Hello, my name is Candice Bowman, and I serve as the Residential Director for the Western Division of Wall Residences. Our organization has been serving individuals with ID/DD and behavioral health needs for 30 years. We currently serve more than 600 individuals in residential services statewide and are reliant on Medicaid funding to support our services. To be able to continue the availability and quality of services, we are asking that the General Assembly approve the proposed 35% rate increase advocated by Virginia ACCSES for all waiver services. Sponsored Residential should always be included in such increases, given its proven cost-effectiveness as Virginia’s most affordable residential service. Thank you for your attention and efforts in ensuring funding is allocated appropriately for these vital services.

Good afternoon, I am writing to request the General Assembly to approve the proposed 35% rate increase advocated by Virginia ACCSES for all waiver services. Sponsored Residential should always be included in such increases, given its proven cost-effectiveness as Virginia’s most affordable residential service. Sponsored residential service providers open their homes as businesses subject to multiple levels of state and federal inspections and reviews, to provide successful and inclusive services up to the end of life to Virginia's most vulnerable citizens with disabilities. This service utilizes other services such as home health and hospice to assure people can remain in the community and avoid re-institutionalization in hospitals and nursing homes, thus saving thousands of dollars in care costs. The low staff to client ratio also promotes individual attention to prevent health issues from worsening in these populations, who experience increased risks of aspiration, falls with injury, seizures/status epilepticus, pressure injuries and sepsis that can be life threatening. Please support this model financially to assure it can continue with quality, dedicated care providers who are appropriately supervised and supported by agencies such as mine. Thank you. Sincerely, Rebecca Ledingham, LCSW

Good afternoon, I am writing to request the General Assembly to approve the proposed 35% rate increase advocated by Virginia ACCSES for all waiver services. Sponsored Residential should always be included in such increases, given its proven cost-effectiveness as Virginia’s most affordable residential service. Sponsored residential service providers open their homes as businesses subject to multiple levels of state and federal inspections and reviews, to provide successful and inclusive services up to the end of life to Virginia's most vulnerable citizens with disabilities. This service utilizes other services such as home health and hospice to assure people can remain in the community and avoid re-institutionalization in hospitals and nursing homes, thus saving thousands of dollars in care costs. The low staff to client ratio also promotes individual attention to prevent health issues from worsening in these populations, who experience increased risks of aspiration, falls with injury, seizures/status epilepticus, pressure injuries and sepsis that can be life threatening. Please support this model financially to assure it can continue with quality, dedicated care providers who are appropriately supervised and supported by agencies such as mine. Thank you. Sincerely, Rebecca Ledingham, LCSW

We are writing to express concern regarding the proposed rate cap for private day educational services included in HB 1600. L. Notwithstanding any other provision of law, for services provided on or after July 1, 2025, the rate of reimbursement to localities for private day educational services shall not increase more than 2.5 percent over the rates for such services provided the previous year. Private day educational services are a critical component to the continuum of services necessary to serve students with special education needs. Students served in private day schools require a level of educational services and supports not available in the public school setting. The availability of these services is crucial to ensure those students with the highest support needs receive a free and appropriate public education as is protected by federal law. It is rare that the costs for personnel, and other general costs associated with running a private day school program, would only increase by 2.5% a year. The proposed cap of 2.5% falls short of the 3% increase in public school teacher salaries that was approved for this year and the upcoming school year. This makes recruiting and retaining teachers at private day schools, which serve some of the most vulnerable youth in the Commonwealth, an even more challenging task. An additional consequence of the rate cap would have some costs move to localities and local school systems. Fewer children served in private day schools would place more burden on the public schools and increase the number of students placed on home-bound instruction. As a provider of private day educational services for over 50 localities across the Commonwealth, we ask that the language regarding the proposed rate cap be removed from the bill. Sarah Headley-Boyd VP of Education UMFS

I am writing in support of the "Ongoing Efforts to Support Virginia Moms and Improve Maternal Health Outcomes" in the Virginia State Budget. As someone who has been serving pregnant moms for over 20 years now in the greater RVA community I can assure you that this focus is needed in Virginia and should be a top priority of approval in for our state budget by ALL legislators in this session. This investment to strengthen maternal health in the Commonwealth which is focused on the three pillars including Virginia State Budget Investment is essential to ensure that our state has healthy moms, healthy families and Healthy Communities. Together we can do this! Thank you for voting yes to this additional Budget Investment!!!

Thank you to each of you for your longstanding commitment to improving the child welfare system in Virginia and investing in the futures of children and youth. While much work has been done in the past several years, our system is far from perfect and continues to require additional investment to ensure that the children we take into care as a state receive the best care and best opportunities for long-term success. Virginia’s social services system has had a significant workforce retention crisis for many years, which affects thousands of children in the foster care system. This year, the Virginia General Assembly can help solve this crisis by continuing to steadily invest in the stabilization of the workforce through increased salaries and compensation. The frontline workers in our social service departments work long hours ensuring children and youth are safe throughout the Commonwealth. Additionally, Virginia continues to work towards increased kinship care and prevention services. While we have made progress on both of these fronts, we need to continue with that momentum and ensure the appropriate funding is in place to adequately achieve our goals in preventing children from entering foster care and placing them with kin, whenever possible, if they do enter foster care. While considering the Governor’s proposed budget, we ask that you continue investing in prevention services and kinship care, as well as funding to stabilize the social services workforce. Virginia should put children first, particularly the vulnerable children involved in the foster care system and this investment will have a direct, positive impact on those children.

Hello my name is Samira Brooks. I have been a Home Care Worker for over 23 years. I started at a wage of $6.50, twenty three years ago. I now am at the wage of $11 per hour, 23 years later. I have struggled to manage my livelihood with the lie wages and had to miss out on many aspects in my personal life. Due to working 60-80 hr work weeks to have extra money outside of bills. That will now come to an end with the 16 hour cap. I have twin daughters and a son that I have to take care of. Outside of them I help my grandmother with her bills as well as paying my bills with this income. I would love for you to trade places with myself and other HomeCare workers . Take off your suits and ties, dresses or skirts. Put on a pair of scrubs and do what I do for a living. Then turn around and have to stand in front of a committee of people explaining to them the value, the need, the want, the desire, and what you deserve. No one should have to beg for a sufficient living wage. No one should still be at the lower end of the wage bracket after 10-20 on the same job. No one should question, why do I stay in this field? Trust me it isn’t because of the wages that we do this work. It’s because it’s embedded in us and we are needed in this field. We do what family members don’t want to do for other family members. We provide dignity, compassion, hope, love while a person continues to stay in their home. We use our body as equipment by lifting, turning, pulling bathing performing all ADLs that one cannot do for themselves. Only to be told you’re not worth higher pay. You should only work these amount of hours at this low pay. So I stand before you not in humbleness, but with a bitter and sour taste in my mouth. A ILL Matic feeling over my body. A confuse mind, because 23 years later, I am not receiving a wage worthy of the work that I have put in. I cannot retire with the 401(k) plan. I may never be able to retire from this work. Yes my choice, of course. Aren’t you working in the field that you chose? We want we need and we will fight for collective-bargaining, we will fight against this 16 hour cap. We will do all in our power to fight for what we want and what we deserve. It’s only right. We as caretakers give up so much. Don’t we all deserve adequate pay and collective bargaining? Why are people who don’t do the work but are able to make decisions about how much we deserve to be paid per hour and how many hours we can and cannot work for our pay? Before I end, I want to put you in my shoes. With an understanding that one day this will happen to you or a close family member. Ask yourself, what happens when you need care , your wife, your mother, your father, a sibling, one of your children or grandchildren? What happens when one of your family members becomes disabled/sick and requires 24 hrs care? Do you put them in a facility for care or receive care from the comfort of their? The caretaker you trust and love can only be with your love one 16 hours per day, but they need 24hrs of care. Do stop working, though you can’t afford to? Let’s tilt the table even more. You are the caretaker. No one will provide the care for your parents, child or spouse like you. DMAS is now telling you, you can only get paid for 16 hours, though you provide 24 hour care. What will you do? You have the power to make all this right. What will you do? I digress.

My name is Deanna Rennon, I am the VP of Operations-Eastern Division for Wall Residences. We have continued to serve people with IDD and Behavioral Health needs in the Commonwealth since 1995. Our business is funded strictly through Medicaid dollars. There is an on-going concern for business sustainability due to the lack of necessary rate increases causing wage compression as we attempt to raise wages for our direct care staff. We need an increase in rates for the DD waiver services at 35% based on current data to ensure continued services as a phase II of the slot allocations that began last year. I also support the VACSB in their quest for start up costs to get support coordination onboarded and trained to support this process as well. Thank you for all the work you do in allocating funds necessary to sustain and support the people of the commonwealth.

Testimony on Governor Youngkin’s Budget Amendments Presented by Melody Clarke, a Virginia resident. Good morning, esteemed members of the committee and distinguished colleagues. My name is Melody Clarke, while I’m not originally from Virginia, I got here as fast as I could. I appreciate the opportunity to support key provisions within Governor Youngkin’s proposed budget amendments. First, I commend the Governor’s commitment to lowering the cost of living for Virginians. Particularly through two measures: the proposed extension of the increased standard deduction and the working-class car tax relief. These initiatives recognize the financial strain many Virginians face and provide practical steps toward alleviating that burden. For example, extending the standard deduction prevents a tax hike that disproportionately impacts middle-income families, ensuring hardworking Virginians keep more of their earnings. Second, I applaud the focus on improving educational opportunities, particularly the proposed fifty million dollar Virginia Opportunity Scholarship program. This initiative is a vital step in addressing the educational disparities that continue to hinder low-income and minority students. Providing these students with the resources to access private education acknowledges their right to quality schooling and empowers families to make the best decisions for their children’s futures. Finally, I want to highlight the importance of the targeted funding for the School Performance and Support Framework. The fifty-one and a quarter million dollars allocated to this program will provide critical tools and resources to underperforming schools, ensuring that data-driven solutions guide our efforts to close achievement gaps and improve student outcomes. This approach ensures transparency and accountability while fostering collaboration among educators, families, and communities. While we strongly support these measures, more must be done to provide critical learning opportunities for our students and to lower the cost of living. For instance, while the car tax credit offers some relief, it does not fully eliminate one of the most burdensome taxes Virginians face. I speak not only as a policy advocate but also as a Virginian who would continue to pay taxes on a 23-year-old vehicle – that doesn’t make sense! A more comprehensive approach is needed to address this inequity fully. In conclusion, the Governor’s budget amendments represent meaningful progress toward reducing financial burdens, expanding educational opportunities, and improving transparency in our education system. We urge you to support these proposals while considering further reforms that will benefit all Virginians. Thank you for your time and dedication to these important issues. Again, I am Melody Clarke, a Virginia resident.

Good morning/evening. My name is Samira Brooks, and I’m a proud union member of SEIU Virginia 512. I decided to be a leader within our Union so that I could speak directly with our elected officials about the importance of building a care economy before it is too late. You may be asking yourself, “What exactly IS a care economy?” Well, I have your answer. A care economy is one in which those who provide care for others are considered and protected with legislation that allows for the workforce to be more practical and sustainable. So what does that look like? A care economy looks like a world where care providers have paid sick days to protect the clients they deserve, quality healthcare to cure the ailments that they are working through and wages where they can afford to support their family without needing multiple jobs. Doctors and nurse practitioners aren’t expected to work multiple jobs and still provide for their families, so why should other experts that are providing care? Too many working-class Virginians, particularly care providers, aren’t benefiting from the economic growth our hard work creates. Many of us can’t pay all of our bills, afford healthy food, take care of our health, and spend time with our families. Virginia can better support the working families who power our economy. And we can go further and create an economy centered around those who need care and those who provide me. I am asking that you use the power of the positions that we elected you to ensure that we can afford to give care to those who need it most, and so that there will be a workforce in place in the future when we are no longer able to provide care for others or ourselves. Thanks for listening today, and I look forward to seeing you take action because care can’t wait. Issues: That’s why working people across Virginia are joining SEIU and their local unions at historic levels: to win the living wages, benefits, and dignity we all deserve. And that’s why we’re asking Virginia’s elected leaders to focus on legislation and budgets this year that will support working people. We’re asking you to pass: Collective Bargaining rights for all public employees, including Home Care providers, to make sure that hard-working Virginians have a seat at the table; Worker Retention laws to allow localities to protect the frontline contracted providers who keep our communities running; Thank You/Close Thank you for this opportunity. SEIU members look forward to working with you throughout session to make Virginia a better place for all working people.

I fully support Governor Youngkin's Proposed Budget. We need significant relief in form of tax credits. Please eliminate the car tax. I can't afford to purchase a car or maintain insurance after my car accident in September 2023.

Comments Document

The attached document addresses my concerns with regard to Governor Youngkin's proposed amendments to K-12 Funding in the 2024-2026 Virginia State Budget.

Mr. Chairman or Madam Chair: The Commonwealth's employee retirement health insurance supplemental plan is Anthem Advantage65. Anthem Advantage65 is a Medicare supplement plan, not a Medicare Advantage plan. There is a difference! Supplemental plans like Virginia’s retirement health plan are secondary to Medicare, and the copay is paid after Medicare has been billed. After the provider bills Medicare and pays, the claim is transferred to the supplemental plan for additional payment. Medicare Advantage plans provide primary healthcare coverage for Medicare beneficiaries. Providers bill the Medicare Advantage plans instead of Medicare, and the Advantage plan is responsible for the entire payment. As a result, these plans do not pay nearly as well as traditional Medicare coupled with the Commonwealth's retirement health plan. Providers hate Medicare Advantage plans because they are challenging to work with, and they offer low reimbursement. As a result, numerous providers do not accept patients with a Medicare Advantage plan such as the commercial Anthem HealthKeepers Medicare Advantage Plan. Although DHRM states the Commonwealth’s Anthem Advantage65 is a supplemental plan, some providers hear Advantage and refuse to accept the patient for care. I checked with the Department of Human Resources (DHRM). They stated that the Commonwealth's employee retirement plan, Advantage65, had been named before the Medicare Advantage Plans became popular. Unfortunately, DHRM has not been proactive in changing its name. It is a shame that former employees who have worked a lifetime for the Commonwealth are burdened with explaining the difference to every new provider, and the state's retirement health plan is misnamed. A simple name change can stop this! I would like your help in changing the Commonwealth's Anthem Advantage 65 to something else. I appreciate your consideration of this request.

Comments Document

ATTACHMENT SUMMARY: I authored a memo outlining five different policy alternatives for eliminating the Virginia car tax, considering each alternative's ability to fully eliminate the tax, cover foregone local revenues, and to gauge public responses. I have spoken with many local leaders (boards of supervisors, commissioners of revenue, directors of finance, etc.) about the car tax, what local considerations are, and potential policy avenues for eliminating the tax. As a result, I understand the different local/regional needs and concerns with eliminating the car tax. I have also collected data from local governments on their car tax revenues/rates, etc. I have also studied how other states have successfully/unsuccessfully eliminated the car tax. I would love to engage in this discussion on potentially cutting / eliminating the tax. Email: callahan@thomasjeffersoninst.org Phone: 561-512-0679 Public Policy Student at the University of Virginia

Dear Members of the House Appropriations and Senate Finance and Appropriations Committees, RE: Virginia Business Ready Site Program (VBRSP) The Hampton Roads Executive Roundtable submits this Statement of Support for an additional $50M investment in the VBRSP program. This investment is absolutely critical for Virginia to remain the top State of Business and compete effectively with other states looking to attract private capital and new high-paying jobs. Hampton Roads in particular has key sites needing development, such as the Coastal Virginia Commerce Park in Chesapeake, which will require additional state support ahead - and which can yield future tax revenue, job creation, and innovation. Time is of the essence. The recent announcement of Microphorous to invest $1.3B and create 2,000 jobs in Southern Virginia is an example of how investment today for critical infrastructure can pay off to "prime the pipeline" for major companies and site development consultants to even consider Virginia. As you know, the Roundtable is comprised of major business and higher education CEOs and Presidents in Hampton Roads, with the mission to expand our region's economy and competitiveness. We also serve as the Support Organization for GO VA Region 5, and we align the site readiness dollars permitted under GO VA with VEDP VBRSP, working closely with the Hampton Roads Alliance and our regional cities. Thank you for your support, and I am happy to provide further information. Nancy L. Grden. President & CEO Hampton Roads Executive Roundtable Support Organization, GO VA Region 5 3 Commercial Place | Suite 1320| Norfolk, VA 23510 ngrden@roundtablehr.org www.roundtablehr.org

As the CEO of the Shenandoah Valley Partnership, the regional economic development organization for twelve localities in the Shenandoah Valley Region, I am strongly in favor of the amendment for an additional $50 million for the Virginia Business Ready Site Program, as well as a strong advocate for site development. If existing business or a new business wishes to expand they must have a place to locate. As an example, on behalf of our region, the Shenandoah Valley Partnership leveraged an $831,000 GO Virginia grant for due diligence work on 9 sites across the region into $300 million in new investment and almost 500 jobs in just the last 3 years. This economic growth was the result of one major company expansion and two new companies locating. The bottom line is that if Virginia wishes to grow and prosper, we require sites foremost for our existing business to flourish as well as new companies to locate. Otherwise, our existing business growth will become other states' economic development prospects.

Comments Document

Owned by the nonprofit Preservation Virginia, the original site of the 1607 James Fort is facing increasing recurrent flooding. To ensure continued visitor access, a $22 million campaign launched to create new infrastructure to protect the site from flooding. The next phase of funding will result in additional studies, construction documents, and elevated pathways to maintain visitor access to the fort site. This work was not listed in the Governor’s budget, however support form the Commonwealth of Virginia is critical to keeping the James Fort site open to visitors. Keep in mind this location is separate from the Jamestown Settlement operated by the Jamestown-Yorktown Foundation. Additional funding is needed to continue the Department of Historic Resources’ Black, Indigenous, and People of Color Historic Preservation Grant Program. Projects supported in the first two years of the program represent a successful track record of saving, surveying, and preserving traditionally underrepresented historic sites. Current funding for the program will run out by the end of the fiscal year and was not included in the Governor’s budget. Similarly, a continuation of the African American Cemetery & Graves Fund was not included in the Governor’s budget. This program supports the maintenance and care of cemeteries established prior to 1948, specifically for the internment of African Americans. Funding will deplete by the end of the fiscal year, so additional support is needed to continue the program.

As a member of the PUSH Maternal Health Coalition, I am grateful that the Governor's budget funds perinatal health hubs and makes improving access to timely prenatal care a priority. That being said, I urge the Governor to consider other important PUSH priorities including presumptive eligibility for Medicaid for pregnant women. Allowing different providers, including Federally Qualified Health Centers (FQHCs), as well as community-based organizations to perform presumptive eligibility screenings would allow pregnant women eligible for Medicaid coverage to have earlier access to care and would allow providers to get reimbursed timely. We also encourage the Governor improve access to care for pregnant women in carceral settings by applying for an 1115 demonstration waiver.

I am full time caregiver for my mom. My mom was diagnosed with Alzheimer’s disease, I’m a live in attendant, haven’t always lived with my mom however I feel my mom knew that something was going on with her because she insisted that I move in with her and right after she retired the visible changes began. Some may say why not put her in a nursing home, I’ve watched my mom take care of other people and as her daughter she deserve for the same care to be returned to her the way I know she would want. I take pleasure in taking care of her however it’s one of the most difficult jobs I’ve ever had!! This budget hearing is important to me because there has to be a change, caretakers need more pay and proper benefits. Otherwise it feels as though what we provide is not a real job! I applied for Medicaid in the beginning of all this and I have to drive an hour and 15 mins away for dental care, 45 mins away for a dermatologist, either Dr.’s don’t accept or they are not taking new patients. With the cost of living, it’s extremely difficult to go in the store to buy common essentials without spending at least $50. Not to mention having to buy gas for a vehicle. I employ you to please ma’am, sirs consider our plea in making the necessary changes we need as Caretakers. Thank You!!

Americans for Prosperity Virginia supports this budget. While this is an opening bid for legislators to consider, we believe this is a fair offer to Democrats that want to lower the cost of living in Virginia, making raising a child more affordable and provide generous education options. We appreciate the gracious opening bid and hope those opposed to this will act in good faith to land in a place that is a win - not for a party - but for the people of Virginia they represent.

Does the budget for the State of Virginia stand for an expense or an investment? Just about everyone feels it is an expense. But if you remember the saying, "An ounce of prevention is worth a pound of cure.", can you see my point of view that the budget is an investment? An investment in having an actual living wage for the minimum wage in Virginia means more prosperity for this State. It becomes a go to destination for employment. It gets a bigger tax base. It has more people able to afford housing. It has more people with disposable income. Billionaires, big corporations, and shareholders can afford it and still make more money than the rest of us beyond their wildest dreams of avarice. And more consumers will be able to buy what they are selling. Smaller businesses will get a workforce that wants to stay there and be more efficient and productive, garnering more profit. An investment in public schools now means more children across the state get that priceless thing called an education. Educated children become an educated workforce. Down the line that means more productivity and more prosperity for our State. Get the picture?

Vocal Virginia is the only statewide mental health organization in Virginia that is entirely staffed and governed by individuals living with mental health challenges. With over 2,000 members across the Commonwealth, we advocate for meaningful improvements in mental health policy and services. I urge your support for the following critical budget priorities: 1. Restore Funding for Marcus Alert Programs: $18 Million The state’s budget oversight has delayed funding for six Marcus Alert program sites ready for implementation. These programs, mandated by law, provide crisis response by integrating 911 and 988 services and diverting individuals in crisis from the criminal justice system or hospitalization. The requested funds will ensure these six sites move forward, allow six additional sites to launch, and bring all programs in line with original cost estimates. This funding is essential to meet the 2028 deadline for statewide implementation and improve crisis response systems. 2. Increase Funding for Competency to Stand Trial Services: $1.5 Million Current funding levels for competency restoration are insufficient, leaving Community Services Boards (CSBs) with unfunded mandates for evaluations and restoration services. This investment will increase reimbursement rates, expand outpatient restoration services, and provide clinician training. Strengthening outpatient capacity will reduce strain on state psychiatric hospitals, where forensic admissions continue to rise due to unmet restoration needs. 3. Support Funding for Youth Peer Support Specialists: $800,000 Governor Youngkin’s budget includes $800,000 for 10 youth peer support specialists and related training. Peer specialists play a vital role in supporting youth with lived experience navigating mental health challenges. This funding will provide targeted, age-appropriate support to young people in need and expand access to crucial peer-led services. These priorities address immediate gaps in crisis response, forensic mental health services, and youth support, all of which are vital to strengthening Virginia’s mental health system. Fully funding these initiatives will ensure we build a more accessible, equitable, and effective mental health care network. Thank you for your time and for your continued leadership in improving mental health services for all Virginians. Your commitment to these critical needs will have a profound impact on countless lives across the Commonwealth.

Comments Document

I am sharing a summary of my experience with ICE detainers in Virginia, which was published on my social media platforms. Governor Glenn Youngkin's proposed budget and Sanctuary city ban are intended to maintain public safety by transferring violent criminals, who are unlawfully present in the USA, to ICE. However, my experience differed. I was not accused of a violent crime, and neither were the females I encountered who were being detained on ICE detainers. The detainees included naturalized U.S. citizens, green card holders, and valid visa holders, all of whom were being held on ICE detainers. Most were detained beyond the 48-hour deadline for ICE. I observed these incidents at the Richmond City Justice Center, Riverside Regional Jail, and Chesterfield County Jail. ICE has been funding its operations in Virginia through grants, such as SCAAP. What is the rationale for allocating Virginia tax dollars to fund operations for a federal agency instead of requesting Congress to provide additional funding to ICE, if necessary, to support its operations in Virginia?

Dear House Appropriations and Senate Finance and Appropriations Committee, Thank you for considering the Governor’s Proposed Budget Amendments in regards to maternal health in our Commonwealth. As the Executive Director of a non-profit organization who works with pregnant women daily, I urge you to please approve these added resources for the women of our Commonwealth who are carrying the next generation of Virginians. We have seen firsthand the need for additional resources for pregnant women and we feel strongly that the Governor's plan will improve outcomes for pregnant women and their children. At Pregnancy Help Center of Chesterfield, we answer calls daily from women who are looking for prenatal care and as well as women who have delayed prenatal care due to a lack of resources. Additional resources for these women is essential. Thank you for your consideration and hopefully, your approval, of more maternal care. Blessings, Carla Herrmann Executive Director Pregnancy Help Center of Chesterfield.

Thank you so much great opportunity for blessing healthy womans with babies/children this is my honor open my heart and arms for this great opportunity thank you

Thank you so much great opportunity for blessing healthy womans with babies/children this is my honor open my heart and arms for this great opportunity thank you

My name is Richard Edwards and I work with Hand 'N Heart (HNH Virginia) -- we're a personal care service provider supporting seniors and veterans throughout the state. We provide home based care for senior citizens and veterans who require regular support, due to aging and/or disability, to continue living in their own homes and communities. Our services are much less expensive than nursing or facility-based care, are better for long-term health outcomes, and are what people want most often -- to stay in their own homes. We are asking that the Virginia General Assembly raise the rates for Personal Care services to $32.44/hr ($35.88/hour for NOVA) to support the availability and delivery of home-based personal care. Right now, we are not able to fully meet the need for services in our community because the Medicaid rates for Personal Care are too low to attract and retain high quality staff. Potential workers can easily make more in service or retail jobs, or if they want to stay a caregiver, can make significantly more in a hospital or facility-based setting. Raising the personal care rates to $32.44/hr ($35.88/hour for NOVA) would go a long way to helping us recruit the staff that Virginia's citizens deserve. Thank you so much for taking our input and for your consideration.

VSHL and it's members throughout Virginia strongly support the Governors proposals to strengthen Maternal Health resources in the Commonwealth. It is critical that we provide much needed support to all moms and their babies regardless of their circumstances. These budget proposals are based in common sense and supported evidence that changes are needed to assist more women to safely give birth and care for their children.

My name is [Your Name], and I am here on behalf of Birth In Color, an organization dedicated to improving maternal health outcomes and ensuring equitable care for all families. We are pleased to express our support for the Governor's budget, which highlights critical maternal health initiatives. These efforts demonstrate a much-needed commitment to addressing the disparities in maternal and infant health outcomes. It is crucial, however, to emphasize the importance of investing in community-based organizations like ours. These organizations are deeply embedded in the communities they serve and are uniquely positioned to provide culturally competent and personalized care. We also stress the need for continued investment in perinatal hubs and protecting families during this vulnerable time. These initiatives are vital to creating a more equitable and supportive maternal health system. Thank you for prioritizing maternal health, and we look forward to collaborating to ensure these efforts result in meaningful and lasting change.

Home care collective bargaining is needed to better advocate for us. Low wages is forcing me to work multiple jobs with no respect help because the wages are low. New reporting guidelines attached to pay with no training. Better communication of information.

Comments Document

The Virginia Association of Area Agencies on Aging are seeking a 4.35 million dollar investment from the Commonwealth to address the ever-increasing needs of seniors.

Hello I am Stephanie Bakely from Strengthening Our System Inc and our organization is also a member of VaACCSES. Thank you for listening to me today. We provide services throughout a portion of southwest VA. Waiver rates and slots: To meet the Governor’s initiative from last year to fill the historic 3440 Priority one waiting list slots and continue to fund and provide support to the 15000+ persons currently receiving services, rates must increase by more than 3%. An increases of approximately 35% is needed for the growing costs associated with provider operations, to offer competitive wages, and benefits amongst a growing shortage of workers. Businesses must be sustainable to continue to support people and those from the Priority One waiting list. Our agency serves roughly 100 individual and continues to have issues with turnover mainly for better pay, vacancies in which we have worked hard since COVID to decrease however continue to have a consistent deficit and can't really grow with referrals because of lack of staffing. Of the individuals served the number of hours we are covering with staff is at the most 55% of the hours monthly. We push to keep staff with good benefits ( health insurance, retirement, mileage and PTO) however it just never seems to be enough with added administrative pressures on top of quality supports. We are a private provider and as of now the owner has stated revenue decreases have kept salary levels the same since 2022. The money has been pushed to DSPs with 7% increase this past July. The industry is challenging as is and the lack of increases and or bonuses create an added burden and demotivator. We rely on DMAS funding solely and continue to struggle with workforce due to opportunities on all levels especially retail. We would greatly appreciate the push for more than 3% DMAS Rate Study: To document the true cost of providing services to Virginian’s with disabilities, we’re grateful to the General Assembly and the US DOJ for requiring a third party study of provider rates. However, as VaACCSES submitted in 9 pages of initial comments, and unless DMAS includes provider input and allows a reasonable timeline to develop the study, train staff, and obtain the data, this effort and budget will be wasted. LTESS / EES Funds Combined: VaACCSES supports the Governor’s budget language to combine the LTESS and EES funds as it is written. This will enable more people to maintain services and employment opportunities.