As a social worker for the city of Chesapeake, I have observed how severely at-risk the youth aging out of foster care are for homelessness, substance use, criminal convictions, domestic violence, and so much more. Individuals aging out of foster care experience such struggles due to the environments and conditions in which they were raised that was completely out of their control. It is the responsibility of the state and child welfare system to intervene in any way that they can, and this bill would support those efforts. The collaboration between the local Department of Social Services and the Local Housing Authorities would support positive outcomes within the child welfare of Virginia. Thank you, Olivia Berry, MSW

I am an intersectional professional working with teens and young adults with foster care experience. I myself Aged out of foster care, and fostered & adopted teens from foster care. I am an expert in what happens to young people as they transition out of foster care. In 2024, 533 individuals aged out of foster care in Virginia. 200 of them left at age 18, about a 100 were 19 or 20 and the last 200 were 21 years old. 40-50% of these individuals will be homeless within one year through no fault of their own. Landlords do not like to rent to young adults. The few Landlords willing to rent to such young people want them to have a good credit, great rental history or a co-signer. Many of these youth don't have a supportive adult in their lives to co-sign, they are too young for a good rental history or credit score. Most of them are not even making a livable wage in their entry level jobs. In fact, most of the youth are turning 18 with have never had a job, sat in the driver's seat or their own money to put into a bank account. The Federal John H Chafee law requires supportive services for the youth that transition of out of foster care until the age of 23 but most of the time when a former foster youth called for support from their old workers the workers don't have the capacity to help. Which leads to the negative outcomes reflected on the National Youth in Transition Database (NYTD) seen below. Since the Foster Youth to Independence Housing Choice Voucher was announced in 2019 Virginia has struggled to utilize this valuable HUD Resources due to the conflicting jurisdictions of the public housing authorities and the Local Dept of Social Services. The Public Housing Authorities only service individuals living in their county/city, but 80% the youth in care live more than 5 miles from the county/city that holds custody of them. Virginia Dept of Social Services hired consultant to conduct research and offer recommendations as to how Virginia can offer these vouchers to all those who qualify, in the community they are connected to, and their recommendation was for VDSS to play an active role. Currently VDSS does not have the authority to enter into an MOU and the program will not allow the a housing authorities to enter into a MOU with 120 local DSS offices. According to the GuideHouse consultants Virginia could access an additional 800 housing vouchers if this bill were to pass. Currently Virginia has less that 200 vouchers allocated with less that 30% utilized. The passing of this bill can decrease the homeless population for former wards for the state significantly! From 60 to 1000, many of which are young adults with preschool aged children (24% of former foster youth aged 21 had a child in the last 2 years, 10% of 19 yr olds had a child in the last 2 years, 4% of the 17 year old had a child in the last 2 years). Please review the other relevant data this bill will have a positive effect on: 41% of 21 yrs old & 16% if 19 yr olds were homeless in the last year 64% of 21 yr olds & 62% of 19 yr olds have a High School Diploma or GED 7% receive public housing assistance 65% of 21 year olds & 52% of 19 year olds are employed 31% receive public food assistance 16% youth (14+) received life skills development services (90% is the national standard) For the last few years Advocates have been working to extend foster care to the age of 23. This bill will offer the same supports at a low cost.

The Virginia Chapter of the National Shattering Silence Coalition Support SB819

Senate Bill 821 proposes that nursing home residents residing in a private room have the right to place electronic monitoring devices, such as cameras, in their rooms. However, the bill fails to protect the majority of nursing home residents and creates unnecessary burdens without addressing the real challenges facing long-term care in Virginia. Primary Concerns with SB 821: 1. Excludes Most Nursing Home Residents: The bill only applies to residents in private rooms, leaving out those in semi-private rooms (two or more beds). More than 90% of Virginia’s nursing home beds are licensed for Medicaid, and the vast majority of residents live in semi-private rooms, meaning this bill would exclude most nursing home residents from its protections. 2. Financial Burden on Residents and Families: Residents or their families would bear the full cost of purchasing and installing electronic monitoring equipment. Medicaid does not cover these costs, making it financially out of reach for many who need protection the most. 3. Disproportionate Impact on Low-Income and Minority Residents: Medicaid residents, who are disproportionately from low-income and minority communities, would be left out due to the bill’s private-room requirement. This worsens existing disparities in access to nursing home protections. 4. Harms High-Quality Providers: Non-profit nursing homes, like the Masonic Home of Virginia where I am employed, offers private rooms for all residents and we consistently deliver a high quality of care, and our community would be disproportionately affected by this bill. Non-profit homes like ours lead the way in ensuring high standards of care, and this bill would create unnecessary burdens without addressing the underlying issues facing nursing home care in Virginia. 5. Existing Protections: Virginia’s nursing homes already comply with robust regulations (VA Code § 32.1-138 and 12 VAC5-371-191) ensuring resident rights and transparency, including: -Privacy protections -Notice and disclosure requirements -Liability and cost considerations -Recording and data security measures The current framework allows residents and families to make informed decisions while supporting high-quality, person-centered care.

Mr. Chairman and Members of the Senate, Thank you for the opportunity to comment today. I want to express my strong opposition to Senate Bill 821, which proposes allowing nursing home residents in private rooms to install electronic monitoring devices, such as cameras. While the intention behind this bill may be to enhance the safety and oversight of residents, it ultimately fails to protect the majority of those in long-term care facilities and does not address the pressing challenges facing our nursing homes in Virginia. A major concern with SB 821 is that it only applies to residents in private rooms, excluding the vast majority who live in semi-private rooms. Over 90% of Virginia’s nursing home beds are licensed for Medicaid, and most residents are in shared accommodations. This exclusion creates a significant gap in care and oversight that cannot be overlooked. Additionally, the financial implications of this bill are troubling. Requiring residents or their families to cover the full cost of purchasing and installing electronic monitoring equipment imposes a heavy burden on those who are likely already struggling to meet basic living expenses. Since Medicaid does not cover these costs, this measure becomes out of reach for many residents who need protection the most. The bill's focus on private rooms disproportionately affects low-income and minority residents, who are often Medicaid recipients. By excluding these vulnerable populations, SB 821 exacerbates existing disparities in access to essential protections within nursing homes, leaving many without the oversight they deserve. Non-profit nursing homes, known for providing high-quality care and often offering private rooms, would also face undue challenges from this legislation. These facilities are already committed to high standards of care, and this bill would add unnecessary burdens without addressing the underlying issues in nursing home care. It’s important to note that Virginia's nursing homes already operate under robust regulations that ensure resident rights and transparency. Current laws include privacy protections, notice and disclosure requirements, and stringent liability considerations. These existing frameworks support informed decision-making for residents and families while promoting high-quality, person-centered care. In conclusion, I urge you to reject Senate Bill 821. Instead of creating a solution that benefits only a small subset of residents, we should focus on more comprehensive reforms that address the systemic issues facing all nursing home residents in Virginia. Let us work together to promote equitable care and ensure that all residents receive the protections they deserve. Thank you for your time and consideration, Kaitlyn Seyler, LNHA, CDP, QCP Kseyler@pinnacleliving.org

I am writing opposing SB 882, Licensure of Anesthesia Assistants. The licensure of a third, dependent anesthesia provider , of which there are approximately 3500 nation-wide, will not solve the anesthesia provider shortages. Utilizing the existing licensed anesthesia providers (physicians and Certified Registered Nurse Anesthestists) would help to correct the provider shortages. Additionally, fair pay and benefits would also encourage employment with facilities or groups versus temporary workers, which has severely impacted the marketplace. Licensure of AAs in Virginia would have a profoundly negative impact on availability of clinical sites and opportunities for both CRNA and physician anesthesiologist trainees/residents. Licensure of AAs is not the answer to provider shortages. Vote no on SB 882

Please find attached written testimony in support of SB826 by Samuel Hooper, legislative counsel at the Institute for Justice. We support the predetermination process, the elimination of remaining references to "moral turpitude" in the Virginia Code, and the expansion of current provisions to those professions regulated by the Department of Health Professions.

To the Honorable Members of the Virginia General Assembly, I respectfully present that this bill would ultimately harm the recovery community more than it would help. When we faced the overdose crisis, Virginia responded by deregulating Naloxone, making it more accessible for everyone. Now, increasing regulations on recovery housing will reduce the availability of safe, affordable housing. More requirements added to SB838 will create long-term barriers, especially for communities of color and lower-income individuals seeking non-Oxford recovery housing. The idea of criminal penalties for those seeking to help others in recovery—often house managers or owners in recovery themselves—is deeply troubling. What if a house manager runs a recovery home based on spiritual principles not compatible with DBHDS guidelines? What if they answer to higher standards than the Commonwealth? Why is Oxford given a carve-out—does it not have potential for the same abuses this bill targets? Recovery is personal, and it varies widely from individual to individual, community to community. What works in Richmond is not the same as in Northern Virginia or the 81 corridor. A universal set of standards will only limit housing availability everywhere. The goal should be to decentralize recovery, not centralize it. Abuses should be addressed, but at the local level. Homes with problems should face reputational consequences within the communities they serve. Courts, probation, and non-profits already have systems in place to prevent funding poor practices. If someone commits a crime, they should be charged—there's no need for SB838. The call line feature in SB838 is also concerning. In early recovery, people may act out or seek to retaliate when things don’t go their way. This will lead to misuse of the line, tying up resources better spent elsewhere. House managers will be less willing to take risks on people they want to help for fear of vindictive retaliation. As a result, fewer people will have access to safe, effective recovery housing. In conclusion, SB838 should not proceed. If it must, I recommend following West Virginia’s approach—bar recovery housing from public funds rather than criminalizing it. Keep recovery housing independent and decentralized by allowing it to be privately funded. This will help reduce waste, fraud, and abuse. Thank you for your time and consideration. Sincerely, Nick Yacoub Old Dominion Men's Recovery Center OldDominionRecovery.com 540-751-8601

On behalf of the R Street Institute, I would like to submit the attached testimony in support of SB 841.

I am writing to urge you to vote yes on SB882 to approve licensure for CAAs in Virginia. CAAs are an integral part of the anesthesia care team and are highly educated with great patient outcomes. Licensing CAAs in Virginia would expand access to anesthesia services within the state and help your constituents. Thank you.

I’m a CAA and I strongly urge you to support this bill for licensure of CAAs in Virginia!

I urge you to support the bill allowing for licensure of anesthesiologist assistants (CAAs) in the state of Virginia. Now more than ever, we have to stand united. CAAs can practice in any state via the VA network, and this has helped to alleviate the shortage of anesthesia providers in all states. However, with the new restrictions on federal employment opportunities, patients will go back to suffering from the reality of the anesthesiologist shortage. Allowing CAAs to practice throughout the state will be in the best interest of all constituents.

Good Morning, Madame Chair and members of the subcommittee. My name is Alan Alvarado, and I am a student anesthesiologist assistant finishing my studies at Case Western Reserve University’s Washington, D.C. campus. I am testifying today in strong support of SB 882. I have been a proud Virginia resident for over three years. Before pursuing this career, I served as a statistician for the Centers for Medicare and Medicaid Services and worked as an epidemiologist in state of Maryland. Virginia has become my home—I was recently married here, and my husband and I hope to grow our family in the years ahead. As a native Spanish speaker from Panama, I am passionate about providing high-quality, accessible anesthesia care, particularly in obstetric settings. Passing SB 882 would allow me to serve the patients of this state—the place where I have built my life—rather than being forced to relocate elsewhere. I am writing to you today from Children’s National, as I prepare for a pediatric case, because I believe in the importance of this legislation. I respectfully urge you to support SB 882 so that I, and others like me, can continue to serve the people of Virginia. Thank you.

My name is Arafat and I was raised in Fairfax county for over 20 years! I’m also a graduate of VCU (2012), GO RAMS! I’ve been working in Austin, Texas now and have been practicing for almost 8 years as C-AA. I am looking forward to return to the great state of Virginia if this bill passes! I still have my home in Herndon, Virginia and all the community members I grew up with are still in the area. Thank you all for supporting this bill and hoping to hear good news!

My name is Kevin Sistani, I am a practicing CAA from the DMV who trained in Washington, D.C. After 5 years of working in Missouri and Michigan, I have moved back home but currently commute into DC to work. Prior to my anesthesia training, I was fortunate enough to have worked in Vienna, and with immediate family members living and working all over Virginia, I truly can attest to the benefits that they have come to find in their own careers. My father recently retired, working for Fairfax County government for over 25 years and to this day maintains his pride and describes how fortunate he was to have served the commonwealth and the great citizens of Virginia. I am aware of the continuing need for skilled anesthesia providers in the state of Virginia, and with a favorable outcome I am anticipating practicing in Virginia and doing my best to provide for the citizens of the state which has already done so much for the community at large in our area. Washington, DC, North Carolina and 20 other states already license CAAs and as a profession we are recognized by Medicare, Tricare, and all commercial insurance payers as well as able to practice in any Veteran’s Affairs Hospital. The Virginia Joint Commission on Health Care unanimously recommended licensure of CAAs, as they recognize it will expand access to health care and bring more health providers to Virginia, which is currently experiencing a serious healthcare workforce shortage. CAAs are highly trained and educated advanced practice providers who works within the anesthesia care team to deliver safe and quality anesthesia care to patients. CAAs will not replace CRNAs or anesthesiologists, but will add another provider to the team and allow for more patients to access anesthesia care. As we look toward improving patient safety for all Virginians, I want to express my support for this bill. I have worked in various parts of the country and want to confirm that our training provides us with the tools to confidently care for patients and work within the Anesthesia Care Team model. I was fortunate enough to have been trained by some of the best and brightest anesthesia providers in the field by training in DC and was able to enhance my anesthesia skills in different settings and acuity levels since my graduation. The goal is to provide expanded and safe care throughout the country, and I am confident that with the passing of this bill I will be able to take my experience and provide for the Virginians who deserve safe and effective anesthetics.

Dear members of the Health and Human Services Health Professions Subcommittee: My name is Amanda, and I am a Nurse Anesthesia student here in Virginia. I was raised just outside of Franklin, VA, near a little town called Sedley, and I have seen firsthand the challenges of accessing quality healthcare in rural areas. I am writing to express that I strongly oppose SB882, which seeks to license Certified Anesthesiologist Assistants (CAAs) in Virginia. Many rural hospitals across Virginia rely on CRNA-only anesthesia models because CRNAs are trained to practice independently. CAAs, however, require direct supervision from an anesthesiologist, meaning they cannot provide anesthesia services unless an anesthesiologist is physically present in the facility. This is similar to how a surgical assistant can not perform surgery without a surgeon present. However, would we train more surgical assistants to address a shortage of surgeons? No—we would invest in training more surgeons. Likewise, Virginia should focus on expanding the CRNA workforce rather than introducing CAAs, who would be unable to practice in many rural settings due to their supervision requirement. Additionally, licensing CAAs will negatively impact Virginia's Nurse Anesthesia training programs. CAA students would compete for already limited clinical training sites, reducing opportunities for CRNA students. Many CRNA students, including those with families, already struggle to find in-state training sites, often having to travel out of state for months at a time. This bill would only worsen that problem. Furthermore, in 2017, the Virginia Board of Health Professions unanimously concluded that CAAs do not qualify for licensure in the state, setting specific criteria that have yet to be met. Additionally, a 2024 Joint Commission on Health Care report recommended further study before considering licensing CAAs in Virginia. Moving forward with SB882 disregards these expert recommendations. Before supporting SB882, ask yourself: Will licensing CAAs actually improve anesthesia access in rural areas, or will it divert resources away from providers who can already meet these needs? Should we invest in a workforce that requires constant supervision, or should we prioritize training independent providers who can serve all Virginians, regardless of location? For these reasons, I urge you to oppose SB882. Instead, Virginia should focus on strengthening its existing CRNA workforce to ensure safe, effective, and accessible anesthesia care for all patients, especially in rural communities like mine. Thank you for your time and consideration of my comments.

My name is Nick Bontempo and I have been a practicing CAA since 2019. I am writing in support of SB882. Having trained in Washington, DC and lived in Alexandria, VA, I am aware of the continuing need for skilled anesthesia providers in the state of Virginia. CAA’s are highly trained advanced practice anesthesia providers who complete both a rigorous science based undergraduate degree followed by a masters program specifically trained in anesthesia practice. Working within the ACT model of anesthesia with the supervision and collaboration of physician anesthesiologists, we provide anesthesia care in a number of settings. Our goal is to provide expanded and safe care throughout the country.

Certified Anesthesiologist Assistants (CAA) provide safe, efficient, cost effective anesthesia care. Licensure of an additional anesthesia provider would decrease surgical wait times, increase access to care, and decrease the anesthesia shortage seen in Virginia. Admission to a graduate level AA program is highly competitive and requires the course work necessary for consideration to physician assistant programs and medical schools. AA students undergo graduate level training encompassing the physiology, pathophysiology, pharmacology, and airway management necessary to become safe anesthesia providers. Training involves comprehensive study in general and regional anesthesia through didactic courses, high fidelity simulation, and hands-on clinical experiences. AA programs are rigorously accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), ensuring a standardized and high-quality education for CAAs. The Standards and Guidelines for Anesthesiologist Assistant programs detail the profession's scope and the depth of training required. Similar to other anesthesia training programs, CAAs are required to complete a requisite number of supervised clinical experiences and more than 2000 anesthesia specific clinical hours. These clinical experiences encompass a broad range of procedures, including but not limited to the placement of arterial and central venous lines, spinal and epidural blocks, and peripheral nerve blocks. CAAs, alongside CRNAs and Physician Anesthesiologists, are trained in Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and Pediatric Advanced Life Support (PALS), which are the national standards for emergency care. This training ensures that all anesthetic plans involve highly trained providers capable of effectively responding to and managing acute emergency situations in a coordinated team environment. As noted in the educational standards, CAAs are equipped to evaluate and treat life-threatening situations based on established protocols. I encourage you to support SB 882 to license certified anesthesiologist assistants in Virginia

As a lifelong resident of Virginia, a graduate of the University of Virginia, and a holder of a Master of Science in Anesthesia from Case Western Reserve University School of Medicine, I strongly support the licensure of Certified Anesthesiologist Assistants (CAAs) in our state. Virginia is facing increasing demands on its healthcare workforce, and the addition of CAAs will strengthen anesthesia care teams, ensuring safe and efficient delivery of anesthesia services. CAAs are highly trained, master’s-level anesthesia providers who work exclusively within the Anesthesia Care Team (ACT) model, a framework endorsed by The Joint Commission for its proven safety and effectiveness. Our specialized education equips us with the skills necessary to provide high-quality anesthesia care under the direction of physician anesthesiologists, enhancing patient outcomes and optimizing surgical efficiency. Granting licensure to CAAs in Virginia will not only expand our anesthesia workforce but also retain highly educated professionals like myself who have a strong commitment to serving this state. By allowing CAAs to practice, Virginia can attract great anesthesia providers while ensuring patient safety remains a top priority. I urge policymakers to support CAA licensure and recognize the essential role these skilled professionals play in strengthening our healthcare system. Sincerely, Timothy Olukanni

I am asking you to SUPPORT this bill and allow expansion of anesthesia care in your state. CAAs are highly skilled, rigorously trained advanced practice providers who provide excellent care throughout the anesthesia care team (ACT) model. The ACT, led by a physician anesthesiologist, is the safest method to provide anesthetic care to patients of all ages and sizes. They are recognized by the American Society of Anesthesiologist as a safe and effective member of the ACT. By passing this bill, you will expand the care of patients in your state as well as welcoming VA natives back into the state as licensed CAAs.

Please support the licensure efforts for Certified Anesthesiologist Assistants!

I am Dr. Emil Kurian. As an anesthesiology resident finishing residency at John’s Hopkins in Maryland, I have seen firsthand the benefits of the ACT model. The field of anesthesiology has a large demand for qualified, experienced anesthetists who are able to care for patients under the care of physician anesthesiologists. As an anesthesiologist I would be happy to supervise with CAAs. I believe the state of Virginia would benefit from the introduction of CAAs. Together CAAs and anesthesiologists can provide safe care for patients.

CAAs have been shown to be a safe and effective anesthesia provider in the Anesthesia Care Team Model. This model is the gold standard for providing the best possible outcomes and highest level of anesthesia care for patients across the country. They are an equal provider to CRNAs and are used interchangeably in facilities where both providers practice. (See attached anesthesia safety study by Stanford) CAAs already serve citizens of Virginia who travel to Washington DC for medical care. There is no reason CAAs shouldn’t be able to provide that same care within the borders of Virginia, especially with so many of those providers living and paying taxes in Virginia. The entire nation is experiencing a critical anesthesia staffing shortage. CAAs can help alleviate some of this and provide the highest level of care to patients in need.

I have worked with many AAs in Washington DC and they have been excellent part of an anesthesia care team. They provide excellent care for patients, and contribute to patient well being. It would be a benefit to both patients and physicians in the commonwealth if they are allowed to practice.

I fully support SB882 regarding the licensure of Anesthesiologist Assistants in the state of Virginia. This bill, if passed, will help meet nationwide anesthesia provider shortages by providing safe, cost effective, and top-quality anesthesia providers to Virginia.

I am Dr. Christopher Kurian. As an Anesthesiologist who completed residency at Harvard, I have seen patients with complex medical history. The Anesthesia Care Team (ACT) model has been proven to be a safe & efficient want to deliver anesthesia. I believe anesthesiologist & CAAs can work together to provide excellent care to Virginians. I am in support of bringing CAAs to Virginia.

My name is Ashley Mathew, I am CAA practicing at GW University Hospital. As an anesthetist for the last 2.5 years I have a big believer in the ACT model. Physician anesthesiologist and CAAs working together safe and efficient care for patients. In addition, I think make CAAs would be open to moving to the beautiful Virginia if they were able to practice there.

Please consider passing this legislation to allow the practice of certified anesthesiologist assistants in Virginia. CAAs are excellent support for hospital systems and undergo rigorous training to make them competent providers of anesthesia. Allowing CAAs to practice brings jobs to Virginia, will help alleviate staffing issues in hospitals, and will improve patient outcomes in hospitals.

Hello, my name is Se Chang. I have been a Certified anesthesiologist assistant (CAA) since 2020. As a Virginia resident since 2006, having attended high school, college, and graduate school while being a Virginia resident. I strongly support the bill SB 882 to license Certified Anesthesiologist Assistants (CAAs) in Virginia. Currently, I must commute to D.C. from Alexandria for work due to the lack of CAA licensure in our state. This not only impacts my personal life but also deprives Virginia of the valuable services CAAs provide. My long term desire is to be able to work in my home state. CAAs are highly trained, physician anesthesiologist-supervised anesthesia professionals who enhance access to safe, quality care. Licensing CAAs in Virginia will improve healthcare access, particularly in underserved areas, and offer cost-effective solutions. It will also allow professionals like myself to contribute to the healthcare system within our own community. I urge you to support this important legislation. As far as CRNAs and CAAs are concerned. Our training and pathways to becoming anesthetists may be different, but our day to day jobs are not different in the facilities that I am currently credentialed to work at. The CRNAs and CAAs at my facility have the same job description and we treat each other with respect. Both the American Society of Anesthesiologist (ASA) and American Academy of Anesthesiologist Assistants (AAAA) are against the vision of American Association of Nurse Anesthesiology (AANA) to give nurse anesthetists the title of Nurse Anesthesiologist. As a CAA, I fully recognize the need for a direct Physician Anesthesiologist (MD or DO) supervision and team model for the safety of patients.

We believe the ACT model with physician led care is the best course of action in treating patients. We strongly encourage everyone to take a look at SB882

Hello, My name is Manar Masood and I am a recent graduate of the Emory Master of Anesthesiology Program! I am writing to express my support for AAs working in the state of Virginia. I am originally from Illinois, where we are not yet licensed to work; last year, however, my sister was very interested in attending George Mason and moved to start her education there. I no longer had any reason to return to Illinois, so I began to look for jobs near where my family was now planning to live. If you look at the map of where we can practice, you would notice that we have opened three states in the last three years. We have a strong presence in the South from Texas to the Carolinas, and we have worked for years in D.C. and in the Midwest. We provide the safest form of anesthesia care in the Anesthesia Care Team Model, under the medical direction of an anesthesiologist. The anesthesiologist and AA work together to provide the most thorough care, at the highest standard achievable. This is the standard that all Virginians, now including my family, deserve. As time goes on, the shortage of healthcare personnel, including in anesthesia, will worsen. Under the Anesthesia Care Team Model, we can start to address hospital staffing needs WITHOUT having to sacrifice patient care, which is paramount and utterly critical to the Anesthesia Care Team. All citizens of Virginia deserve to be taken care of at the highest standard. Thank you for your time!

I am in support of this bill. I am an anesthesiologist assistant living and working in Washington DC, but my family dream is to move to eastern Virginia to practice, live, and grow our family. But I cannot do that because Virginia does not have licensure for anesthesiologist assistants, so I cannot work. If this bill passes, we would move within the year.

Hello, my name is Samuel Vargas, current Certified Anesthesiologist Assistant in the North East Georgia area. I support SB882. I work in a level 1 trauma setting which utilizes over a hundred of my anesthetist colleagues. CAA make up the the majority of the anesthetist utilized in our hospital system with the remaining anesthetist pool being made of our CRNA colleagues. With the ongoing shortage of healthcare personnel in every state, allowing us to be licensed in your state will allow relief to granted to countless hospitals in the state of Virginia. Me and my colleagues are doing it here in Georgia, allow us to provide safe and effective anesthesia care for you in Virginia. Thank you, Samuel Vargas CAA

My name is Daphne Tolentino, and I am from Alexandria, Virginia and have lived in Virginia for 17 years. I am a Certified Anesthesiologist Assistant (CAA) and I cannot practice in my home state because my license isn’t recognized currently in Virginia; I currently reside in Virginia but must commute into Washington, DC every day in order to work. Eighteen states, the US territory of Guam and neighboring Washington, DC license CAA’s and we are recognized by government programs such as Medicare, Tricare, and are allowed to practice in any VA hospital. I am asking you to vote in SUPPORT of SB 882 so that I can start working in my home state of Virginia. I am a highly qualified advanced practice provider who trained extensively in the delivery and maintenance of quality anesthesia care, as well as advanced patient monitoring techniques to ensure we provide high quality care to our patients. I want to provide this care to the citizens of Pennsylvania, my own friends and family, which would be allowed if SB 882 is passed. I graduated from Case Western Reserve University’s School of Medicine with a (Master of Medical Sciences in Anesthesiology or Master’s of Science in Anesthesia) degree and then passed a board certifying exam to become an Anesthesiologist Assistant. I have been practicing for 18 years and I currently practice at MedStar Washington Hospital Center in Washington, DC. Ultimately, passing SB 882 and allowing the licensure and practice of CAAs in the Commonwealth of Virginia will also greatly improve the free market economy for anesthesia services in Virginia. Adding another qualified anesthesia provider to practice in the state creates equal opportunity and provides an opportunity to reduce the burden of the healthcare workforce shortage being experienced by all Virginians. As a CAA of 18 years and a Virginia resident, I strongly encourage your support of CAA legislation, so Virginia patients can benefit from the highly trained care that CAAs provide in conjunction with Physician Anesthesiologists. I would love to be able to continue to settle down in Virginia and take care of patients in my own state, as well as raise a family in the state I consider home. Thank you for your consideration. Please feel free to contact me if you have any questions or want to discuss this further. Thank you Daphne Tolentino CAA

My name is Akash Sinha and I am a certified anesthesiologist assistant practicing in Washington, DC. I am the immediate past president of Virginia Academy of Anesthesiologist Assistants, currently the Chief Anesthetist at George Washington University Hospital and work part time at Children’s National Hospital. I have lived in Virginia for 4 years and plan on staying here long term since my partner is from Norfolk, VA. I currently must commute across state lines to work in Washington, DC as Virginia doesn’t recognize my license or skill set at this time. I am here to testify in strong support of SB 882, legislation that would authorize the licensure and regulation of certified anesthesiologist assistants, also known as CAA’s. Passing this bill would provide the residents of Virginia access to the benefits CAAs currently provide—benefits that patients in 23 jurisdictions already receive today. The Joint Commission on Health Care unanimously supported licensure of CAAs as Virginia is experiences a healthcare workforce shortage and CAAs could add an additional provider to the workforce. I completed my anesthesia training with Case Western Reserve University’s School of Medicine at their DC location, graduating with a Master of Science in Anesthesia. After graduation, I, along with all other CAAs, took a national certification exam and continue to submit continuing medical education and take recertification exams as laid out by our certifying body. All CAAs possess a premedical undergraduate background and complete a comprehensive didactic and clinical program at the graduate school master’s degree level. The typical CAA master’s program is 24 to 28 months. We are trained extensively in the delivery and maintenance of safe and quality anesthesia care as well as advanced patient monitoring techniques. My profession has been serving patients for over 50 years. CAAs are recognized by the Centers of Medicare and Medicaid (CMS), Tri-care, and all major commercial insurance payors. CMS recognizes CAAs as qualified non-physician anesthesia providers, just like our CRNA counterparts. CAAs are as safe and effective as nurse anesthetists. I have worked alongside CRNA’s, and most people don’t know who is a CAA or CRNA without asking, as we have the same job responsibilities and duties, and work together cohesively. As a CAA of 6 years, and a Virginia resident, I strongly encourage your support of CAA legislation, so Virginia patients can benefit from the highly trained and safe anesthesia care CAAs provide. I would love to be able to continue to settle down here with my partner who would like to be close to their family in Norfolk. Thank you for your consideration.

My name is Nicole Moore. I am a certified anesthesiologist assistant and the current president of the American Academy of Anesthesiologist Assistants, but more importantly I am a Virginia resident and have lived in Virginia for the past 10 years. I moved here for graduate school to become a Certified Anesthesiologist Assistant and fell in love with the state, ultimately leading me to stay. I met my now husband, who served in the Navy for 10 years, here and we are looking forward to starting a family here, near his family and work. I currently must commute across state lines to Sibley Memorial Hospital in Washington, DC as Virginia doesn’t recognize my license or skill set at this time. I am here to testify in strong support of SB 882, legislation that would authorize the licensure and regulation of certified anesthesiologist assistants, also known as CAA’s. Passing this bill would provide the residents of Virginia access to the benefits CAAs currently provide—benefits that patients in 23 jurisdictions already receive today. The Joint Commission on Health Care unanimously supported licensure of CAAs as Virginia is experiences a healthcare workforce shortage and CAAs could add an additional provider to the workforce. I completed my anesthesia training with Case Western Reserve University’s School of Medicine at their DC location, graduating with a Master of Science in Anesthesia. After graduation, I, along with all other AAs, took a national certification exam and continue to submit continuing medical education and take recertification exams as laid out by our certifying body. All AAs possess a premedical undergraduate background and complete a comprehensive didactic and clinical program at the graduate school master’s degree level. The typical AA master’s program is 24 to 28 months. We are trained extensively in the delivery and maintenance of quality anesthesia care as well as advanced patient monitoring techniques. We understand the disease states, pharmacology and all other factors that can influence an anesthetic and ensure we provide high quality care to our patients. My profession has been serving patients for over 50 years. CAAs are recognized by the Centers of Medicare and Medicaid (CMS), Tri-care, and all major commercial insurance payors. CMS recognizes AAs as qualified non-physician anesthesia providers, just like our CRNA counterparts. AAs are as safe and effective as nurse anesthetists. In my current practice I work alongside CRNA’s, and most people don’t know who is an AA or CRNA without asking, as we have the same job responsibilities and duties, and work together cohesively; giving each other breaks and relieving one another at the end of a shift. There is no peer-reviewed or other credible evidence of any sort that the care provided by an anesthesiologist assistant is less safe than that of a nurse anesthetist. In October of 2018, there was a study published that concluded “The specific composition of the anesthesia care team was not associated with any significant differences in mortality, length of stay, or inpatient spending.” As a CAA of 8 years, and a Virginia resident, I strongly encourage your support of CAA legislation, so Virginia patients can benefit from the highly trained care CAAs provide. I would love to be able to continue to settle down here and raise my children in the state I consider home. Thank you for your consideration

Dear Chair and Members of the Health and Human Services Committee, I am writing to express our strong support for Senate Bill 981. As the Executive Director of the Virginia Community Health Worker Association and a Certified Promotora de Salud, I believe this bill provides a crucial opportunity to showcase the positive impact and effectiveness of community health workers (CHWs) in improving health outcomes and addressing health disparities in our communities. This bill is a step toward recognizing the value of CHWs and ensuring they (CHWs) are integrated into our healthcare, social services, and community based systems in a meaningful way. It will provide much-needed evidence to support further investment in this workforce, which plays a vital role in building healthier, more connected communities. Additionally, I urge you to consider incorporating greater transparency in government processes related to the recruitment, funding, training, and provision of resources for CHWs. Clear guidelines and accountability will help ensure that these workers have the tools they need to succeed and that communities benefit from the services they provide. Thank you for your time and consideration. We are hopeful that SB981 will pass, as it supports our ongoing efforts to improve health equity in Virginia. Sincerely,

A letter in support of SB 1350 from the Asthma and Allergy Foundation of America (AAFA). AAFA is the leading patient organization for people with asthma and allergies, and the oldest asthma and allergy patient organization in the world.

The passing of SB 1350 is extremely important to not only our family, but the entire food allergy community who lives, works in, and visits Virginia. Food allergies are on the rise and are extremely serious, in some cases, even life threatening. Staff being aware of allergens in a restaurant setting and being able to clearly communicate them to guests accurately is paramount to the safety and well-being of diners. Raising awareness of this important issue is the first step to ensuring a safe dining experience for all those afflicted with food allergies, giving them accurate knowledge and empowering them to make the safest choice.

The mental health of children and youth is at greater risk than ever, and both the House and Senate supported versions of this bill providing mental health first aid instruction to youth and adults who work with youth. However, this Senate substitute corrects problems in the original wording of both versions. Virginia has been providing the evidence based Mental Health First Aid training for several years, so instead of tasking the state with creating a training, the Senate bill tasks state agencies with encouraging school staff and students to participate in the training. It is important that training maximize opportunities for participation in all schools. It can connect children in distress with appropriate supports, and save lives.

As long as we don’t get repeats of experiences like mine: https://neuroclastic.com/abused-at-the-dentist-autism/