Good Morning! My name is Thomasine Wilson, I'm a Home Care Worker, I've been in this profession for 20 years. I live in Richmond. I'm here today on behalf of the underrepresented first responder and essential worker (the Home Care Worker). It's because of us that older adults and people with disabilities are able to stay healthy and safe in their homes and not be subjected to a institutional environment. MY ASK TO YOU TODAY IS TO PASS COMMON SENSE LEGISLATION: 1. To give all Home Care Workers whether consumer directed or private a livable wage based on the economy and current rate of inflation. 2. Increase paid sick days from 5 to 7 annually. 4. When allocating waiver slots consider the years the qualifying person has been waiting and the overall number of consumers on the waiting list. Then diffuse the allotted slots to bring down the list. Let's make 2024 the year that Virginia goes down in history as the state for the people ( working families). Thank You Note: disregard all previous notes due to typographical errors.

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.

I’m currently a Home Care worker for my 6-year-old grandson Malcom, who was diagnosed with Down Syndrome and a member of the union SEIU VA 512. I received my master's degree in counseling and became a Social Worker. I retired from a job I loved, as a part time as an Intensive In-Home counselor. I worked with people who had mental health challenges. I stopped working because I knew the importance of "family taking care of family." I would never say 'no' and turn my back on my family because my daughter and my grandson needed me. As a home care worker, I taught Malcom daily living skills, to cleaning up, visited the grocery store, he learned how to scan items, he can fold clothes and organize his toys. Since I've been his caretaker his communication skills have improved. especially when he gets frustrated. I am so happy I chose to work with him. His grades in school improved, increased his social and receives positive feedback and compliments from his teachers. I also see a positive changes in my daughter. She is encouraged by the growth he has made, and she is modeling my patience while working with him. Malcom has grown and I so proud of him. I went from a part-time job in 2014, earning $35hr, to a home care worker earning only $12.71hr, in 2022. I am 65 years old, and I planned on being fully retired by now, but I knew I had to move back to Virginia. I knew I had to help my daughter and my grandchild, through the consumer directed home care program. But who is there to help home care workers? Home care workers change and improve lives and save the state billions of dollars. These services that we provide benefit the family we take care of, which includes grandsons and daughters. But the reality is Homecare workers live without viable benefits. Causing so many workers to leave the field and look for higher paying jobs with benefits or they end up working multiple jobs. The low salary, lack of benefits, results in many who work while sick. This lack of fair labor standards negatively impacts caregivers and families, not only physically but mentally. This program continues to save the state billions yet, home care workers cannot afford a day off and we are currently not in the budget to receive a wage increase as home care workers. As a Home care worker and a SEIU VA 512 union member, we should have the right to be in a union and to collectively bargain. I have always been a member of a union from 1986 to 1991 to 2023. I've witnessed the positive impact of collective bargaining for workers. As a home care worker and a SEIU 512 union member, I ask you to support the right for home care workers to collectively bargain, increase the minimum wage to $15 before 2026, paid family leave, restore the 720 Respite hrs., and support quality union jobs for all Virginians. Thank you for giving me the opportunity to speak to you in support of home care workers which includes benefits and raises in the upcoming budget. I answered the call when my daughter and grandson needed me. Today, I ask you to answer the call because home care workers need the opportunity for stability in their lives through collective bargaining, restoring 720 Respite hours, $15/hr and benefits. Let's make Virginia ideal for working families across the state. Thank you for your time and consideration.

My name is Jeanne Robinson, I’m currently a Home Care worker for my 6-year-old grandson Malcom, who was diagnosed with Down Syndrome and a member of the union SEIU VA 512. I received my master's degree in counseling and became a Social Worker. I retired from a job I loved, as a part time as an Intensive In-Home counselor. I worked with people who had mental health challenges. I stopped working because I knew the importance of "family taking care of family." I would never say 'no' and turn my back on my family because my daughter and my grandson needed me. As a home care worker, I taught Malcom daily living skills, to cleaning up, visited the grocery store, he learned how to scan items, he can fold clothes and organize his toys. Since I've been his caretaker his communication skills have improved. especially when he gets frustrated. I am so happy I chose to work with him. His grades in school improved, increased his social and receives positive feedback and compliments from his teachers. I also see a positive changes in my daughter. She is encouraged by the growth he has made, and she is modeling my patience while working with him. Malcom has grown and I so proud of him. I went from a part-time job in 2014, earning $35hr, to a home care worker earning only $12.71hr, in 2022. I am 65 years old, and I planned on being fully retired by now, but I knew I had to move back to Virginia. I knew I had to help my daughter and my grandchild, through the consumer directed home care program. But who is there to help home care workers? Home care workers change and improve lives and save the state billions of dollars. These services that we provide benefit the family we take care of, which includes grandsons and daughters. But the reality is Homecare workers live without viable benefits. Causing so many workers to leave the field and look for higher paying jobs with benefits or they end up working multiple jobs. The low salary, lack of benefits, results in many who work while sick. This lack of fair labor standards negatively impacts caregivers and families, not only physically but mentally. This program continues to save the state billions yet, home care workers cannot afford a day off and we are currently not in the budget to receive a wage increase as home care workers. As a Home care worker and a SEIU VA 512 union member, we should have the right to be in a union and to collectively bargain. I have always been a member of a union from 1986 to 1991 to 2023. I've witnessed the positive impact of collective bargaining for workers. As a home care worker and a SEIU 512 union member, I ask you to support the right for home care workers to collectively bargain, increase the minimum wage to $15 before 2026, paid family leave, restore the 720 Respite hrs., and support quality union jobs for all Virginians. Thank you for giving me the opportunity to speak to you in support of home care workers which includes benefits and raises in the upcoming budget. I answered the call when my daughter and grandson needed me. Today, I ask you to answer the call because home care workers need the opportunity for stability in their lives through collective bargaining, restoring 720 Respite hours, $15/hr and benefits. Let's make Virginia ideal for working families across the state. Thank you for your time and consideration.

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.

Please continue to support state-contracted brain injury services administered by DARS. The community based specialized network of supports, including case management, clubhouses, and day programs, is a national leader in brain injury support provision with decades of experience in the provision of high quality person-centered supports for survivors of the unique and challenging disability of acquired brain injury. This support is for state-funded services. We do not support a brain injury waiver in any recently proposed form. We believe any such decision should be made with the genuine engagement of stakeholders & not behind closed doors. Thank you.

Good morning, my name is Grace Feazelle. I am a member of Our Voices and have lived in my own apartment with support paid for by my Medicaid Waiver in the city of Norfolk for 8 years. I am here today to talk to you about the need to fund the priority 1 wait list so people with disabilities in crisis can get the support they need. As well as the need for more providers that support people with disabilities to live a “life like yours” in their own place. Since moving into my own apartment, I have been able to gain true independence. I am a proud advocate for myself and others. I am a firm believer in using my voice for those who cannot. At times I have been asked to be a presenter at other advocacy events. I hope to continue sharing my story with others to show that the life you want is not impossible to have.  I love being able to do volunteer work and helping others. I attend church regularly and spend quality time with my family. Other things I like to do are volunteer and care for children, go shopping and out to eat, hang out with friends or visit Busch Gardens. Staff at Hope House support me in so many ways. Staff helps me get ready for the day. They make sure my choice of meals, snacks, and drinks are prepared. Staff assist with all my household tasks and hygiene needs.  For advocacy they help me set up my tech devices and go over materials. If I need them, they help me with transportation when I make appointments with my doctors or meet up with my friends. It's important for others to have their own control of their life and their decisions.  If I did not live in my own home someone else would control the things I like to do and places I go.  Making life decisions is an important part of being human. Please support the Arc of Virginia’s Priorities to fund the priority 1 wait list and Building More Supports for A Life Like Yours agenda. Thank you for allowing me the opportunity to speak today and thank you for listening.

Comments Document

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!

Good morning my name is Kevin Benton. I am a member of Our Voices and have lived in my own apartment with support paid for by my Medicaid Waiver in the city of Norfolk for 27 years. I am here today to talk to you about the need to fund the priority 1 wait list so people with disabilities in crisis can get the supports they need. And the need for more providers that support people with disabilities to live a "life like yours" in their own place. It is important for all people with disabilities to have the option to live on their own and to make their own choices. Living on my own has given me self-worth, and I feel good knowing I can make my own choices by living independently. Please support the ARC of Virginia's Priorities to fund the priority 1 wait list and Building More Supports for A Life Like Yours agenda. Thank you for the opportunity to speak to you today and thank you for listening.

Good Morning Members of the General Assembly, As Executive Director of a the Middle Peninsula Northern Neck CSB, I want to express my thanks and appreciation for your support of the CSB in the last General Assembly. I am requesting that you continue in support of the Funding Package that supports the Workforce Development Package. Our rural agency continues to not be able to fill critical positions; positions that make a difference in the lives of so many individuals. At a time when there is an increase in behavioral health challenges, our agency is unable to meet those needs due to position vacancies. For years, our agency has "grown" our own clinical staff through internships and offering clinical supervision for licensure. We have found that providing internships for our community members who want to pursue a career in behavioral health has served us well. Paid Internships in tandem with scholarship programs and student loan repayments would make a difference in many of our "budding" behavioral health professionals. Secondly, I am requesting that you support the proposed increase in Early Intervention Services. Early Intervention Services are critical services for infants and children born with developmental disabilities. It can save funding 7:1 if these young people can receive the services as infants vs the cost in later life. Last year, this program at our agency was in deficit status, Serving children in 10 rural counties with skilled professionals, i.e. Physical, Speech, and Occupational Therapist is expensive especially as services are provided in the home. Supporting this additional funding would only help sustain this critical program. On behalf of the parents of children with disabilities, I thank you for your support of this increased funding. Again, my thanks for your continuing support of Community Services Boards and the many individuals we serve. Please know that the General Assembly's support this past year has begun to make a difference. For the first time in a very long time, I feel optimistic about the future of the critical services we provide our communities. Linda Hodges

Thank you for this opportunity. I am a Virginia native and resident who is also a former award-winning NASA engineer turned award-winning entrepreneur. As a private citizen and on behalf of all citizens of the State, I make the following very specific request: Specifically, I am requesting that the State: a) Create a Wildlife Corridor and Crossing Grant Fund, and b) Appropriate $5 million to leverage significant but time-limited Federal funding opportunities for connectivity projects supported by Virginia’s recently released Wildlife Corridor Action Plan (https://dwr.virginia.gov/wildlife/corridors/). This is a ONE-TIME-ONLY limited amount of funding that will bring in truly enormous, lasting and quantifiable return. The reason for this request is straightforward, and the time is now – both of which I explain next. Wildlife Corridors, or Crossings, are simple enough in concept: they are passages placed in locations selected through careful study that allow large (and small) animals to get from one side of a road to another without ever being in the road itself. The need is high, as Virginia now ranks as the 9th WORST STATE in the country for animal-vehicle collisions and fatalities. This is a dramatic worsening from even two years ago when we were an unacceptable 15th-worst. This means the trend is going in the WRONG DIRECTION, and we must do something now. Indeed, “Hot Spot” areas of these casualties have been identified in ALL regions of the State, so the problem affects all Virginians. Having myself been witness to numerous instances of these tragic collisions, they are nothing but horrific. The loss of life – both human and animal – and the costs associated with these tragedies is tremendous... though AVOIDABLE, as we now know. Not only do Wildlife Crossings prevent tremendous loss of both human and animal life as well as prevent vast financial loss due to both fatal and non-fatal crashes – with an over 90% reduction demonstrated already in Virginia! – they’ve also been proven to ENHANCE TOURISM as well as significantly increase the SAFETY AND ECONOMY OF ROADWAY SHIPPING of all goods – i.e., major big, perpetual business benefits that can and should also be realized here in Virginia. The time is now because the available Federal funds targeted for leveraging are competitive and time-limited, and more and more states are positioning themselves favorably to compete for them. Importantly – and thanks to the visionary strong bi-partisan support provided by our General Assembly through now two Administrations – Virginia has established itself as an early leader by virtue of the preparatory steps it has been able to complete in the area of Wildlife Crossings. In other words, Virginia and our Department of Transportation in partnership with all those who together developed our Wildlife Corridor Action Plan are fully ready and desiring to take this powerful and transformative next step. That said, the competition is fierce and this opportunity is very much a “one shot deal.” We won’t be able to put off attempting to secure the significant Federal funding in the mindset that it will still be available even just a year from now... because it won’t be. Simply, we must free up this one time $5M funding now, because doing so will allow us to leverage it many, many times over for tremendous monetary and life-saving benefit to Virginians, businesses, and visitors for years and years to come. THANK YOU.

Comments Document

This is a request to increase funding for Virginia's children and public education.

Good morning Members of the Virginia General Assembly. My name is Linda Martin, the mother of a 32 year old son, James Martin, with Autism, Hearing Loss, Williams Syndrome and he is non-verbal. First I'd like to thank you for your past support of the Developmental Disabilities Medicaid Waiver. I am here to support the Governor's proposed 3,440 new DD Medicaid Waivers for those on the Priority One Wait List. My son, after several years of being on the list has finally been moved to priority one. You see, I am in my mid sixties and he has become too dependent on me for life skills. He is also ready and willing to become a productive working citizen. Neither of us adults are able to care for him during the working day as we have full time jobs. This can result in potentially dangerous decisions when left alone. Ultimately, he needs a Supported Employment, and Residential Support with skill building services so the he can fulfill his dream to be a working citizen and to eventually care for himself independently. Secondly, Virginia needs to provide funding to Build Provider. That can be achieved if you fund initiatives that support the providers to service existing and newly funded DD Waivers. I hope that you can find it in your hearts to support The Arc of Virginia's Legislative Agenda. They have supported me and so many other parents of children and adults to get the services they need to help their loved ones achieve their potential independence. I pray that you can understand that these proposed slots for the DD Waiver will be good for Virginia in the long run because they need help in becoming productive individuals. Although, Jamie may never hold a education-based position, I believe with the help of the waivers and the providers he can thrive and feel useful in the community.

1. Fully fund Waiver slots for the 3,440 people on the DD Priority 1 Waiver waiting list These are people who are likely to be in crisis during the upcoming year. People who are living with aged or sick parents or grandparents. 2. Approve a set of essential services that would step in before someone reaches a crisis point. This would be more cost-effective as well as reducing the human toll associated with crisis situations. 3. In light of the provider and workforce shortages, extend the allowable time a person can retain their slot to a year before they would lose that slot. 4. Fund a series of proposed initiatives that will build the capacity of providers to serve existing and newly funded DD Waiver Slots with supports provided in the community. 5. Match the Supported Living Rate to the 4-person group home rate in order to create parity between services and to eliminate the current incentive for congregate services. I submitted these comments earlier today, but I neglected to note that we are asking for full funding of waivers for people on the Priority 1 waiting list.

Dear General Assembly Members, Having been an advocate for our challenged population, especially those with disabilities for almost forty years, I have always been shocked and amazed at the amount of duplication and dollars wasted with so many organizations and commissions, including some government entities who are attempting to do the very same things at taxpayer expense. Perhaps, the Commonwealth would be well served if JLARC would do a complete audit of all disability and social programs, with the specific intent of addressing duplications. For example, the VIEW program funds setting in local social services budgets could be reassigned to several programs with a better track record in assisting the targeted population.

“Archaic Tax Code ” – what’s archaic is that Virginia’s top income tax bracket starts at $17,001 which is below minimum wage! ($12.00/hour times 2080 full time hours/year equals $24, 960.) Instead the Governor proposes cuts to the income tax rate, an increase in the state sales and use tax, and elimination of localities’ personal property tax on cars. Cutting the income tax rate without fixing the archaic tax bracket means that people earning minimum wage will see a pittance while the wealthy will reap a huge benefit. The sales and use tax does not even pretend to be progressive, the poorest person pays exactly the same tax as the richest. I do support the intention to tax digital goods. I realize that the car tax is not in the state budget, but it was brought up in the governor’s speech. The car tax is the second largest source of revenue after real estate for local government. As a whole, this tax proposal shifts revenue, and thus control, away from the government closest to the people and even more into the hands of this Dillon Rule state. Education – we need real help paying teachers to stay in the profession, and repairing and replacing crumbling schools. This budget reduces the state investment as measured in inflation-adjusted dollars. It doesn’t address the deficiencies in the JLARC report. It also continues to divert public tax support away from public schools. On the other hand, I commend the wise investment in child care. We now have the unsustainable situation where an early childhood educator with a degree and a typical salary cannot afford child care for her own child. We know that professional early childhood education can determine whether a child is successful in school and later thrives as an adult. I am also pleased with the long overdue investments in mental health. I have been advocating for full funding for STEP-VA for years. We’ve known since the 1970s that community based support is better for the individual and less costly for society, but it has never been funded as it should be. Housing – despite the desperate need for more low income housing, there are no funds budgeted to replace the RGGI funding for weatherizing low income homes. A home is not affordable if it is energy burdened because it lacks repairs and insulation. Flooding – the budget includes $100 million for one year of funding of the Community Flood Preparedness Fund. This is well below what RGGI was bringing in and seems to assume that magically there won’t be any more disasters after next year. One aspect of flooding is that wastewater systems are often overwhelmed. The state’s aid in replacing aging infrastructure is appreciated but it needs to be larger. The Electric Vehicle Rebate was established as part of the move to clean energy. It needs to be funded but it’s not in the budget.

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.

I am single older woman with one income. I would love to purchase a new car, since my current vehicle is a gas burning car and getting older. After looking at the sticker price of electric cars, I was discouraged. How do we cut vehicle pollution and afford an electric vehicle? A rebate at the point of sale is the best option for someone like me. Cutting the sticker price of a vehicle at point of sale is the best way to keep car payments reasonable and keeping the streets where we live clear of polluting vehicles. I am asking that you seriously consider your constituents, many in the same shape as myself. They want to contribute to cleaner neighborhoods where we live. I live in a neighborhood where asthma is very high and one of the sources of poor air quality is the vehicles traveling in the neighborhood. Please consider budgeting an EV sales rebate in the Commonwealth. Thank you, Lynn Godfrey Portsmouth, VA

We need to take care of nature. This means allocating money to remove invasive species. This means allocating money to plant native species of plants and flowers that bring a unmeasurable amounts of benefits to Virginia. This means allocating money to ensure our water is safe from forever chemicals. This means allocating money to create wild life infrastructure that allows animals to cross the road (via a bridge) that goes over busy roads. 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

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.

Virginia’s EV Rebate Program codified in 2021 is one of the most progressive, equitable financial EV incentive programs in the nation. It now must be funded. Budget amendments would provide $40M in the first year, and $40M in the second year. Your constituents are counting on you to fund the EV rebate program this session Most people purchase cars based on a monthly payment (what they can afford each month). Without the ability to lower monthly payments, Virginians may not be able to afford the upfront purchase price of their ideal electric vehicle (EV) and may be forced to drive another gas car, locked into the long-term regiment of gas stations, oil changes, and tail pipe pollution. 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. Virginia’s rebate will maximize the impact of the Federal tax incentive by increasing choice. While the Federal incentive has restrictions based on the EV’s place of manufacture, Virginia’s point of sale rebate is applicable to all EVs, enabling a wider choice.

Comments Document

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).

1. Fully fund the 3,440 DD Waiver slots in the introduced Budget. 2. Approve a set of essential services that would step in before someone reaches a crisis point. This would be more cost-effective as well as reducing the human toll associated with crisis situations. 3. In light of the provider and workforce shortages, extend the allowable time a person can retain their slot to a year before they would lose that slot. 4. Fund a series of proposed initiatives that will build the capacity of providers to serve existing and newly funded DD Waiver Slots with supports provided in the community. 5. Match the Supported Living Rate to the 4-person group home rate in order to create parity between services and to eliminate the current incentive for congregate services.

Comments Document

Attached is a description of state needs to provide support for people who have sustained a brain injury, their families, and service providers. In short, these needs include a more competitive pay grade for case managers and other service providers, an increase in community services to support survivor independence, as well as a Cost of Living Adjustment. On average, state brain injury case managers earn $10,000 less annually in comparison to CSB/City case managers. This has led to staff turnover and difficulty in filling positions to support the brain injury population. Secondly, community services are limited for those with brain injuries who do not qualify for a waiver or Medicaid. Eggleston's Brain Injury Services program has included a request to fund community support staff for people in this situation. Finally, state funded brain injury service providers are requesting to be added to the Central Appropriations language for cost of living adjustments.

Good Morning Committee Members, I speak to you today as a parent of a Chesapeake teen with Autism Spectrum Disorder (level 2), Intellectual Disability, Epilepsy, and ADHD who has been on the Developmental Disabilities (DD) Medicaid Waivers Program waiting list for 10 years from ages 6 to 16. As my son is transitioning into adulthood, he needs the support that this waiver program offers more than ever so that he can become a fully included member of his community. He wants to work, which will allow him to pay taxes and contribute to the overall well-being of his community. He wants to live independently, which will give him a sense of autonomy and confidence. He wants to have a life just like his peers. However, due to his complex medical needs and developmental disabilities, he will need support, which his family and his community should provide. We, his family, have been and will continue to support our son to our best ability, but we will not live forever. Please support the fully funding the additional Medicaid waiver slots for the Developmental Disabilities Medicaid Waivers Program and support children like my son, who came into this world to show us how important it is to care for one another. Thank you for your time and attention. Sincerely, Nicole Miller Resident, Chesapeake, VA (Greenbrier Area)

Comments Document

Summary Doran did not need to be in an institution, but the Virginia Developmental Disability (DD) Waiver system failed him, and Virginia taxpayers paid more for that failure. If you want to reduce the chance Doran’s peers suffer the same fate, please approve a budget with the Virginia Network of Private Providers’ request for an 18% increase in DD Waiver rates. Doran died at 18 in an institution. He was non-verbal, non-mobile, and medically complex and vulnerable. Had he been home, he might still be alive. At home, he certainly would have cost Virginia taxpayers less for better care! He should have been home. Doran Needed: Private Duty Nursing (PDN) 24 hours a day, 7 days a week. Doran’s Challenge: In 2 years of approved 24/7 PDN coverage, he only received full coverage 2 weeks! The lack of 24/7 coverage resulted in him being admitted to an Intermediate Care Facility (ICF), where his medical conditions worsened immediately and substantially. At the Fairfax Regional Budget Hearing in 2018, the legislators present were told Doran would be admitted to an ICF if he did not successfully receive the PDN he was authorized. To avoid institutionalization, it was requested the Department of Behavioral Health and Developmental Services (DBHDS) be required to implement the customized rate for PDN to support people with complex needs so he could stay home with adequate supports. A customized rate for PDN was not made available, and PDN did not improve, so Doran was admitted to the ICF at greater cost to Virginia taxpayers. At the Fairfax Regional Budget Hearing in 2019, the legislators present were told Doran had been admitted to the ICF because he did not receive the PDN he was authorized. It was again requested the DBHDS be required to implement the customized rate for PDN to support people with complex needs so he could come home with adequate supports. A customized rate for PDN was still not made available, so Doran stayed at the ICF at greater cost to Virginia taxpayers. He did not survive 2 years of institutionalization. He should have been home, where his care cost Virginia taxpayers less. Doran’s death was avoidable, and his institutionalized care was expensive for Virginia taxpayers and resulted in worse outcomes, including him paying the ultimate price. The insurance claim from the transition hospital for his final 35 days of life was $44,850.92. That comes to $53.93/hour for each hour of a 24-hour day. That was $16.51/hour more than PDN companies were reimbursed for a Registered Nurse (RN) under a Medicaid Waiver in Northern Virginia on 31 May 2019. If those companies could have recruited and hired RNs with a rate 18% higher, as Virginia Network of Private Providers is requesting, the rate would have only been $43.51, and they may have been more successful hiring RNs capable of managing Doran’s complex needs. He would have had a better chance to receive the care he required at home, where his care would have still cost Virginia taxpayers less. More information is attached.