Public Comments for 01/03/2024 House Appropriations and Senate Finance and Appropriations Committees - Western Virginia - VIRTUAL PUBLIC HEARING - 2024-2026 Budget
Someone I love is one of the over 40,000 Virginians that uses Medicaid Waiver Services! I have 2 children who have benefited from waiver services for the past 10 years. Without the supports they have received via the waiver program they would not be as functional as they are today. I am disappointed in the recent changes and the lack of financial compensation for a group of people that have supported us to the ends of the earth after leaving the doctors office with a diagnosis and no solution, next steps, or guidance. Our CD services provider has provided us with guidance and resources and support over the years when it felt like nobody else was in our corner! I am proud to say that I attribute the passion and supports provided by our provider to my kids ability to be functional members of society in the future. Without these supports I feared what the future may have looked like. To make these services sustainable and build the provider network available to those who want it, the following things MUST happen: 1) Consumer Directed Service Providers must get a significant rate reimbursement increase. Nobody works for free and the high turnover of CD services providers staff due to pay has a negative impact on the people using these services and all of the other providers involved in service delivery. The increases in past years don’t even make for an appropriate cost of living raise for these people who are providing this much needed service in the ever changing waiver program with constant guidelines changes. It seems the CD services providers are being ask to do more and more work but there is not additional compensation being provided for that additional workload which leads to more burnout and in turn high turnover that is already vastly experienced in the human services fields of work to begin with. 2) The degree requirement for CD services providers needs to be removed. There are many people who have more passion for the clients that are excluded by this ludicrous degree requirement and ultimately it makes staffing impossible and in turn penalizes the individuals using services with high turnover of providers that they desperately need to maintain and navigate the waiver program. In past years before the change in requirements we had some of the most dedicated CD services providers who understood the strife and struggles we face as a population that no degree could have ever provided them the experience to understand. Education should not be the only factor considered when hiring staff to work with a disabled population that is receiving services. Education does not dictate intelligence or ability and certainly doesn’t begin to touch passion for working with the disabled population. 3) Telehealth or video methods should be allowed for some components of CD Services, allowing for some visits to be conducted virtually. Times are changing and so are modern technologies and conveniences. It is absurd to think that the waiver program cannot adapt to modern ways in some capacity. In person 100% of the time leads to a breakdown in communication of information. Sometimes a missed visit or a scheduling complication because of the in person requirement means a breakdown in the ability to gain knowledge needed solely based on a lack of convenience and in an ever changing waiver program with constant new guidelines and requirements when information is not shared it can cause huge detriment and disruption of those services.
Someone I love is one of the over 40,000 Virginians that uses Medicaid Waiver Services! I have 2 children who have benefited from waiver services for the past 10 years. Without the supports they have received via the waiver program they would not be as functional as they are today. I am disappointed in the recent changes and the lack of financial compensation for a group of people that have supported us to the ends of the earth after leaving the doctors office with a diagnosis and no solution, next steps, or guidance. Our CD services provider has provided us with guidance and resources and support over the years when it felt like nobody else was in our corner! I am proud to say that I attribute the passion and supports provided by our provider to my kids ability to be functional members of society in the future. Without these supports I feared what the future may have looked like. To make these services sustainable and build the provider network available to those who want it, the following things MUST happen: 1) Consumer Directed Service Providers must get a significant rate reimbursement increase. Nobody works for free and the high turnover of CD services providers staff due to pay has a negative impact on the people using these services and all of the other providers involved in service delivery. The increases in past years don’t even make for an appropriate cost of living raise for these people who are providing this much needed service in the ever changing waiver program with constant guidelines changes. It seems the CD services providers are being ask to do more and more work but there is not additional compensation being provided for that additional workload which leads to more burnout and in turn high turnover that is already vastly experienced in the human services fields of work to begin with. 2) The degree requirement for CD services providers needs to be removed. There are many people who have more passion for the clients that are excluded by this ludicrous degree requirement and ultimately it makes staffing impossible and in turn penalizes the individuals using services with high turnover of providers that they desperately need to maintain and navigate the waiver program. In past years before the change in requirements we had some of the most dedicated CD services providers who understood the strife and struggles we face as a population that no degree could have ever provided them the experience to understand. Education should not be the only factor considered when hiring staff to work with a disabled population that is receiving services. Education does not dictate intelligence or ability and certainly doesn’t begin to touch passion for working with the disabled population. 3) Telehealth or video methods should be allowed for some components of CD Services, allowing for some visits to be conducted virtually. Times are changing and so are modern technologies and conveniences. It is absurd to think that the waiver program cannot adapt to modern ways in some capacity. In person 100% of the time leads to a breakdown in communication of information. Sometimes a missed visit or a scheduling complication because of the in person requirement means a breakdown in the ability to gain knowledge needed solely based on a lack of convenience and in an ever changing waiver program with constant new guidelines and requirements when information is not shared it can cause huge detriment and disruption of those services.
Someone I love is one of the over 40,000 Virginians that utilize Medicaid Waiver Services! To make these services sustainable and build the provider network available to those who want it, including the many people who will get those DD waiver slots in the coming years, the following things MUST happen: 1) Consumer Directed Service Providers must get a significant rate reimbursement increase. 2) The degree requirement for Service Facilitators needs to be removed. 3) Telehealth or video methods should be allowed for some components of CD Services, allowing for some visits to be conducted virtually.
Hello my name is Anna Thomas and I work as the Outreach Manager for Moms In Motion and At Home Your Way. I also am the aunt of a nephew who has severe autism and am advocating for his rights as a CCC+ Medicaid waiver recipient, and someone who is on the DD Waiver waitlist. It is wonderful that the governor plans to fund all of the priority 1 DD Waiver slots in his new budget. Unfortunately, if we do not also address provider capacity, simply awarding those slots will not solve the problem of people being able to access services. Consumer-Directed services have existed since 2005. It gives people the ability to choose how and by whom their services will be delivered. As of the end of 2023, unfortunately, these services have become unsustainable, with many providers closing their doors. The more than 40,000 people in Virginia that use these services WANT to continue to have this choice. In order to make these services sustainable and build the provider network available to those that want it, including the many people that will get those DD waiver slots in the coming years, the following things MUST happen: 1) CD Service Providers must get a significant rate reimbursement increase 2) The degree requirement needs to be removed. 3) Telehealth or video methods should be allowed for some components of CD Services. I'd like to go into more detail about the only one of those 3 pieces that needs funding: 1) The MOST important change that has to happen is that the General Assembly MUST fund a significant CD provider rate reimbursement increase. Consumer-Directed (CD) services have not had a significant increase since the inception of the services in 2005. Do you know that the minimum wage in Virginia in 2005 was $5.15/hr? Today it is $12/hr, which is a 133% increase. Two years ago, the General Assembly had temporarily given all providers a 12.5% increase. When it came time to make permanent changes, almost every other DD provider saw a much more significant increase, even more than the Burns & Associates recommended 50th percentile rates. CD services, though, were left at 12.5%. This is the one and only increase we have seen since 2005. How should CD providers use a 12.5% increase to cover a 133% increase in minimum wage??? Last session, we got bipartisan agreement in both the house and the senate to put our Burns & Associates recommended 50th percentile rate increase into the budget. Unfortunately, during the course of budget negotiations, once again our rate increase was stripped out of the budget. We cannot function on 2005 rates! 12.5% is not enough! It does not make CD services a sustainable choice for Virginians with disabilities! I'm here today to ask you to fund a significant CD Services Provider Rate Increase. It needs to be at least the 50th percentile of the BLS, as recommended by Burns & Associates in the most recent rate rebase study, which is based on 2019 data. That is still not enough to get us to 2024 minimum wage, but at least it would be enough to make these services sustainable and bring CD Services to the same level as all other DD Waiver providers. In addition to the rates, removing the requirement that Service Facilitators have degrees and allowing some portions of our services to be done using video conferencing methods would go a very long way toward Consumer-Directed provider capacity, which will sustain the services that so many Virginians want and need.
Thanks to the governor for funding all of the priority 1 DD Waiver slots in his new budget. Unfortunately, if we do not also address provider capacity, simply awarding those slots will not solve the problem of people being able to access services. Consumer-Directed (CD) services give people the ability to choose how and by whom their services will be delivered. As of the end of 2023, unfortunately, these services have become unsustainable, with many providers closing their doors in recent years. In order to make these services sustainable and build the provider network available to those that want it, the following things MUST happen: 1) A significant CD Provider rate reimbursement increase MUST happen (see attachment for details). Last session we had agreement in both the House and Senate for an amendment to address this, but these were stripped out in final budget negotiations and CD service rates we re once again left out of the budget. Please do not leave us out again this session! 2) Please remove the degree requirement for CD Providers, much the same way you did for state employees last session. This will enable providers to pull from a wider pool of candidates to be able to fully staff our teams. 3) Please allow for some portions of CD Provider services to be conducted via virtual/video method in order to make our visits less invasive for families, less expensive for employers, and more desirable for workers, thereby attracting more people to do this work. In the PDF attached, please find details for each bullet referenced above. Thank you for all of the hard work that you do! We appreciate you listening to our concerns and needs!
Refer to Attachment
Good morning, my name is Erika Rogers. I’m a participant in the Partners in Policymaking Program with VBPD. My State Delegate is Buddy Fowler and my State Senator is John McGuire. I am here today to talk to you about the issue of accessible changing tables. I am a single mom of 10 kids, 7 who still live at home, 4 of whom have Down syndrome. I would love to tell you about my 20 year old son, Caleb. I adopted Caleb from Ukraine when he was 9 1⁄2 years old and he weighed just 26 lbs. He was extremely malnourished and had only been given 1 bottle a day and 1 diaper change a day for 9 1⁄2 years. Now, 11 years later, he is 20 and weighs 125 lbs. Unfortunately, due to the early neglect and abuse, he never learned to chew, is incontinent and wears a diaper and is non verbal. Imagine with me, if you will, that you are watching Caleb for me and decided to go out to do some shopping. You realize he needs a diaper change. You walk into the public bathroom and into the handicapped stall. What then? The only changing station is for infants. It’s a public bathroom and you have to lay him on the floor and kneel down next to him to change him. Can you picture that? Pretty disgusting and dehumanizing, isn’t it. I am asking that all businesses and buildings that receive Federal or State funding have an adult changing table available. They are accessible for infants, children AND adults who deserve the dignity of not having to lay on the floor in a public building to have their needs met. This would be a great start! Thank you for the opportunity to bring this important issue to your attention. Erika Rogers
We are are recent EV purchaser in 2023. I was disappointed to see state rebate for EV was (then) and still is not funded. Can our finances afford another EV going forward? It's hard to say. With the Federal Rebate of $7500 already in place allowed us to purchase our first EV in 2023. That was the only reason we could. Having a state rebate on top of Federal incentives puts EVs within reach for our family and lower to middle income families, and helps reduce tailpipe pollution, smog, and improve overall health and safety on the roads. This State Rebate, along with a Federal Rebate, helps us with getting rid of our other gas car and buy another EV. But, the higher upfront cost of EVs puts them out of reach for us and many car buyers. Because the rebate would occur at the point of sale, EV buyers would be able to lower their monthly payments and enjoy a wider selection of vehicles from which to choose. Investing in EVs is the right choice for Virginians and I encourage the GA to fund the currently un-funded rebate program.
Dear Senators, I am a state employee teaching at a public higher education institute. My family depends on my fixed income. I appreciate that the budget included a 1% salary raise for state employees; however, that is inadequate considering the high inflation rate. For example, most poor and lower middle-class people will spend more on groceries than luxury products. Even discounted groceries such as Aldi in my area have increased their price. People like me are losing more money due to inflation compared to the proposed salary raise. My family barely survived during the pandemic due to the generous raise we received from the government. I would request you consider the idea of a higher salary raise for the next two years. Thank you
Lowering the cost of owning an EV by providing a tax incentive from the state of Virginia is "One small step for mankind" but a very good and necessary step. This is an opportunity for Virginia to show some governmental leadership by indicating to its citizenry that some type of alternate energy source is necessary --petroleum will not last more than just a couple more generations. While recently visiting the Smithsonian I was surprised by reading that petroleum is primarily comprised of ancient plankton. I always thought it was dinosaurs or plant matter. There's just not enough of these resources left in nature to sustain the ever increasing demand for petroleum. Petroleum is not renewable. I hope that you will help step in the right direction.
I am recent EV purchaser. Not having a state rebate almost prevented us from buying one, and I know that if the rebated had existed and had been available at the point of purchase, we would have made the decision sooner. Now, we must decide what to do when our other (gas) vehicle no longer meets our needs. Can our finances afford another EV? It's hard to say. Having a state rebate on top of Federal incentives puts EVs within reach of lower and middle income families, and helps reduce tailpipe pollution. Although the cost of owning an EV is lower than that of a fossil fuel vehicle over the vehicle's lifespan, the higher upfront cost of EVs puts them out of reach for many car buyers. Because the rebate would occur at the point of sale, EV buyers would be able to lower their monthly payments and enjoy a wider selection of vehicles from which to choose. Investing in EVs is the right choice for Virginians and I encourage the GA to fund the currently un-funded rebate program.
Hi. My name is Jessica Swanson and I would like to speak with you about direct support professionals. As you may know, direct support professionals provide pivotal services to people with disabilities. These are the caregivers that help people with disabilities get out of bed every day, go to work or school, attend appointments, and participate in the community. They are truly essential workers, but they are not valued as such. Medicaid currently pays direct support professionals $13.34 per hour. Think about that - $13.34. Walmart pays more. Target pays more. Restaurants pay more. Fast food pays more. UPS pays more. Fedex pays more. Kroger pays more. Banks pay more. Sheetz pays more. Virginia treats people with disabilities and their caregivers as if they are disposable by not paying direct support professionals a living wage. Dependable direct support professionals are impossible to find because the pay is so low. In my particular case, I cannot find employment because I cannot find dependable direct support professionals to assist me in getting to and from a work location. I have a bachelors degree from Roanoke College and a masters degree from Virginia Tech with over a decade of employment history, but the scarcity of direct support professionals over the last several years has left me sitting at home. I was able to work from home during the height of the pandemic, but employers want their workers in the office now so that leaves me high and dry. I'm begging you to fight for liveable wages for direct support professionals. Show these vital caregivers that their work is valued. Show people with disabilities that they matter. Thank you for attending this hearing and allowing everyone here to express our concerns. I genuinely hope that you take what I have expressed with you throughout your political careers and fiercely advocate for people with disabilities. We're the only minority group that you can join at any minute and Virginia needs to step up to the plate and support us. PLEASE GIVE DIRECT SUPPORT PROFESSIONALS A LIVING WAGE.
Members of the Budget Committee—Western Division January 3, 2024 My name is Jeanne Trabulsi from Warren County. I ask that in the Governor’s Proposed Budget the sum of $244,872 for FY25 and the sum of $244,872 for FY26 that is listed under Item 16 for Economic Development Services not be supported for the Virginia Israel Advisory Board (VIAB). Why? 1. First of all, I believe that VIAB is not an advisory board and should be repatriated back to the executive branch where it began in 1996. VIAB is a chamber of commerce for a foreign state— not an advisory board for Virginia constituents. On the other hand, the Latino Advisory Board serves the interests of the Latino-American community of Virginia; the Asian Advisory Board serves the interests of the Asian community of Virginia; and the African American Advisory Board serves the interests of African American community of Virginia. 2. The VIAB website evidences my claim as it states that “VIAB is a government agency that helps Israeli companies build US operations in Virginia.” VIAB’s sole concern, then, is with the economic interests of a particular foreign nation. Any group wanting to bring in foreign development, whether from Israel, Canada, or Morocco, should not be called an advisory board and should be closely overseen to make sure there are not conflicts of interest with homegrown businesses, the environment and other pertinent issues. 3. VIAB simply should not be able to advocate for Israeli interests while continuing as an agency funded by Virginia taxpayers, with free office space in state government buildings and with access that homegrown Virginia businesses do not have. 4. To sum up, I ask that legislators strike from the budget the sums of $244,872 for FY25 and $244,872 for FY26 that are listed under Item 16 for Economic Development Services. If you insist on leaving this allocation intact, you must provide the same for all the other Advisory Boards. If you do not, this could be considered an example of gross impropriety. Respectfully yours, Jeanne Trabulsi 101 Walnut Court Front Royal, VA 22630
People respond to incentives to make better choices. A better choice for someone looking to buy a new car is to choose an electric vehicle. We have just finished the hottest year in recorded history. We need to do more -- and do it sooner -- to slow this progression towards a world we won't want to live in. By providing a rebate for choosing an electric vehicle, the General Assembly will send a strong message that Virginia is doing something to combat climate change. A rebate will help people with lesser means join this movement towards a cleaner, greener future. Please fund the EV rebate program. Thank you.
Fund Virginia's currently unfunded Electric Vehicle Rebate Program
Clean transportation funding is essential to reducing harmful tailpipe pollution that disproportionately and negatively affects the health of lower income Virginians. Additional funding for transit needs to be designated in order to provide frequent, reliable service for all, and to reduce the number of cars on our roads. The budget should also include funding for Virginia’s EV Rebate Program, in order to put tax dollars back into the pockets of Virginians who want clean vehicle options that are currently out of their financial reach. For low income buyers, a Virginia rebate would amount to a $125 reduction on a monthly car payment for a 3-yr loan. It has been two years since Virginia passed legislation to create the EV Rebate Program, yet it remains unfunded. Sticker price is the top barrier for people who want to buy an EV. The state rebate would complement Federal incentives to put EVs within reach of lower- and middle-income families, and help reduce tailpipe pollution. While Federal incentives limit consumers’ choices based on where an EV is manufactured, Virginia’s rebate applies to all EVs, giving residents a wider range of options.
Rebates for EVs would put them within reach of so many interested people who cannot now afford the initial expense, thus reducing our collective carbon footprint.
I am writing to show my extreme support for a Wildlife Corridor Grant Fund. It is our legal and moral duty to protect nature. This means protecting our water from chemicals, protecting our wild life from human activity, and protecting our old growth forests. Without nature, we are nothing. Let’s protect this beautiful world we live in. We TAKE so much from nature. We can at least make a small attempt to GIVE back to nature, I’m an highly encouraging the support of funds and resources to protect the nature of Virginia. I demand that the Virginia Government enforces legal and moral practices that help nature, not hurt it.
The attached document contains comments by the Virginia Conservation Network regarding funding for water and resilience, land conservation, transportation, and energy projects. VCN’s full budgetary asks can be found in Our Common Agenda (https://vcnva.org/our-common-agenda).
hey folks amke sure you!!! a-= get those wiaverrs done!!!! b= raise rtaes on providers and mentors got it goood!
My 13 year old son is one of the over 40,000 Virginians using Consumer-Directed Services with a Virginia Medicaid Waiver! He is also on the DD Waiver waitlist in Priority 2 status. To make these services sustainable and build the provider network available to those who want it, including the many people who will get those DD waiver slots in the coming years, the following things MUST happen: 1) Consumer Directed Service Providers must get a significant rate reimbursement increase. 2) The degree requirement for Consumer Directed Service Providers needs to be removed. 3) Telehealth or video methods should be allowed for some components of CD Services, allowing for some visits to be conducted virtually. Thank you for taking time to read our comments and take these things into consideration. My son deserves to live a happy and healthy life at home and not risk being institutionalized because of the risk of consumer directed services not being an option for us in the future.