EVV for live ins is just forcing me into an institution because I can barely find someone to live in and help as it is. If they would open up space for us in an institution so i can die a slow death instead of pretending they are supporting us in the community, that would help (and oddly enough will cost the government more money but they seem to want that) .

Do you think we can get Virginia to reopen institutions? They are cutting everyone’s hours and the cumbersome requirements of EVV for live ins and added task completed documentation, etc is making it impossible to staff the job anyway. Since the government doesn’t want to support community placements, when are they going to open up easy to access institutions again?

I have a live in caregiver and a live out. The visiting live out has to adjust their shift EVERY week therefore resulting in "non compliant" status on their shifts. I have to continuously coordinate with the visiting caregiver and payroll to fix the shifts etc. Please don't force more work for me by forcing EVV on my live in caregiver!

The majority of states do not require EVV (electronic visit verification) for live in providers. CMS (Centers for Medicare and Medicaid Services) does not require EVV for live in caregivers. CMS provides an exception for EVV for live in caregivers because they do not visit. There is currently a portal where caregivers can log time without the constraints that EVV would put on a live in 'round the clock provider. EVV was never meant for persons that do not visit. Do not put the constraints of EVV on live in caregivers. Thank you.

Good morning. My name is Nancy Wein, and I am co-chair of the Virginia Coalition for Human Rights (VCHR). We have been presenting testimony at these hearings since 2019 –expressing our opposition to the funding of the Virginia Israel Advisory Board (VIAB), which serves essentially as a taxpayer-funded chamber of commerce for a single foreign country, Israel. Today, I wish to address this issue: VIAB’s blatant disregard of their responsibility as a state-funded board to provide public access to their meetings. On December 2nd, the VIAB board held their meeting in the General Assembly building in Senate Committee room 311. Prior to the meeting, members of our community sought access to the video livestream so that we could listen to the meeting in real time. A few of us in the Richmond area were able to attend in person, but the video stream provided by legislative services was NOT utilized for this meeting which I remind you, was taking place in a Senate Committee room! Rather, the VIAB board used their own technical staff to provide zoom access only to members of their board. After the meeting, we sought to obtain a recording of this zoom meeting only to be informed that the zoom meeting for some reason had not been recorded and was not available to us. Those of us who did attend the meeting heard some rather disturbing communication. For example, there was a suggestion that the next meeting “might not be here” in the General Assembly building. And in response to a question from a board member who was on zoom, Mel Chasin, chairman of VIAB, said “we can discuss this offline”. It certainly sounds as though they have something to hide. At one point, Mel Chasin said quite emphatically “we do not lobby – as a state agency, we’re not allowed to lobby”. But we know that VIAB has funded multiple trips to Israel for elected officials in all 3 branches of our state government! Is this not lobbying? Simply put, VIAB, unlike all other advisory boards, does not represent a constituency within the commonwealth. They represent and speak for a foreign entity, Israel. They are willing and eager to receive taxpayer funding, but they show an arrogant disregard for playing by the rules. Especially in times when these funds can assist Virginians who are experiencing all kinds of financial hardships, there is no justification for our taxpayer money to be used to support a country that is committing crimes against humanity. It is beyond time for our General Assembly to remove VIAB from the state budget. You must defund VIAB in this budget cycle.

Defunding of the Virginia Israel Advisory Board

Defunding of the Virginia Israel Advisory Board

Calling for defunding of the Virginia Israel Advisory Board in this budget cycle

Good morning! I am Nancy Rives and I live in the city of Richmond where I am well represented by Del. Betsy Carr. I am a retired high school history teacher and I am here to speak about the only foreign advisory board in Virginia with a taxpayer-funded budget. The Virginia Israel Advisory Board receives $300,000 a year which could be better used to serve Virginians in need during a time when the federal government is drastically cutting aid to social programs that benefit the poorest of our citizens. My main concern today is that this board has no day-to-day oversight and promotes businesses engaged in continuing a regime of apartheid, ethnic cleansing and genocide in Israel. At a time when Virginians are becoming increasingly skeptical of support for Israel, why continue to fund VIAB? The VIAB should, if it continues to exist at all, be incorporated into the Virginia Economic Development Partnership which was created by the General Assembly in 1995 and is part of the Executive Branch, under the aegis of the Secretary of Commerce and Trade. It is staffed by professionals, not appointed citizens and all of its employees are required to follow civil service rules, conflict of interest standards, freedom of information requests and the law with impartiality. The VIAB is the only foreign advisory board in the state of Virginia and it receives a taxpayer-funded budget. Why do we have this outlier - whose stated mission is to redirect economic development funds towards israeli, and not Virginia businesses? And, in fact, some of the Israeli businesses that are located in Virginia have been implicated in violations of international law as documented by the UN General Assembly report on Israeli practices and settlement activities affecting the rights of the Palestinian people in the Occupied Territories. Among these, Energix Renewable Energies headquartered in Arlington, Virginia and IAI (Israel Aerospace Industries) headquartered in Herndon VA. have been cited because they operate facilities in the illegal settlements on Palestinian land in the West Bank. Even more disturbing, as Palestinians in Gaza have suffered displacement, bombings, destruction of schools and hospitals, under genocide, Israeli weapons manufacturers, headquartered in Virginia, are supplying the military drones and weapons systems being used to kill Palestinians, even now under a supposed ceasefire. Please use the funds instead to help Virginia students especially as federal programs are being decimated. Thank you.

Good morning, my name is Alex Hilert and I'm a Richmond resident. I'm a Licensed Practicing Counselor providing substance use services and I'm also member of the DSA, Democratic Socialists of America and Richmond For Palestine among other groups. As a Jewish American, I am particularly disturbed by the weight and power of the Virginia Israel Advisory Board. No other state has such a board as an official government body. While Virginia has since created an African American, Latino, Asian, and LGBTQ+ advisory boards, they do not receive the same state funding as VIAB or enjoy the same access and privileges as VIAB. Additionally, while these groups serve to promote economic development for historically oppressed communities living in Virginia, VIAB helps redirect state and federal grants to a foreign government engaged in a regime of ethnic cleansing and apartheid. It is important to remember that a great many Jewish people do not support Israel, in fact its support is at an all time low. As we make this year's state budget, it is past time cut funding for VIAB. Over the past two years, Israel has been found to be guilty of committing genocide of Palestinians by nearly every major human rights organization and the UN. The fact that we continue to use VA taxpayer dollars to support bringing companies Israeli companies to VA is appalling. Especially ones with a track record of breaking international laws and developing drone technology which has contributed to the destruction of over 70% of Gaza killing over 64,000 people. I urge you today to have the courage to introduce a budget amendment to defund VIAB so we can invest that money into schools, housing, and healthcare programs. As a counselor, everyday I see the struggle of people trying to afford their basic needs like housing and childcare, this is who our tax dollars should be supporting, not VIAB. My clients with addictions are up against a criminal justice system that cuts them no breaks. It is hard work seeing my clients struggle to find a place to live and employment all while navigating recovery. We often forget that addiction is a disease that needs treatment and support, it is not a moral failing. I know by reinvesting this money in recovery housing and reentry programs we would do a lot of good for some of the most marginalized citizens in VA rather than using that money to support Israeli companies.

CMS guidance specifies that EVV (electronic visit verification) can be an exception for live in caregivers mainly because they DO NOT visit. However, because of the legislative goal of collecting data to address fraud, DMAS is attempting to interpret EVV as a requirement for live in providers and as result many consumers will not be able to find live in caregivers that fear privacy invasion. EVV will capture consumer and provider activities. This misplacement of priorities by DMAS has caused the most persistent anxiety and widespread fear among consumers and live in workers about privacy invasions. Such privacy violations can include: government and/or criminal archiving of personal information; hacking of cell phones and other devices; collection and illegal use of personal data; photo and video capture of bodily functions and personal care activities; recordings or eavesdropping on personal and private conversation; and other concerns.

Hello, folks! My name is Rob Hammel and I am the president of the Chesterfield Education Association. I am writing to underline the importance of targeted incentives designed to hire more educational staff. Chesterfield County has been understaffed for several years. We have the biggest deceits in our Special Education and Math departments. Many of our students currently have virtual math teachers instead of real people in the classroom. There just aren't enough teachers to go around. Many of our Special Education students are struggling to get the services they need to be successful. You can see the results of these shortages in our test scores. Our buildings that lack math teachers, such as Falling Creek Middle, lag far behind buildings that are fully staffed. With a program of targeted financial incentives, we could build our work force to the point where all of our students are able to succeed. I urge you to support budget amendments that would provide funding for programs that will fully staff our schools in Chesterfield, and Central Virginia.

Good morning/afternoon, Chair Torian and Chair Lucas, and members of the House Appropriations and Senate Finance & Appropriations Committees. My name is Donald Barrow, President & CEO of Community Transformers Equity & Impact Innovators. Across Central Virginia, we stand alongside families, connecting them to health resources, delivering food directly to homes when cupboards are empty, coordinating services, and ensuring vulnerable mothers are not navigating pregnancy alone. We proudly serve as part of the Maternal Health Care Quality Alliance and the Urban Baby Beginnings Interdisciplinary Team. Why Perinatal Health Hubs Matter — Especially in Central Virginia • Care coordination is the essential core function of perinatal hubs. Families often face overlapping barriers — transportation, housing challenges, mental health needs, and food insecurity. • After 8 years of interviews with providers and mothers, one message is constant: families need trusted support to navigate the system. • Virginia’s Maternal Mortality Review findings show that lack of coordination leads to preventable complications. • Perinatal hubs link health care to real-world supports — including behavioral health, community services, and food delivery when families cannot get to resources themselves. _ Protecting Hub Funding • Sustained funding is critical if Virginia truly intends to reverse maternal and infant mortality. • This is not a pilot — it strengthens a proven hub model working in Virginia for over 35 years. • Cutting hub funding would widen disparities and weaken trusted community networks in Central Virginia. Why We Must Maintain FAMIS MOMS • Providers across Central Virginia are seeing more uninsured pregnant women. • FAMIS MOMS ensures providers are reimbursed and ensures mothers receive comprehensive prenatal care... before emergencies occur. • Without it, many would rely only on Emergency Medicaid, which covers care only when a crisis hits. • Crisis-based care is more expensive and far riskier for mothers and babies. Eliminating FAMIS MOMS would be a costly step backward for families and providers. Closing Message Perinatal hubs and FAMIS MOMS are lifesaving, community-anchored investments. They coordinate care, deliver essential resources like food, and help ensure healthier outcomes across Central Virginia. On behalf of Community Transformers Equity & Impact Innovators and our partners, I respectfully urge you to protect and fully fund these programs so every mother and baby in Virginia has the opportunity to thrive

DOWN WITH EVV FOR LIVE INS. With decreasing availability of live in personal care attendants (PCA's) and chronically inadequate wages, EVV for live in caregivers will push more consumers with disabilities into nursing facilities, which take away our dignity, and ***cost MUCH more in Medicaid dollars than the Consumer directed community model of care. State governments must accept the responsibility of these ramifications as they knowingly pursue EVV for live ins in the face of a provider availability crisis. Forcing individuals out of the community and into nursing facilities by not addressing the provider shortage is irresponsible; further exacerbating this provider crisis via mandatory EVV for live ins is discriminatory under federal laws. The ability to live integrated in the community is a civil right for people with disabilities under the ADA and the Olmstead decision. Our civil rights will be violated by the collateral damage of EVV for live in care providers.

I am concerned about the proposed requirement for live-in caregivers to use EVV (electronic visit verification) while caring for their disabled loved ones. I am the parent and caregiver to my two minor children with disabilities. My boys require full care for all of their activities of daily living throughout the day, and the reality of their level of care means I am constantly shifting between traditional parenting and caregiving, responding in real time to their needs. Currently, as a live-in caregiver, I can submit my hours via the web portal, which enables me to do so in my downtime (usually once they’re asleep) when I am not actively caregiving. This allows me to be present as both a parent and caregiver, two roles that often overlap. The idea of adding on the mental load of having to adhere to a requirement to clock in and out as I’m shifting between roles is unrealistic and a distraction from the present and relentless needs that are constantly coming my way throughout the day. The nature of home and community based services is to prioritize a more seamless home life; an EVV requirement for live-in caregivers has the spirit of institutionalized care that values surveillance over quality, which is no doubt why federal law allows for exemptions for live-in caregivers. Why should Virginia go out of its way to complicate an already difficult and high demand situation for families caring for their loved ones at home? My other concern is around attendant care service rates. The barely-above-minimum wage rate is the biggest barrier we have in securing and retaining care for our children and is the primary reason why I am a full time caregiver. As my boys get older and bigger, this also restricts our ability to be active outside of the home and is contributing to our isolation as a family. The rate should reflect the nature of the job. Right now for central Virginia that rate is $13.88/hour, which is well below what babysitters in our area are asking (closer to $20/hour). As the minimum wage increases in our state, so must this rate, lest we fail to meet the great caregiving needs for our most vulnerable citizens.

I respectfully urge the Governor and members of the General Assembly to remove state funding for the Virginia Israel Advisory Board (VIAB) from the proposed 2026–2028 Biennial Budget. At a time when Virginia faces pressing needs such as affordable housing, public education, healthcare access, and climate resilience, public funds should be allocated with the utmost care and ethical consideration. State dollars should not support entities (i.e., Virginia Israel Advisory Board, VIAB) whose affiliated partnerships or economic activities are linked, directly or indirectly, to ongoing international conflicts involving widespread civilian harm and severe humanitarian consequences. Numerous international human rights organizations and United Nations have raised grave concerns regarding large-scale destruction and loss of civilian life in Gaza. Many of the companies and institutions promoted through international trade and defense-related partnerships have been implicated in sustaining or enabling these outcomes. Regardless of one’s political views on the broader conflict, it is neither appropriate nor necessary for Virginia taxpayers to subsidize advisory bodies that risk entangling the Commonwealth in morally contentious global disputes. Virginia can and should pursue economic development that reflects our shared values: respect for human rights, peaceful cooperation, and responsible stewardship of public resources. Removing budgetary support for VIAB does not preclude private business engagement or cultural exchange, but it does ensure that the Commonwealth remains neutral, principled, and focused on the urgent needs of its residents. For these reasons, I strongly oppose the inclusion of state funding for the Virginia Israel Advisory Board in the proposed biennial budget and urge its reconsideration.

My name is Dot Walton and I am a resident of Charlottesville, VA. I retired in 2016 having spent 38 years in the public school system, the majority of those years as a Special Education Resource teacher. I am writing to address my concerns with regard to Governor Youngkin’s proposed 2026-2028 Budget and its impact on K-12 Education Funding. Governor Youngkin’s Budget shows a lack of political will, not a lack of resources. With revenues exceeding expectations, reserves at historic highs, corporate tax preferences preserved, and hundreds of millions of dollars directed toward new tax cuts, Virginia has the capacity to do better. What’s missing is a commitment to raise the revenue necessary to fully fund public education and meet the needs identified by lawmakers’ own studies. Have you not forgotten the 2023 JLARC Study which identified billions of dollars of annual unmet needs in Virginia’s K-12 funding system? With Democrats now in control of the General Assembly and a new administration preparing to take office, this budget must be fundamentally reshaped. Virginia needs sustained, ongoing investments in public education , not one-time bonuses and inflation-lagging compensation changes. A serious conversation about fair, reliable revenue options to ensure every student attends a fully staffed, well-resourced school will be absolutely critical for Virginia’s future. Virginia’s students and educators deserve a budget that reflects the Commonwealth’s values and its capacity. Governor Youngkin’s budget fall short, and it is now the responsibility of the General Assembly and the next administration to fix it. On a personal note, I strongly believe that providing ALL children in our Commonwealth, regardless of their zip code, with a free and quality public education should be the priority for ALL our legislators, regardless of their party affiliation. I started teaching in 1977 and I am STILL waiting for our elected legislators in the House and the Senate to FULLY fund public education (not just SOQ positions) and to ensure that Virginia’s educators, both teachers and education support professionals, are finally paid at the national average. Thank you for allowing me the opportunity to submit my thoughts and concerns.

January 6, 2026 Hello Chair Torian, Chair Lucas, and members of the House Appropriations and Senate Finance & Appropriations Committees, My name is Greta Johnson Randolph, and I am the Director of Outreach for The Saint Paul’s Baptist Church in Richmond and Henrico. I am writing to express my support for protecting funding for perinatal health hubs, formally recognizing care coordination as a defining function of these hubs, and preserving funding for the FAMIS MOMS program. Care coordination is the foundation of effective maternal and infant health care. At Saint Paul’s we have had the pleasure of serving as community partners with Urban Baby Beginnings (UBB) for about nine years. We host monthly Community Food Distributions and UBB serve alongside us to distribute diapers, and work with community members on educating parents on navigating systems that they may not be able to navigate alone. Families are introduced to health care resources, social services, behavioral health, and more. The monthly Food and Diaper distributions are a one stop shop to receiving nourishments and diapers along with helping educate to decrease the risk of prenatal preventable complications and delayed treatment. Underfunding programs may cause parents to consider between proper care for their babies verses feeding and/or medicine or understanding and receiving resources needed. Please restore the $2.5 million in funding that has been cut from the budget which can and will increase costly care. Virginia’s Maternal Mortality Review shows that care coordination is a priority in reducing maternal and infant deaths. Preserving funding for FAMIS MOMS prenatal care program and perinatal health hubs support mothers and babies through coordinated care and help save lives. Protecting perinatal health hubs with care coordination as a core function and keeping the FAMIS MOMS programing are paramount to obtaining the maternal and infant health outcomes needed and desired. Please seriously consider supporting these priorities in the final budget. It is a matter of life and health. Thank you for your consideration, Greta Johnson Randolph Director of Outreach The Saint Paul’s Baptist Church 4247 Creighton Road Henrico VA 700 E Belt Blvd Richmond VA

Requiring live-in caregivers to use EVV: ➡️This misrepresents how care actually happens and forces caregivers to log artificial “shifts” that don’t reflect reality. You are providing care intermittently throughout the day and night. ➡️EVV systems Do not recognize “on-call” or “standby” time Require repeated clock-ins at night and Penalize caregivers for gaps in activity that are natural for caregiving. ➡️There are technology barriers, especially for older caregivers. Live-in caregivers may: Be older adults that have limited access to reliable smartphones or data. They may be providing care while managing exhaustion or stress. EVV requires: -Frequent app use -Troubleshooting technical errors -Corrections for missed or rejected entries. ➡️Federal Law allows exemptions: Federal Medicaid law allows exemptions and alternative compliance methods for live-in caregivers. Many advocates argue that requiring full EVV for live-in care: ➡️➡️1) Conflicts with the purpose of home- and community-based services ➡️➡️2) Undermines caregiver stability ➡️➡️3) Prioritizes surveillance over care quality

Requiring live-in caregivers to use EVV: ➡️This misrepresents how care actually happens and forces caregivers to log artificial “shifts” that don’t reflect reality. You are providing care intermittently throughout the day and night. ➡️EVV systems Do not recognize “on-call” or “standby” time Require repeated clock-ins at night and Penalize caregivers for gaps in activity that are natural for caregiving. ➡️There are technology barriers, especially for older caregivers. Live-in caregivers may: Be older adults that have limited access to reliable smartphones or data. They may be providing care while managing exhaustion or stress. EVV requires: -Frequent app use -Troubleshooting technical errors -Corrections for missed or rejected entries. ➡️Federal Law allows exemptions: Federal Medicaid law allows exemptions and alternative compliance methods for live-in caregivers. Many advocates argue that requiring full EVV for live-in care: ➡️➡️1) Conflicts with the purpose of home- and community-based services ➡️➡️2) Undermines caregiver stability ➡️➡️3) Prioritizes surveillance over care quality

Requiring live-in caregivers to use EVV: ➡️This misrepresents how care actually happens and forces caregivers to log artificial “shifts” that don’t reflect reality. You are providing care intermittently throughout the day and night. ➡️EVV systems Do not recognize “on-call” or “standby” time Require repeated clock-ins at night and Penalize caregivers for gaps in activity that are natural for caregiving. ➡️There are technology barriers, especially for older caregivers. Live-in caregivers may: Be older adults that have limited access to reliable smartphones or data. They may be providing care while managing exhaustion or stress. EVV requires: -Frequent app use -Troubleshooting technical errors -Corrections for missed or rejected entries. ➡️Federal Law allows exemptions: Federal Medicaid law allows exemptions and alternative compliance methods for live-in caregivers. Many advocates argue that requiring full EVV for live-in care: ➡️➡️1) Conflicts with the purpose of home- and community-based services ➡️➡️2) Undermines caregiver stability ➡️➡️3) Prioritizes surveillance over care quality

Requiring live-in caregivers to use EVV: ➡️This misrepresents how care actually happens and forces caregivers to log artificial “shifts” that don’t reflect reality. You are providing care intermittently throughout the day and night. ➡️EVV systems Do not recognize “on-call” or “standby” time Require repeated clock-ins at night and Penalize caregivers for gaps in activity that are natural for caregiving. ➡️There are technology barriers, especially for older caregivers. Live-in caregivers may: Be older adults that have limited access to reliable smartphones or data. They may be providing care while managing exhaustion or stress. EVV requires: -Frequent app use -Troubleshooting technical errors -Corrections for missed or rejected entries. ➡️Federal Law allows exemptions: Federal Medicaid law allows exemptions and alternative compliance methods for live-in caregivers. Many advocates argue that requiring full EVV for live-in care: ➡️➡️1) Conflicts with the purpose of home- and community-based services ➡️➡️2) Undermines caregiver stability ➡️➡️3) Prioritizes surveillance over care quality

Requiring live-in caregivers to use EVV: ➡️This misrepresents how care actually happens and forces caregivers to log artificial “shifts” that don’t reflect reality. You are providing care intermittently throughout the day and night. ➡️EVV systems Do not recognize “on-call” or “standby” time Require repeated clock-ins at night and Penalize caregivers for gaps in activity that are natural for caregiving. ➡️There are technology barriers, especially for older caregivers. Live-in caregivers may: Be older adults that have limited access to reliable smartphones or data. They may be providing care while managing exhaustion or stress. EVV requires: -Frequent app use -Troubleshooting technical errors -Corrections for missed or rejected entries. ➡️Federal Law allows exemptions: Federal Medicaid law allows exemptions and alternative compliance methods for live-in caregivers. Many advocates argue that requiring full EVV for live-in care: ➡️➡️1) Conflicts with the purpose of home- and community-based services ➡️➡️2) Undermines caregiver stability ➡️➡️3) Prioritizes surveillance over care quality

Requiring live-in caregivers to use EVV: ➡️This misrepresents how care actually happens and forces caregivers to log artificial “shifts” that don’t reflect reality. You are providing care intermittently throughout the day and night. ➡️EVV systems Do not recognize “on-call” or “standby” time Require repeated clock-ins at night and Penalize caregivers for gaps in activity that are natural for caregiving. ➡️There are technology barriers, especially for older caregivers. Live-in caregivers may: Be older adults that have limited access to reliable smartphones or data. They may be providing care while managing exhaustion or stress. EVV requires: -Frequent app use -Troubleshooting technical errors -Corrections for missed or rejected entries. ➡️Federal Law allows exemptions: Federal Medicaid law allows exemptions and alternative compliance methods for live-in caregivers. Many advocates argue that requiring full EVV for live-in care: ➡️➡️1) Conflicts with the purpose of home- and community-based services ➡️➡️2) Undermines caregiver stability ➡️➡️3) Prioritizes surveillance over care quality

Requiring live-in caregivers to use EVV: ➡️This misrepresents how care actually happens and forces caregivers to log artificial “shifts” that don’t reflect reality. You are providing care intermittently throughout the day and night. ➡️EVV systems Do not recognize “on-call” or “standby” time Require repeated clock-ins at night and Penalize caregivers for gaps in activity that are natural for caregiving. ➡️There are technology barriers, especially for older caregivers. Live-in caregivers may: Be older adults that have limited access to reliable smartphones or data. They may be providing care while managing exhaustion or stress. EVV requires: -Frequent app use -Troubleshooting technical errors -Corrections for missed or rejected entries. ➡️Federal Law allows exemptions: Federal Medicaid law allows exemptions and alternative compliance methods for live-in caregivers. Many advocates argue that requiring full EVV for live-in care: ➡️➡️1) Conflicts with the purpose of home- and community-based services ➡️➡️2) Undermines caregiver stability ➡️➡️3) Prioritizes surveillance over care quality

Requiring live-in caregivers to use EVV: ➡️This misrepresents how care actually happens and forces caregivers to log artificial “shifts” that don’t reflect reality. You are providing care intermittently throughout the day and night. ➡️EVV systems Do not recognize “on-call” or “standby” time Require repeated clock-ins at night and Penalize caregivers for gaps in activity that are natural for caregiving. ➡️There are technology barriers, especially for older caregivers. Live-in caregivers may: Be older adults that have limited access to reliable smartphones or data. They may be providing care while managing exhaustion or stress. EVV requires: -Frequent app use -Troubleshooting technical errors -Corrections for missed or rejected entries. ➡️Federal Law allows exemptions: Federal Medicaid law allows exemptions and alternative compliance methods for live-in caregivers. Many advocates argue that requiring full EVV for live-in care: ➡️➡️1) Conflicts with the purpose of home- and community-based services ➡️➡️2) Undermines caregiver stability ➡️➡️3) Prioritizes surveillance over care quality

I am looking for a live in caregiver to help me. It is getting harder and harder to find someone. EVV is going to make it impossible to find a live in caregiver willing to put a spy app on their phone for low pay. I am definitely not putting a spy app on my phone! My son lives with me. I care for him - day and night. Why do they need a live in to use EVV when they don't visit? Different situations exist but this will be a hassle & ridiculous.

To: The House Appropriations and Senate Finance and Appropriations Committees Subject: Opposition to EVV Expansion Affecting Residential Caregivers I am writing to oppose the proposed expansion of Electronic Visit Verification requirements to include live-in caregivers in Virginia's upcoming biennial budget. This policy fails to account for how residential care actually works and will harm the families who depend on it. The current portal system works. Caregivers can log their hours when circumstances permit, which aligns with federal CMS guidelines that already recognize live-in caregivers as appropriately exempt from standard EVV requirements. Caregivers already submit an attestation that hours submitted occur within the recipient’s home or accepted alternate location. Virginia should not abandon a functional, compliant system to create additional layers of bureaucracy that serve no legitimate oversight purpose. Consider what happens during a medical emergency—a fall, a diabetic episode, sudden confusion or aggression. The caregiver's attention must be entirely on the person in crisis. Yet under this proposal, there would be pressure to ensure documentation is current to avoid payment issues. This creates an impossible choice between immediate care and administrative compliance. For elderly caregivers already managing exhausting daily demands, adding technology troubleshooting during emergencies isn't reasonable—it's dangerous. The economics also don't support this change. Family-provided residential care keeps people out of institutions at a fraction of the cost. When administrative burdens become overwhelming, caregivers burn out and quit. The individuals they've been supporting then enter nursing facilities or group homes where taxpayer costs increase dramatically. Whatever small amount might theoretically be saved through tighter timekeeping will be obliterated by increased institutionalization expenses. There's also a basic conceptual mismatch. EVV systems are built around discrete service visits with clear start and stop times. Live-in caregivers don't work that way. They're present continuously, responding to needs as they arise—sometimes multiple brief interactions per hour, sometimes long stretches of standby availability, always on call. Forcing this reality into visit-based documentation doesn't improve accuracy; it just creates fiction. The message this sends to family caregivers matters. These are people providing round-the-clock support, often to their own relatives, typically for modest compensation. Treating them as compliance risks requiring enhanced monitoring rather than as partners in cost-effective care delivery is both insulting and counterproductive. Virginia should be removing barriers for family caregivers, not adding them. I strongly encourage the General Assembly to maintain the existing live-in caregiver exemption and reject this proposed expansion of EVV requirements.

To: The House Appropriations and Senate Finance and Appropriations Committees Subject: Opposition to EVV Expansion Affecting Residential Caregivers I am writing to oppose the proposed expansion of Electronic Visit Verification requirements to include live-in caregivers in Virginia's upcoming biennial budget. This policy fails to account for how residential care actually works and will harm the families who depend on it. The current portal system works. Caregivers can log their hours when circumstances permit, which aligns with federal CMS guidelines that already recognize live-in caregivers as appropriately exempt from standard EVV requirements. Caregivers already submit an attestation that hours submitted occur within the recipient’s home or accepted alternate location. Virginia should not abandon a functional, compliant system to create additional layers of bureaucracy that serve no legitimate oversight purpose. Consider what happens during a medical emergency—a fall, a diabetic episode, sudden confusion or aggression. The caregiver's attention must be entirely on the person in crisis. Yet under this proposal, there would be pressure to ensure documentation is current to avoid payment issues. This creates an impossible choice between immediate care and administrative compliance. For elderly caregivers already managing exhausting daily demands, adding technology troubleshooting during emergencies isn't reasonable—it's dangerous. The economics also don't support this change. Family-provided residential care keeps people out of institutions at a fraction of the cost. When administrative burdens become overwhelming, caregivers burn out and quit. The individuals they've been supporting then enter nursing facilities or group homes where taxpayer costs increase dramatically. Whatever small amount might theoretically be saved through tighter timekeeping will be obliterated by increased institutionalization expenses. There's also a basic conceptual mismatch. EVV systems are built around discrete service visits with clear start and stop times. Live-in caregivers don't work that way. They're present continuously, responding to needs as they arise—sometimes multiple brief interactions per hour, sometimes long stretches of standby availability, always on call. Forcing this reality into visit-based documentation doesn't improve accuracy; it just creates fiction. The message this sends to family caregivers matters. These are people providing round-the-clock support, often to their own relatives, typically for modest compensation. Treating them as compliance risks requiring enhanced monitoring rather than as partners in cost-effective care delivery is both insulting and counterproductive. Virginia should be removing barriers for family caregivers, not adding them. I strongly encourage the General Assembly to maintain the existing live-in caregiver exemption and reject this proposed expansion of EVV requirements. Sincerely,

To: The House Appropriations and Senate Finance and Appropriations Committees Subject: Opposition to EVV Implementation for Live-In Caregivers in the 2026-2028 Biennial State Budget I am writing to express my strong opposition to the proposed requirement of Electronic Visit Verification (EVV) for live-in caregivers. This mandate is fundamentally incompatible with the reality of live-in care and poses a direct threat to the safety and stability of Virginians with disabilities and their families. 1. Live-in Care is Not a "Visit" Electronic VISIT verification is designed for workers who come and go, not those who reside with their care recipients. Live-in caregivers provide continuous, 24/7 on-call support rather than clock-based shifts. Forcing these caregivers to log artificial start and end times misrepresents how care is actually delivered and ignores the intermittent nature of tasks performed throughout the day and night. 2. Safety and Neglect Concerns Requiring a caregiver to stop during a "personal urgency" or a medical crisis—such as a seizure or behavioral episode—to access a website or app is a risk for unintentional neglect or harm. Caregivers should be focused on the immediate needs of their loved ones, not troubleshooting technical errors to ensure they are paid. 3. Unnecessary Administrative Burden and Federal Exemptions The Centers for Medicare & Medicaid Services (CMS) already allows for an exemption for live-in caregivers, recognizing the unique nature of their work. Virginia currently utilizes a functional, CMS-compliant portal where caregivers can log hours when they have a free moment. Replacing a working system with one that adds "administrative red-tape" is an obscene and unnecessary burden, particularly for older caregivers who may already be managing high levels of exhaustion and stress. 4. Fiscal and Systemic Impact Treating family caregivers with distrust and forcing them to "jump through criminal hoops" threatens the sustainability of community-based care. If these administrative burdens become too great, families may be forced to quit, pushing individuals toward expensive institutionalization. This outcome would ultimately cost the Commonwealth significantly more than maintaining the current live-in exemption. I respectfully urge the General Assembly to defend the live-in caregiver EVV exemption and reject any budget language that would impose these impractical requirements on Virginia families. Sincerely,

The Center for Healthy Communities at the Virginia Poverty Law Center is committed to ensuring equitable health outcomes among all Virginians regardless of economic resources. Pursuant to this overarching goal, VPLC does not support the numerous program cuts in the 2024-2026 and 2026-2028 proposed budgets that will negatively impact the health and safety of children, families, and harm at-risk communities in rural areas. We are most concerned about Item 290(H) of the 2026-2028 proposed budget, which seeks to eliminate FAMIS Prenatal Coverage that provides access to prenatal and limited post-natal care to pregnant individuals that would be eligible for Medicaid and FAMIS Moms but for their immigration status. This decision works against the progress made in maternal health outcomes over the past several years in Virginia and is inconsistent with what multiple other states are doing. This category of coverage has existed in Virginia since 2021 and has been available to all states since the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA). Coverage for this group of pregnant individuals was established because prenatal care is vital to the health and safety of the US citizen child that they are carrying that has yet to be born. Regardless of the immigration status of the pregnant parent, their health is fundamentally intertwined with that of the citizen child. Congress recognized this when passing CHIPRA in 2009 and reaffirmed this when protecting this coverage during the budget reconciliation process last summer. Notably, Virginia is one of 24 states that has adopted this option; both red and blue states have opted to cover undocumented pregnant people throughout the course of their pregnancies including Alabama, Arkansas, Texas, Colorado, Maryland, Tennessee, and Wisconsin.1 This budget cut is also fiscally irresponsible. Without FAMIS Prenatal, these pregnant individuals will only be able to utilize emergency care pursuant to the Emergency Medical Treatment and Labor Act (EMTALA). Under these circumstances, it is highly likely that a pregnant individual who would have been covered under FAMIS Prenatal would not receive any care for their pregnancy until being in active labor. This means that preventable life-threatening complications that could have been discovered during a routine prenatal office visit, including preeclampsia and gestational diabetes, will go undetected. Treating these issues on an emergency basis is expensive. An average NICU stay for a premature baby costs at least $70,0002. Moreover, the Federal reimbursement rate for emergency Medicaid (care covered by EMTALA) is significantly lower than it is for FAMIS Prenatal. For emergency Medicaid, the Federal government pays half the costs of care while the Federal government pays approximately 65 percent of the cost of care under FAMIS Prenatal. In making this change, the budget proposal claims that this change will save the state 13.2 million dollars in general fund (GF) spending in year one and 16.2 million in GF spending in year two. However, the proposal also acknowledges a loss of federal funding (non-general fund spending) of 21.4 million dollars in year one and 26.1 million dollars in year two. We are admittedly leaving over 20 million federal dollars on the table each year if we make this change.

My name is Will Agudelo. I am submitting this written testimony in support of keeping Service Dogs of Virginia’s $250,000 appropriation in the Governor’s proposed 2027 budget. I served as an officer in the United States Marine Corps from 2012 to 2022. My most recent combat deployment was nearly a yearlong tour in 2018 in Helmand Province, Afghanistan. Within weeks of returning from deployment, we lost one of our own to suicide. Coming home should be the end of the fight, but for some it isn’t. It is difficult to describe the weight of losing a fellow service member to an invisible enemy. After I returned in late 2018, my life changed in ways I did not recognize at the time. Over the coming years, I began exhibiting behaviors that were clear indicators of post-traumatic stress. I convinced myself that nothing was wrong - only that the world was dangerous and that I simply needed to stay alert. That constant vigilance took a toll. My relationships suffered---I withdrew from people I cared about - family and friends - and I often did so abruptly. Nights were the hardest. Almost every night was disrupted by nightmares. In 2021, things reached a breaking point. A friend witnessed one of my nighttime episodes and urged me to seek help. That conversation ultimately led me to a psychiatrist and the start of a treatment plan. Despite treatment, I still struggled - particularly with PTSD-related nightmares. As my tolerance to medication increased, my dosage increased as well, and eventually I reached the maximum dose for three different prescriptions. I learned about psychiatric service dogs while attending a PTSD outpatient program. When I returned home, I began researching ADI-accredited organizations in Virginia. Service Dogs of Virginia stood out because it was clear the organization is well-run, intentional, and accountable. The stories I read were consistent: these dogs help people regain independence and stability. When I began meeting SDV’s staff, it became even clearer how much time, expertise, and care goes into preparing each dog and supporting each handler. I was matched with my service dog Zach a year and a half ago. Zach has made daily life feel manageable again. When my anxiety builds, he grounds me in a way that is difficult to explain unless you’ve lived with constant hypervigilance. In public, his presence helps me stay oriented and focused instead of scanning every room and every person. At night, Zach has been especially impactful. For the first time in years, I’ve had periods of consistent, restful sleep, which has improved my ability to function the next day - better concentration, better emotional regulation, and more capacity to participate fully in my relationships and responsibilities. With medical oversight, I’ve been able to reduce my medications to just one. SDV’s work is not abstract - it’s practical, measurable, and life-changing for the people who receive these dogs. The level of training, follow-through, and care that SDV provides is extraordinary, and it directly translates into improved quality of life for veterans like me. State support would allow SDV to expand and sustain this work for more Virginians who are doing everything they can to heal and regain their independence. On behalf of my family, I am grateful for SDV’s work, and I respectfully request your support for this appropriation. Respectfully, Will Agudelo

EVV for live in caregivers is dangerous and a lawsuit waiting to happen. A caregiver forced to choose between being paid and not paid based on an arbitrary set of hours when they must stop whatever personal urgency they are addressing to access a website, clock in/out, and list tasks is going to be at risk for neglecting or harming an individual unintentionally. A visiting caregiver who uses EVV comes to the home and goes. They get a break upon arriving and leaving to use the clock. Hence, EVV - electronic VISIT verification works for a visitor. The live in caregiver does not get the luxury of any kind of timed break. They are constantly caring and available around the clock. How are they to stop what they are doing to mess with technology and not cause risk to the care recipient? In Virginia there is a portal where live in caregivers go to sign in and post their hours when they get a free moment. It is the best access for live ins, works well, and is fully approved by CMS. Why is the state forcing something that is going to get caregivers sued down their throats?

Maintain the exemption of EVV for live in caregivers. Don't force this burden on live in caregivers. Bottom line about EVV for live ins: DMAS is trying to stymie so many people involved in this community based system to get more people to quit doing it, so they don’t have to pay as much. It’s evil. The hoops they make people jump through to take care of others is criminal. Plain and simple, it’s criminal.

Many folks in Virginia are thinking the main reason for attempting to add such a complicated mess as EVV for live in caregivers is to ultimately recommend euthanasia for the people with disabilities by making getting community support next to impossible. Please, don't make this so. Please, say no to EVV for caregivers that live with their charge. Thank you for your time.

Statement on Behalf of the Tobacco Free Alliance of Virginia To: The Joint House Appropriations and Senate Finance and Appropriations Committees Regarding: The Governor’s Proposed 2026-2028 Biennial State Budget Date: January 7, 2026 Subject: Request for $2.6 Million Annual Appropriation to Sustain the Virginia Department of Health’s Tobacco Control Program Good morning, Chairs and Members of the Committees. My name is Gonzalo Aida, and I am providing written comment as Chair of the Tobacco Free Alliance of Virginia (TFAV). We are a statewide coalition of healthcare providers, community organizations, and public health advocates dedicated to reducing the burden of tobacco use on our Commonwealth. I am here to alert you to an urgent fiscal cliff facing our public health infrastructure and to respectfully request an amendment to the Governor’s proposed 2026-2028 budget. We are asking for $2.6 million in annual state funding to sustain the Virginia Department of Health’s (VDH) Tobacco Control Program. The Emergency: A Looming Fiscal Cliff Unlike many other states, Virginia has historically provided zero state dollars for the operations of our VDH Tobacco Control Program, relying instead on a 100% federal grant from the Centers for Disease Control and Prevention (CDC). Due to recent and severe federal budget cuts, the CDC’s Office on Smoking and Health has been effectively defunded. As a result, the federal grant that entirely supports Virginia’s program will expire this April. Without immediate state intervention in this budget, the VDH Tobacco Control Program will cease to exist in fewer than four months. What We Will Lose If this funding is not replaced, the consequences for Virginia will be immediate and damaging: Collapse of "Quit Now Virginia": The state’s 1-800-QUIT-NOW helpline, which provides free cessation coaching to thousands of Virginians annually, will go dark. End of Youth Prevention: Critical resources used by schools and parents to combat the youth vaping epidemic will be eliminated. Loss of Federal Match: We will lose the infrastructure required to apply for any future federal opportunities that may arise. The Economic Case Tobacco use remains the leading cause of preventable death in Virginia, costing our state approximately $3.6 billion annually in direct health care costs. Much of this burden falls on Medicaid and, by extension, Virginia taxpayers. The requested $2.6 million is a modest investment to protect a program that saves the Commonwealth money. Data consistently shows that comprehensive tobacco control programs deliver a high return on investment by averting costly chronic disease treatments for heart disease, cancer, and stroke. Conclusion Virginia cannot afford to let its primary defense against tobacco addiction collapse. We ask you to appropriate $2.6 million annually to the Virginia Department of Health. This funding will ensure that when a Virginian decides to quit tobacco next May, there is still someone on the other end of the line to help them. Thank you for your leadership and for your commitment to the health of all Virginians.

Defend Live-In Caregiver EVV exemption and back the arc of va action plan!!!! Overview- Electronic Visit Verification (EVV) is designed to confirm that home- and community-based services actually occur, but it creates unique and serious problems for live-in caregivers, especially family caregivers. Position Statement: Live-in caregivers do not work in visits — they provide continuous, on-call care that doesn’t fit the EVV model. 1. Care provided by a live-in caregiver is continuous, not clock-based. ● They provide care intermittently throughout the day and night ● They respond to unpredictable needs (seizures, elopement, behavioral crises, toileting, medications) ● EVV requires: Clock-in/clock-out times and defined tasks during defined hours which do not match the live-in caregiver model which is not provided in shifts but rather continuously during the day. 2. Overnight and on-call hours are hard to document and can’t be forced into artificial shifts. Live-in caregivers: ● Sleep in the home but must remain available, can be awakened multiple times per night. ● Provide supervision even when not actively performing tasks ● EVV requires constant logging in and logging out of shifts, which is artificial for live-in caregivers. ● EVV leads to artificially underpaying or even nonpayment of live-in caregivers for real work performed. 3. Live-in caregiver face technology barriers and the burden of constant compliance with EVV ● Live-in caregivers may: Be older adults who are managing exhaustion and constant stress and who may have limited access to and knowledge of reliable technology. ● EVV requires the live-in caregiver to use the app constantly, troubleshoot the frequent technical errors and follow up on missed or rejected entries. ● Mistakes can result in delayed or denied payment by DMAS, even when care was provided. DMAS also penalizes caregivers who have to make corrections to their timesheets. 4. Many live-in caregivers are family members who have left higher paying jobs to provide care to their loved ones. soo Defend Live-In Caregiver EVV exemption and also make sure you back the rest of the arc of va action plan! which is right here! https://www.canva.com/design/DAG5Kos92M4/WjdTeP_Wz__QQEm2yfN1CA/view?utm_content=DAG5Kos92M4&utm_campaign=designshare&utm_medium=link2&utm_source=uniquelinks&utlId=h0f7ed6b567

This requirement is obscene for live- caregivers. They are on call 24/7 and making them clock in and out is ridiculous and next to impossible to do. Thank you for hearing me!

To whom it may concern; I am the wife of a disabled man, who I have had to give special attention to since his back surgery in 2017. This surgery placed 4 rods and 26 nuts and bolts into my husband's vertebrae, to keep him from becoming placed in a wheelchair permanently. My husband and I dealt with tremendous difficulties in trying to maintain a quality of life. Most of which dealt with moving around in our own home for him with a walker, and now a cane. Things like a simple shower where difficult as we had a tub in the master bathroom and in the front bathroom was a very small shower with limited mobility. It was very unsafe for my husband and he suffered greatly while I bathed him in this confined area. With being on disability we are on a fixed income which greatly limited us in being able to fix the problem ourselves, financially. Our social service agent gave us a number to call about applying for grants to help us pay for remodeling our master bathroom. This is where everything changed for us. A young man named Seth came to our home and discussed the process of applications for Home Modifications for Disabled and Elderly persons. It was a bit daunting at first, with paper work and finding contractors. We got through it, with Seth's help and reassurance. With in a short period of time we found the contractor, the grants were approved, and my husband received a very welcomed and appreciated gift of a walk in shower with safety bars around , 2 beatiful benches to sit on, and so much room.....he could stand in this shower while grabbing the safety bars and I could help with wash without any problems. The quality of life with something so simple as a walk in shower has helped to give not only my husband an improved quality of life, but me as well. We want to thank you all for helping so many like my husband Jeff, in recieving this gift and we pray you will continue in other areas of Virginia that are in need. Respectfully and Sincerely, Mr. & Mrs. Jeffrey A. Corbin 5412 Partlow Rd. Partlow, Va. 22534 (540)621-4314

we don't visit.... people with disabilities should not be tracked like criminals... we fought so hard to prevent EVV for live ins. CMS does not require this and provides an exemption which families already fought for and received. Why are we going down the same rabbit hole again?

My is Joyce Banks.they helped me l go my bathroom remodel with a walking shower and they did a marvelous job and I just love it.thank so much for the disability research center.

I would like to say there are 17 Centers for independent living CILs across Virginia and dRC is the one serving Fredericksburg Spotsylvania Stafford Caroline and King George and they have a small amount of funding to do what the can in the area west but the CIL dedicated to Orange could do so much more. We had the privilege of getting a grant to remodel some of our bathroom after my husband had a major stroke and became disabled/paralyzed to his left side. With the grant remodeled we are able to get him in the walk in shower. A total blessing for his well being. With our experience with our home modification work is exactly the kid of real-world examples that helps legislators understand why these services matter. and why people in rural counties like Orange Madison Culpeper and Rappahannock deserve the same access through a locally based CIL. Thank you for considering this. But drc made a life change for me and my husband .

Subject: Public Comment – Support for Brain Injury Case Management and Community Services My name is Rachael Styron, and I work directly with adults living with Acquired Brain Injury in Central Virginia. Every day, I see the critical role that brain injury case management plays in stabilizing individuals, families, and entire communities. Survivors of brain injury often experience challenges with memory, emotional regulation, impulse control, employment, housing stability, and access to medical care. Without consistent community-based case management, these individuals are far more likely to experience repeated emergency room visits, psychiatric crises, homelessness, or involvement with the justice system — all of which cost the Commonwealth significantly more than preventative community services. Case managers serve as the primary coordinators of care. We help individuals access medical treatment, benefits such as SSDI, SSI, SNAP, and Medicaid, stable housing, employment supports, transportation, and crisis intervention. We prevent small problems from becoming expensive emergencies. I strongly urge that the 2026–2028 Biennial Budget prioritize sustained and expanded funding for: Community-based brain injury case management programs Long-term support services for ABI survivors Workforce development and retention for trained brain injury professionals Accessible housing and transportation for individuals with cognitive disabilities Investing in brain injury services is not only compassionate — it is fiscally responsible. When survivors receive proper support, they are healthier, safer, and better able to contribute to their communities. Thank you for your commitment to the people of Virginia.

Isn't a caregiver complicit with DMAS in lying when being forced to post hours that they don't really work? A live in is 24/7 per day. There is no way around that fact, and it will always be. Only paying for certain hours is pushing it, but, now, to ask the caregiver to post untrue hours worked is totally over the top. Live ins do not visit so electronic VISIT verification is not feasible for them.

I am writing to encourage the dismantling of the Virginia Israeli Advisory Board. As a mother of 2, I am appalled that my tax dollars are supporting the cooperation between our commonwealth and a regime that has been committing genocide against the Palestinian people since October of 2023. I do not understand why my children's school is constantly asking for money while my taxes support initiatives like VIAB. In a time where Palestinian children are dying of bombings, hunger, and cold, I am disappointed that our Commonwealth is not taking a stronger stand on being on the right side of history.

back evvvv ands arc of va action plan!!! Position Statement: Live-in caregivers do not work in visits — they provide continuous, on-call care that doesn’t fit the EVV model. 1. Care provided by a live-in caregiver is continuous, not clock-based. ● They provide care intermittently throughout the day and night ● They respond to unpredictable needs (seizures, elopement, behavioral crises, toileting, medications) ● EVV requires: Clock-in/clock-out times and defined tasks during defined hours which do not match the live-in caregiver model which is not provided in shifts but rather continuously during the day. 2. Overnight and on-call hours are hard to document and can’t be forced into artificial shifts. Live-in caregivers: ● Sleep in the home but must remain available, can be awakened multiple times per night. ● Provide supervision even when not actively performing tasks ● EVV requires constant logging in and logging out of shifts, which is artificial for live-in caregivers. ● EVV leads to artificially underpaying or even nonpayment of live-in caregivers for real work performed. 3. Live-in caregiver face technology barriers and the burden of constant compliance with EVV ● Live-in caregivers may: Be older adults who are managing exhaustion and constant stress and who may have limited access to and knowledge of reliable technology. ● EVV requires the live-in caregiver to use the app constantly, troubleshoot the frequent technical errors and follow up on missed or rejected entries. ● Mistakes can result in delayed or denied payment by DMAS, even when care was provided. DMAS also penalizes caregivers who have to make corrections to their timesheets. 4. Many live-in caregivers are family members who have left higher paying jobs to provide care to their loved ones. 1● EVV requirements can make caregiving feel punitive and distrustful and push families towards choosing institutional care due to the increased unnecessary burdens placed on them by constant administrative red-tape which does not improve care. SUMMARY: EVV systems are designed for short, scheduled visits — not for the reality of live-in caregiving. Requiring live-in caregivers to use EVV misrepresents how care is delivered, threatens privacy, increases unpaid labor, and risks driving family caregivers out of the system. Exemptions to using EVV are allowed for live-in caregivers by CMS and they have been working successfully allowing families to care for their loved ones in the community. also back the rest of the arc of va aciton plan!

My name is Jeanne Robinson and I am currently a home care worker for my grandson that has Down Syndrome . I am speaking to support continuation of home care benefits for family members because without these benefits, it would affect the whole family. Because a lot of family members provide services to their family and without the services or continuation of the services it will impact the family immensely because it will disrupt the services and because of the lack of benefits, it also will cost the government more money because the family will to pay for services that they could get for free if they provide them themselves or they not qualify financially for the services. Also this will cut down on crime and potential ongoing family problems. The reason this is very important to me is because I am a Retired Social Worker and I know the problems that affect the families and community if the services are not provided. It will cost the government more money because these people will potentially need ongoing therapy because of separation issues and other mental health issues. Also this might cause crime because of the lack of treatment for their disability. Therefore if there is a family member in the home providing services, the client is more likely to respond positively to the services being offered and there will be a successful rate for the family and also for the community as a whole and cutdown on crime rate. In order for home care workers to be able to provide the services we need to have collective bargaining, which gives us a sense of security, knowing that we have a job to continue to help our family members and it also helps our families to stay together because we will a skilled person in our home that they are familiar with. Also the family is not afraid that they have to find another person that they aren’t comfortable with because they’re not getting paid enough and it just builds a sense of confidence in what you’re doing and for your community as a whole because you’re providing services for your family and also saving the community from any adverse reactions that might come for somebody that’s lacking services. Also, the home care worker will be able to know that the job is secure and remain in the position which will also affect the family member that they’re caring for because they might not trust whoever is coming in and as I said at the beginning I am speaking to support of collective bargaining for home care workers so that we will have a seat at the table and be able to provide the services that are needed for our family and our clients?

My name is Michelle Pinsky. I am a deaf Virginian and a concerned citizen-servant. I am here to comment on digital accessibility and the lack of clear, enforceable funding for compliance in the proposed 2026–2028 budget. In the last biennial budget, the General Assembly included budget language directing the Virginia Information Technologies Agency to prioritize its General Fund resources for implementation of House Bill 2541. That language appears in Item 81, paragraph 3h, and applies to the second year of the biennium. Through a Freedom of Information Act request, it was learned that these General Fund resources were not expended for HB2541 implementation, despite a looming compliance deadline this April. I want to be clear that I am not alleging misuse of funds. The issue is that the funds remain unused, despite clear legislative intent and an impending deadline. Separately, in my own efforts to understand how accessibility requirements are being carried out, I have learned that accessibility work is frequently treated as an unfunded responsibility. I am not speaking on behalf of any agency. I am describing what I have personally learned as a citizen trying to understand how the law is being implemented. HB2541 strengthened Virginia’s digital accessibility standards, but compliance requires resources. Accessibility work involves remediation, testing, procurement changes, training, and sustained oversight. Policy alone does not make systems accessible. This concern is especially urgent because the statutory compliance deadline for HB2541 and the ADA Title II update is April 24, 2026. Without dedicated funding in the upcoming biennium, agencies and the public face a narrowing window to meet those requirements. As a deaf Virginian, I experience the impact of inaccessible digital systems directly. When accessibility is not funded, the burden shifts to individuals rather than being addressed systematically by the Commonwealth. I respectfully urge the General Assembly to address this gap in the 2026–2028 budget by explicitly appropriating funds for digital accessibility compliance and clearly identifying responsibility and accountability for their use for each agency.

I am the Executive Director of vaACCSES. We are a large association whose member agencies serve the ID-D population. We strongly ask for support for appropriate rate increases for all services offered in the DD Medicaid Waiver. Providers are financially limited in their service provision by reimbursement rates set by the General Assembly. We ask you to support an overall increase of 5% in the rates paid for each of the following fiscal years for all DD Waiver Services. This rate increase is a start towards a long-term effort to have these services funded at a level that allows hiring and staffing in a competitive labor market. Thank you for your consideration and support. John Salay