As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

We strongly support every state hospital providing video visitation in the manner as provided for under HB388. Long distance transportation is hard for some family members, and video visitation allows for the ability to see and hear a loved one for those who do not have the means for regular in-person visits. These visits can be life saving by providing contact with family and hope for recovery. Life during the pandemic has shown have effective and cost saving the technology can be when used in this way. Bruce Cruser, Executive Director Mental Health America of Virginia

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

I support video visitation in state facilities.

I am writing in support of HB 306 to be heard in committee tomorrow morning, which will allow a religious exemption to vaccines during an epidemic. Religious exemptions exist so that citizens can act freely in mind, body and spirit. Even in a time of an epidemic, citizens must have the opportunity to act on their conscience whatever that may be. The Nuremberg Code requires bodily autonomy and informed consent for any medical treatments to one’s body. Having religious exemption makes sure that remains the rule of law. As we’ve seen over the last two years, government has retained control over persons and their bodies in a way that would make Thomas Jefferson role over in his grave. Let Virginia continue to be religiously free, as the birthplace of religious freedom. Support HB 306.

I SUPPORT HB 388, 481, 484, 538, 877, 878, 1012, 1105, 1106, 1211, 1329, and 1342. Also, I object to the language used to describe non-citizens - the word "alien" is dehumanizing and I suggest retiring it permanently when referring to non-citizens. I OPPOSE HB 937 and 1359. It is everybody's right to control their own fertility and to NOT be forced to carry an unwanted pregnancy to term. Both of these bills directly or indirectly undermine that right.

Support HB 388 – Family Video Visitation Should Continue Permanently (also see my statement attached) HB 388 helps ensure that Zoom-type video visitation, which has provided critical connectivity between state hospital residents and their families, continues past the pandemic. Over the past year, video visitation provided critically needed connectivity between hospital patients and their families and friends while in-person visits were suspended. Among its benefits are:  Reducing social isolation. After two years of living through a pandemic, everyone has suffered to some degree from loss of social contact including people in the outside community. It’s important to understand that people with psychological and cognitive impairments tend to be much more isolated to begin with. Their inbuilt isolation is compounded by living in institutional settings.  Helping people with limited resources to stay in touch with family members and friends in the hospital. Zoom-type technology increases the opportunity for people with low-incomes, or lacking the money or means of transportation, to visit and to provide emotional support for patients. Patients in Virginia psychiatric hospitals often end up far from home. For example, forensic patients from Northern Virginia are generally sent to Western State, which is 150 miles from the Falls Church area. Average driving time is two hours and 20 minutes each way.  Allowing parents to see their young children. Hospital rules and restrictions can make it difficult for children to visit their parents in person. Video visitation allowed a mother living in the hospital to see her child for the first time!  Providing all families with a way to supplement hospital visitation by telephone or in-person.  Helping patients prepare for discharge and re-integration into the community.  Increasing hospital accountability through more frequent and complete contact between families and patients. The cost of setting up video visitation is minimal. Western State Hospital purchased Kindles for this purpose within its existing budget. It’s also possible for video visitation to create savings by reducing the burden on staff to administer and supervise in-person visits. The main issue has been overcoming institutional inertia and training staff to help patients schedule and access visits. Hospital social workers and rehabilitation staff who prepare patients for re-entry into the community understand their need to maintain connectivity with family and friends and have been particularly supportive of tele-visiting. Reducing social isolation both increases the likelihood that patients can successfully return to life in the community and decreases the likelihood of relapsing into crises that involve costly hospitalizations.

See attached document: "Ensure video visitation is available to residents of all Virginia psychiatric hospitals and their families: Please enact HB 388." Statement of Karl Polzer to the Health, Welfare and Institutions Committee, Virginia House of Delegates

Comments Document

The Healthcare Distribution Alliance (HDA) once again would like to respectfully voice it's opposition to HB 478 and to a drug importation program. We would also like to request that the committee vote to continue the bill to 2023, since there are too many concerning factors for this bill to safely move forward in 2022. The main concerns regarding the implementation of a drug importation program in Virginia that we would like to highlight for the committee are: - that it would conflict with the United State’s highly efficient and secure drug supply chain system, protected by federal law through the Drug Supply Chain Security Act (DSCSA). This is especially significant since enhanced drug security requirements though the DSCSA will be going into effect in 2023. -that it would significantly increase the likelihood of allowing counterfeit or contaminated medications to enter the U.S. supply chain, putting Virginia patient safety at great risk. HDA is the national trade association representing primary healthcare wholesale distributors — the vital link between the nation’s pharmaceutical manufacturers and more than 180,000 pharmacies and other healthcare settings nationwide. Please see the attached full letter for more details regarding our concerns, and contact us with any questions. Thank you for your consideration. Sincerely, Kelly Memphis HDA

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

I am writing in support of HB 306 to be heard in committee tomorrow morning, which will allow a religious exemption to vaccines during an epidemic. Religious exemptions exist so that citizens can act freely in mind, body and spirit. Even in a time of an epidemic, citizens must have the opportunity to act on their conscience whatever that may be. The Nuremberg Code requires bodily autonomy and informed consent for any medical treatments to one’s body. Having religious exemption makes sure that remains the rule of law. As we’ve seen over the last two years, government has retained control over persons and their bodies in a way that would make Thomas Jefferson role over in his grave. Let Virginia continue to be religiously free, as the birthplace of religious freedom. Support HB 306.

Comments Document

I have submitted written testimony outlining the reasons a program like this cannot be implemented, including: Canada’s ban on bulk exports designed specifically to stop programs like these; and The fact that state Medicaid programs already get better pricing than Canadian provinces and therefore cannot save money by importing Canadian medications. Both Florida, Colorado and New Mexico have all applied to HHS to ask for permission to operate a Canadian drug importation program, and Florida has even committed $40 million to set it up, with $10 million spent so far. To date no state has received federal approval and at each stage, Canada has placed stronger restrictions on any Canadian wholesaler who would consider contracting with a U.S. state. I know that removing financial barriers to healthcare are an important priority for elected officials at every level of government. However these programs cannot be implemented in the current environment and are poor candidates for addressing these barriers. Thank you for your consideration, Shabbir Imber Safdar Executive Director, Partnership for Safe Medicines www.safemedicines.org

Comments Document

On behalf of the Healthcare Distribution Alliance (HDA), I would like to thank you for the opportunity to submit for the record our views regarding HB 478, which would establish a Wholesale Prescription Drug Importation Program in Virginia. HDA is the national trade association representing primary healthcare wholesale distributors — the vital link between the nation’s pharmaceutical manufacturers and more than 180,000 pharmacies and other healthcare settings nationwide. We oppose HB 478 and offer these comments to respectfully express our concerns regarding the implementation of any Drug Importation program, and most importantly our concern that it would conflict with the United State’s highly efficient and secure drug supply chain system, protected by federal law. This bill would also significantly increase the likelihood of allowing counterfeit or contaminated medications to enter the U.S. supply chain, at great risk to patient safety. Canadian importation conflicts with US federal law (Drug Supply Chain Security Act). The U.S. pharmaceutical supply chain is the most sophisticated, efficient, and highly secure drug supply chain system in the world, and the security of the supply chain was further strengthened in 2013 by the passage of the federal Drug Supply Chain Security Act, commonly referred to as DSCSA. The DSCSA adopted a comprehensive, practical approach to increase safety, continue efficiency, and minimize inconsistencies among competing state requirements. Drugs that are sold or designated for sale in Canada and other countries do not conform with U.S. traceability regulations, nor would these countries be required to modify or change their regulations to comply with U.S. law. Allowing for the importation of drugs from Canada or other countries would impede the efforts of the DSCSA regulations in further securing the U.S. supply chain, and thereby increase the risk of illegitimate or counterfeit medications entering the U.S. market. HDA recognizes this measure includes a provision for Virginia to comply with the DSCSA to “the extent feasible,” but we do not see a way for this compliance to be achieved. Additionally, drugs approval by the FDA are contingent upon the strictest guidelines for product integrity, good manufacturing practices, scientific data analysis and public safety. Although there are drugs available for sale in Canada or other countries that may be priced at a lower cost for varying reasons, it is important to recognize other countries’ regulatory agencies have different approval guidelines, dosage recommendations, and quality assurances. Internationally manufactured drugs are susceptible to counterfeiting, containing insufficient or too much of an approved medicine’s active ingredient or to being contaminated by unsanitary manufacturing conditions. It should also be noted that Canada has consistently expressed its unwillingness and incapability to become a supplier for the United States’ demand for prescription medicines over the past two years, stating that Canada’s market is too small to meet U.S. demands, importing drugs from Canada would not significantly lower U.S. prices, and Canada’s priority remains ensuring a steady and affordable supply of pharmaceuticals for Canadians. To protect patients and uphold U.S. standards, the Healthcare Distribution Alliance respectfully opposes this bill. Thank you for your consideration.

Comments Document

The Healthcare Distribution Alliance (HDA) respectfully opposes HB 478 and offer the attached letter to outline our concerns regarding the implementation of any Drug Importation program. In the letter, we highlight to the members of Subcommittee #3 the ways a drug importation program would conflict with the United State’s highly efficient and secure drug supply chain system and with federal law, as well as significantly increase the likelihood of allowing counterfeit or contaminated medications to enter the U.S. supply chain, putting the safety of Virginia patients at great risk. Please see the attached letter for more information, and thank you for your consideration. Sincerely, Kelly Memphis Director State Government Affairs, HDA kmemphis@hda.org

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

Comments Document

Please see attached support letter for HB 481, including a presentation of the evidence as to why the bill is so important for health care purchasers in the Commonwealth. Thank you!

I SUPPORT HB 388, 481, 484, 538, 877, 878, 1012, 1105, 1106, 1211, 1329, and 1342. Also, I object to the language used to describe non-citizens - the word "alien" is dehumanizing and I suggest retiring it permanently when referring to non-citizens. I OPPOSE HB 937 and 1359. It is everybody's right to control their own fertility and to NOT be forced to carry an unwanted pregnancy to term. Both of these bills directly or indirectly undermine that right.

I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable.

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

As a SALT (Social Action Linking Together) advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Most of us recognize the importance of education to the full realization of our potentials. This is a win for each individual that grasps this opportunity even if never used for employment. Even more, when this opportunity results in more fulfilled persons and a more productive citizenry, we all will be the better for it.

As a SALT (Social Action Linking Together) advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Mike Gillotte

I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers.

I SUPPORT HB 388, 481, 484, 538, 877, 878, 1012, 1105, 1106, 1211, 1329, and 1342. Also, I object to the language used to describe non-citizens - the word "alien" is dehumanizing and I suggest retiring it permanently when referring to non-citizens. I OPPOSE HB 937 and 1359. It is everybody's right to control their own fertility and to NOT be forced to carry an unwanted pregnancy to term. Both of these bills directly or indirectly undermine that right.

Chairman Orrock HWI & Members: Vote yes for HB 484! SALT 1300 members enthusiastically Support Delegate Helmer’s bill HB 484. HB 484 is a SALT Priority Issue: is to Reform the TANF. The Elimination of the 2-year cliff –would make it possible to better provide TANF parents with opportunities for job training and education to access real jobs that provide opportunities to leave welfare and to be self-sufficient without the need to return to the welfare rolls—in short, to become independent tax payers; Not Tax users. The goal of TANF must be to: convert welfare from a “ dead-end job factory” into “ a Second chance “ for Virginia families. As the past, Deputy Director of Family Services in another state, I know the value of HB 484, so that when we hired welfare recipients, with learned that with additional training they became excellent case management employees with the added benefit of far less turnover. Virginia’s current two-year TANF time limit requires modification in order to accommodate those attempting to move out of poverty via education and training programs. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Vote yes for HB 484! John Horejsi jhorejsi@cox.net ---MORE--- Time limit on TANF Benefits • Virginia’s TANF program was established in 1995. • Virginia’s 24-month time limit applies only to TANF recipients subject to work requirements. It does not apply to non-parents (40% of cases), for example. • 79% of former recipients who have exhausted their TANF eligibility have income at or below poverty line; 35% have income below 50% of the Poverty level. • TANF Recommendations: • Education and skills training should be provided to permit adult caretakers to attain their highest practical functional level and, where possible, to achieve self-sufficiency. • Meaningful exemptions to the state 24-month time limit on cash assistance should be provided for parents who are unable to find employment that pays wages at least equal to the poverty line or who lose such employment through no fault of their own.

HB 484 is a SALT Priority Issue: which is to Reform the TANF. The Elimination of the 2-year cliff –would make it possible to better provide TANF parents with opportunities for job training and education to access real jobs that provide opportunities to leave welfare and to be self-sufficient without the need to return to the welfare rolls—in short, to become independent tax payers; Not Tax users. The goal of TANF must be to: convert welfare from a “ dead-end job factory” into “ a Second chance “ for Virginia families. As the past, Deputy Director of Family Services in another state, I know the value of HB 484, so that when we hired welfare recipients, with learned that with additional training they became excellent case management employees with the added benefit of far less turnover. Vote yes for HB 484!

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

I SUPPORT HB 388, 481, 484, 538, 877, 878, 1012, 1105, 1106, 1211, 1329, and 1342. Also, I object to the language used to describe non-citizens - the word "alien" is dehumanizing and I suggest retiring it permanently when referring to non-citizens. I OPPOSE HB 937 and 1359. It is everybody's right to control their own fertility and to NOT be forced to carry an unwanted pregnancy to term. Both of these bills directly or indirectly undermine that right.

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

Comments Document

Please see the attached letter explaining the National Community Pharmacists Association's support for HB 560.

Honorable Delegates: I hope you allow me to speak to the issue. Though I am not a resident of Boykins, I am licensed to practice Pharmacy in Virginia, and I did own a Pharmacy there for sixteen years, a Pharmacy that had been in existence for decades. It is now closed because of the issue this bill will help to address. Up until the last five or so years of this Pharmacy's history people were free to choose where they wanted to have their medications filled. When the PBMs gained control of prescription dispensing by dictating terms of place and price all freedom disappeared. There were several industries in the area who contracted with the PBMs for prescription insurance that mandated that maintenance medications had to be filled by their mail-order or chain pharmacies. Private policies did the same. When that happened the prescription volume, total patient traffic, and profitability went below a sustainable level. I was forced to close. With the closing went the loss of decades of service to a community of 600 people. Service that included immunization services, compounding service (humans and veterinary), disease state counseling, medication therapy management, and after-hours emergency availability, plus knowing patients one-on-one and their needs. That is all gone. Now, those 600 people, not the wealthiest, have to drive 16 miles one-way to Franklin, or Emporia (~30miles), Murfreesboro, NC (18 miles), Conway, NC (now closed) to purchase any prescription or wait for the mail to come, which adds to the cost of healthcare. Their freedom has been taken away. Their access to one on one -get your questions answered in a way that helps because I know you- healthcare is gone. Prescriptions to PBMs are just a means of profit and profit only. They have no interest in the person in need of medical assistance. That is why they dictate by place and price access to medications. Passing this legislation will at the very least let people know they DO HAVE A CHOICE. It will not correct the past, but my prayer is that it will stop the erosion of healthcare. Healthcare, by definition, was meant to be one-on-one, not en masse. This will at least allow that to take place again. Please stop the erosion! Thank you for allowing me to speak.

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

The Virginia Board for People with Disabilities supports transparency and accountability for the utilization and cost of services in intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs). This bill would give policymakers and other stakeholders the information needed to oversee key utilization and cost trends in ICF/IIDs, as well a better understanding of the barriers to discharge to a home- or community-based setting, as recommended in our June 2021 assessment of the topic. ICF/IIDs are one the most segregated settings for individuals with disabilities to receive residential care. Oversight is necessary to ensure that the Commonwealth is serving people in the most integrated setting, appropriate to their needs and desires, as required by the Americans with Disabilities Act and enforced by the Commonwealth’s Settlement Agreement with the U.S. Department of Justice. ICF/IIDs are also one of the most expensive settings for the Commonwealth in terms of cost per bed. Excess utilization poses a cost to the Commonwealth because it is less expensive to serve someone in a home- or community-based setting. According to available federal data, Virginia added the second highest number of ICF/IDDs out of all 50 states between 2010 and 2020. Currently, the Commonwealth only publishes utilization and cost data for ICF/IIDs that are owned by the Commonwealth, known as Training Centers. However, the vast majority of ICF/IIDs are not owned by the Commonwealth. House Bill 651 would fix this information gap.

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As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

Please gently PBI HB877. We need to give any benefits to those who *legally* and only legally come here. I know many folks who have, who follow the laws and work hard. Stop penalizing them for obeying the law. Please move to report HB1098 for obesity. Tough disease. It is a linchpin in many others, and treating it would be best. HB1105, please gently PBI. I didn't take courses but have been introduced to a lot of people of all backgrounds and that positive interaction is going to do more than any training that is not scientifically proven. Please move to report HB1359 because we need to know who of these admins (hospitals) are in our health records snooping around.

I SUPPORT HB 388, 481, 484, 538, 877, 878, 1012, 1105, 1106, 1211, 1329, and 1342. Also, I object to the language used to describe non-citizens - the word "alien" is dehumanizing and I suggest retiring it permanently when referring to non-citizens. I OPPOSE HB 937 and 1359. It is everybody's right to control their own fertility and to NOT be forced to carry an unwanted pregnancy to term. Both of these bills directly or indirectly undermine that right.

Stop with the lies!

No! Stop with the lies! Cannibas is much safer than alcohol and pharmaceuticals!! Let the average person be free with a plant! Stop holding the little guy back....just stop.

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

I am writing in support of HB 306 to be heard in committee tomorrow morning, which will allow a religious exemption to vaccines during an epidemic. Religious exemptions exist so that citizens can act freely in mind, body and spirit. Even in a time of an epidemic, citizens must have the opportunity to act on their conscience whatever that may be. The Nuremberg Code requires bodily autonomy and informed consent for any medical treatments to one’s body. Having religious exemption makes sure that remains the rule of law. As we’ve seen over the last two years, government has retained control over persons and their bodies in a way that would make Thomas Jefferson role over in his grave. Let Virginia continue to be religiously free, as the birthplace of religious freedom. Support HB 306.

I SUPPORT HB 388, 481, 484, 538, 877, 878, 1012, 1105, 1106, 1211, 1329, and 1342. Also, I object to the language used to describe non-citizens - the word "alien" is dehumanizing and I suggest retiring it permanently when referring to non-citizens. I OPPOSE HB 937 and 1359. It is everybody's right to control their own fertility and to NOT be forced to carry an unwanted pregnancy to term. Both of these bills directly or indirectly undermine that right.

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

I SUPPORT HB 388, 481, 484, 538, 877, 878, 1012, 1105, 1106, 1211, 1329, and 1342. Also, I object to the language used to describe non-citizens - the word "alien" is dehumanizing and I suggest retiring it permanently when referring to non-citizens. I OPPOSE HB 937 and 1359. It is everybody's right to control their own fertility and to NOT be forced to carry an unwanted pregnancy to term. Both of these bills directly or indirectly undermine that right.

I oppose HB937 . Planned Parenthood provides necessary healthcare to low income people and families. Defunding them will harm so many people and help no one.

I am opposed to any efforts to defund Planned Parenthood. I support a woman's right to have an abortion. Planned Parenthood provides many other health care services besides abortion. Defunding Planned Parenthood will limit access to birth control (causing more unwanted pregnancies), sexually transmitted disease testing (causing the more spread of STDs), cancer screening, and other medical services that are mostly provide to low income citizens. These efforts to undermine Constitutionally protected rights for women that have existed in this Country since 1973 are backwards and mean. I look forward to you representing my views before the General Assembly. Respectfully, Silver Persinger

Nice try, we know this is an attempt to take funding from Planned Parenthood. You are attempting to restrict access to birth control, cancer screenings, annual exams, and STI testing and treatment to people who depend on the Planned Parenthood center in their neighborhood. Healthcare is difficult enough to attain and afford for many Virginians, stop trying to make it harder.

I support all of these bills to increase coverage for children, to train care providers in the pernicious influence of cultural bias and systematic racism that can skew our medical decisions (without us even realizing it). I worked as a hospital RN, and then a Nurse Practitioner for 23 years. Nurse practitioners have the education and professional certification requirements to work collaboratively. We do not need practice agreements or supervision by a medical doctor to work within the law and limits of our profession. I do not agree with any measures to limit the dissemination of birth control to women who seek help in limiting conception. I do not know the details of Mr LaRock’s bill, but I have followed his history of preference for the State to control women in their choices for their contraception and well-being within their life limitations. I believe doing all we can to educate girls and women to be their own decision makers, and equal to men spiritually, mentally, and legally will reduce the incidence of unwanted and too early pregnancy better than any heavy-handed scare tactics.

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

I have no official position on this bill, but wanted to note that the program this bill seeks to create may address a gap in coverage for children who are in Virginia's foster care system but whose immigration status prevents them from being eligible for Medicaid or other public health coverage. Local departments of social services take custody of these children due to abuse, neglect or abandonment, but there is no established fund available to them to cover health care costs for these children. Agencies often must seek funds from outside private and charitable organizations to pay for health care costs for these children. Some localities allow CSA funds to cover costs. This program could provide local agencies access to a consistent funding source for them to take better care of these vulnerable children.

I am writing in support of HB 306 to be heard in committee tomorrow morning, which will allow a religious exemption to vaccines during an epidemic. Religious exemptions exist so that citizens can act freely in mind, body and spirit. Even in a time of an epidemic, citizens must have the opportunity to act on their conscience whatever that may be. The Nuremberg Code requires bodily autonomy and informed consent for any medical treatments to one’s body. Having religious exemption makes sure that remains the rule of law. As we’ve seen over the last two years, government has retained control over persons and their bodies in a way that would make Thomas Jefferson role over in his grave. Let Virginia continue to be religiously free, as the birthplace of religious freedom. Support HB 306.

Members of the Committee: Thank you for the opportunity to provide comments on behalf of the American Lung Association on HB 1012 sponsored by Delegate Tran. The American Lung Association strongly supports this bill. The American Lung Association supports reforms to health insurance programs that ensure universal access to quality and affordable healthcare services, preventive care, and appropriate specialty care for all consistent with national guidelines. The American Lung Association opposes discriminatory barriers to healthcare coverage and firmly believes that all people, including children living within the United States should have access to affordable, adequate, and accessible health care. The Lung Association believes that every child in Virginia should have access to affordable and comprehensive health coverage. HB 1012 is an important step by creating a health coverage program available to all children in Virginia, regardless of immigration status. According to the Commonwealth Institute, this policy change would offer a new and affordable health coverage option to almost 1 in 10 (9.3%) uninsured children in Virginia. Federal law prohibits children with an undocumented immigration status from accessing health coverage through Medicaid, the Children’s Health Insurance Program (CHIP), and the Affordable Care Act (ACA) marketplace. Virginia should join 10 other states (CA, IL, MA, NY, OR, WA, NJ, CT, VT, and ME) and the District of Columbia who currently uses or plans to use state-only funds to cover income-eligible children in Medicaid/CHIP who are otherwise ineligible due to immigration status. The Lung Association strongly supports this bill as a way of increasing access to healthcare for all Virginians.

I SUPPORT HB 388, 481, 484, 538, 877, 878, 1012, 1105, 1106, 1211, 1329, and 1342. Also, I object to the language used to describe non-citizens - the word "alien" is dehumanizing and I suggest retiring it permanently when referring to non-citizens. I OPPOSE HB 937 and 1359. It is everybody's right to control their own fertility and to NOT be forced to carry an unwanted pregnancy to term. Both of these bills directly or indirectly undermine that right.

For those of us who believe that healthcare is a human right, there are no exceptions or asterisks. Healthcare is a human right, period. No person should be denied lifesaving healthcare due to financial reasons or migration status. And yet, almost 100,000 children in Virginia lack access to healthcare because they do not qualify for existing programs. HB1012 takes Virginia a step in the right direction, guaranteeing health coverage for all children in the commonwealth. Those legislators who truly care about promoting a culture of life in Virginia should wholeheartedly support this measure.

Comments Document

My name is Matthew Van de Graaf, and I am a fourth year medical student at EVMS. I am testifying on behalf of the Medical Society in support of House Bill 1012. As an aspiring pediatrician, one of my favorite experiences in medical school has been volunteering to see uninsured children at our free clinic, but it often simultaneously frustrates me. My patients and their families face obstacles when accessing healthcare that their peers do not. Because the clinic relies on physicians volunteering their time, they do not get to develop the friendly and comforting relationship with a pediatrician that so many of us knew. If their baby develops a fever or their middle schooler has an asthma attack, calling for a sick visit isn’t an option. Every child should have the opportunity for a healthy start, but 4.9% of children are uninsured in Virginia. Even among those who are citizens, 4.1% are uninsured. Meanwhile, 10 states & DC either currently or have plans to provide health coverage to income-eligible children regardless of immigration status. We are stronger when we accept and nurture those around us, and this is no different. We have an important opportunity before us, and each of you has the chance to vote on this. On behalf of the Medical Society & myself, I urge each of you to take this opportunity; vote in favor of House Bill 1012. Thank you for your time.

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.

I support all of these bills to increase coverage for children, to train care providers in the pernicious influence of cultural bias and systematic racism that can skew our medical decisions (without us even realizing it). I worked as a hospital RN, and then a Nurse Practitioner for 23 years. Nurse practitioners have the education and professional certification requirements to work collaboratively. We do not need practice agreements or supervision by a medical doctor to work within the law and limits of our profession. I do not agree with any measures to limit the dissemination of birth control to women who seek help in limiting conception. I do not know the details of Mr LaRock’s bill, but I have followed his history of preference for the State to control women in their choices for their contraception and well-being within their life limitations. I believe doing all we can to educate girls and women to be their own decision makers, and equal to men spiritually, mentally, and legally will reduce the incidence of unwanted and too early pregnancy better than any heavy-handed scare tactics.

Unconscious bias is a very practical bill that can have significant long term impact.

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

Please gently PBI HB877. We need to give any benefits to those who *legally* and only legally come here. I know many folks who have, who follow the laws and work hard. Stop penalizing them for obeying the law. Please move to report HB1098 for obesity. Tough disease. It is a linchpin in many others, and treating it would be best. HB1105, please gently PBI. I didn't take courses but have been introduced to a lot of people of all backgrounds and that positive interaction is going to do more than any training that is not scientifically proven. Please move to report HB1359 because we need to know who of these admins (hospitals) are in our health records snooping around.

I support all of these bills to increase coverage for children, to train care providers in the pernicious influence of cultural bias and systematic racism that can skew our medical decisions (without us even realizing it). I worked as a hospital RN, and then a Nurse Practitioner for 23 years. Nurse practitioners have the education and professional certification requirements to work collaboratively. We do not need practice agreements or supervision by a medical doctor to work within the law and limits of our profession. I do not agree with any measures to limit the dissemination of birth control to women who seek help in limiting conception. I do not know the details of Mr LaRock’s bill, but I have followed his history of preference for the State to control women in their choices for their contraception and well-being within their life limitations. I believe doing all we can to educate girls and women to be their own decision makers, and equal to men spiritually, mentally, and legally will reduce the incidence of unwanted and too early pregnancy better than any heavy-handed scare tactics.

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

Please gently PBI HB877. We need to give any benefits to those who *legally* and only legally come here. I know many folks who have, who follow the laws and work hard. Stop penalizing them for obeying the law. Please move to report HB1098 for obesity. Tough disease. It is a linchpin in many others, and treating it would be best. HB1105, please gently PBI. I didn't take courses but have been introduced to a lot of people of all backgrounds and that positive interaction is going to do more than any training that is not scientifically proven. Please move to report HB1359 because we need to know who of these admins (hospitals) are in our health records snooping around.

I oppose HB 1105. Recognizing implicit bias and cultural competency is important. Medical school and residency training includes this in their training. The challenges are physicians are overwhelmed with required/mandated educational requirements from the Federal government, Joint Commission, medical malpractice carriers, Board recertification requirements, CME requirement. The Commonwealth of Virginia already requires 30 hours of CME per year for physicians plus 2 hours relating to opioids. My board recertification requires 50 hours of CME per year. There is truly little evidence that requiring 2 hours every two years of implicit bias and cultural competency for everyone is going to accomplish its goals. In many cases health providers are pulled from patient care to complete the above requirements. Adding 2 additional hours of CME to all health care providers who are burned out from the pandemic is not effective use of their time. I would suggest health organizations, or the Board of Medicine be more focused on which health care providers would benefit from an intervention/specific training related to implicit bias and cultural competency. Sincerely yours, Roger Hofford, M.D. Roanoke, VA

Comments Document

Although my name is Dr. Ladd, I have a doctorate in political science, not medicine. I am writing because HB1105 concerns our fundamental responsibility to provide equal protection of the laws. Although a member of the Senate committee considering this bill recently suggested that there was no proof that race bias is causing adverse health outcomes, the New England Journal of Medicine has an article in their current issue that has a long list of studies proving otherwise. Since we therefore know that human beings are prone to hold biases that can interfere with critical medical decisions, it is incumbent on the government to protect the public from this harm. HB1105 is a modest step toward addressing this complex failing of the profession. It is not an intrusion into the field of medicine by government, the medical profession itself has identified this problem and called for steps to address it.

I SUPPORT HB 388, 481, 484, 538, 877, 878, 1012, 1105, 1106, 1211, 1329, and 1342. Also, I object to the language used to describe non-citizens - the word "alien" is dehumanizing and I suggest retiring it permanently when referring to non-citizens. I OPPOSE HB 937 and 1359. It is everybody's right to control their own fertility and to NOT be forced to carry an unwanted pregnancy to term. Both of these bills directly or indirectly undermine that right.

Please support HB1105. Having a young child with sickle cell and dealing with medical staff who was not familiar with the disease or on how to treat my child lead to them calling CPS on my husband and I. We waited for hours while the doctor was trying to get in contact with a pharmacist until we decided to leave and go elsewhere for care. Instead of the doctor admitting that they were not trained on how to treat my son, she just made us wait for hours in a room while my son was in pain with a fever and wheezing. We decided to leave and take him elsewhere. The doctor assumed we were leaving with our son to do who knows what. CPS was contacted and they called while we were finally receiving care from another hospital. I honestly believe more training would have eliminated this horrible situation. I had to make sure my son got treatment immediately, but this doctor tried to make us feel guilty for doing what was best for our son and receiving the care he deserved.

It is clear that something must be done about implicit bias in healthcare. As an RN of 37 yrs, and Women's Health Nurse Practitioner for 27yrs, I have personally seen the result of bias . Black women are dying two to three times more than their counterparts in pregnancy associated deaths, and in Virginia, the mortality rate is three to four times more. I am 100% supportive of this bill which establishes two hours of Unconscious (implicit and cultural competency) Bias Training as a criterion of eligibility for all health care professionals seeking renewed licensure every biennium by the Virginia Board of Medicine. It would certainly benefit the over 13000 Advanced Practice Nurses as well. Healthcare providers already participate in opportunities for continuing education, and this topic, as with the opioid crisis, is needed and timely. There is no fiscal impact.

I support all of these bills to increase coverage for children, to train care providers in the pernicious influence of cultural bias and systematic racism that can skew our medical decisions (without us even realizing it). I worked as a hospital RN, and then a Nurse Practitioner for 23 years. Nurse practitioners have the education and professional certification requirements to work collaboratively. We do not need practice agreements or supervision by a medical doctor to work within the law and limits of our profession. I do not agree with any measures to limit the dissemination of birth control to women who seek help in limiting conception. I do not know the details of Mr LaRock’s bill, but I have followed his history of preference for the State to control women in their choices for their contraception and well-being within their life limitations. I believe doing all we can to educate girls and women to be their own decision makers, and equal to men spiritually, mentally, and legally will reduce the incidence of unwanted and too early pregnancy better than any heavy-handed scare tactics.

As the author of a book on Unconscious Bias (Overcoming Bias: Building Authentic Relationships Across Differences), there is indisputable evidence that unconscious bias affects all well-meaning people in ever profession. In health care, it is literally a life or death matter to ensure that health care professionals are aware of their biases and trained on how to interrupt them. Please support this crucial bill to ensure access to quality health care for all Virginians.

Please support HB1105. This bill will help bring an immediate solution to the maternal mortality crisis that is costing the lives of women and infants

Unconscious bias is a very practical bill that can have significant long term impact.

Please support HB1105

Please support HB 1105 as everyone deserves the same level of health care in our community. We often don't realize the subtle biases that influence our decisions and consequently might impact another person in a less than desirable manner. Having training to recognize those implicit biases will help to mitigate the disparity that is evident in maternal mortality rates. This disparity is completely unacceptable for this time and our community.

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

I am writing in support of HB 306 to be heard in committee tomorrow morning, which will allow a religious exemption to vaccines during an epidemic. Religious exemptions exist so that citizens can act freely in mind, body and spirit. Even in a time of an epidemic, citizens must have the opportunity to act on their conscience whatever that may be. The Nuremberg Code requires bodily autonomy and informed consent for any medical treatments to one’s body. Having religious exemption makes sure that remains the rule of law. As we’ve seen over the last two years, government has retained control over persons and their bodies in a way that would make Thomas Jefferson role over in his grave. Let Virginia continue to be religiously free, as the birthplace of religious freedom. Support HB 306.

The Federation of Virginia Food Banks strongly supports HB1106. Produce Rx programs have had demonstrated success at improving nutritional intake for food insecure families, and the research is clear that food insecurity correlates with diet-related illness. This bill would come at a critical time, as food banks have seen a sustained increase in demand for emergency food assistance since the beginning of the COVID-19 pandemic. Expanding Produce Rx programs would go a long way toward establishing healthier communities while also investing in local agriculture. It's a win-win for Virginians.

I SUPPORT HB 388, 481, 484, 538, 877, 878, 1012, 1105, 1106, 1211, 1329, and 1342. Also, I object to the language used to describe non-citizens - the word "alien" is dehumanizing and I suggest retiring it permanently when referring to non-citizens. I OPPOSE HB 937 and 1359. It is everybody's right to control their own fertility and to NOT be forced to carry an unwanted pregnancy to term. Both of these bills directly or indirectly undermine that right.

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

Please increase the number of individuals with lived experience for the workgroup. These folks have a critical perspective that is essential and cannot be represented by other members. Why are more insurance reps than people with lived experience proposed?

I appreciate the sentiment to study this important issue. However, I am appalled that only one out of eleven representatives are those who have experienced mental health issues personally and first-hand. The additional 3 insurance representatives should be replaced with 3 individuals who directly experienced or were impacted by mental health issues. Further, this study should include a section that articulates medical causes of mental health issues and tests and treatments that should be utilized rather than solely psychiatric drugs or therapy. And, at least one of the additional personally affected workgroup members should represent this sub-set of mental illness. And, finally, the study should evaluate care facilities available to treat medically-induced mental health issues and establish at least one care facility in Virginia to meet this unique need.

Delegate Hope- thank you for this bill- but you only have one family member or individual - Can you add more? Please

Coordinated Specialty Care is an evidence-based practice to provide early intervention to those with emerging psychosis. To date Virginia has established eleven programs providing this treatment. This falls far short of the need. For these programs to be developed and sustained the Commonwealth will need to establish resources for ongoing funding. Medicaid and commercial insurance are logical sources of funding for Coordinated Specialty Care. This work group will develop the foundation for future funding. I support the passage of this important bill.

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 SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

I SUPPORT HB 388, 481, 484, 538, 877, 878, 1012, 1105, 1106, 1211, 1329, and 1342. Also, I object to the language used to describe non-citizens - the word "alien" is dehumanizing and I suggest retiring it permanently when referring to non-citizens. I OPPOSE HB 937 and 1359. It is everybody's right to control their own fertility and to NOT be forced to carry an unwanted pregnancy to term. Both of these bills directly or indirectly undermine that right.

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 SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

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

As a SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

I SUPPORT HB 388, 481, 484, 538, 877, 878, 1012, 1105, 1106, 1211, 1329, and 1342. Also, I object to the language used to describe non-citizens - the word "alien" is dehumanizing and I suggest retiring it permanently when referring to non-citizens. I OPPOSE HB 937 and 1359. It is everybody's right to control their own fertility and to NOT be forced to carry an unwanted pregnancy to term. Both of these bills directly or indirectly undermine that right.

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 SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

I SUPPORT HB 388, 481, 484, 538, 877, 878, 1012, 1105, 1106, 1211, 1329, and 1342. Also, I object to the language used to describe non-citizens - the word "alien" is dehumanizing and I suggest retiring it permanently when referring to non-citizens. I OPPOSE HB 937 and 1359. It is everybody's right to control their own fertility and to NOT be forced to carry an unwanted pregnancy to term. Both of these bills directly or indirectly undermine that right.

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 SALT (Social Action Linking Together) and Cornerstones advocate, I encourage you to support HB 484, with Delegate Dan Helmer as patron. This legislation exempts from mandatory participation in the Virginia Initiative for Education and Work recipients of Temporary Assistance for Needy Families those enrolled full-time in an accredited public institution of higher education or other postsecondary school licensed or certified by the Board of Education or the State Council of Higher Education for Virginia and are taking courses as part of a curriculum that leads to a postsecondary credential, such as a degree or an industry-recognized credential, certification, or license. Passing this legislation would make moving off welfare into the workforce a much easier task, which would be a win-win for both those receiving TANF and taxpayers. Post-secondary education, GED, vocational education, and most credentialing programs, as well as apprenticeships, require more than 24 months for the screening, access and completion process. Eliminating the two-year limit is the right thing to do. Preparing adult TANF recipients for jobs to fully support their families should be a primary goal for Virginia. Attaining this goal would be a win-win for both TANF recipients and taxpayers. However, the current two-year time limit on the continuous receipt of TANF benefits is an impediment, making that goal unattainable. Regards, Sarah Newman

Please gently PBI HB877. We need to give any benefits to those who *legally* and only legally come here. I know many folks who have, who follow the laws and work hard. Stop penalizing them for obeying the law. Please move to report HB1098 for obesity. Tough disease. It is a linchpin in many others, and treating it would be best. HB1105, please gently PBI. I didn't take courses but have been introduced to a lot of people of all backgrounds and that positive interaction is going to do more than any training that is not scientifically proven. Please move to report HB1359 because we need to know who of these admins (hospitals) are in our health records snooping around.

I SUPPORT HB 388, 481, 484, 538, 877, 878, 1012, 1105, 1106, 1211, 1329, and 1342. Also, I object to the language used to describe non-citizens - the word "alien" is dehumanizing and I suggest retiring it permanently when referring to non-citizens. I OPPOSE HB 937 and 1359. It is everybody's right to control their own fertility and to NOT be forced to carry an unwanted pregnancy to term. Both of these bills directly or indirectly undermine that right.

Fluvanna County’s Community and Policy Management Team opposes the passage of this bill. This public body asserts that this bill would have a net negative impact on the mental health treatment of many youths served in the Commonwealth of Virginia. Reading between the lines, we would like parents to be more involved, but not all parents are seen by their children as a safe space; this bill could very likely reaffirm this perception, and cause any mental health provider to also be seen as an equally unsafe space, resulting in any pursuit of mental health treatment of many children to be, ultimately, a futile endeavor, due to the consequences of this bill becoming a barrier to many children accepting the help they need.