Tax cuts on the highest brackets do not help working people. If the governor and the general assembly were really focused on improving the live of working people, then why not cut taxes for the brackets below $17,000? The answer to me is that there is no will by our government leaders to fully fund the public good and instead dispense with public money as if there are not serious problems in this state. Tax cuts will not solve the crisis in education. Teachers are leaving the profession. Students are suffering. And bonuses are lackluster effort to solve this catastrophic problem. Virginia fails to fund English as a second language properly, continues recession-era caps on support position funding, falls near the bottom of the list in per pupil state funding. Teachers are not paid near the same as professionals outside education, so it is easier and more fiscally advantageous in this state to switch out of education, depriving the classrooms of experienced and quality teachers. If this governor was serious about supporting educators this budget was be very different. And if the general assembly is serious about protecting public schools that many of their constituents love and support, then they need to take bold action, like a 11% raise in teacher pay and fully funding the SOQs, in order to deliver the schools our students deserve.

I appreciate this opportunity to share my comments, and extend my sincere thanks to the Appropriations Committee Chairs and Members. A Norfolk native, I am very fortunate to live on the Elizabeth River, in my family’s home to which we moved in the 1970’s when I was little. While at the outset, the river was almost wholly dead from suffocating pollutants, I have over the years seen many changes, good and bad, to the water and all it hosts, from marine life to human life and business. First – The Good: Thanks to years of effort from a suite of entities dedicated to saving the Chesapeake Bay and our local estuaries, I now see marine life and birds that were absent and silent when I was young. That said, the level of marine industrial activity (shipping, etc.) has markedly increased. This shows, with proper regard, both nature and human industry can successfully exist. It also shows, that at the very least, the level of existing funding for these important marine protection programs dedicated to the care and cleanliness of the Chesapeake Bay watershed (water, land, and air), must be maintained or even increased. This includes: All water quality programs; $75M for Agricultural best management practices cost-share program; $300M for Wastewater solutions; $50M for Stormwater Local Assistance Fund (SLAF); Chesapeake Bay Preservation Area/Living Shoreline DEQ Support Staff; Oyster Survey – the successful results from all of which I can gratefully observe from my own home. Next – The Bad: Despite the good, my neighborhood suffers some of the worst flooding from subsidence and climate change of any area in the country – none of which was an issue when I was little. But these days? Good luck to you if you are out of groceries or other necessities on the increasingly frequent sunny-yet-completely flooded days. The issue is very serious, affecting all – from residents to businesses, and even our National Security given the mounting consequences to the nearby Norfolk Naval Base, too. Any and all ongoing and proposed subsidence and/or flooding mitigation, and resilience efforts would therefore be important funding candidates (e.g., RGGI is the only source of funding for resilience). Moreover, now is not the time to end the Community Flood Preparedness Program. It serves an urgent vital purpose that the newly conceived revolving loan fund by its own design cannot now, or ever, be able to serve. Finally, one growing area of deep concern I see is for the Menhaden fish. While those in authority, with no scientific backing, claim in dangerous unfounded fashion that the species’ population is increasing, it is plain to see – from my own home, and elsewhere – that the once rebounding ospreys, previously decimated in the 1970’s by pesticides almost to extinction, having then shown a slow but sure return to the area in the early 2000’s – are now evidently not finding sufficient levels of menhaden fish to eat – their almost exclusive food source – as they were able to find even three (3) years ago. I urge the powers-that-be to fund the implementation of rigorous protections for this sadly undervalued yet critically important feeder fish. Thank You.

Hampton-Newport News Community Services Board thanks our legislators for your continued support of community services for individuals with behavioral health needs and developmental disabilities. For this upcoming session, CSB Workforce Development funding remains our top budget priority. Our CSB’s ability to recruit and retain staff is extremely challenging. We currently have a 24% turnover rate — nearly a quarter of our workforce. It is difficult to function with this high turnover rate because not only are we losing staff, knowledge is also often lost when our employees leave. As the demand for community-based behavioral healthcare continues to increase, we are consistently being tasked with doing more without additional resources. We have implemented sign-on and retention bonuses, increased starting salaries, and added shift differentials for some of our most difficult to fill positions such as RNs, LPNs, and Licensed Therapists; yet we continue to lose essential staff primarily due to compensation. Our budget cannot withstand these retention efforts in the long run without financial support to continue these bonuses and extend them to all CSB staff. Although the State psychiatric facilities received funding to address compensation last year, the General Assembly did not provide any funding for CSB workforce initiatives. This investment has yielded positive results for the State hospitals, while CSBs have been left not only competing with private providers, but now, we are further competing with State hospitals for staff. The infusion of funds into select parts of the system causes entities that should complement each other to compete with each other— destabilizing one part of the system to mend another. The result is a fragmented system of care that leaves individuals who need services hanging in the balance. We want to stress that CSBs require investment in all areas of the workforce— including staff for developmental disability, mental illness, and substance use disorder services. • We support the proposed additional funding for DD waivers in the Governor’s budget; however, please note that the turnover rate for the staff who coordinate these services is so high, that this sector of the workforce must first be stable in order for CSBs to successfully manage the additional waiver slots. • While we welcome the Governor’s proposed investment to expand crisis services, CSBs are struggling to staff our existing crisis services. Workforce funding is crucial for the full crisis continuum to materialize and be effective. • Finally, alleviating the State hospital census pressure requires investment not only in crisis services, but in the CSB staff who provide post-crisis services and those who work to support individuals with maintaining their stability in the community. Therefore, we respectfully ask for your support of the VACSB’s budget request of $162.6 million in FY 24 to provide quarterly recruitment and retention bonuses for our CSB staff providing direct services. Thank you for your continued support!

I recently moved back to my home state of Virginia after 23 years in the midwest. I live in James City County. I want to thank you for your past support of the DD Waiver Program, and ask that you fund the 1,100 DD Waiver slots currently included in the Governors proposal. I would also ask that you look at the Medicaid income limits and consider increasing them or allow the disabled to automatically be eligible. This is important to me because my 27 year old disabled daughter has lost her medicaid benefits since moving back to Virginia because her social security disability income has taken her over the $1506 monthly income allowed in this state. She is required to also draw from her fathers disability income as he became disable from a stroke 3 years ago, and that additional benefit has taken her $100 over the maximum allowed to receive medicaid benefits. She wants to work. She was working. A 20 hour job in a cafeteria she loved. If she works again in Virginia and finally receives the DD Waiver, she will be disqualified for being $100 over the maximum income for medicaid and then her little bit of job income on top of that. Having the medicaid maximum income so low is keeping the disabled who want to work, and become a productive part of the community, sitting, with no Medicaid, and no waiver benefits to provide support to live after both parents are gone. This transition has been an eye opener for me as the sole caretaker for my husband and guardian for my daughter. We moved back here to be closer to family for my husband, but in the meantime, the DD Waiver benefits and Medicaid benefits by daughter was already receiving, were lost in the transition. I’m devastated knowing I’ve taken away a future of security for her for $100, that Virginia would give her with the DD Waiver if I become incapacitated. What will happen to her now? This is why I support the Arc of Virginia’s Legislative Agenda and ask that you fund the 1100 slots currently included in the Governors proposed budget. And that you reassess the income limits for medicaid. These individuals need us to do better by them. Thank you.

I'm on the list of speakers, but never got the zoom link. Please re-send to CEO@momsinmotion.net

Good morning. My name is Carol Bauer, I am a National Board Certified Teacher and have been an elementary teacher for 27 years. I currently serve as the Virginia Education Association Vice President. As you amend and improve the budget, please consider the important role education has played in our economy and the well-being of Virginians during COVID and will continue to play going forward. Please amend the budget to include an increase in compensation for educators to raise Virginia’s teachers’ pay to the national average. A bi-partisan bill was passed years ago to bring compensation up, but there has not been sufficient funding to support the will of the General Assembly. We are losing educators due to the lack of adequate compensation, and you can help prevent educators leaving. For a state that has high educational outcomes it is time to compensate those who are in the schools working with our students every day. Additionally, amend the budget to increase the recognition for National Board-Certified Teachers (NBCT). These teachers have worked to improve their instructional practice and support their students. Research shows that NBCT have higher student outcomes and are committed to their students and communities which are results we all support. The Standards of Quality (SOQ) ensure all students in Virginia have a minimum of educational support, yet Virginia’s budget does not fully fund the SOQs and consequently does not fully support all of Virginia’s students. Please support budget amendments that fully fund the SOQs and remove the support staff cap on localities. In this era public discourse around public education it is easy to see how supporting democracy and public education supports all Virginians. Respectfully submitted, Carol Bauer, NBCT, VEA Vice President

Funding for CSB Workforce: With an increase in need for mental health treatment, Community Services Boards (CSB) are experiencing significant staff shortages. CSBs serve and meet the complex needs of people with severe MH conditions, Substance Use Disorders and Developmental Disorders in our communities. Keeping pace with demands in our communities is also critical to preventing admissions to mental hospitals, jails and preventing suicides .Virginia is ranked 38th in the nation in the availability of MH professionals. We are asking for $162.6M in FY 24 for quarterly recruitment and retention bonuses for direct care providers. STEP-VA : we are also requesting $8.7 for increased funding for STEP-VA. All 9 Steps were funded. However the first 3 Steps were funded and implemented in 2019 but funding has remained the same; not accounting for inflation. Funding for Permanent Supportive Housing : for people with serious mental health conditions: Permanent Supportive Housing (PHS) . PHS is an evidence based practice which demonstrates positive outcomes such as, reduced hospitalizations, and homelessness and improved behavioral and physical health. Wait time for housing in Virginia is high; just in Virginia Beach it's 5 months. We request that you support funding for permanent supportive housing. Jail Diversion: We request that you increase funding for programs in our communities that help divert people with mental health conditions away from incarceration. Almost 25% of jail inmates in Virginia have a mental health disorder. Jail Diversion programs help in identifying individuals diagnosed with serious mental health conditions and connecting them with community resources that can provide treatment and other services to prevent incarcerations.

Comments Document

I have 2 main requests: First, please fund DD Waivers for all on the Priority 1 list. These Virginians are at extreme risk. Second, please increase the pay for supportive living so that providers can attract caregivers and make community engagement and inclusion possible.

Topic: Consumer Directed Medicaid Waiver Services Rates Call To Action: • Support a FIX for the 5 Consumer Directed (CD) Medicaid Waiver Services rates. • Support an amendment to the budget that would correct the rates and bring them up to the 50th percentile BLS rates that were recommended by the Burns & Associates (B&A) Rates Rebase Study last year (with no services falling below the current 12.5%). Background: • CD Services were created in 2005 to help people direct their own care and make their own choices. • The state did not have the capacity to administer these services themselves and so they opened it to a sort of public partnership with private providers. • Services Facilitators (SFs) administer CD Services in order to help people find, hire, manage, train, and retain good Personal Care Attendants. Services Facilitators help people become their own Employers of Record, ensuring their authorizations for services are getting approved, that their needs are being met and that they are safe, and that their attendants are getting paid properly through the fiscal agents. Rate Facts: • Since 2005, the 5 CD services have received exactly 1 rate increase, last year (2022), and it was only 12.5%, which equates to about 0.7% per year. That is not enough to keep up with minimum wage increases, inflation, cost of living increases, additional administrative burden, and so on. • CD Services WERE included, along with the other 30+ DD Waiver Services, in the recent Burns & Associates Rate Rebase Study. The B&A recommendation for CD Services was an average rate increase of 69%, which would bring them up to the 50th percentile of the BLS. • CD Services were left out of the group of DD Waiver Services in the last session that received the B&A recommended rates. Ask: • Please support the amendment that will FIX Consumer Directed Medicaid Waiver Services Rates and bring them up to the B&A recommended 50th percentile rates, ensuring none of them fall below the current 12.5%.

My daughter is 37 and has intellectual disabilities. We have been on the waiver list for quite some time. I have had a great deal of trouble getting the help my family needs. Even when my husband became ill with ALS, and needed 24 hour care, I was still unable to move up on the waiver list. I then had 2 adults needing 24 hour care, in addition to helping my 89 year old father, and it has caused me to be exhausted and my health has suffered . My husband passed this past summer and I was told that my daughter wouldn’t move up to a priority one until I was deceased. Individuals don’t always fit in the current criteria and the system needs to be more proactive in helping families before we get to this point. I know budgeting is always an issue but this is a “quality of life” issue. PLEASE consider this very dire issue and make more DD Medicaid waivers available!

End the institutional bias in Attendant pay rates. I'm presenting a case for equity in Personal Care Attendants pay rates by sending this email, The low pay of Consumer Directed (CD) in-home Personal Care Attendants has caused my husband not to return to work and is one of the factors of why I resigned from my full-time wage job of over 8 years. Speaking as an Employee Of Record (EOR), for equitable access to Home and Community Based Services (HCBS), close the gap between minimum wage and living wage for CD in-home attendants. What I've experienced/seen: 1. Myself and others can not find Medicaid Consumer (self) Directed personal care in-home attendants because they are not paid anything close to a living wage. A fast food job pays more than an in-home Consumer Directed (CD) attendant job. Solutions: Close the gap between minimum wage and living wage rates for Consumer (self) Directed Medicaid in-home Personal Care Attendants. In Virginia the gap is $6.23. And/or remove penalties for supplementing a CD attendants pay so I the Employer Of Record, can compete with fast food, etc. To earn a LPN, require nursing school students serve as a CD in-home attendant for 6 months. 2. Stop the split of CD attendant hours when services are through Agency Directed. The split in my CD attendant hours ensures an agency office administration gets paid in the instance when no attendant can be sent to my home. The split of hours was hidden from me when I repeatedly asked how Agency Directed would impact Consumer Directed. When an agency attendant does not come to work, a CD attendant can not submit those hours for payment even though they are doing the work of the agency attendant. Because of agency unprofessionalism and unethical behavior, their attendant turnover rate is extremely high. These agencies are numerous which deplete my hiring pool for a Consumer (self) Directed personal care in-home attendant. Agencies have used my CD attendant hours to be paid when no attendant comes into my home. When there are one time payments (COVID19 hazard pay) agencies are in charge of getting payments ($1000) to their eligible attendants. Agency attendants may have no knowledge of and/or may not receive these payments because it is left up to the agency. Also agencies are not required to report which of their attendants receive these one time payments. Whereas CD attendants receive one time payments from time they have already summited.

My name is Dr. William Sroufe, and I am the Superintendent for Colonial Heights Public Schools, I support the extension of reading specialists to four and fifth grades, math specialists, and paying to help teachers qualify to teach dual enrollment in the Governor’s budget. I would also like to see completing the removal of the support cap. Thank you.

Comments Document

Please see my attachment--Thank you.