The Virginia League of Conservation Voters encourages you to SUPPORT HB1853. (Subramanyam) Public utilities; shared solar; minimum bill. This legislation limits what costs may be included in the minimum bill for shared solar and caps the minimum bill at 2X Dominion’s basic customer charge. It also expands the size of Dominion’s program from 200 MW to 10 percent of Dominion’s peak load (roughly 1,600 MW). Reasons to SUPPORT HB1853: Roughly half of Virginia’s population can’t participate in residential rooftop solar, either because they are renters, or lack sufficient roof space to install solar for their personal use. Expanding the cap on Dominion’s program will lower energy costs for participating customers, especially low-income customers that are exempt from the minimum bill. Small-scale shared projects help reduce the amount of utility scale solar needed to comply with the VCEA, which reduces impacts to farms and forests. Dominion’s shared solar program is positioned to attract investors who want to leverage billions in federal incentives established by the Inflation Reduction Act, but these funds will go elsewhere without a scalable program in Virginia. Shared solar helps Virginians take ownership of their energy needs, and insulate themselves from high utility bills due to volatile fossil fuel costs.

HB1875 - I am highly suspicious of any blanket “disability” clause. Too open ended. HB2035 - Too expensive. Businesses are trying to stay afloat, this will hurt them further. If the economy gets better, but with a bad recession coming, it will not be positive. HB1854 - For this, as long as the public can see the reports. HB2366 - Way too expensive. $12K & then meds can be $5K. That would hurt a lot of places trying to pay for that.

Freedom Virginia strongly supports this bill

SALT's 1300 members appreciate the opportunity to support SB1875. We speak today because of the heartbreaking stories we have heard from many of our SALT advocates, faith communities representatives and nonprofit social services representatives that work directly with low-income working poor and impoverished in our state, namely those who have difficulty in paying their energy bills and frequently require help in making payment. We believe in the interest of wanting to see them restored to a productive life and to be able to get a job and support their families and to be involved in their communities in a positive way--to be future regular paying customer's of utilities. support SB1875. thank you

HB1875 - I am highly suspicious of any blanket “disability” clause. Too open ended. HB2035 - Too expensive. Businesses are trying to stay afloat, this will hurt them further. If the economy gets better, but with a bad recession coming, it will not be positive. HB1854 - For this, as long as the public can see the reports. HB2366 - Way too expensive. $12K & then meds can be $5K. That would hurt a lot of places trying to pay for that.

Please support HB 1988! Paid time off is so important, and all who work should be able to raise and care for family members with dignity. As I parent, I know how important it is to be able to care for my kids when they are sick--and to know that, when I do, my job is protected. The pandemic has only made the need for sick leave clearer--when we keep our sick kids stay home, and when we are able to stay home to care for them, we keep everyone healthier and safer.

Please consider this comment in support of Delegate Guzman's proposed HB1988, which expands paid sick leave benefits, inclusive of employees' needs to care for children whose schools or places of care are closed to public health emergencies. I am a graduate student and adjunct instructor at VCU, a member of the United Campus Workers of VA union, and a mother to an 8-month old son. This fall, when my child's care provider--whose hours were already limited due to the expense of childcare and my limited pay as an adjunct instructor--came down with COVID-19 had to close their operations, I was forced to take unpaid time off in order to take care of my son. Childcare remained unavailable to us for this reason for nearly two weeks, during which time I lost out on wages, fell behind on work and studies, and worried about the burden placed on my colleagues to pick up my slack. I am far from the only person affected by this issue, and the impact felt by working parents when daycares close is exacerbated by the childcare crisis in our state. Working parents already struggle with lengthy waitlists and exorbitant costs; this does not need to be compounded by the struggle to find last-minute care or take unpaid time off in the middle of a public health emergency. I urge the committee to advance HB1988 and support working parents like me. Thank you.

I support both these bills--we need family and worker paid family and sick leave. As the mother of two young children and as a full time worker at a state institute of higher ed, I know how important paid family and sick leave are. When I had my two children, my university employer did not offer ANY sort of paid family leave, and it was only by divine luck that my children's births happened to be aligned with a break for my teaching schedule. I have had several co-workers who completed teaching full course schedules days after giving birth to their babies. In 2023, we cannot expect families to hope for miracles if they want to have children, care for their sick children and elders, and cope with medical crises themselves. We need the basic protections these bills would offer us as workers.

Please support HB 1988 - for the health of our communities. In the era of covid-19, we need to make sure that getting sick doesn't mean not being able to pay bills or going into debt. We also need to protect our communities by making sure sick individuals are not forced into work where they have the potential to spread their sickness. I am a graduate student at William & Mary. When I got covid-19 in 2021, I was sick for three weeks. To my knowledge I am not a member of a vulnerable population, but still the virus took me out. I was sick as a dog for two of those weeks, and for the third week I had migraines whenever I would try to focus on work. I was lucky I had an understanding supervisor, and that I am not on an hourly wage. But if I hadn't been, I can't imagine what I would have had to do. What if I had been working two part-time hourly jobs, like many Virginians do? I would have had to force myself into work, or I would have had to forgo groceries or get into debt to make rent. We can't control whether we get sick; but we can control how we support people who do. Please support HB 1988 so we can build healthier communities in the pandemic.

Support HB 1988 and HB 2035! Both of these bills will provide valuable protections for Virginia's workers. Anyone who works hard should be able to raise and care for a family with dignity. But too many workers don’t see their hard work honored with the ability to take paid time off to care for a sick family member, or take care of a health emergency. HB 2035: My dad died of cancer when I was 17, and my mom would not have been able to financially manage if she hadn't been able to access paid family and medical leave. Everyone should have access to similar support. HB 1988: My partner works in restaurants and doesn't have paid sick leave, so they are constantly choosing between making other people sick and working enough hours to pay rent. They are conscientious and do not want to make others sick, but that is a choice that they shouldn't have to make. Providing access to paid sick days for Virginia’s workers would allow them to maintain economic security and ensure a healthier, more productive workforce in the Commonwealth.

I write to urge strong support for SB1988. Paid sick leave benefits workers by allowing them to recover safely and securely. Expanding these provisions to cover parents who are taking care of sick children also provides essential support for working families. No parents should have to choose between their wages and taking care of their kids.

I am writing in SUPPORT of HB 1988, which would expand paid sick leave to even more workers in Virginia. As a member of United Campus Workers for Virginia fighting for quality childcare access across the state, I'm particularly invested in the bill's acknowledgment that a child's sick day IS a caregiver's sick day. For years, I've watched friends and colleagues scramble to locate childcare on days when their children are sick or, during the pandemic, when care centers have to close because of possible exposures. I've seen kiddos too sick to go to school trying to rest in a parent's office because no one can stay home. All Virginians deserve to work in spaces where their health and well-being, and that of their families, are a priority. This isn't just an ethical stance; it makes financial sense, too. Workplaces benefit when employees have time to recover from illness, when they aren't juggling Zoom meetings in between temperature checks, when they're not forced to choose between isolating and a paycheck (a terrible decision that has exacerbated the spread of COVID-19 in our communities). A whopping 85% of Virginia voters say employers should offer paid sick days, including the Virginians for Paid Sick Days Coalition: an alliance of 25 statewide organizations: www.vapaidsickdays.org. Constituents are loud and clear on this issue--please support HB 1988 and make paid sick leave a reality!

Comments Document

The Iron Workers Employers Association opposes HB1988 because of the broad burdens it places upon construction contractors, particularly upon those who already provide extensive and expensive health and welfare and other programs for their employees. It is requested that construction be excluded from the Act's requirements. The basis for this is included in the attached statement.

The Roanoke Regional Chamber opposes HB 1988 as it calls for a one-size fits-all approach to paid time off policies that may not work for all businesses. Please allow businesses to decide the approach that works best for them and their employees.

Comments Document

Attached letter provides support for HB1988, Paid Sick Days, from the American Association of University Women of Virginia (AAUW-VA).

Comments Document

Dear Chairwoman Byron and other Members of the Committee: My name is Quintin Reed, the Government Affairs Coordinator for Small Business Majority, a small business organization with offices nationwide, including here in Virginia. Our mission is to empower America’s diverse entrepreneurs to build a thriving and equitable economy. Today I am testifying to express our support for House Bill 2035, legislation that will require the Virginia Employment Commission to establish and administer a paid family and a medical leave program. This proposal would allow small business owners to offer additional benefits to their workforce, helping them attract and retain skilled workers and compete in this labor market. The COVID-19 pandemic underscored the importance of accessing paid family and medical leave. Nationwide, we’re seeing other states passing measures to implement state-run paid family and medical leave programs. A modernized and robust benefits infrastructure would benefit small business owners and their employees, helping to level the playing field for small employers that can’t afford to provide paid family leave on their own. Under the program, benefits are paid to eligible employees for family and medical leave. The program would be funded through modest employer and employee contributions, which would be assessed beginning in 2025. What’s more, the proposal would also allow self-employed individuals to opt in into the program, which can support the overwhelming majority (80%) of Virginia’s entrepreneurs. Implementing a paid family and medical leave program is a commonsense policy solution that small businesses can get behind. A Small Business Majority survey found that a majority of small business owners support programs providing access to paid medical leave (73%) and parental leave (67%). Virginia small businesses want to offer benefits to their employees because it helps them retain staff and compete with larger competitors, which is why 66% of Virginia small business owners support establishing a state-run paid family and medical leave program. Passing HB 2035 will bolster the Virginia small business ecosystem by providing them access to the benefits they need to attract a robust workforce. We urge you to vote yes on HB 2035 to create a paid family and medical leave program in the Commonwealth to support the small business community. Thank you, Quintin Reed Government Affairs Coordinator Small Business Majority

On December 14, 2014, my husband Joe and I received the devastating news that our then eight-year-old daughter, Julia, had brain cancer. Joe is the family’s primary wage earner and carries our health insurance policy, so I took up the role of primary caregiver. I quickly used all of my available paid leave and the maximum 30 days of donated leave from generous colleagues. I was truly lucky to have compassionate school administrators who did everything they could to accommodate me. But, a little over three months after my daughter’s diagnosis, I had to take a one-year leave of absence to get Julia through treatment. The one-year leave became two as Julia continued to battle cancer. Thankfully, her treatment went well, and she is now a happy and active 11th grader. But, after two years away from work, I had to take a job at a different school, in a different district, for less pay. These are the kinds of decisions that too many working families face – women in particular. HB2035 presents a solution to the problem, helping women in particular but all working people to stay in the workforce while balancing care and family responsibilities. That is why I urge you today to support Delegate Sewell's HB2035.

Hello, My name is Nichole Wescott-Hayes and I represent the American Heart Association. The AHA is an international volunteer lead organization of over 35 million volunteers across the nation. In 2019 the Association published an article regarding maternal mortality rates and cardiovascular disease and committing the organization to 10 strategies to help improve the outcomes of all current and future mothers. One of those recommendations is paid family and medical leave. Paid family and medical leave allows mothers (maternity leave) and fathers (paternity leave) to take paid time away from work to bond with a new child after birth, adoption, or placement in foster care. AHA supports gender neutral parental leave to promote gender equity in the workplace. • As many as 23% of employed mothers return to work within 10 days of giving birth because of an inability to pay for living expenses without income. • Employees with access to paid leave benefit by experiencing an increased level of wage replacement during leave and an increased likelihood that women will be working nine to 12 months after a child’s birth, compared to women who take no leave. In addition to economic benefits, research has established that paid leave enhances child and parental physical and emotional health. • For example, infant mortality rates are inversely correlated with the duration of paid family leave. Other health benefits include fewer low birthweight babies, fewer ER visits, fewer hospital readmissions for infants and mothers, higher rates of breastfeeding, a lesser likelihood of sending a sick child to school, longer parental lifespan and improved mental health, as well as increased long -term achievement for children. A father’s involvement has been significantly associated with emotional, psychological, behavioral, and cognitive 5 benefits to children. Paternity leave also has a positive effect on the return of mothers to the workplace and has been associated with increased rates of breastfeeding. In addition to parental leave related to the birth or placement of a child, paid family and medical leave is also important for the millions of heart survivors across the nation. When a person suffers a cardiac episode of any kind, rest an the reduction of stress is always part of the treatment plan for that person to return to 100%. If a person is afraid of not being paid immediately after that incident, many will return to work too soon and jeopardize the chances of fully healing. For all of these reasons, the AHA is fully supportive of paid family and medical leave that will support families who find themselves in a situation where they need to take time off of work to care for themselves or others.

Please support HB 2035! Paid family and medical leave is so important, and all who work should be able to raise and care for family members with dignity. As I parent, I know how important it is to be able to care for my kids when they are sick--and to know that, when I do, my job is protected. The pandemic has only made the need for sick leave clearer--when we keep our sick kids stay home, and when we are able to stay home to care for them, we keep everyone healthier and safer.

HB1875 - I am highly suspicious of any blanket “disability” clause. Too open ended. HB2035 - Too expensive. Businesses are trying to stay afloat, this will hurt them further. If the economy gets better, but with a bad recession coming, it will not be positive. HB1854 - For this, as long as the public can see the reports. HB2366 - Way too expensive. $12K & then meds can be $5K. That would hurt a lot of places trying to pay for that.

I am in strong support of HB2035. If you can't take care of your family, then what good is your job? 12 weeks of paid family leave will make a huge difference for Virginians. Pregnancies and illnesses can't be planned and don't adapt to your work schedule, as any parent or caretaker knows. Rather than facing job loss, financial distress, or choices between survival and giving family members the care they need, the people of Virginia deserve to live and work with dignity. I am a graduate worker myself and have seen many colleagues struggle with unexpected sickness or pregnancies, often facing the choice of whether to stay in the program or not. Robust family leave will help keep talented people in their jobs!

I support both these bills--we need family and worker paid family and sick leave. As the mother of two young children and as a full time worker at a state institute of higher ed, I know how important paid family and sick leave are. When I had my two children, my university employer did not offer ANY sort of paid family leave, and it was only by divine luck that my children's births happened to be aligned with a break for my teaching schedule. I have had several co-workers who completed teaching full course schedules days after giving birth to their babies. In 2023, we cannot expect families to hope for miracles if they want to have children, care for their sick children and elders, and cope with medical crises themselves. We need the basic protections these bills would offer us as workers.

I'm writing in support of HB2035. As a graduate student worker at UVA, I've worked alongside countless fellow grad students and faculty who opt not to have children, or for whom having children is a significant source of stress, because they can't take time off work. As someone who hopes to have and raise kids in Virginia, I hope I and my partner will be able to count on Paid Family and Medical Leave.

Support HB 1988 and HB 2035! Both of these bills will provide valuable protections for Virginia's workers. Anyone who works hard should be able to raise and care for a family with dignity. But too many workers don’t see their hard work honored with the ability to take paid time off to care for a sick family member, or take care of a health emergency. HB 2035: My dad died of cancer when I was 17, and my mom would not have been able to financially manage if she hadn't been able to access paid family and medical leave. Everyone should have access to similar support. HB 1988: My partner works in restaurants and doesn't have paid sick leave, so they are constantly choosing between making other people sick and working enough hours to pay rent. They are conscientious and do not want to make others sick, but that is a choice that they shouldn't have to make. Providing access to paid sick days for Virginia’s workers would allow them to maintain economic security and ensure a healthier, more productive workforce in the Commonwealth.

I am writing in support of HB2035. As a teacher in my thirties, my decision to not have children is due in large part to the challenges I would face obtaining supported leave time. I know teachers and graduate students who attempt to time pregnancies for late spring and early summer in order to make use of a summer break; this kind of planning is deeply challenging, and as we all know, there is so much about pregnancy that is unpredictable. No worker should have to choose between having, supporting, or caring for a family and their job. Paid Family and Medical Leave would make Virginia a stronger home for workers; it's staggering to think that currently, an estimated 41% of working adults in Virginia have no paid sick days or paid time off, and more than than 80 percent of food industry workers and 75 percent of childcare workers have no paid sick days. Please support HB2035 and help build a safe, healthy Virginia for all working families.

Comments Document

January 23, 2023 The Honorable Kathy J. Byron House Commerce and Energy, Subcommittee #4 Pocahontas Building, Room E307 900 East Main Street Richmond, Virginia 23219 Re: HB 2035, Paid family and medical leave program Chair Byron and members of the House Commerce and Energy Subcommittee #4, the American Council of Life Insurers (ACLI) appreciates the opportunity to offer the following statement on House Bill 2035, which would require the Virginia Employment Commission to establish and administer a paid family and medical leave program with benefits beginning January 1, 2026. ACLI members are the leading writers of life insurance, annuities, disability income insurance, long-term care insurance and supplemental benefit insurance here in Virginia and across the country. House Bill 2035 would allow an eligible employee to take leave not only to care for a family member, but also for their own personal medical reasons. However, many employers already provide their employees with paid leave benefits for their own personal medical reasons through disability income policies underwritten by life insurers or through self-insured plans. Life insurers offering disability income insurance are well-equipped with the organizational structure, professional staff and expertise to administer employee benefit programs. Of the handful of states that currently require employers to provide disability and/or family medical leave benefits to their employees, almost all permit and encourage private insurer involvement in providing and administering those benefits. Further, as the fiscal notes associated with these types of plans indicate, there can be significant administrative and personnel costs to the state associated with establishing PFML programs. Accordingly, Virginia is the first state to make family leave plans a type of insurance that employers can voluntarily purchase for their employees. The Virginia General Assembly enacted the first of its kind legislation that paved the way for employers in the Commonwealth to expand access to paid family leave benefits which makes the need for this legislation redundant. ACLI applauds that the new law recognizes and encourages private sector and self-insured employer plans that meet or exceed those benefits provided by the program. Chair Byron, we appreciate the opportunity to provide our comments on House Bill 2035. Respectfully submitted, Michelle Carroll Foster Regional Vice President, State Relations michellefoster@acli.com

Comments Document

On behalf of Sun Life, we respectfully submit this letter in response to Virginia House Bill 2035 regarding the design a Paid Family and Medical Leave (PFML) program. As a one of the largest leave administration providers in America, Sun Life provides income security and leave management services for employees who need to take time off from work because of their own medical condition or for family care reasons, including birth of a new child and care for a family member who is ill. In our day-to-day work, we regularly witness first-hand the profound importance and personal impact of providing paid family and medical leave benefits to employees, and we applaud Virginia for seeking to create a PFML program for employees in the state. In designing Virginia’s program, we respectfully ask that lawmakers leverage leave administrators’ experience with other states’ PFML programs, specifically in regard to providing employers with flexibility to meet the statutory PFML requirements and creating a sustainable pricing model. Attached please find some considerations related to the inclusion of private plans including the predominance of the model in states who offer PFML, the ability for employers to offer enhanced benefits, the employee and employer experience, and the public good. Thank you, Abigail O'Connell

The Roanoke Regional Chamber opposes HB 2035. This legislation will be costly to employers AND employees as both parties must pay into a trust fund - a fund that some employees/businesses may never use. Last session, legislation was passed with unanimous bipartisan support that created paid family medical leave insurance policies that companies may optionally purchase. We ask that these insurance policies continue to be optional, and we thank the committee for its consideration.

My name is Jessica Bowser and I am one of the hundreds of thousands of Virginians who found themselves unemployed during the pandemic and relied upon unemployment benefits at a time when opportunities for employment were few. I applied for assistance in good faith. I followed every instruction I was provided and filed every weekly claim on time. When the first benefit period expired, I was notified by the Virginia Employment Commission that I was eligible for continued assistance and encouraged to apply, which I did, and was granted. The benefits I received were a fraction of my monthly expenses but were invaluable in helping me and my family get by. You can imagine my surprise when I opened my mailbox one day this past May to find a stack of 67 letters from the Virginia Employment Commission, each letter stating I owed money to VEC totaling nearly $35,000. I tried in vain to contact VEC to receive an explanation for the letters. I spent nearly two weeks calling every VEC office in the Commonwealth, sending emails, leaving messages, and contacting my legislators for assistance. Every attempt to communicate with VEC was a dead end. In the meantime, I sought out the legal advice of an attorney who shared with me that he was handing dozens of similar cases in which the VEC was demanding repayment of benefits from struggling Virginians. I filed an appeal in May and it was two months before I received acknowledgment that my appeal was received. Eight months later, I am STILL awaiting a hearing. The waiting period that I have been bound by for the last eight months has made it nearly impossible to plan my family’s future. Not knowing if or when I could be made to repay $35,000 that was spent on bills and other living expenses long ago, is putting additional financial strain and pressure on me and my family. Why should hardworking Virginians who applied for benefits in good faith be made to pay for the mistakes of the VEC? Please support HB 2115 and end this nightmare for over 366,000 Virginians. Thank you.

Please support HB 2115! The pandemic has shown us how precarious employment can be, and it's important that we maintain continuity of benefits for those who need them.

In 2020, during the lockdowns of the COVID-19 pandemic, Transportation staff in Fairfax County Public Schools had no reasonable assurance that they'd return to work for summer school or at the start of the 2020-21 school year. In May 2020, drivers and attendants had guaranteed work hours for summer school cancelled due to virtual learning. Despite holding an offer letter of guaranteed work, drivers and attendants were paid nothing by FCPS and offered no work to compensate for the cancelled work. Staff were then advised by direct supervisors to apply for unemployment. Dozens of employees applied for unemployment, assuming we'd be approved based on Governor Northam's statement from March 18, 2020, "If individuals are out of work because of what we're mandating, unemployment benefits will be allowed to them." Megan Healy, Chief Workforce Advisor to the Governor, is also quoted as saying, "Workers who aren't sure if they meet the new guidelines should submit applications anyway," and, "If you kind of think you don't qualify, just apply." These staff, including myself, applied for unemployment in good faith. We told the truth. We wanted to work, and we needed the money to survive. Many of us started receiving payments from VEC and thought that meant we'd been approved. I received weekly payments until returning to work for the regular school year in August 2020. It wasn't until almost a year after my initial application that I received my first letter telling me that I'd been overpaid and must repay the entire balance I received in 2020. I appealed every letter I received, went to an appeal hearing and lost, appealed again and eventually had an "Eligible" determination. My hope was that all other drivers and attendants in my situation would be declared Eligible as well, possibly even without having to jump through all the hoops of losing appeal hearings and repeatedly appealing decisions. Sadly, that doesn't seem to be the case. VEC needs to process these applications properly and give waivers to anyone who received funds who filed due to loss of their job or loss of hours. These employees are being held to the standard of operating in Good Faith and VEC needs to be held accountable as well. Everyone should be doing everything they can to rectify this situation for the workers.

Good morning, My name is Thomas Lamb. I was employed as an FFX Co public schools bus driver for 19 years. My spouse, daughter, and son-in-law also work for FCPS. Covid-19 put us all in a difficult situation in the summer of 2020. The summer months were never a “break”, but were business as usual, working for FCPS. We could not afford to take a “break”. In the spring of 2020 we were offered summer positions, same as every other year. But summer school was canceled and, at that time, FCPS rescinded the offered summer positions, which meant no hours and no wages. FCPS supervisors urged us to apply for unemployment and said, “Apply, the worst that can happen is you will be denied.” Little did I know how false that statement was. In 2021 the ineligibility letters, the over payment letters, and the repayment letters arrived. Appeals and waiver requests were filed and there seems to be no rhyme or reason as to how these cases are adjudicated. I know of many other hardworking, dedicated FCPS bus drivers and those in other positions, who are in this same situation. Some have never even received a waiver form and some have submitted a waiver request and have heard nothing. This issue is closing in on 3 years. Repayment of these benefits would not only be a financial hardship……it HAS BEEN and, CONTINUES TO BE A MENTAL HARDSHIP having these overpayments hanging over our heads for who knows how many more years??? It’s crucial that this bill is passed as many waiver requests were filed before the deadline but still have not been processed. Thank you!

Thank you for this bill. I am struggling to resolve this exact issue with the VEC. Due to an “administrative error” on their part, I was given benefits during COVID. They are requiring me to payback $15, 127, I was very upfront with them on my application, disclosing all necessary information. I did not know that I could not receive benefits due to being on a leave of absence. Even still, I disclosed this to them and they approved the benefits. I have been dealing with the VEC for so long now, trying to get this decision reversed. Thank you for working toward this bill.

Writing in strong support of this bill. The Virginia Colorectal Cancer Roundtable works tirelessly to increase screening rates in Virginia, and the Southwest region where I live has the lowest rate of screening in the state. All options for screening should be fully available to all citizens, and non-invasive screenings are critical to reducing the burden of this disease. Financial risk can be a major factor in patient decisions around healthcare, and the current paradigm around stool-based tests inhibits us from increasing our screening rate.

As a nurse navigator for colorectal oncology, I understand the importance of colorectal screening for prevention of this disease. I am in full support of Bill 2356 to improve access to colorectal screening for Virginians.

To: Del. Delores McQuinn Virginia Commerce and Energy Subcommittee RE: HB 2356 Dear Delegate McQuinn and Members of the Virginia Commerce and Energy Subcommittee: I am writing to support in the strongest possible way the passage of HB 2356 to assure insurance coverage of colorectal cancer screening beginning at age 45 and coverage of colonoscopy as part of the follow-up of positive initial screens. I am a primary care physician at the University of Virginia and serve as Chair of the Guideline Development Group for the American Cancer Society. I was lead author of the American Cancer Society's 2018 Colorectal Cancer Screening Guideline that recommended lowering the starting age from 50 to 45. This was based on the fact that a rapidly increasing number of young people are being diagnosed with colorectal cancer, which is the second leading cause of cancer death among both men and women, and is extremely preventable with regular screening. In my practice, I have seen many individuals diagnosed with late-stage, incurable colorectal cancer in their early 50's, which would have been prevented by starting screening at age 45. We have several extremely effective screening tests, including stool-based testing, which can be done in the comfort of the individual's home & without taking time off from work, which is a particularly important consideration for the many Virginians who may not live near a health care facility, and/or who don't have time to take off from work. However, if their initial screening test is positive, it is critical that their insurance covers the follow-up colonoscopy, since lack of coverage is a frequently cited barrier to getting the colonoscopy that would save their lives. HB 2356 would address both the earlier starting age of 45 years as well as the insurance coverage for colonoscopy to follow-up a positive initial screening test. I urge you to pass this bill to help save the lives of thousands of Virginians over the coming years. Sincerely, Andrew M.D. Wolf, MD Albemarle County, Virginia

Colorectal Cancer is the third leading cause of cancer related death in the US, impacting over 50,000 americans and 5,000 Virginians every year. This disease is preventable. As a Colorectal surgeon and member of the Virginia Colorectal Cancer round table, I strongly support this bill. The USPSTF, American cancer society, and other professional societies have recommended lowering the age of colonoscopy screening to 45 years in average risk adults. Bill 2356 will support access to screening services and reduce cost of colonoscopy for positive non-invasive screening test. This will help us achieve our mission of having as many patients as possible screened for a preventable cancer.

I am a Registered Nurse working every day to increase colorectal screening rates in Virginia. Since the recommended screening age for colorectal cancer has been lowered to 45 years of age, more of my patients are asking for at-home stool-based testing. These younger patients are working full-time with busy work/family schedules and do not have the time or financial stability to take an entire day off for a colonoscopy. The option to test at home, has not only increased screening rates, but has saved lives due to early detection. However, when a positive non-invasive (stool based) test requires a follow-up colonoscopy to complete the screening, the patient should NOT feel the burden of cost. The CRC screening coverage mentioned in HB 2356, is covered at the federal level by CMS and through the ACA. I am requesting approval of HB 2356 at the state level to assure that all Virginians can be screened for colorectal cancer beginning age 45 without the burden of cost sharing.

Hitting Cancer Below the Belt is a colorectal cancer prevention non-profit based in Richmond and serving the Commonwealth of Virginia. Through our work in communities across the state we encounter much hesitation by our citizens to screen for colorectal cancer which is the second leading cause of cancer death in men and women. Early detection saves lives and timely screening is being hampered by the cost-sharing issue our citizens currently face. For example, many patients opt for an easy, in-home colorectal cancer screening test which is a stool-based test. If the stool based test is positive the patient must complete their screening with a colonoscopy. It is critical to complete the screening process, but without HB2356 the patients are left with a large out of pocket cost! This cost causes financial challenges AND has become a huge barrier to screening for our nation's second cancer killer Colorectal cancer can be prevented through timely screening. We save not only lives, but billions of dollars in health care costs when we detect cancer at the early stage or remove the chance of a cancer developing through colonoscopy. Please support HB2356 and follow the federal guidance already established in regards to screening for colorectal cancer. Save lives, save money. It's a win-win.

As a colon cancer survivor, I strongly support this bill to ensure that all Virginians can be fully screened for colorectal cancer (including receiving a colonoscopy after a positive stool or other non-invasive test) beginning age 45 without the burden of cost sharing. I strongly support passage of HB 2356. Hartley Jones 6401 29th St. N Arlington, VA 22207

Comments Document

Letter of Support for HB2356

Today should have been my mother's 65th birthday. In 2008, she was diagnosed with colorectal cancer. She was operated on immediately and had part of her colon removed. She received chemo, radiation, and immunotherapy for 4 years. I will be 44 this year. Initially, I was told that I needed to wait until I was 40 to receive my first test. When I turned 40, I was told the age had been increased to 45. I explained to my primary care doctor that I was considered high risk due to my family history. Still, no support. In 2021, my mother passed from cancer. I still have yet to receive a screening for this deadly disease. I urge you to pass this bill.

HB1875 - I am highly suspicious of any blanket “disability” clause. Too open ended. HB2035 - Too expensive. Businesses are trying to stay afloat, this will hurt them further. If the economy gets better, but with a bad recession coming, it will not be positive. HB1854 - For this, as long as the public can see the reports. HB2366 - Way too expensive. $12K & then meds can be $5K. That would hurt a lot of places trying to pay for that.

Comments Document

Dear Chair Head and Members of Subcommittee #4, On behalf of the Virginia Association of Hematologists and Oncologists (VAHO) and the Association for Clinical Oncology (ASCO), I have submitted a letter in support of HB 2366, which would provide fertility preservation treatments for Virginia patients with cancer. If you have any questions about cancer care, we would be glad to be a resource moving forward.