without the medical equipment necessary to improve independence only because of where they live i.e. a nursing home. Please consider this when voting for this bill. How would you feel if your mother developed bed sores that require hospitalization and contractures that prevent her from getting around only because her Medicaid policy would not pay for a wheelchair that would allow her the ability to get out of bed. No one should be denied the ability to navigate their living environment just because of where they live.. If Medicaid can pay for it at home why not a nursing home???

I am in support of H.B. 241. Everyone should be able to get medical equipment made to their specifications no matter what insurance or aid they have or whether it is needed for home or a facility.

I have worked with patients who require specialized equipment for over 18 years. I have seen many unfortunate trends in insurance coverage resulting in a significant reduction of daily independence versus a persons ability to be independent when provided with the right equipment. There are many young people (early 20s) who have suffered from a traumatic injury and are permanently disabled who are residing in nursing homes due to a lack of consistent caregiver support and lack of needed specialized durable medical equipment. If they were able to achieve a level of independence with therapy and empowered by the right equipment, they would be able live a life of independence and productivity. The current law wastes MANY taxpayer dollars. The recommended bill would resolve this issue What’s the issue?: Virginia Medicaid recipients who live in nursing facilities are denied wheelchairs prescribed by their doctors, solely because they live in nursing facilities. If they had the means/support to return home after an injury Medicaid would pay for their wheelchairs. How would this legislation save taxpayer dollars?: Good question! Since the folks we’re talking about cannot access appropriate equipment, they are relegated to lie in bed or use equipment that is not appropriate. This leads to secondary complications like bed sores…which Medicaid pays for…to the tune of hundreds of millions of dollars per year! If this legislation passes, it would cost Virginians about $3.8million…but would save the taxpayers 10’s of millions of dollars ATLEAST. While also giving people the chance to get: out of bed/out of the nursing facility/back to their homes/back to work/back to life. Therefore, I urge you to support this bill to reduce unnecessary skilled nursing facility stays, reduce wasted dollars, and empower many Virginians to live productive lives.

In regards to HB241, I can personally attest to the need for patients to have access to complex medical equipment when transferring to skilled nursing facilities. I work in inpatient rehab and am appalled that patients have their one means of independence (complex power wheelchairs) taken away just because they require extended care at a long term facility. This must be passed and changed.

As a person with a disability and dependent on a motorized wheelchair, I was astounded to learn the people who live in nursing facilities in Virginia cannot receive medically necessary equipment prescribed by a physician in a rehab setting. I have visited people in nursing homes and, without my wife and my community, I would have to live in a nursing home also. Hi am often one bad situation away from living in a nursing home. Without access to a suitable motorized wheelchair and other durable medical equipment I would be bedbound or would be waiting for someone on staff to push me from place to place in a standard wheelchair. When I have durable medical equipment I can get around independently once someone gets me up and then my wheelchair. I can even get out and about in my community. This does so much for my psyche! When it is well maintained my chairs and motors and batteries will last five, seven, or 10 years. It is an investment that, all in all, pays off in my independence and overall health. I support this legislation and the efforts to provide funding for people in nursing facilities who depend upon durable medical equipment to meet their unique needs.

I have been a paraplegic for nine years and use a wheelchair full time for mobility. My wheelchair has been made specifically for me to maximize my quality of life and minimize the likelihood of developing pressure sores, which can involve lengthy hospital stays for treatment and observation. Currently, Virginia's Medicaid program does not cover wheelchairs for people who have a similar condition to me but who's situation requires that they stay in a skilled nursing facility. Without the use of a properly fitting wheelchair, medical problems related to skin breakdown are far more likely to occur which is ultimately several times more expensive to treat than a wheelchair would have been in the first place. Please vote yes on HB241 to improve the quality of life for disabled Virginians and ultimately save the Commonwealth money on Medicaid disbursements for preventable pressure sore treatments.

I support H.B.241 because I believe Virginians living with disabilities should have the same access to prescribed equipment no matter whether they live in a nursing facility or the community. Precision fitting is so important to the long term health of an individual, it would seem there should be no distinction based on residence. From a financial standpoint, well-fitted equipment potentially saves money by lowering the chances of issues such as pressure sores, improving cardiovascular function through improved mobility, and other factors that could affect costly secondary treatments.

I’m Kent Keyser. I vote in Arlington County. I am an advocate with the United Spinal Association for equal access to health care for people with disabilities. Delegates, thank you for your public service. I hope you will support Delegate Adams’ bill, HB 241, to amend the Virginia’s Medicaid budget to cover customized power and manual wheelchairs which are medically necessary and are prescribed by a physician to meet the daily needs of residents of skilled nursing and long term care facilities. Not only do these customized wheelchairs prevent medical complications, like bed sores, aka Pressure Injuries, which can cost over $150,000, studies overwhelmingly agree that these customized wheelchairs, prescribed by physicians, improve the physical health, mental health, and overall independence of people living with disabilities. Let me give you an example. These customized wheelchairs include components that are known as complex rehabilitative and seating technologies. For people like me who have a spinal cord injury, or for others with traumatic brain injuries or strokes, these medically prescribed components allow us to be able to use a wheelchair. Let me explain. I still need someone to help me in and out of bed, mornings and nights. But because my spinal cord injury limits my trunk control, my ability to hold myself back in my wheelchair, I have a complex rehab component on my wheelchair that allows me to tilt back so I can function independently all day. Without that tilt function, long ago, I would have rotted away by being bedridden. Instead for fourteen years that tilt function and the customized cushion I sit on have helped keep me healthy – fourteen years and no pressure wounds – fourteen years and no spinal cord injury related hospital readmissions. Fourteen years of earning a living and fourteen years of paying Virginia taxes. Please vote to close this critical gap. Every Virginian prescribed medically necessary equipment should have equal access to the technologies available to meet their health and safety needs regardless of where they live in Virginia.

Subcommittee members, I am contacting you today to encourage you to support HB 241 regarding power wheelchairs in nursing homes. This subject has become important to me because my own son is recovering from a spinal cord injury suffered July ’20 which resulted in quadriplegia. Fortunately, he has good insurance through his wife and we have been able to care for him at home, though it has taken a team of us 24/7. But this has all left me with insights which compel me to advocate for others who find themselves in similar circumstances as my son but without his considerable resources. It is my understanding that Medicaid does not currently provide power chairs for nursing home residents, even for those whose extreme physical limitations leave them vulnerable to pressure ulcers (bedsores). For these patients, bedsores are not just a simple nuisance; they can quickly lead to expensive hospitalizations in the ICU, and sometimes ultimately even death due to sepsis. The most important strategy to help PREVENT bedsores is changing a patient’s position at least once every two hours. Unfortunately, a patient who is paralyzed due to stroke, spinal cord injury, etc. cannot do this for themselves. Therefore, it is up to the busy nursing home staff to be sure that position changes are done, eating up much of the care-givers’ time. Power chairs have the ability to recline, which enables the patient to shift their weight themselves without having to rely on a staff member to do it for them. Making power chairs available to these severely disabled patients could literally help make the difference between life and death for them. The loss of life due to sepsis resulting from pressure ulcers is tragic, especially since in many cases it can be avoided. This tragedy is aggravated by the fact that the cost of the basic powerchairs which could be supplied to these patients is far less than the overall cost for wound care and hospitalization. It might also increase efficiency in nursing homes, as less staff-time would be required for such frequent re-positioning during the day. I firmly believe that having a power chair available was a game-changer for my son. Although a bedsore was beginning to form after a month of being bed-ridden in the ICU at VCU Medical Center (under the very best of care), he has not suffered one since. Getting up out of bed and into a chair was important; being able to recline very frequently in order to shift his position was key. On a personal note, having the ability to move from one room to the next without depending on anyone else is priceless. As a voter, I appreciate a commonsense approach to keeping Medicare costs and expenditures down. In my opinion, preventative measures make more sense than expensive wound-care and hospitalizations. Approval of power chairs for those nursing home residents most in need of them is the smart thing to do. The improved quality of life afforded to these patients by the independence provided by those power chairs makes it the right thing to do. Please consider supporting this bill. Sincerely, Lesa Collins Ph 434-665-4105

We support the bill.

As a nursing home resident in Arlington, not having access to a custom fitted CRT Wheelchair has been a barrier in my ability to re-engage with my life and my community post injury. It effects my independence, the quality of my life and what I can or cannot do. It can make a difference between whether I am bedridden or able to engage outside of the walls of the nursing home and live more independently. As a quadriplegic, I received my first motorized wheelchair As a gift through a charitable organization, but it was not fitted to me. Consequently, it caused pressure sores that kept me primarily bedridden during the first two critical years post injury. If I had been mobile, I would I have had more opportunity to gain strength and develop more independent skills through the use of the chair. Instead, I was essentially warehoused as a bedridden nursing home resident, with virtually no mobility and zero independence. Later, my high school graduating class generously donated money to help me purchase a used motorized Wheelchair and have it fitted to me. Unfortunately, properly seating and fitting me to the chair to me was easier said than done. It took approximately 18 months before the chair was comfortable and more usable by me. This involved paying out-of-pocket for dozens of appointments and countless hours of labor by Wheelchair technicians. The modifications and adjustments are ongoing and I have a $1900+ invoice for custom padding as recent as two weeks ago. I want the same right to necessary, appropriate and fitted equipment as my fellow Virginia Medicaid neighbor living across the street in an apartment.

This issue is important to me because I am an Occupational Therapists that has dedicated my career to working with people with disabilities for the past 20 years. I have seen first-hand how not having access to appropriate medical equipment for seating and mobility has resulted in significant medical complications, functional declines, and devastating psychological concerns. When a person has access to their medically appropriate seating and mobility device, they have improved functional capacity, independent mobility, proper stability and support, reduced pain, reduced need for caregiver assistance, reduced risk of pressure injuries, and an improved quality of life. Everybody has the right to have functional mobility, it is a basic human right! Not only does providing our nursing home residents with the custom equipment they need to be functional, safe, and more independent, but it has a huge impact on the financial and caregiver strain that facilities experience. It’s pretty simple, what would you want your loved one to have access to?

Comments Document

A year and a half ago I had an accident that changed my life forever. I was mountain biking at Bell Isle here in Richmond when I crashed. I couldn't move and had difficulty breathing because the crash severely damaged the spinal cord in my neck. Five days later I woke up with a tube in my stomach, another one in my throat, and no sensation below my shoulders. I was unable to eat, speak, move, or breathe on my own. I laid in bed like this for 1 month and my only source of physical activity was having a foam wedge alternate from being under my left and right side every 4 hours. When I left the ICU I went to an inpatient rehab facility that specialized in spinal cord injuries. They noticed a small white dot above my tailbone that looked like a pimple. Later that week I received a power chair that allowed me to travel around the facility and tilt back every 20 minutes. By tilting back I relieved pressure off of that white dot. It completely healed the following week. I cannot begin to express how important that power chair was to every aspect of my health. It did relieve pressure off of my tailbone, but I honestly couldn't feel that part of my body. What I did feel what is the overwhelming sense of Joy to independently travel around the facility. I was motivated to see what other parts of my life I could get back. When you have a condition like mine you need to count your blessings. I try not to look back and think about how my life could be different, but when I do I remain thankful. I'm thankful that I had good insurance. I'm thankful that I went to a specialized facility. I'm thankful that the experts around me took the extra precaution the treat that white dot as the beginning of a pressure sore and not a pimple. I could be one out of 10 people in a hospital right now that has a pressure wound. I could be taking up space in a hospital bed for a month and a half, the average length of time to heal a pressure wound. I could be in nursing facility, without a power chair, still rotating every four hours on a foam wedge. Approximately 4% of the Medicaid budget is spent treating pressure wounds. The average cost of a power chair is $5500 and the average cost of a pressure wound is over $86,000. A person on Medicaid is able to receive a power chair UNLESS they go to a nursing facility. HB 241 simply removes this exception. Vote yes on HB 241. It's not just right for the budget, it's right for the people.

Approximately 15,000 Virginians who are Medicaid beneficiaries reside in nursing facilities across the state. About 10% of these people live with disabilities which require specialized wheelchairs for their mobility, independence and to prevent secondary medical complications like bed sores. These wheelchairs provide people living with disabilities access to independent functional mobility, and access to social, recreational and community activities, they also prevent pain and suffering from these secondary medical complications. By providing people with disabilities living in nursing facilities specialized wheelchairs, this legislation will promote their optimal health and well-being and also will create a cost savings in prevention of costly medical complications that occur when people do not have access to medically necessary equipment. As a wheelchair user living with quadriplegia, this issue is important to me because everyone deserves the right to have their health and mobility. People with mobility impairments like mine should not be confined to a bed or improper mobility aides. This causes an unnecessary and depressing lack of independence, drastically reducing quality of life. More importantly, it leads to many health complications which bring about costly surgeries and in some cases even death. I hope you'll consider passing this bill and its corresponding budget amendment Item 304#40h. Thank you, Josh Sloan

I am writing to voice my support for bill HB241. I work in the Complex Rehab industry, helping to provide wheelchairs as a licensed Assistive Technology Professional. I work with individuals day in and day out who have had a tough situation take their life and turn it upside down and cause them to require the need of a power wheelchair. Whether it is because of an accident that has caused physical trauma to the spinal cord or because of a neurodegenerative disease like ALS or MS, when the ability to walk is taken from someone it is always life changing and devastating. Imagine you are no longer able to independently get yourself from one spot to the next without the aid of a wheelchair and for a lot of these individuals you require assistance to do simple things like eating, toileting, and dressing. For many people in these situations their wheelchairs are the key to the little bit of independence they have left. What is frustrating in the state of Virginia is if your situation requires you to go to a skilled nursing facility, your ability to get the mobility equipment that you need is taken from you. This is unfair. This is unjust. This absolutely needs to change so that for people in these situations they have the ability to live their life to the fullest extent possible with the same technology available to everyone else.

Providing people with appropriate equipment will help them maintain their health, quality of life, and safety. People with sensation deficits will obtain skin breakdown when sitting on inappropriate cushions this will cause health issues such as infection leading to hospitalization and possibly sepsis or osteomyelitis. When people have wheelchairs they are unable to maneuver their overall health both physical and mental health decline. These chairs can also cause poor posture placing them at risk for scoliosis, shoulder pain, and inability to maintain balance to perform their activities of daily living independently. Why should people in facilities not have the quality of life compared to those who are in the community. If you allow them to have the proper equipment they will have more opportunity to be independent with their activities of daily living, be more independent with leisure activities, social interaction and an improved quality of life.

My name is Dr. Megan Murphey and I am the Assistive Technology Specialist at a large free standing inpatient rehabilitation hospital. I spend my days helping people recover from devastating injuries such as traumatic brain injuries and spinal cord injuries, as well as medical issues like stroke and Multiple Sclerosis. I also help prescribe custom wheelchairs for individuals with disabilities. When someone is admitted to our facility they work hard to regain their independence and return to their home, families, work and community. Unfortunately, not every patient has the support system or resources to return to their home when they discharge, and are forced to transition into skilled nursing or long term care facilities. Because of the current statute they are now also unable to have access to the prescribed wheelchair. This wheelchair is vital to their ability to get out of bed, to look out the window, to go the bathroom to use the toilet or to brush their teeth at the sink. Lack of access to this equipment not only takes their only source of independence and ability to perform necessary daily tasks but also can lead to bed sores from lack of mobility. Bed sores cause pain and suffering and can lead to infection and death. Bedsores are also significantly more expensive to treat than what the cost of providing a custom wheelchair is. Not only will this legislation improve the quality of life for Virginian’s with disabilities living in nursing facilities but will provide a way to prevent costly medical issues and save the health care system money. It should not matter where people with disabilities live, if they need a medically necessary wheelchair they should have access to one. Please pass this legislation and associated budget amendments so I never have to tell another patient they cannot have the wheelchair we worked so hard together to perfect.

I'd like to thank Del. Coyner and Sen. Lucas for introducing this vitally important piece of legislation, HB319, to address literacy instruction and assessment. I'm a student with dyslexia who grew up in the public school system here in Fairfax, and although it's one of the best public school systems in the nation, I've seen since the time I was in second grade the gross inequalities in the access to reading instruction and support. My family was able to afford tutors and private reading instruction, my parents were able to read with me every night, and because of that additional out-of-school support I received for years, I was able to eventually read at grade level. Those kind of resources should be considered a fundamental right that we need to guarantee to every student as part of their free appropriate public education, and not just offered to those whose families can afford it. I'm immensely excited about this bill, particularly the provision related to intervention services, which have been a source of major inequities, and I look forward to seeing the positive impact this bill will have over the next decade in expanding opportunities for students like me. Thank you again for the legislators who have signed on, and the advocates for your tireless work on this important issue.

I support HB1047, HB319, HB418, and HB419.

Comments Document

Dear Education - Early Childhood/Innovation Subcommittee, my name is Tyvon Bates, and on behalf of American Federation of Teachers Virginia, I am writing to urge you to support HB 319 chief patroned by Delegate Coyner. Virginia does not have a comprehensive statewide approach for teaching literacy. This is one reason that children are falling below benchmarks on state reading assessments. COVID-19 has only exacerbated this issue, causing a near twofold increase in the number of at-risk K-2 readers.8 We urge lawmakers to support Delegate Carrie Coyner’s bill, which would create a literacy plan for Virginia that is aligned with the science of reading, a body of research outlining how schools can best teach and assess early reading, including the use of evidence-based practices to promote literacy. I hope you will join me in supporting HB 319.

Please support HB319, HB 418, and HB 419. These bills will make great strides for Virginia's children and their literacy. We cannot afford to wait any longer. I hope as you consider these bills you will also champion the need for urgency . We risk the continued loss of years waiting for districts to begin implementation. Our children do not have the time to wait they need these bills implemented as quickly as possible. Thank you.

I am writing to urge you to support HB 319, HB 418, and HB 419. I am a first grade teacher in Fairfax County Public Schools and for the past two years I have immersed myself in learning everything I can about the science of reading. Even though I have taught 1st and 2nd grade for ten years now, I am embarrassed to say that before learning about the science of reading, I didn't understand a lot about how children developed the skills to become proficient readers. I had been trained in teaching reading using the "balanced literacy" approach. In the early grades, students taught through a balanced literacy approach can appear to be fluent readers. They read formulaic "leveled texts" filled with memorized high-frequency words and peppered with other words that students are meant to guess based on the picture and maybe the first letter. Students move through these levels with just enough picture support to suggest that they are becoming proficienct readers, but then when they reach 3rd grade and beyond where they encounter more unfamiliar multisyllabic words and the picture support drops off, it becomes apparent that they never learned the skills to break down and read words using phonics. After learning about the science of reading, I now know that decoding skills (the ability to read the words on the page) are developed in a sequential and systematic way through explicit phonics instruction where students first learn basic phonics patterns and then move to more challenging ones as they develop mastery. I am grateful that my district, FCPS is adopting a new approach to literacy that aligns with the science of reading. I hope that by passing these three bills, we can move Virginia toward ensuring that every new teacher learns reading instructional practices that align to the science of reading, that we are using evidence-based interventions to address reading gaps and abandoning programs based in balanced literacy such as Reading Recovery, and that we are giving every early reading educator the training and tools they need so that they are equipped to unlock the potential in every child to become a proficient reader.

Literacy is a human right without which there is no freedom and there is no justice. The last two school years have brought unprecedented challenges. The loss of life, health, and economic security has been devastating and the crushing toll on student learning will be felt for years. In a time where all students have suffered, the learning loss for Black and Hispanic children has been catastrophic. These losses are particularly concerning when viewed through the lens of the long-standing minority student achievement gap. This disparity in learning begins the moment children enter school and are not taught effectively to read. The Fairfax County Branch of the NAACP is committed to equity in education and to ensuring that all children are given an opportunity to excel academically. It is with this core mission at heart that we wholeheartedly support HB319. We are grateful to our fellow advocates in the educational equity and disability communities for continuing to press for this change in public policy, and we are grateful to our legislature for bringing forth such a powerful bill which will enrich the lives and futures of countless children.

Please vote for this. So, teachers can learn how to help with reading issues. Thanks

Please pass the literacy bill. I have friends whose kids would greatly benefit from this. Thanks

Fellow Virginians, you have the very rare opportunity to give EACH Virgina student the greatest gift they will ever receive. That being the gift of reading. YOU can do this by voting yes to the HB 319 Literacy Act. I am the 77-year-old grandmother of two grandsons that have dyslexia. They are in my heart. I am also a former 3rd grade teacher from the 70s. I still remember, after all these years, the struggles that I encountered while trying to teach some of my students the skills of reading on very thin information that was taught to those entering into the field of education back then. These students also have my heart! Of course, reading is taught much differently now. But it can be even much better, by using DECADES of studies and research, where science-based instructions and testing will begin in grade K. I do believe that this will give each Virginia student an equal start from DAY ONE. And, also, make YOU the giver of a the most wonderful gift.

Comments Document

Submitting written testimony in support of HB 319 -- The Virginia Literacy Act -- on behalf of ExcelinEd in Action. Thank you for your consideration of this important legislation!

I wish to convey my support for house bill 318, 319, and 418. What makes Virginia strong is commitment to meeting the learning needs of all students through the various stages of language skill acquisition. In truth, there are many steps which could be undertaken to strengthen education throughout the Commonwealth. What these bills have in common is a focus on demonstrated approaches to further learning outcomes using what are really modest levels of resources. Please pass each of these measures out of committee! Respectfully Norm Hall Vienna VA

Please VOTE YES and support this critically important bill! Explicit, systematic, cumulative literacy instruction based on the science of reading is critical for teaching our VA students how to read. Decades of research supports this methodology. As an education advocate I have dedicated many years to helping our students thrive. Literacy education based on the science of reading is best practice for ALL students regardless of ability. It is long past time, that our VA schools teach reading effectively. Thank you!

Thank you for this opportunity to speak to literacy concerns in Virginia. Dyslexia runs in my family and we all live in Virginia. My oldest child was seven years old when we had him diagnosed in 2002. The same was true for his brother in 2004. My dream was that one day my grandchildren could start their public education with a foundation in reading that had been accurately assessed and support provided. My hopes are waning. There is a sense of urgency to this bill, so please support HB319 as it is written and implement that start date and do not delay. I am an intake coordinator for a psychology practice and every day I talk to parents who are surprised and frustrated that their children are not reading. I have seen so much damage that is done within a lifetime of poor reading skills. Please support HB319.

HB319/SB616 We are in a literacy crisis in Virginia and we need to invest in our children's literacy by ensuring they receive a curriculum rooted in science-based reading research and evidence-based literacy instruction. They deserve teachers who can well trained and hit the ground running and impart foundational literacy skills at the beginning of their academic careers without the current wait-to-fail model .This comprehensive literacy bill will pull multiple levers, simultaneously, to support all VA divisions as they transition their staff and curriculum to science-based reading research and evidence-based literacy instruction. My daughter is 17, about to graduate Fairfax County Schools and is not capable of reading her college applications. Thankfully she is recieving private remediation now but the challenge is undoing poor instruction from poorly trained teachers without fidelity. Please support these bills to improve the outcomes of the children of Virginia.

Please support HB319 and bring the current body of knowledge about how to comprehensively provide early reading instruction and evidence-based literacy assessment to the Commonwealth. It is time for Virginia to provide consistent and comprehensive early literacy instruction. I am asking as a parent with two dyslexic children serviced by special education in public schools. I know first-hand that instruction using the science of reading and evaluation for reading difficulties as early as Kindergarten and 1st grade can avoid or minimize costly special education services necessary without proper early reading instruction. There is a robust body of research that has found that “students who are on track and reading at the end of first grade are almost invariably still good readers at the end of fourth grade, whereas students who are not readers at the end of first grade are highly unlikely (88%) to be reading at the end of fourth grade” (Juel, 1988). Similarly, 70% of below average readers in 3rd grade remain below average readers in 8th grade (Landerl & Wimmer, 2008). Simply put, it is far better to teach reading using the science of reading from the beginning and assess, identify, and appropriately address problems as early as possible. HB319 outlines a multi-faceted statewide literacy plan that embraces 40 years of research and evidence regarding the creation of proficient readers; HB319 aims to support and empower teachers, students, and parents. Virginia's data shows that current practices are not working and that the pandemic has only exacerbated these problems. Thank you for your service to the Commonwealth and please support HB319.

Please support HB 319, 418 and 419. These bills will help Virginia's children learn to read and gain more proficiency in acquiring language arts skills. BUT also please consider shortening the time frame as we can no longer sit around and wait as we will be losing precious time waiting on the implementation. We need action NOW to give these children a better start in life with acquiring the reading skills that they deserve to be taught by a public education system! Thank you. Signed - Mom of a dyslexic son whose top notch public school could not provide the basic Science of Reading remediation desperately needed after not being diagnosed until mid 3rd grade.

As a Virginia educator and educational leader specializing in literacy and social emotional learning for the past 15 years, I wish to support HB319 | Coyner | Virginia Literacy Act; early student literacy, evidence-based literacy instruction, etc. and HB419 | Delaney | Institutions of higher education; education preparation programs; coursework; audit. Data in northern Virginia schools have long demonstrated that our most vulnerable populations: minority students, economically disadvantaged, English learners and students with disabilities do not achieve basic literacy standards at the same rate as their peers, when receiving instruction based in "balanced literacy" practices alone. This failure to provide an equitable educational experience resulting in equitable access to higher level education is unnecessary when we have over 40 years of government funded research which empirically tells us the instructional practices that work. As someone who has been responsible for instructing hundreds of children in scientifically based early literacy (direct instruction and structured literacy) interventions and has witnessed the positive shift in progress firsthand, I can attest to its success. Should appropriate literacy instruction based in science (direct instruction and structured literacy) be delivered to all students as their first form of instruction, we would not be spending the amount on intervention, remediation and staffing which we currently are in our public schools. More recently in my career, as someone who has been responsible for teaching thousands of Virginia teachers literacy practices through post-service professional development, I can also attest to the fact that the vast majority of new and veteran teachers alike are not aware of the differences in literacy approaches that are evidence-based versus those which are not. This currently is requiring a great deal of retraining, substitutes to cover classrooms and time away from instruction, all which come at the expense of taxpayer dollars. Should universities be required to rewrite their coursework to include skills and competencies grounded in research, that burden would be alleviated from our public school systems. These bills support one another in a two pronged approach to eliminate the negative outcomes created by widespread and long-standing miseducation in literacy: require school systems to implement evidence-based curriculum for the students of today, and better prepare our teachers of tomorrow. We need all citizens to be critical thinkers, effective communicators and problem solvers. Without acquiring literacy skills at a proficient enough rate to access factual information in current contexts, as well as historically, the knowledge of others who came before us, that is simply not possible. Without having the deep level of literacy necessary to access higher education opportunities, choices in adulthood are severely limited. When significant portions of our overall population do not have access to information, because we have not equipped them with adequate literacy skills to effectively read and critically think, the impacts on the individual's quality of life, as well as the societal and workforce impacts are immeasurable. Scientifically based literacy instruction is a human right and civil rights issue, and implore our commonwealth's leaders to take the first step in addressing it by passing these bills. Thank you!

As the parent of a child with dyslexia, I would like to support these 3 bills. Our sons reading disability was missed by multitudes of educators and once identified the schools were ill-prepared to instruct him using a structured literacy program. The Commonwealth must have a data-driven literacy program. This ultimately benefits all students.

Comments Document

To Whom it May Concern, We are in the midst of a literacy crisis in Virginia and we need to invest in our children's literacy by ensuring they receive a curriculum rooted in science-based reading research and evidence-based literacy instruction. They deserve teachers who can hit the ground running and impart foundational literacy skills at the beginning of their academic careers without the current wait-to-fail model that was in place for my own daughter who couldn't learn to read. I urge you to send this bill to the House for a vote and to pass this bill into law for the betterment of our children and future workforce of the Commonwealth. Thank you for your time, Melissa Martin Teacher Decoding Dyslexia Advocate.

We lost our good friends and their beautiful family to a move they needed to make due to the need of sufficient education for their two boys with dyslexia.

As a veteran teacher of 15 years, with instructional/leadership experience in special education, general education, and literacy intervention, this house bill is tailored for a specific type of learner and needs for specialized instruction. Yes, it is critical that our teacher programs better prepare teachers with literacy knowledge and assessment tools to determine best fit instructional practices for each student. Classrooms have a diverse set of students to include students with disabilities, English as a Second Language Learners, typically developing students, as well as above average and gifted learners. This is 2022 - we have advanced in education well beyond a blanket approach to instruction. What's good for some is NOT good for all. We need to be prescriptive and intentional with our decisions. Any approach that overemphasizes one aspect of literacy over another will neglect other important areas. The Science of Reading is body of research that has recently re-ignited the “Reading Wars” of balanced literacy approach versus phonics-only approach which has resulted in schools frantically snatching up phonics instructional books and putting them into the hands of untrained teachers. There is no argument that systematic and explicit phonics instruction is a key component of literacy instruction; however, proper training and appropriate and engaging methodologies are essential so that children can apply what is learned in the context of reading and writing. I respect the work that has been done by the Science of Reading researchers and, as a result, have been trained various instructional approaches grounded in this body of research. As a reflective practitioner, I have adjusted my instructional practices while using assessment information to determine if either of these programs would be a best fit methodology for students. On the other hand, I also respect and honor the work done by the decades of research compiled by leading researchers in the field of literacy Fountas and Pinnell, Dr. Marie Clay and other psychologists, educators, professors, and literacy specialists as they have studied children reading engaging, continuous text. Decades of research and success results exist amongst many with children of various abilities and demographics with this specific body of research. In conclusion, I am not debating that explicit and systematic phonics instruction is a key component to teacher preparation and literacy instruction in Virginia. I am, however, fearful of that HB318 overemphasizes one approach of skills-based teaching tailored to 20% of the total population with severe reading difficulties, thus having a detrimental impact on the progress and growth on the vast majority.

My middle school daughter is dyslexic. It is because of the phonemic based literacy intervention she received in school that she is currently an A student. She has received support since second grade and lives school. She would be in a much different position without the early intervention she received. Please support these literacy bills.

It is time for Virginia to provide literacy instruction based on the science of reading. Children learn best when they are taught to read explicitly by teaching phonics, phonemic awareness, and fluency. In addition, according to the simple view of reading, reading equals decoding ability as well as comprehension and as a result, literacy instruction should also focus on the acquisition of background knowledge. I would love to see a curriculum that actually enables students to acquire background knowledge implemented across Virginia schools. An example of such a curriculum would be Wit & Wisdom, ARC Core, and Core Knowledge Language Arts.

Upport our students and families

I'm Donna Owens. For over a decade, we tried to work with our public schools to identify and teach our dyslexic children to read, spell, and write. But despite the schools' good faith efforts, the public school system was miserably ill-prepared to help. Thankfully, our family had the financial resources and knowledge to privately teach our children. Thousands of dollars and countless hours later, one dyslexic child is now a financially independent working adult and the other dyslexic child is a dean's list college student. They probably would not have graduated from high school if they had only been given access to the public schools' balanced literacy instruction. Balanced literacy does not work. Virginia has been failing to teach too many children to read for decades. Although fully implementing Delegate Coyner's Literacy Act will be challenging, we have no other choice lest we suffer the consequences of having a semi-literate Commonwealth.

Please evaluate our literacy programs and institute science based proven instruction. My 8 year old has an IEP and is being evaluated for a reading disability. There needs to be more options to help these struggling readers! Thank you

I lost a good friend because they had to sell their home and move to an area that had a private school for their dyslexic children

Good afternoon, Delegates of the House Education Committee! My name is Melinda Mansfield and I am writing to ask for your support of: HB319 - Delegate Carrie Coyner's Virginia Literacy Act that will ensure that Virginia's children will learn to read. HB319 https://drive.google.com/file/d/1GqECg9POKdBRySvAFtpYd13gyVQHoJfD/view SB616 - (after crossover) Senators Lucas and McClellan's Virginia Literacy Act that will ensure that Virginia's children will learn to read. SB616 Bill Support https://drive.google.com/file/d/1GqECg9POKdBRySvAFtpYd13gyVQHoJfD/view HB419 - Delegate Karrie Delaney's bill ensures Virginia's Institutes of Higher Education use science-based reading research and evidence-based literacy instruction in their curriculum and confirms compliance at least every 5 years with an audit. HB419 Bill Support https://docs.google.com/document/d/1-pK5JoqwjI039tDe9HcCsnYQlOYKVKWKbPyD5RQOgJ4/edit HB418 - Delegate Karrie Delaney's bill removing the product name 'Reading Recovery' from our Virginia educational code HB418 Bill Support https://docs.google.com/document/d/1-pK5JoqwjI039tDe9HcCsnYQlOYKVKWKbPyD5RQOgJ4/edit Virginia is in the midst of a literacy crisis and we must invest in our children's literacy by ensuring they receive a curriculum rooted in science-based reading research and evidence-based literacy instruction. Children deserve teachers and reading specialists who can hit the ground running and impart foundational literacy skills at the beginning of their academic journey. Teachers deserve adequate tools and preparation so they may teach children how to read, handwrite, write and spell “to make the difference that they want to make.” School districts deserve support and guidance in picking professional development, curriculum, intervention, computer and supplemental literacy programs so that they are not subject to slick marketing campaigns. The consequences of a slow start in reading become titanic in middle school and beyond because they exponentially accrue over time. Therefore, this must be done in elementary school before a child moves to middle and high school. Moreover, the middle and high school model is not adequately set up for real remediation. WE must move from a “remediation” model to a “preventative” model of literacy instruction. The investment in our children, teachers and school districts is way overdue. If you cannot read or write…you cannot do math, history, science, civics, computer programming, etc. Literacy is the foundation for all learning. Please co-patron these bills and encourage your colleagues to do the same. The chief patron's and their staff are ready to answer any questions you have about the bills. Although the challenge ahead of us is enormous, I am hopeful that future generations of Virginia's children will have an opportunity to learn to read write proficiently and grow to be productive members of our society. Literacy is a right!

It is imperative that Virginia base its literacy instruction on methods that are evidence-based. I am a tutor for dyslexic students in Arlington, one of the highest-ranked systems in the country, yet many students require extra support for reading instruction that they should be getting in school. Many students cannot afford to pay upwards of $70 per tutoring session, nor should they have a need if schools are teaching them to read. Please implement the requirement that all teachers, not only reading teachers or special education teachers, are trained in teaching reading through evidence-based methods. (HB319, HB418, HB419)

Literacy is a basic human right! Thank you for supporting our children!

I believe in literacy being a basic right of every human

I believe that every school should do their best to ensure every child has the best literacy instruction possible. This needs to be the primary focus in k-2 grades as research shows that students who are behind by 3rd grade will most likely never “catch up.” The emphasis on phonics and language acquisition is vital in order to teach all students to read!

I believe in literacy being a basic right of every human and we lost good friends because they had to sell their home and move to an area that had a private school for their dyslexic children.

My name is Susan King, and I live in New Kent County.. My daughter, Emma Claire, was diagnosed with dyslexia in first grade. To say that Dyslexia is an important issue that impacts my family every day is an understatement. It’s frustrating, confusing and impacts Emma Claire’s self esteem. It’s left her with anxiety . She’s been failed by the public school system, which doesn’t not consistently use evidence-based practices to teach literacy and provide the appropriate reading intervention services. Our daughter’s elementary school neither recognized the issue – instead attributed her frustration and confusion to her behavior – and had no reading specialists or teachers with the appropriate training and qualifications to deliver the specialized instruction that she needed. In order to get her the appropriate intervention, we had to hire a private tutor, at a cost of more than $200 a week, driving from our home in New Kent to Richmond. That’s 100 miles (50 miles each way), 2 times a week so Emma Claire could meet with her after school. With the pandemic and virtual school, and after our difficult experiences trying to obtain the appropriate accommodations for our daughter at her public school, we’ve abandoned the public school system all together. Opting for a private school that can provide the services she needs. And we are not alone. I’ve heard parents, like us say they’ll never send their children to public school again because of the lack of support they received and the negative impact that had on their child. When it comes to dyslexia, it definitely isn’t a “one size fits all” approach. Our teachers need the training and skills necessary to provide the appropriate instruction and intervention for students, like our daughter. This bill also provides parents with tools to use at home to further help their young learner. I’m incredibly fortunate to be able to provide my daughter with tutors and a specialized private school. But the majority of parents do not have this same luxury. They need to partner with schools to ensure their child reaches his or her full potential. As the parent of a child with dyslexia, I’m asking for your help in ensuring that our schools, teachers, and administrators have the tools to provide a quality education to all students. They deserve every opportunity not just to learn but to excel. I’m asking for you to please support HB319.

I believe quality education is a basic right

Both of our children, now ages 8 and 10 have been diagnosed with dyslexia. Our 10-year-old is currently reading at a first grade level our eight-year-old cannot yet read at all. After spending more than $50,000 out of pocket, every ounce of energy we have and strong advocacy with their school in Loudoun County Virginia, they finally received services, after initially being declined. The services being provided are the bare minimum of what they need. My oldest is going into middle school next year and he is considered “at risk”. We uprooted our entire family and moved to the Richmond area so that he could attend a private school that costs $33,000 a year where he would finally receive the proven structured literacy program that works for all struggling readers not just dyslexic students. It should not be this way, not in 2022 . All students are entitled by law, to a free and appropriate education. I have teacher friends that have are part of a Facebook group called “things I should have learned in college” that was created by teachers and is for teachers. Why aren’t teachers being taught the science of reading? There is no excuse.

Our children with learning disabilities deserve more!

I am writing in support of bills HB318, HB418, and HB419. I am a parent of two elementary school kids in Loudoun county. We desperately need improves screening and literacy programs for our kids. My sons are in 4th and 2nd grade. They both were in virtual learning during the first year and half of the pandemic. My 2nd grader is in the process of getting an IEP. He has dyslexia and other specific learning disabilities. We need programs that teach all of our kids how to read and identify those with dyslexia and other learning disabilities sooner. My son is now over a year behind in reading and writing as his dyslexia was not discovered until this year. His confidence has taken a huge blow. The more I have educated myself about dyslexia and now learned that 15-20% of kids have dyslexia I was surprised to learn that we aren’t doing an adequate job providing proven multi sensory structured literacy for all our kids. The literacy scores for our students have continued to fall and a major revamp is needed. Thank you for your thoughtful consideration of these bills. All our kids deserve a fair and good education.

I am writing in support of these important bills (HB319, HB418, HB419) that will provide vital improvements to our education system. We need evidence-based curriculum and should be looking at what is best for all our students, not lining the pockets of curriculum companies.

HB319 | Coyner | Virginia Literacy Act; early student literacy, evidence-based literacy instruction, etc.--YES! YES! YES! Long overdue! Thank you from a Teacher/Reading Interventionist! HB356 | Tata | Public schools; regional charter school divisions.--YES! YES! YES! Long overdue! Thank you from a teacher with experience in a magnet school in Texas and a charter school in Maryland!

Reading should be a fundamental priority in education. We know what works with a large percentage of students with dyslexia and other reading challenges, and yet our curriculum does not provide the support for these proven methods. Please support empirical programs for literacy.

HB319/SB616 We are in the midst of a literacy crisis in Virginia and we need to invest in our children's literacy by ensuring they receive a curriculum rooted in science-based reading research and evidence-based literacy instruction. They deserve teachers who can hit the ground running and impart foundational literacy skills at the beginning of their academic careers without the current wait-to-fail model that was in place for my own daughter who couldn't learn to read in Fairfax County Schools. This comprehensive literacy bill will pull multiple levers, simultaneously, to support all VA divisions as they transition their staff and curriculum to science-based reading research and evidence-based literacy instruction. HB319 & SB616 Talking Points for Support of the Bill https://drive.google.com/file/d/1GqECg9POKdBRySvAFtpYd13gyVQHoJfD/view HB319 & SB616 Support Flyer https://drive.google.com/file/d/1enxMHOdS3nRo4cU6gR7Lx5FLcJbrvZuR/view HB418 Reading Recovery is a product name and should not be a part of VA Education Code Talking Points for Support of HB418 https://docs.google.com/document/d/1-pK5JoqwjI039tDe9HcCsnYQlOYKVKWKbPyD5RQOgJ4/edit HB419 We are in the midst of a literacy crisis in Virginia and we need to invest in our children's literacy by ensuring they receive a curriculum rooted in science-based reading research and evidence-based literacy instruction. They deserve teachers who can hit the ground running and impart foundational literacy skills at the beginning of their academic careers without the current wait-to-fail model that was in place for my own daughter who couldn't learn to read. This bill ensures Virginia's Institutes of Higher Education use science-based reading research and evidence-based literacy instruction in their curriculum and confirms compliance at least every 5 years with an audit. Talking Points for Support of HB419 https://docs.google.com/document/d/1-pK5JoqwjI039tDe9HcCsnYQlOYKVKWKbPyD5RQOgJ4/edit

Please support this bill. For too long districts have been staffed by those who received erroneous training on how literacy in children really worked. That has led to adoption of many balanced literacy curricula that receive failing grades when it comes to how the curricula teach kids to read. Our most disadvantaged kids lose out the most under balanced literacy, which doesn't work for many, but all kids benefit from using structured literacy methods. We've known for 40 years how to teach kids how to read. John McWhorter says it well in a pair of op-eds published 11 years apart: https://www.theroot.com/we-know-how-to-teach-black-kids-1790881629 https://www.nytimes.com/2021/09/03/opinion/kids-reading-spelling.html Look at Tennessee and Colorado where bills like this one have been adopted to see that they truly work.

Comments Document

Good afternoon, Delegates of the House Education Committee! My name is Melissa Martin and I am a member of Decoding Dyslexia Virginia, as well as a teacher. I am writing to ask for your support of: HB319 - Delegate Carrie Coyner's Virginia Literacy Act that will ensure that Virginia's children will learn to read. HB319 Bill Support SB616 - (after crossover) Senators Lucas and McClellan's Virginia Literacy Act that will ensure that Virginia's children will learn to read. SB616 Bill Support HB419 - Delegate Karrie Delaney's bill ensures Virginia's Institutes of Higher Education use science-based reading research and evidence-based literacy instruction in their curriculum and confirms compliance at least every 5 years with an audit. HB419 Bill Support HB418 - Delegate Karrie Delaney's bill removing the product name 'Reading Recovery' from our Virginia educational code HB418 Bill Support We are in the midst of a literacy crisis in Virginia and we need to invest in our children's literacy by ensuring they receive a curriculum rooted in science-based reading research and evidence-based literacy instruction. They deserve teachers who can hit the ground running and impart foundational literacy skills at the beginning of their academic careers without the current wait-to-fail model that was in place for my own daughter who couldn't learn to read. Please co-patron these bills and encourage your colleagues to do the same. The chief patron's and their staff are ready to answer any questions you have about the bills. Although the challenge ahead of us is enormous, I am hopeful that future generations of Virginia's children will have an opportunity to learn to read efficiently and grow to be productive members of our society. Reading is a right! Best regards, Melissa Martin Decoding Dyslexia Virginia 434-242-9496

Good afternoon, Mr. Chairman, and committee members: Thank you for the opportunity to comment on HB 16 and thank you, Delegate Fowler, for your work updating our state’s Safe Haven law. We, Virginia is for Children (an advocacy group for the lives of vulnerable children in our state), are following the Safe Haven law efforts and are fully supportive of the extension to thirty days of age for infant relinquishment. This is a reasonable, standard amount of time for a mom/parent to conclude that they cannot parent their baby OR, change their mind and decide they can parent their baby. Such a significant, life-altering decision does not need to be rushed or hurried. We know that moms who have just given birth, especially those who are alone, need time to recover physically and emotionally. Moms can experience postpartum depression after the birth of child, this typically occurs within the first 1-3 weeks after birth, parents can be in desperate situations- experiencing homelessness, abuse, addiction and need time to get help. Twenty-one states are now at thirty days for age of relinquishment. Utah just extended their law to thirty days in February, 2020 and approved funding for safe haven law awareness. Extending this law can potentially save more infants from abuse, neglect, and abandonment and give parents the time they need to make important decisions. We hope the committee will approve the extension and consider providing state funding for safe haven law awareness and promotion of safe haven locations or “safe baby sites”. Not enough parents are informed about the law’s existence and the process involved. Our group is especially interested in a state funded, DSS promoted, 24-hour confidential, crisis hotline that would provide intervention and support for women in crisis pregnancies and struggling parents, so that they can get the help they need to parent their baby. Thank you, Mr. Chairman, and committee members for your time and for the opportunity to voice our support of this bill. Sincerely, Leah Kipley VA is for Children

I'm a volunteer with Moms Demand Action for Gun Sense in America, and I support this bill.

911 operators experience the same issues that deputies experience

Comments Document

Although the MEWA and AHP proposals being considered by the General Assembly differ in their particulars, they are all intended to allow small businesses and self-employed individuals to risk select out of the common risk pools created by the Affordable Care Act. This will inevitably have the effect of increasing the cost of health coverage for older individuals or small groups and for people with pre-existing conditions who are not covered by the AHP or MEWA. Moreover, insofar as the proposals would cover small groups or individuals as large groups, or split up the small group and individual single risk pool, they would violate federal law. All of this is explained further in the attached testimony.

Just like to be heard about the bills thank u

It is a continuing financial burden to localities to be asked to house state responsible inmates without receiving full compensation from the state. Our localities have long understood that state beds in correctional facilities may not always be readily available. We are glad to afford the state the opportunity to place inmates in our facilities, but we must be fully compensated for our actual costs - the same costs we pay for the daily care of an inmate. By making our communities absorb this expense, you effectively prevent us from investing these dollars in education, law enforcement, fire & rescue, streets and other infrastructure, etc, Just do what is fair by you local partners and service providers & with a budget flush with excess revenues - send some of it here!

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Hello I am writing to recommend a great resource for your blog on virginia.gov. I hope you find it to be the right fit for your readers. Join our JustCBD experts on a journey of insight as they expose your dominant personality traits, your inner secrets and hidden desires, purely based on your go-to vape juice flavour. Whether you like peach, plum or papaya the flavour you choose reveals a lot about you and your personality. Although a person may like to dabble in different flavours depending on their mood, there is always that one go-to flavour that we keep going back to. That one flavour can tell us a lot about your personality and how you like to live your life. CBD experts Nataly Komova and Kristina Shafarenko have teamed up with JustCBD to create a detailed infographic covering 20 of the most popular vape flavours and the meaning behind the flavours we choose. Nataly Komova a nutritionist and CBD blogger has this to say "I’m always intrigued what a person's go-to vape juice flavour is as it can reveal so much about them as a person." Kristina Shafarenko a psychologist and freelance writer says "The vape flavours we choose are a reflection of our personality. Flavour psychology is something that I’m incredibly passionate about and the psychology behind the vape flavours we choose is an endless source of fascination for me." Find out what your dominant vape fruit flavour says about you with this handy infographic. https://justcbdstore.com/what-your-favourite-fruit-flavour-says-about-you/ ### ENDS ### Notes To Editors: About JustCBD JustCBD, strives to improve people’s daily lives with the most convenient and effective CBD products all over the world. They offer a vast selection of fast acting and powerful CBD oil as well as a passionate team of knowledgeable sales reps with exceptional customer service skills. About Nataly Komova Nataly is a London-based nutritionist and CBD blogger. Her passion for CBD was heightened after experiencing first-hand what CBD did to relieve her skin condition. Nataly’s aim is to spread the word about the benefits of CBD through blogging and participating in CBD and health events. In her spare time she loves jogging in the great outdoors whilst listening to her favourite playlists. About Kristina Shafarenko Kristina is a relationship and wellness psychologist and freelance writer. She covers a variety of topics including health & fitness, sexual wellness and relationships. When she’s not writing you can find her planning her next getaway, visiting coffee shops or relaxing at home with her cat Buddy.

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Let me introduce you to Nutritional Products International, a global brand management company based in Boca Raton, FL, which helps domestic and international health and wellness companies launch products in the U.S. As senior account executive for business development at NPI, I work with many health and wellness brands that are seeking to enter the U.S. market or expand their sales in America. After researching your brand and product line, I would like to discuss how we can expand your penetration in the world’s largest consumer market. At NPI, we work hard to make product launches as easy and smooth as possible. We are a one-stop, turnkey approach. For many brands, we become their U.S. headquarters because we offer all the services they need to sell products in America. NPI provides sales, logistics, regulatory compliance, and marketing expertise to our clients. We import, distribute, and promote your products. NPI for more than a decade has helped large and small health and wellness brands bring their products to the U.S. NPI is your fast track to the retail market. For more information, please reply to this email or contact me at MarkS@nutricompany.com. Respectfully, Mark Mark Schaeffer Senior Account Executive for Business Development Nutritional Products International 150 Palmetto Park Blvd., Suite 800 Boca Raton, FL 33432 Office: 561-544-071 MarkS@nutricompany.com

Many companies are known for their product development. That is their expertise. As senior account executive for business development at Nutritional Products International, I have worked with brands that have created and developed innovative products that consumers would want to buy. But these companies don’t have the staff or knowledge to successfully launch their products in the U.S. This is why many domestic and international health and wellness brands reach out to NPI. Launching products in the U.S. is our expertise. On a daily basis, I research companies in the health and wellness sectors, which is how I came across your brand. NPI, a global brand management company based in Boca Raton, FL., can help you. Through a one-stop, turnkey platform called the “Evolution of Distribution,” NPI gives you all the expertise and services you need when you launch your product line here. We become your headquarters in the United States. What does NPI do? We import, distribute, and market your product line. When you work with NPI, you don’t need to hire a U.S. sales and support team or contract with a high-priced Madison Avenue marketing agency. NPI, along with its sister company, InHealth Media, collaboratively work to market your products to consumers and retailers throughout the U.S. For more information, please reply to this email or contact me at MarkS@nutricompany.com. Respectfully, Mark Mark Schaeffer Senior Account Executive for Business Development Nutritional Products International 150 Palmetto Park Blvd., Suite 800 Boca Raton, FL 33432 Office: 561-544-071 MarkS@nutricompany.com

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Let me introduce you to Nutritional Products International, a global brand management company based in Boca Raton, FL, which helps domestic and international health and wellness companies launch products in the U.S. As senior account executive for business development at NPI, I work with many health and wellness brands that are seeking to enter the U.S. market or expand their sales in America. After researching your brand and product line, I would like to discuss how we can expand your penetration in the world’s largest consumer market. At NPI, we work hard to make product launches as easy and smooth as possible. We are a one-stop, turnkey approach. For many brands, we become their U.S. headquarters because we offer all the services they need to sell products in America. NPI provides sales, logistics, regulatory compliance, and marketing expertise to our clients. We import, distribute, and promote your products. NPI for more than a decade has helped large and small health and wellness brands bring their products to the U.S. NPI is your fast track to the retail market. For more information, please reply to this email or contact me at MarkS@nutricompany.com. Respectfully, Mark Mark Schaeffer Senior Account Executive for Business Development Nutritional Products International 150 Palmetto Park Blvd., Suite 800 Boca Raton, FL 33432 Office: 561-544-071 MarkS@nutricompany.com

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Get the Commonwealth back on track! The US Constitution must be adhered to! No more Lobbyist intervention!

I support this bill.

Q

Many companies are known for their product development. That is their expertise. As senior account executive for business development at Nutritional Products International, I have worked with brands that have created and developed innovative products that consumers would want to buy. But these companies don’t have the staff or knowledge to successfully launch their products in the U.S. This is why many domestic and international health and wellness brands reach out to NPI. Launching products in the U.S. is our expertise. On a daily basis, I research companies in the health and wellness sectors, which is how I came across your brand. NPI, a global brand management company based in Boca Raton, FL., can help you. Through a one-stop, turnkey platform called the “Evolution of Distribution,” NPI gives you all the expertise and services you need when you launch your product line here. We become your headquarters in the United States. What does NPI do? We import, distribute, and market your product line. When you work with NPI, you don’t need to hire a U.S. sales and support team or contract with a high-priced Madison Avenue marketing agency. NPI, along with its sister company, InHealth Media, collaboratively work to market your products to consumers and retailers throughout the U.S. For more information, please reply to this email or contact me at MarkS@nutricompany.com. Respectfully, Mark Mark Schaeffer Senior Account Executive for Business Development Nutritional Products International 150 Palmetto Park Blvd., Suite 800 Boca Raton, FL 33432 Office: 561-544-071 MarkS@nutricompany.com

I wholeheartedly support Arab American Heritage month. I'm from a Jewish background, and I feel that Arab Americans have not been fully recognized or appreciated. I have met many of then in the past few years and have so appreciated getting to know their culture and history. Arab American Heritage month is a wonderful idea!

Please support HB 509 - Until the second amendment is repealed, it must be respected.

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No anti 2A legislation please!!!!

Many companies are known for their product development. That is their expertise. As senior account executive for business development at Nutritional Products International, I have worked with brands that have created and developed innovative products that consumers would want to buy. But these companies don’t have the staff or knowledge to successfully launch their products in the U.S. This is why many domestic and international health and wellness brands reach out to NPI. Launching products in the U.S. is our expertise. On a daily basis, I research companies in the health and wellness sectors, which is how I came across your brand. NPI, a global brand management company based in Boca Raton, FL., can help you. Through a one-stop, turnkey platform called the “Evolution of Distribution,” NPI gives you all the expertise and services you need when you launch your product line here. We become your headquarters in the United States. What does NPI do? We import, distribute, and market your product line. When you work with NPI, you don’t need to hire a U.S. sales and support team or contract with a high-priced Madison Avenue marketing agency. NPI, along with its sister company, InHealth Media, collaboratively work to market your products to consumers and retailers throughout the U.S. For more information, please reply to this email or contact me at MarkS@nutricompany.com. Respectfully, Mark Mark Schaeffer Senior Account Executive for Business Development Nutritional Products International 150 Palmetto Park Blvd., Suite 800 Boca Raton, FL 33432 Office: 561-544-071 MarkS@nutricompany.com

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Comments Document

Dear Delegates: 1 in 10 people will have a seizure. 1 in 26 will develop epilepsy, like my teen daughter. Please vote Yes to HB1178. This is a zero cost, easy to implement, high impact bill. Seizure First Aid is almost always an overlooked component of first aid. The Seizure First Aid informational posters referenced in HB1178 are available for FREE from Epilepsy Foundation of America (EFA, referenced in the amendment). The poster can be found at this link, in 14 different languages (EFA has also forwarded a letter to you confirming this. It is attached to these comments, as well.): https://www.epilepsy.com/living-epilepsy/seizure-first-aid-and-safety/first-aid-seizures-stay-safe-side Here is the English version: https://www.epilepsy.com/sites/core/files/atoms/files/SFA%20Flier_HQ_8.5x11_PDF.pdf The distribution is as easy as an automated email OR simply placing the link to the poster on the Employer Resources website maintained by the Department of Labor and Industry: (https://www.virginia.gov/services/business/employer-resources/) Please consider this information as you review HB 1178 in the Appropriations Committee and on the House floor. Respectfully, Concerned VA resident, mom, and advocate for seizure safety and epilepsy awareness

Comments Document

Dear Delegates: 1 in 10 people will have a seizure. 1 in 26 will develop epilepsy, like my teen daughter. Please vote Yes to HB1178. This is a zero cost, easy to implement, high impact bill. Seizure First Aid is almost always an overlooked component of first aid. The Seizure First Aid informational posters referenced in HB1178 are available for FREE from Epilepsy Foundation of America (EFA, referenced in the amendment). The poster can be found at this link, in 14 different languages (EFA has also forwarded a letter to you confirming this.): https://www.epilepsy.com/living-epilepsy/seizure-first-aid-and-safety/first-aid-seizures-stay-safe-side Here is the English version: https://www.epilepsy.com/sites/core/files/atoms/files/SFA%20Flier_HQ_8.5x11_PDF.pdf The distribution is as easy as an automated email OR simply placing the link to the poster on the Employer Resources website maintained by the Department of Labor and Industry: (https://www.virginia.gov/services/business/employer-resources/) Please consider this information as you review HB 1178 in the Appropriations Committee and on the House floor. Respectfully, A concerned VA resident, mom, and advocate.

Public posting of Seizure First Aid signs in the workplace could have a positive impact on the safety of not just those with epilepsy, but everyone in the workplace, including fellow employees and in the case of businesses, patrons. I urge you to support this proposed legislation

To Our Honorable Delegates, I want to add to the personal request that was sent last night/early this a.m.: I implore you all to PLEASE VOTE YES ON HB-1178. This will SAVE LIVES of those with seizures and/or epilepsy in the workplace or in public! Seizures affect lives in many ways: LIVELIHOOD LIFESTYLE LOVED ONES LIFE TIMELINE If there are individuals familiar with the simple steps to take to aid someone having a seizure for whatever reason, this can greatly improve the 4 Ls listed above! My husband has suffered from seizures for years. PLEASE VOTE YES ON HB-1178! May God bless you and your families. Best Regards, Mrs Kathleen Evans

As a wife and mother of someone with Epilepsy I ask that you please vote in favor of HB1178. Currently over 84,000 Virginians have Epilepsy. Majority of these individuals are working in our community. We need to keep them safe and allow them to live a normal life as anyone else by simple education or signs in the workplace. As a wife of someone with epilepsy we have personally been impacted by the lack of education in the workplace for seizure safety. We are the fortunate ones to have gone 10 years seizure free but many do not and seizures are a daily challenge. We have been in situations where if my husband and felt a seizure coming on he would call and hide in a safe place until I could arrive because he feared what others at work would do or think. We also have had situations where the wrong safety measures were performed that caused more harm then care. These are situations no spouse ever wants to be in as it’s very fearful when your not present snd no one has the knowledge to help your significant other. In my medical profession I have come across numerous individuals that still believe “old wives tales” and outdated education is the way to treat seizures. In the future when my husband goes into work or when my son is old enough to work I want both of them and the other Members of the Epilepsy community to be able to goto work safely. Epilepsy has had a bad stigma for years and it’s time to break this cycle. Members in the Epilepsy community can live a normal life and have the right to work. My Husband has been a firefighter for 16 years and is very educated in the field. We never have let Epilepsy defeat him in his career or personal life. We have been put in some uncomfortable situations and had to deal with negative backlash at times. Instead of giving up we educate others and fight on! Even from someone who saves lives his life is just as important to save too. I ask that you support HB1178 to provide seizure education in the workplace.

As a wife and mother of someone with Epilepsy I ask that you please vote in favor of HB1178. Currently over 84,000 Virginians have Epilepsy. Majority of these individuals are working in our community. We need to keep them safe and allow them to live a normal life as anyone else by simple education or signs in the workplace. As a wife of someone with epilepsy we have personally been impacted by the lack of education in the workplace for seizure safety. We are the fortunate ones to have gone 10 years seizure free but many do not and seizures are a daily challenge. We have been in situations where if my husband and felt a seizure coming on he would call and hide in a safe place until I could arrive because he feared what others at work would do or think. We also have had situations where the wrong safety measures were performed that caused more harm then care. These are situations no spouse ever wants to be in as it’s very fearful when your not present snd no one has the knowledge to help your significant other. In my medical profession I have come across numerous individuals that still believe “old wives tales” and outdated education is the way to treat seizures. In the future when my husband goes into work or when my son is old enough to work I want both of them and the other Members of the Epilepsy community to be able to goto work safely. Epilepsy has had a bad stigma for years and it’s time to break this cycle. Members in the Epilepsy community can live a normal life and have the right to work. My Husband has been a firefighter for 16 years and is very educated in the field. We never have let Epilepsy defeat him in his career or personal life. We have been put in some uncomfortable situations and had to deal with negative backlash at times. Instead of giving up we educate others and fight on! Even from someone who saves lives his life is just as important to save too. I ask that you support HB1178 to provide seizure education in the workplace.

Say NO to the bills that take away Collective Bargaining. Employees in the state of VA deserve Collective Bargaining. Teachers, firefighters and Policeman deserve a position in determining what happens in their profession. For too long they have had to sit back and let others who are not part of their profession, decide what happens in their profession. Give them a voice to determine what is in the best interest for their profession. Teachers work day and night to provide what is in the best interest of students- no one knows better then they do how to achieve this- they deserve a voice in the decision-making We will lose the best teachers, firefighters and policemen if we take away this critical opportunity for them to have a voice in their professions. Say NO to the bills that take away Collective Bargaining.

Good morning honorable members of the Committee, Massachusetts is often said to have the strongest public schools in the nation. Did you also know that Massachusetts Educators also have strong collective bargaining rights. Massachusetts invests in education. With the current staffing shortages, show Virginia families and educators that you are in strong support of education by supporting collective bargaining rights. Virginia educators earn 7k below the national average and many are abandoning the profession. Can you blame them? Sincerely Brian McGovern

To Our Honorable Delegates, I want to thank you all in advance for considering and then VOTING YES on HB1178. Our communities so need this bill to be passed. This bill being passed can ultimately make SUCH A POSITIVE DIFFERENCE in the lives of our population in VA who suffer with seizures, whether due to epilepsy or other disorders. SUCH A SIMPLE INSTRUCTIONAL POSTER being posted in workplaces has the potential to take away the fears of loved ones whose child or adult relatives are in the workplace or are out and about living their lives and happen to suffer a seizure! It literally WILL SAVE LIVES! My husband suffers from epilepsy due to a fall he suffered while in college. One in 10 people are diagnosed with seizures; 1 in 26 are diagnosed with epilepsy. That could be one of YOUR OWN LOVED ONES. Let's take this out of the shadows. PLEASE VOTE YES ON HB1178. Sincerely, Kathleen Evans

We know what are students need more than anyone. I work out Special Education students every day. They always asking why do we have to do this or that. They ask why people who don't know them make them take test they know that they will pass. I want to speak for these students who fight a different type of battle every day. Let us who know what to do have a say. Most of you have no idea what special needs children fights every day because you have never been around my students.

My daughter has epilepsy and has had multiple seizures at work. Her epilepsy does not limit her ability to do her job however each instance of her having a seizure is almost like ground hog day all over again in that new employees who have not seen her have a seizure are not sure what to do. Placing this poster in all work places will make her safer and help others know how to respond to a seizure. I especially like the "Call 911 if..." part of the poster. Since her employer and her peers know she has epilepsy there is NO need to call 911 when she has a seizure. However due to lack of knowledge an administrator insisted on calling 911 during a seizure. A seizure is embarrassing enough without being surrounded by EMT's and fire fighters during postictal state after the seizure. She is able to continue working once she has had her seizure and recovers right after the seizure. As a regional director for Epilepsy Foundation of Virginia I hear of instances where employers and coworkers do not know how to respond to a seizure. Witnessing a seizure can be frightening the first time you see someone have a clonic tonic type seizure however, having a simple poster telling people how to respond to a seizure would be helpful. Please support this bill, the more people are educated on the simple steps of reacting to a seizure will reduce the stress and anxiety of the people of have epilepsy and are afraid to be out in public due to the lack of knowledge about epilepsy. BTW-Stress and Anxiety are two common triggers for epileptic episodes so we can educate all and help reduce onset seizure activity at the same time is a Win Win situation.

The price of energy affects the poor and working man much more than it does any rich politician or or entitled class. The idiocy espoused by the Biden administration and the leftist politicians in America is it is not just laughable, it is anti-American and impacts impacts each one of us in a negative way. Stop the spread of communism in our country. Put America First. Let us together make America Great Again.

These bills will repeal educators' progress toward gaining collective bargaining. They will silence educators' voices. School decisions will not be able to capitalize on the experiences and skills of their experts in their school systems, the educators. Why deny educators a seat at the table? Why squelch expert input? Educators are the experts in our schools. Bargaining with educators benefits our students' learning conditions. It improves educator working conditions, and ultimately benefits our Virginia communities. Bring the experts to the table. I urge you to vote no on these bills. Sincerely,

My daughter has epilepsy and has had 2 seizures at work. Her epilepsy does not limit her ability to do her job well. She is well respected by her employers and she has received recognition from her peers for making a difference. Placing this poster in all work places will make her safer and help others know how to respond to a seizure. I especially like the "Call 911 if..." part of the poster. Since her employer and her peers know she has epilepsy there is NO need to call 911 when she has a seizure. However due to lack of knowledge an administrator insisted on calling 911 during a seizure. A seizure is embarrassing enough without coming to surrounded by EMT's and fire fighters. As a leader in a local support group I hear of instances where employers and coworkers do not know how to respond to a seizure. Witnessing a seizure can be frightening. Having a simple poster telling people how to respond to a seizure would be helpful. Please support this bill.

Quoting from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8051941/ “The History of Epilepsy: From Ancient Mystery to Modern Misconception” by Muacevic and Adler: “Societal knowledge and perception of epilepsy have been directly correlated to the successful treatment of epilepsy…. In essence, the more that is understood about epilepsy by the public, the better the lives are for people with epilepsy.” First Aid knowledge is one of the tools which enhance employability of people with epilepsy, while also protecting their health when a health incident occurs. This bill is simply good public policy.

I experienced discrimination while working at my place of employment because of my epilepsy. It was used against me to help terminate me from my job. It was stated that I was dangerous to others at the workplace when actually it was a place that dealth with people with health conditions. It was not fair to me at all and I tried to educate management about this but they would not listen. I was forced to work from home and then it was stated that my work was not sufficient. None of this was true.

My name is Peggy Hartley. I currently care for an epileptic student in York County schools. My family owns a private business, also. I urge you to support HB 1178 to provide First Aid instruction to businesses. I believe it is vital for seizure patients to have the assurance of safety in the event of a seizure in public places. By providing basic first aid instructions for employees or in the form of a poster, visible to the public, seizure patients can be cared for until medical personnel arrives. By providing the safety of informed care, seizure patients can feel comfortable in any setting. Thank you for your support!

The Epilepsy Foundation of Virginia, representing more than 84,800 people living with epilepsy, supports this bill. In addition to the epilepsy community we represent, 1 in 10 people are affected by a seizure at some point in their life. Given the prevalence of seizures, it is common sense that every workplace have a seizure first aid sign.

I am in support of this.

Back in the mid-60s I was erroneously taught to do the 2 things that are only listed on the DO NOT DO list as my aunt had epilepsy. The general public NEEDS to know what to do and what not to do. I urge you to do the job for which you were elected: our biding. Thanks you for your willingness to serve.

This bill is so important to the safety and livelihood of those living with this- usually invisible- disease. The previous bill passed in schools was an enormous and great step, and now that step needs to be taken further. There is no reason or excuse not to pass this bill. Thank you.

The Arc of Virginia supports HB 1178. Many people with developmental disabilities experience seizures. The Bill will increase access to employment for people with disabilities by helping to build workplaces where people can feel safer knowing their teammates have access to information on how to respond in the event that they have a seizure while at work without burden on businesses. Thank you

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Dear Sirs: Please consider passing the HB105 and HB1232 bills into law. There is a even greater need for treatment options due to both the Opioid Crisis and the pandemic. I wholeheartedly agree with VOCAL for the need to have citizen representation on the Behavioral Health Commision. Please know that the decisions you make will impact our future and the health and welfare of this great nation. Sincerely, Kattrell Lewis Peer Support Specialist

Comments Document

Dear Chairman and Committee Members, My name is Jennifer Spangler. I live with a mental illness and advocate on behalf of myself. HB 1232 adds non-legislative non-voting citizen members, 3 who have or are receiving services, to the Behavioral Health Commission. This participation, research shows, will make the policy generated from the Behavioral Health Commission more cost efficient and effective. The experience of living with serious mental illness is not something a person can pick up with common sense, age, or policy expertise. Our perspective of the experience in state mental health facilities and with emergency custody orders (ECO) and temporary detention orders (TDO) as described when we are well is essential to help guide future policy to ensure it is quality and acceptable. Please support adding citizen members, including 3 people who have received services, to the Behavioral Health Commission to improve behavioral healthcare for the 1 in 5 who will experience a mental health challenge in their lifetime. Thank you

Speaking as someone with mental health diagnoses and lived experience with a mental health related hospitalization, unless you’ve been there you really do not understand fully the impact of different initiatives to the patient experience. We need a voice at the table with regard to our own care. It has been far too long that we have been locked away and done what is best for us in the eyes of those who don’t have the same struggles. It is necessary to empower those with lived experience in the decision making process about how mental health care moves forward.

Mental Health Services and Support of Caregivers. Time for real change. Housing/Land/community with supportive services as a comprehensive wrap around within their tiny village neighborhood, provided by state, counties and non-profits who's effort would provide sustainable change to this people group and their caregivers in long term sustainability and self management with a goal of stability in mental "new normal" with some graduating to complete independence. Work programs, garden marker, bread shop, wood working, auto repair, plus other work projects and accountability within their own. Suppport Non-profit efforts for this type comprehensive change. Example:google: "Community First" Austin, TX, and "Tiny Home Village" North Carolina.

I support this bill.

All the above

Many companies are known for their product development. That is their expertise. As senior account executive for business development at Nutritional Products International, I have worked with brands that have created and developed innovative products that consumers would want to buy. But these companies don’t have the staff or knowledge to successfully launch their products in the U.S. This is why many domestic and international health and wellness brands reach out to NPI. Launching products in the U.S. is our expertise. On a daily basis, I research companies in the health and wellness sectors, which is how I came across your brand. NPI, a global brand management company based in Boca Raton, FL., can help you. Through a one-stop, turnkey platform called the “Evolution of Distribution,” NPI gives you all the expertise and services you need when you launch your product line here. We become your headquarters in the United States. What does NPI do? We import, distribute, and market your product line. When you work with NPI, you don’t need to hire a U.S. sales and support team or contract with a high-priced Madison Avenue marketing agency. NPI, along with its sister company, InHealth Media, collaboratively work to market your products to consumers and retailers throughout the U.S. For more information, please reply to this email or contact me at MarkS@nutricompany.com. Respectfully, Mark Mark Schaeffer Senior Account Executive for Business Development Nutritional Products International 150 Palmetto Park Blvd., Suite 800 Boca Raton, FL 33432 Office: 561-544-071 MarkS@nutricompany.com

I wholeheartedly support Arab American Heritage month. I'm from a Jewish background, and I feel that Arab Americans have not been fully recognized or appreciated. I have met many of then in the past few years and have so appreciated getting to know their culture and history. Arab American Heritage month is a wonderful idea!

HB1232 strengthens the effectiveness of the Behavioral Health Commission by broadening membership beyond legislators to include the voice of individuals with lived experience facing mental health or substance use challenges. This addition will help ensure that state policies designed to impact the behavioral health of Virginians are informed by those most affected by those policies. While the Commission currently provides opportunity for public comment, including these additional members incorporates their perspective as inherently part of the policy making process, not as an "add on" at the end of meetings when there is time. The result should be a commission that is valued highly as the state's respected, concensus voice on behavioral health policy and legislation.

Please support HB 509 - Until the second amendment is repealed, it must be respected.

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I ask that you support HB1232 adding citizen members to the Behavioral Health Commission. I am a Registered and Certified Peer Recovery Specialist and have been working as a R-CPRS for the last 3.5 years. Rob Whitley Ph.D. published an article in the April 30, 2019 issue of Psychology Today. He outline’s four mental health domains where the ‘nothing about us without us’ mantra could be better enacted to the benefit of all who care about community mental health. Mental Health Governance is one of these domains. Increasingly, the importance of having experts by experience in governing roles is being recognized. Some examples include: the Mental Health Commission of Canada Board of Directors includes several ‘experts by experience’. Likewise, the New Zealand Government appointed renowned peer leader Mary O’Hagan as an official mental health commissioner responsible for recovery work. I ask that you support HB1232 and allow individuals who are experts by experience be added as a part of the Behavioral Health Commission in Virginia.

No anti 2A legislation please!!!!

I ask that you support HB105. HB105 provides access to wrap around recovery and recovery support services in a single location. The legislation is developed and written on sound research using evidence based approaches to provide treatment and support services to individuals with mental health and/or substance use disorder(s). Repurposing and modernizing an existing facility to provide these services makes sense. Please vote in favor of HB105. Recovery is possible when an individual is provided the treatment, services, support, accountability and resources. I am working in the recovery field today helping and supporting others instead of sitting in a prison cell. I was provided with the opportunity to receive help. I ask that you approve this feasibility study that will provide ways for others to find a new way to live and become a productive and responsible member of society. Vote to provide Virginian's a chance at a future and support HB105

I support adding citizen members, including three peers, to the Behavioral Health Commission. Research shows that policy is better when the people affected provide input about services and supports based on their lived experience. If we want a recovery-oriented behavioral health system, we must have representation. As a person in recovery with a mental health condition and someone who has seen mental health affect people from all walks of life including first responders, those with substance abuse issues and those from poverty, I see the importance of having people directly affected by this issue present at this table.

Comments Document

Including people who use health care in policy decisions to improve care that affects them is not new. Research continues to document that including individuals who use behavioral healthcare services in policy decisions delivers quality care that is effective (Dobiasova 2021). Please support HB 1232.

I appreciate the broad stakeholder support that HB1232 has. However, it is essential that this commission have citizen membership and the critical perspective and experience they have. Please support.

HB1232, to add citizen members to the Behavioral Health Commission, achieves benefits for the commission and the public. Research shows that policy is better when the people affected provide input about services and supports based on their lived experience. VOCAL is an organization of more than 2,000 Virginians with lived behavioral health experience. We strongly support citizen membership on the commission. Doing so ensures that the voices of Virginia’s citizens are heard. The commission will benefit by having citizen members that will help them to craft policy that makes behavioral healthcare cost efficient, effective, high quality, and appropriate to the needs of the individuals served. VOCAL joins disability Law Center of Virginia, the Virginia Association of Community Services Boards, the National Alliance on Mental Illness Virginia, Partner for Mental Health, Robin’s Hope, SAARA, Mental Health America of Virginia, Voices for Virginia’s Children, and many other organizations and individuals who support this positive change to providing outstanding behavioral health care to all Virginians.

The behavioral health system is very much still in development. Mental illnesses are also still greatly mysterious and misunderstood. It is without question that the evolution of understanding and care will include representation by those who have lived experience.

It doesn't make sense and has never made sense to have such a commission without community membership. I support this bill, but it is only a start. It's not enough to simply add some seats to a table that has been so deeply exclusionary for so long. The commission must consider thoughtfully the power dynamics that have happened at the table; whose expertise is considered valid, whose is disregarded, and why. The mental health advocacy movement was not started by politicians or professionals with letters behind their name but by service users and families who wanted change. Representation matters of course, but substantive policy change matters more, and that's what we as Virginians care about. I want to know how this Commission is going to actually be responsive to its citizen membership if this bill passes. Policy and outcomes will only be stronger if these viewpoints are not just listened to, but taken seriously and acted on.

HB1232, adds citizen members, including three peers, to the Behavioral Health Commission. Research shows that policy is better when the people affected provide input about services and supports based on their lived experience. If we want a recovery-oriented behavioral health system, we must have representation. Please do what it takes so that this legislation is passed. Thank you.

HB1232, to add citizen members to the Behavioral Health Commission, achieves benefits for the commission and the public. Research shows that policy is better when the people affected provide input about services and supports based on their lived experience. VOCAL is an organization of more than 2,000 Virginians with lived behavioral health experience. We strongly support citizen membership on the commission. Doing so ensures that the voices of Virginia’s citizens are heard. The commission will benefit by having citizen members that will help them to craft policy that makes behavioral healthcare cost efficient, effective, high quality, and appropriate to the needs of the individuals served. VOCAL joins disability Law Center of Virginia, the Virginia Association of Community Services Boards, the National Alliance on Mental Illness Virginia, Partner for Mental Health, Robin’s Hope, SAARA, Mental Health America of Virginia, Voices for Virginia’s Children, and many other organizations and individuals who support this positive change to providing outstanding behavioral health care to all Virginians

I consider the addition of citizens and individuals with a personal history of receiving mental health care services to the commission to be of vital importance. This bill has my strong support.

HB 1232 is the very first bill I have ever felt this compelled to comment on. I am doing it now because it is that important to me. For 25 years, peers in recovery in the state of Virginia have been lobbying for a meaningful voice on matters that concern them. This bill gives peers a literal seat at the table (nothing about us, without us) and gives lawmakers the ability to access the vast lived experiences that we bring to a committee that decides how some of the most vulnerable Virginia citizens are treated. I hope you have the commitment and will to make this happen. Thank you for listening, that is all we have been asking for all these years. Sincerely, Jerry Higginson, President VOCAL Board of Directors

I hope you can get this legislation passed.

I support the bill HB1232 and its effort to spread the use and awareness of peer recovery specialists to larger spaces like the Behavioral Health Commission. Having Peer Recovery Specialists within agencies other than non-profit organizations will help eliminate the stigma around mental illness and substance use. Peer workers can be beneficial by providing a perspective of both a recovery advocate and recovery worker. Their thoughts and input can be used to help improve the communities they live in, help the recovery community as a whole and to educate those who don't have personal experience with mental illness or substance use recovery.

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HB1232, to add citizen members to the Behavioral Health Commission, achieves benefits for the commission and the public. Research shows that policy is better when the people affected provide input about services and supports based on their lived experience. VOCAL is an organization of more than 2,000 Virginians with lived behavioral health experience. We strongly support citizen membership on the commission. Doing so ensures that the voices of Virginia’s citizens are heard. The commission will benefit by having citizen members that will help them to craft policy that makes behavioral healthcare cost efficient, effective, high quality, and appropriate to the needs of the individuals served. VOCAL joins disability Law Center of Virginia, the Virginia Association of Community Services Boards, the National Alliance on Mental Illness Virginia, Partner for Mental Health, Robin’s Hope, SAARA, Mental Health America of Virginia, Voices for Virginia’s Children, and many other organizations and individuals who support this positive change to providing outstanding behavioral health care to all Virginians.

I am in support of HB 1332 because the safety of all staff must be a top priority. Offenders in correctional facilities commit infractions on a continual basis with little or no administrative consequences are issued to offenders which can possibly deter them from interrupting the effective operations of the correctional facility (whether it's jail or prison). There are situations in which correctional officers work at their post and the essential security equipment that is provided for them barely work or don't work at all. Offenders should be held accountable for tampering with security equipment regardless of their security level. For this reason, please support HB 1332. Thank you, constituents.

Surveillance cameras inside the facility are critical to deterring, investigating, and prosecuting criminal activity, such as assault, tampering with other security devices, and introduction and use of contraband, inside the jail. Inmates cover the cameras to hide assaults or other criminal activity. Often, video surveillance is the only tool to identify assailants as victims may be unable or unwilling to do so. Video surveillance is a key piece of evidence during prosecution. For these reasons, I ask that you support HB1332.