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Please protect disable children in Va. We need to take care of them. As parents, We can’t find attendant care, well trained. The regulation changes affect families, adds confusion. Consumed directed services are necessary to proceed our kids.

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Hi I am writing to you on behalf of The Well Connection UK, a media and publishing company. We could easily get virginia.gov featured in various publications such as magazines, online blogs and news sites. This would undoubtedly help virginia.gov with publicity, reputation, domain authority and organic search engine rankings. We have a wide range of options including completely free collaborations, sponsored posts, guest posts and banner ads. If this sounds of interest, please reach out to the senior business development manager, Anita at info@thewellconnection.co.uk and whatsapp +447395206515 (GMT) Kind regards Clifton Junior Outreach Assistant

Please protect disable children in Va. We need to take care of them. As parents, We can’t find attendant care, well trained. The regulation changes affect families, adds confusion. Consumed directed services are necessary to proceed our kids.

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In its present form, SB231 is not appropriate…and should be defeated. Virginia citizens and taxpayers cannot …and should not pay for illegal immigrants who have entered our country and state in violation of our law. This is an undue burden on much needed state-wide resources ; and on a grander scale…creates another incentive for non-citizens to come to our state. I highly recommend you remove any language ….providing for coverage of those here in Virginia in violation of our immigration law.

Please protect disable children in Va. We need to take care of them. As parents, We can’t find attendant care, well trained. The regulation changes affect families, adds confusion. Consumed directed services are necessary to proceed our kids.

The Lung Association believes that every child in Virginia should have access to affordable and comprehensive health coverage. Senate Bill 231 would get us closer to that reality by creating a health coverage program available to all children in Virginia, regardless of immigration status. The Lung Association strongly supports this bill as a way of increasing access to healthcare for all Virginians. If you have any questions or need additional information, please feel free to reach out to me.

The Lung Association believes that every child in Virginia should have access to affordable and comprehensive health coverage. Senate Bill 231 would get us closer to that reality by creating a health coverage program available to all children in Virginia, regardless of immigration status. The Lung Association strongly supports this bill as a way of increasing access to healthcare for all Virginians. If you have any questions or need additional information, please feel free to reach out to me.

I hope this bill does not support illegals when there are Virginia citizens who are suffering right now. Shame on Democrats and Republicans who do not take care of their own America citizens first.

I will keep my comment short and simply say that as the parent of child with severe special needs and medical needs life is already a constant struggle. He is 14 unable to speak, unable to regulate his own emotions, has seizures, suffers from such severe behaviors that he literally gives himself rhabdomylosis from kicking his legs so hard. The last things parents need is the ever changing hoops that are constantly being put up on them. I am fortunate in that I do not even act as the Paid caregiver for my child. So these changes as of now do not impact me. My father is healthy enough to be his attendant and care for my hard to handle son but many people do not have that as an option. I would ask that you as lawmakers simply put yourselves in our shoes for one week, heck for one day, and think what our lives are like and how these changes impact us and our children.

Please consider approving HB 909 and not SB 488. Delaying the decision to approve LRIs as attendants by having DMAS review SB 488 will prevent many LRI attendants from being paid after 3/1/24. My husband/LRI has taken care of our 3 children as a stay at home father for over a decade. My younger two children are Autistic and due to the guardrails put forth by DMAS, my husband is the only one to take care of our younger Autistic sons. I am the only one working at a gross pay of $63K/year as a School Nurse, so my husband will be home to receive and take care of my younger ASD sons when they come home from school. With the amount of pay it takes to provide for our ASD sons, and our oldest daughter, who is going to go to college this coming year, we would need that extra pay to make ends meet (help pay for food/tuition for my daughter next year). The extra pay that we received from my husband working as an attendant since 10/14/23, has helped us with unexpected medical bills, food, and rent. Please consider extending the deadline for LRI justification or eliminating the guardrails that prevent both my husband and I from being paid to take care of our sons.

Thank you for your support of HB909 that closely aligns with SB488 to be considered today. I am writing to ask that you continue to support both bills and work with the Senate on a compromise that will keep this very important legislation moving forward. Unfortunately, the Senate version does not allow for an immediate impact and kicks the can down to road so to speak as SB488 calls for DMAS to make a report later this year instead of calling on DMAS to seek approval from CMS immediately. Special needs children who are receiving Medicaid waiver services have already proven that the care of these individuals is in fact extraordinary. According to DMAS, approximately 1700 of the 40,000 waiver recipients are currently utilizing the ability to have a Legally Responsible Individual (LRI) provide much needed daily supports. Families like my own have struggled for years to find qualified providers outside our families to effectively care for our children. Sadly, in just a few days on March 1 this ability is removed from us unless we meet subjective requirements of DMAS reviewers. I say subjective as families like mine have submitted our proper advertisements proving our attempts to hire, written justification as to why we are the providers of both last resort and best providers, and our service facilitator has submitted the documents to DMAS not once or twice but three separate times and are continuously told the documents are missing. There is a clear flaw in the system, and time is running out. While SB488 includes respite services, HB909 did not include respite. LRIs cannot and have not been able to bill for respite services and therefore respite could easily be removed due to the potential fiscal impact. Instead, it would make more sense to pass the legislation NOW to eliminate the burdensome guardrails DMAS has placed on families without respite included. Perhaps respite could be reported on at a later time instead of grouping all of this together. In closing, I would ask for you to continue to push for supporting the original wording in HB909 by incorporating SB488 into the house bill and eliminating the need for a report later this year. I suspect DMAS can provide a lot of data now on the usage of LRIs currently. Thank you for your consideration in moving forward with legislation to support the disabled community and ensure our children can thrive and grow in their own communities.

Please protect waiver children by allowing parents to be paid caregivers! SB 488 IS NOT worded strongly enough and should be replaced with HB 909. DMAS needs to be forced to address the LRI issue and seek CMS approval, not just "review" it. Please help us continue caring for Virginia's most vulnerable children in their homes with their loving and competent families where they belong! The 3/1 implementation of onorus and abusive "guardrails" need to be addressed NOW. Thank you!

Please protect our special needs kids! I have been unable to find a qualified dependable attendant.

So not only can we not hire people, it’s going to take an arm and a leg to get approved to continue to be the paid attendant. Which means disabled families will lose grocery money, etc. We will risk losing our waivers. Don’t our children suffer enough being disabled. Isn’t our lives already HARD enough? Do you want constituents on welfare so you can continue to call us burdens on the state? What more do you want from us? I mean really?

Please pass this bill. Our disabled children deserve to be cared for by their family members. We should not be forced to seek a stranger as a EOR to over see our personal information and HIPPA information. Where is the responsibility when that person steals our identity, abuse, damages our home etc? Will DMAS take responsibility for that? NO! Most agencies are making parents pay a $200 non refundable fee for training to “maybe be hired as a parent caregiver”. Why are only parents being forced to pay that to be a caregiver but an outside family member of the agency does not? We are being taken advantage of by everyone in this stressful time. There are only 1,700 families being affected by this. Why are we treating disabled families with such disgust. DMAS is worried about fraud. Where is our concern for abuse, identity theft, HIPPA volition?? There are to many people in the cookie jar. We need to change this program like California’s and make it simple. One state department, one agency for all. One payment to a family caregiver. Simple! Our children do not have a voice. Please hear ours and do what’s right.

This bill is so important to our family. We tried for years to hire outside help for my son who has a rare genetic condition. We tried multiple agencies and even tried to hire help directly through the consumer directed model. We haven’t been able to find anyone who is willing to take on this job. The only person who was interested and able to pass the background checks was so scared of my son that she quit after only 4 shifts and never even touched my child. We want to know that my son is receiving the best care possible. At this point in his life that care is coming from me. Allowing me to serve as his paid caregiver has also allowed our family to reduce our dependence on public assistance. We want to always do what is best for my son so that he can grow and thrive in his community. We happen to be one of the families who have an easy time finding someone to take on the role of the employer of record (EOR) but not all families are as fortunate. We ask you to please roll back the new restrictions on who can function in this role and allow families to find the best possible candidate (even the other parent) to take on this unpaid role that has access to so much sensitive personal information including private health information. Please support individuals within the waiver program. The system is desperately trying to keep up with demand but the need is far too great.

I am writing in hopes that the Senate will support legislation allowing parents to continue to serve as paid caregivers. My daughter Maria is two years old and has Lissencephaly, an extremely rare genetic disorder. Maria has daily seizures, is immobile and non verbal. She requires constant care. The care she requires is quite nuanced and very much above the pay grade Virginia has set for attendants. I could not and would not leave her in the care of someone making $17/hr, as we live in Alexandria Va. I could only leave her in the care of a registered nurse. Leaving her with an attendant with extremely basic medical knowledge would be negligent. I will, for the remainder of her short life, serve as her caregiver. I hope you respect the value of my daughter’s wellbeing and the invaluable role I play for her by continuing to allow parents to serve as paid caregivers. I invite anyone who chooses to not support this effort to come to my home and meet my child.

As an LRI for 2 children on the waiver, I am urging you to back this legislation. There are parents and children for whom these changes are so deeply impactful that we have become paralyzed in regards to advocating for ourselves/our children . In 2017 I was given custody of a child who was born to an incarcerated individual suffering from drug addiction. He was born with multiple birth defects. Shortly after taking custody of him— as his organs were shutting down and an emergency order was necessary to protect him from his parents— my own child who is 5 months older began showing signs of special needs. In less than a year I went from 1 medically fragile, high needs child to 2 complex children. In the 4 years that followed, my marriage broke down under the strain and my husband left, unwilling/unable to cope with the constant appointments, care, and protection from illnesses these children required and our inability to secure appropriate care in the form of an attendant to help relieve the burden he was being asked to share. The child I have custody of is related to him, yet no one in his family has been willing to share this responsibility or help in any way. The Appendix K flexibility has literally saved my children and I from homelessness by allowing me to work for one of the children, however, this came after years of trying to hire an attendant unsuccessfully. I have had some people apply, but once the wait for background checks and paperwork surpasses a month or two (or more), they have moved on to other jobs. Some ridicule me for not offering more when they are told about the pay or lack of benefits. In 2021, I was able finally to hire my own adult child for one of the clients, but even they had to leave due to lapses in pay and lack of stability. Hiring is made additionally challenging by regulations governing attendants whereby they are unable to feed my children on a shift, as this task— tube feeding— is not allowed per the attendant and EOR manuals and will not be paid by DMAS. Last year, during a change in fiscal agents due to insurance contracts, I was unpaid for over 3 months, had utilities shut off, had to apply for SNAP & was facing eviction while begging someone to take accountability and fix the “error”. I am now facing the loss of my income if not approved as an LRI, and have been unable to find one caregiver much less the two it will take for me to be able to leave my children and find outside employment. One child missed 40 days of school last year due to illnesses and complications of their conditions— there isn’t a single job I am qualified for that would allow for that sort of absence, nor allow me to return home to administer tube feedings the attendant isn’t allowed to do. The children do not qualify for nursing care otherwise. Compounding this is the numerous medical appointments and therapies each child needs— they are each a full time job in the eyes of the state, as long as a stranger is hired to do the work. Parents/LRIs are the ONE sure thing DMAS can count on to provide safe, reliable care for these children. Some of us are biologically tied to these children, others are guardians who have already relieved another strained system by taking on kinship placements with no assistance. We’re asking for the bare minimum and have already provided the proof that it works and is sustainable. Please support and enact this bill— our lives depend on it.

Please protect disable children in Va. We need to take care of them. As parents, We can’t find attendant care, well trained. The regulation changes affect families, adds confusion. Consumed directed services are necessary to proceed our kids.

Please pass this bill. I have an adult son with lifetime disability and as a pediatric physical therapist I work with disabled children. It is very difficult to get individuals that are not family members to work at the present pay rate. Why are we making it so difficult to allow family members and live ins to provide the needed service as they are unable to work outside the home without having paid personal aids that are reliable.

We already have enough on our plates taking care of disabled children, nobody wants to do this job for coins. Virginia wants to be pro life. Where is the same care and consideration, and fierce support for our disabled children as there are a fetus. Where is this “pro life and pro family”? Stop using our children who already have hard enough lives as political pawns and do the right thing! I’ve already had to leave my career…now you want us to have an even harder time by taking away our caregiver pay and making us humiliate ourselves with these excessive job postings, people laughing at the pay rate, saying our kids are “too much work for too little pay?” What more do you want from us? Help us out. We VOTED for you all. Our lives are already hard!!!!!

SB488 is very important to my family. I have the sweetest 2 year old daughter with disabilities. She cannot walk (or even sit up on her own. She is non-verbal but man does she have a HUGE personality and can communicate to me in her own way. She has many doctors/therapy appointments, at least 2 a week if not more. She just finished a 3 week intensive therapy where she went every day for 3 weeks. I love being involved in her daily care and desperately want to keep it that way. If LRI's (which is me) can only be caregiver of last resort I will have to find another job while someone else takes care of my child. Unfortunately we cannot pay our bills without the Caregivier income. Please support this Bill and allow me to remain my childs paid caregiver of first choice and NOT last resort. I know 100s of families that are begging for this same thing. In emails I have recieved from DMAS, they are making it seem like this transition with their new regulations is making it easy on the parents and at least parents are still getting to remain caregivers to some extent. We only get to remain the caregiver until someone else is found to replace us. Do you know how stressful that is? Constantly posting ads and interviewing when we don't want to find someone else to replace us. Us parents (LRI's) want to be our child's caregiver without posting the ads and being the last resort. If you are going to pay someone to do the job, why not the parent? They say this has to be put into place because of fraud and parents can't "just Bill" for money like we aren't doing anything. Caring for a child with disabilities is not the same as caring for a "typical" child. If they think we aren't properly taking care of our children and just logging hours than can't DMAS come up with something else? Maybe we have a log the tasks we have done while logged in? Maybe our service facilitators have to check in on us more than once a month? There can be other regulations put into place other than having the parent be the Caregiver of last resort. Please consider this Bill. Something needs to happen fast because come March 1st if nothing changes many families and vulnerable children will be affected.a

Our local, state, and federal government needs to fully support families of disabled children. This includes payment for in-home care to legally responsible adults caring for medically fragile children in their home. Parents like myself left full time, great paying jobs, to focus our energy on our special needs children. We know how to best care for them. It is irresponsible to require a parent to bring in an unskilled stranger into our homes to care for our vulnerable children. There are hundreds of reports of outside staff coming in and abusing, neglecting, and stealing from the client. The position is complex and difficult, yet the pay is nominal and there are no added benefits. We need to reward parents and caregivers who are able and willing to drop everything to care for their children. The job is mentally and physically and financially exhausting. But we love our children like no one else can and we want to do the job to its best! Let’s bring our society back to caring for loved ones BY loved ones rather than discarding them off to strangers. We know there must be guardrails to ensure the vulnerable are protected, but do not punish those with good intentions because of the few who abuse the system. Do not make the requirements impossible to achieve. Do not make the rules too complicated to understand. We are doing this for our children! Not for ourselves! Let us help them succeed at life in every way possible. The citizens you serve need your support.

Part 2 of 2 The current language used by DMAS to determine if an LRI is qualified is unclear, subjective and unnecessary and put constant strain and stress on the affected families, in excess of what they already have. As parents, we are in fact the most qualified individuals to care for medically complex minors. It is in the Childrens’ best interest to have the option for LRI caregivers, with the same rules as non-LRI caregivers. There is an ongoing issue we have experienced with DMAS. Our new EOR, who used to work as our service facilitator and is another parent of a child on a medical waiver. After following all of the DMAS guidelines, submitting all necessary paperwork, and submitting the job ads for non-family caregivers, both of our families were denied as LRIs. DMAS’s explanation of the denial was that we did not provide copies of our ad postings and did not submit our plan of care forms. Both families received the same email, yet we completed and submitted our plans of care at the same time in October and sent our ads as we posted them. We just received their denial determination just last week and the new rules go into effect on March 1 leaving very little time to correct the problem. We are not alone in this as we have read several other LRI’s Facebook posts that are experiencing the same issue. Our service facilitator contacted DMAS, including the DMAS Director directly, to make them aware of our personal situations and they acknowledged that it was likely a glitch. We have yet to receive any updates from DMAS. I hope this further illustrates the detrimental impact that the new rules will have on countless Virginia families. They are all watching these bills closely. LRI denials will leave Virginia families with no paid caregiver for their children and loss of income on short notice. Allowing DMAS to self-police and do their own report is not going to solve any issue and will immediately hurt Virginia families. Furthermore, we are genuinely concerned that if we continue to push DMAS to correct the issue any further, they will respond by decreasing our children’s allotted hours as they done so in the past. Again, I urge you to support SB488 as originally written. The new rules set by DMAS eliminates respite services for paid LRIs (LRIs cannot charge respite hours themselves, only non-LRI caregivers are allowed to charge respite). Respite hours provide relief for parents without the worry of leaving their medical complex child with an unqualified, and often underage, babysitter. As a compromise, I will gladly support placing hour limitations per pay-period charged as respite to limit the possibility of fraud which was the original intention of eliminating respite for paid LRI caregivers. I would also support the elimination respite in favor of supporting the elimination of the other unnecessary guardrails on parents as LRIs. I hope for a positive outcome that both respects and supports the Virginia families of medically complex minors, all of which you represent. Respectfully, Richard Plebuch

Part 1 of 2 My name is Richard Plebuch and I am writing to urge you to vote yes on to the original version of Virginia SB488. This bill directly affects my family with 2 medically complex girls, 5 and 8. Both of our children have Medicaid waivers due to their extensive list of medical and behavioral conditions. For the last 8 years we have constantly struggled to find and keep qualified caregivers that are willing to accept the responsibilities at the set pay rate, which we cannot legally subsidize.. We have placed multiple ads to hire caregivers since October 2023, to abide by the new LRI guidelines, and have had no applicants, only comments stating that we should be ashamed of ourselves by offering such a low wage for the required requirements of the position. The caregivers that we have are only sporadically available to work a few respite hours a month, as they have other jobs and cannot afford to accept the caregiver position full time. Among their numerous other medical conditions, both of our daughters have an extremely rare neuromuscular gene mutation which causes numerous issues like falling, periodic paralysis, limited mobility, eating, drinking, vision, respiratory, and most notably choking (laryngospasm) at any time as if they are being strangled from within. The first time I had to perform CPR on her was on the side of I-95 when she was only 7 weeks old. I have personally administered CPR on both of our children countless times. Our children require close supervision due to the high probability of choking and they are not accepted into daycare programs for this reason. We have had only 1 full-time longtime caregiver, but she has since become a full time nurse. The countless other full time caregivers we’ve had only lasted for short periods of time before leaving. We’ve had one caregiver that we had to press charges for grand larceny of, including but not limited to: cash, schedule 1 prescription drugs, and my wedding ring. In addition, she also used illegal drugs, conducted drug deals over the phone, and negligence/child endangerment by leaving our then 9 month old on the edge of our kitchen counter and walked away, all of which were captured by a single camera on the same day. She was only with us for a month before this incident occurred.

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Hi I am writing to you on behalf of The Well Connection UK, a media and publishing company. We could easily get virginia.gov featured in various publications such as magazines, online blogs and news sites. This would undoubtedly help virginia.gov with publicity, reputation, domain authority and organic search engine rankings. We have a wide range of options including completely free collaborations, sponsored posts, guest posts and banner ads. If this sounds of interest, please reach out to the senior business development manager, Anita at info@thewellconnection.co.uk and whatsapp +447395206515 (GMT) Kind regards Clifton Junior Outreach Assistant

Community Health Workers (CHWs) create a huge and great impact on the health and well-being of Medicaid beneficiaries and communities, For this and more the state Medicaid programs should pay for the broad kind of services that CHWs are experts in providing to the community.1 Many studies provide significant evidence that CHWs are effective in these roles, particularly when serving underserved communities, medically, socially, and with many health barriers. More than half of the 50 states planned to expand their state’s CHW workforce. With all the positive health outcomes, well-designed CHW programs have been demonstrated to save as much as $2.47 in Medicaid spending for every dollar spent.16. All of this is because CHWs promote early detection and help with the management of chronic conditions, they have a well of resources to connect individuals into social services that address a range of social determinants of health improving care coordination, and helping prevent illness or hospitalizations. Providing Medicaid financing the CHWs can control costs while improving care coordination, culturally responsive care, and other outcomes to promote health equity. Let me list some of the good outcomes the individuals and the community can receive by providing coverage to pay for CHW: Cultural Mediation Among Individuals, Communities, and Health and Social Service Systems, Providing Culturally Appropriate Health Education and Information, Care Coordination, Case Management, System Navigation, Providing Coaching and Social Support, Advocating for individual communities, Building Individual Community Capacity, Providing Direct Service, Implementing Individual, and Community Assessments Conducting Outreach Participating in Evaluation and Research “By covering the CHW services, state Medicaid programs can more effectively address social determinants of health and health inequities, positioning CHWs to ensure treatment of the whole person and advance community-level health, rather than limiting them to condition-specific activities for individual patients. CHWs can help increase savings while improving care coordination, culturally responsive care, connections to services, and other outcomes to promote health equity.” Partners in Health United States PIH.org/united-states

Why and how should CHW services be covered by Medicaid programs? Several studies have found that interventions using CHWs help to improve health outcomes among racial and ethnic minorities. Therefore, addressing the social determinants of health and health inequities should be done more effectively. CHWs can help improve disease control and reduce mental health symptoms such as depression and substance use disorder. Many state Medicaid programs use CHWs as part of their strategy to address the needs or manage the care of specific populations. States can provide Medicaid payment for CHW services through the state plan or Section 1115 demonstration authority. Section 1115 allows the Secretary of the U.S. Department of Health and Human Services (HHS) to waive almost any Medicaid state plan requirement under §1902 of the Act. The Secretary can also permit federal financial participation for costs not otherwise matchable, allowing states to cover services and populations not included in the Medicaid state plan. There are no federal Medicaid requirements for training and certification for CHWs. States that provide CHW services under the state plan are most likely to define certification and training requirements as a condition for receiving Medicaid payment. There is no reason for not implementing this Bill. Some states require Managed Care Organizations (MCOs) to provide certain CHW services, while others allow but do not require MCOs to provide such services. Medicaid payment for CHW services can be authorized under multiple state plan benefits, such as coverage under the preventive services benefit. States may also cover CHW services under other benefits, such as the outpatient hospital services benefit (42 CFR 440.20). For this benefit, states are not required to identify CHW services in the state plan. A standardized community health worker intervention aimed at addressing unmet social needs estimated a return on investment of $2.47 for every dollar invested to an average Medicaid payer (Kangovi et al. 2020). Considering the overall benefit this will bring to the community, several studies have found a 23.8 percent average reduction in annual Medicaid spending per participant during three years. This resulted in $2.6 million in net savings for the Arkansas Medicaid program (Felix et al. 2011). The special community relationships that CHWs develop can facilitate connections and build an important level of trust between the community and health care systems. CHWs may be members of communities that are typically underrepresented in healthcare settings or may be specifically qualified to provide culturally competent care (CDC n.d., Lloyd et al. 2020). Source: https://www.macpac.gov/wp-content/uploads/2022/04/Medicaid-coverage-of-community-health-worker-services-1.pdf

The National Association of Community Health Workers (NACHW) is pleased to support SB 615. Please see attached PDF for our full testimony.

Necesitamos este bill para mejorar la calidad de vida de las personas de bajos recursos

Los Promotores de Salud (CHWs) son trabajadores publicos en las comunidades quienes trabajan con miembros de las comunidades los cuales experimentan inquidades en salud. Hoy, el subcomite de Servicios Sociales en el comite de Health and Human Services tendran un voto legislativo que impactara la creación de un equipo de trabajo para estudiar los beneficios de Medicaid. Esto hace que hoy sea un dia muy especial para discutir el role e impacto de los Promotores de Salud (CHWs). Como lo dijo la Dr. Leana Wen, Comisionado de Baltimore City, "la salud publica es una herramienta podeora que balancea los niveles en general, al aleja los valores de los miedos de desconfianza y inequalities y los une a los valores de equidad y justicia"

I need you support

Please support LRIs as paid attendants and support the system that surrounds it. The service facilitators that enable consumer directed services are underfunded which leaves us unable to access the services that our children are promised. I wish I could convey how frustrating it is to navigate a broken system to get simple services for our disabled children. Our lives are difficult, but one of the most frustrating parts about it is trying to navigate the red tape for "supports" that are promised to us only to find out that they are actually inaccessible due to lack of funding and support. I'm asking you to support LRIs as paid attendants. We simply ask to be paid for the same work that anyone else would be paid to do. We have more experience, training, and motivation to do the job well, but DMAS wants us to be the "last resort." They would rather I hire anyone else. This makes no sense, especially when I have had to quit my job to care for my child. Even if I were able to find an attendant, I would not be able to go back to work because attendants have a track history of negligence, if they show up at all. Again, this seems built into the system as they are paid very little for the job being done, and often go months without pay for paperwork errors. Our children are in crisis and need your help.

Please protect disable children in Va. We need to take care of them. As parents, We can’t find attendant care, well trained. The regulation changes affect families, adds confusion. Consumed directed services are necessary to proceed our kids.

I am writing on behalf of Virginia Association Of Community Health Workers, thank you for continuing to champion Medicaid reimbursement for Community Health Workers (CHWs). We are so grateful for your support. We respectfully ask that you continue to support this important cause. Community Health Workers improve health while reducing costs. Every dollar invested in a Community Health Worker intervention returns $2.67 dollars to an average Medicaid payer within one fiscal year. Please support: SB615 Thank you again for supporting Community Health Workers.

En nombre de la organizacion de Virginia Community Health Workers], gracias por continuar defendiendo el reembolso de Medicaid para los trabajadores comunitarios de salud (CHW). Estamos muy agradecidos por su apoyo. Le pedimos respetuosamente que continúe apoyando esta importante causa. Los trabajadores de salud comunitarios mejoran la salud y reducen los costos. Cada dólar invertido en una intervención de un trabajador de salud comunitario devuelve $2,67 dólares a un pagador promedio de Medicaid dentro de un año fiscal. Por favor apoya: SB615 Budget Amendment 292 #7s Budget Amendment 288 #68h Gracias nuevamente por apoyar a los trabajadores comunitarios de salud. No dude en ponerse en contacto conmigo en [INFORMACIÓN DE CONTACTO] si puedo ser útil. Atentamente Ysabel Lovo

Me dirijo a ustedes como ciudadano de este estado expresar mi preocupacion Por saber que SB615. Sea aprobada , necesitamos mejorar el acceso a la atención medica y reconocer el papel fundamental que Desempeñan los trabajdores de la salud y comunitarias. En la prestación de servicios de salud a las comunidades

On behalf of [ORGANIZATION], thank you for continuing to champion Medicaid reimbursement for Community Health Workers (CHWs). We are so grateful for your support. We respectfully ask that you continue to support this important cause. Community Health Workers improve health while reducing costs. Every dollar invested in a Community Health Worker intervention returns $2.67 dollars to an average Medicaid payer within one fiscal year. Thank you again for supporting Community Health Workers. Please do not hesitate to contact me at [CONTACT INFORMATION] if I can be helpful. Sincerely,

On behalf of the Virginia community, thank you for continuing to champion Medicaid reimbursement for Community Health Workers (CHWs). We are so grateful for your support. We respectfully ask that you continue to support this important cause. Community Health Workers improve health while reducing costs. Every dollar invested in a Community Health Worker intervention returns $2.67 dollars to an average Medicaid payer within one fiscal year. Thank you again for supporting Community Health Workers. Please do not hesitate to contact me at (571)237-4558] if I can be helpful. Sincerely, Veronica R. Stokes

Necesitamos este bill para tener mejores oportunidades para la comunidad de bajos recursos

I, Christopher Rashad Green, thank you for continuing to champion Medicaid reimbursement for Community Health Workers (CHWs). We are so grateful for your support. We respectfully ask that you continue to support this important cause. Community Health Workers improve health while reducing costs. Every dollar invested in a Community Health Worker intervention returns $2.67 dollars to an average Medicaid payer within one fiscal year. Please support: SB615 Budget Amendment 292 #7s Budget Amendment 288 #68h

I am writing on behalf of the Virginia Association of Community Health Workers (VACHWA) to express our gratitude for your attention to the important issue of Medicaid reimbursement for Community Health Workers (CHWs). Your consideration of this matter is greatly appreciated. We respectfully ask for your continued support in advocating for this cause. Community Health Workers play a significant role in improving health outcomes and reducing costs. It has been observed that every dollar invested in a Community Health Worker intervention yields a return of $2.67 to an average Medicaid payer within one fiscal year. Thank you for your attention to the valuable work of Community Health Workers. Should you require any assistance or further information, please do not hesitate to contact me at (703) 438-1481. Best regards,

On behalf of my self , thank you for continuing to champion Medicaid reimbursement for Community Health Workers (CHWs). We are so grateful for your support. We respectfully ask that you continue to support this important cause. Community Health Workers improve health while reducing costs. Every dollar invested in a Community Health Worker intervention returns $2.67 dollars to an average Medicaid payer within one fiscal year. Thank you again for supporting Community Health Workers. Please do not hesitate to contact me at thaynes5007@email.vccs.edu if I can be helpful. Sincerely, Thomas Cory Haynes

"It is crucial to ensure that legislators and committee members understand the importance and impact this legislation has on the care provided by Community Health Workers (CHWs) to Medicaid members and many vulnerable communities across the Commonwealth of Virginia. The workgroup's creation is a necessary step toward designing an infrastructure that ensures equitable access to health information and resources for the most vulnerable individuals. As you may know, many CHW positions are funded through grants, including federal grants that are about to expire. Sustainable financing through Medicaid will help maintain and expand the CHW workforce and directly address premature leading causes of death." I am a student in this program and I am ready to work for the many underserved cititzens in my community. WE NEED YOUR HELP NOW!

Please protect disable children in Va. We need to take care of them. As parents, We can’t find attendant care, well trained. The regulation changes affect families, adds confusion. Consumed directed services are necessary to proceed our kids.

Please protect disable children in Va. We need to take care of them. As parents, We can’t find attendant care, well trained. The regulation changes affect families, adds confusion. Consumed directed services are necessary to proceed our kids.