N/A

Good afternoon, I am writing in favor of HB103 and extending early intervention services to age 5. As a parent of 2 children who have received EI services, and a 4th year teacher with Montgomery County, I can speak firsthand to the benefits of extending this vital program. The current age out system works under the impression that children will be able to continue vital services through preschools and use of county school intervention teachers. This model doe snot account for the vast caseloads of intervention teachers and the lack of equitable services provided after graduating EI. My son received speech services for a later diagnosed apraxia of speech from 18 mon. - 3 years through EI. At age 3 when he graduated, we were told by our school system that his next step would be to come to our local campus, where he would be placed with an aide and receive virtual speech therapy, as there was only one speech teacher for the county. This is an inequitable transition from the 1-1 in home speech therapy he was receiving through EI. After approximately 1 year of searching, we found a new speech therapist who understood my son's needs and is able to support him. Extending EI would have allowed my son to continue working directly with a known and trusted teacher until he transitioned into the school system, where there was a better chance of receiving services in person. As a teacher, I know that my son's case is not an isolated one. For the last two years I have worked as a kindergarten teacher in MCPS, where each year I work with families who had services, graduated services, or lost quality teachers and now must re-enroll their child into services through the school system. This takes additional time as documentation and testing is completed, different services and types of care are tracked and quantified, and new services begin. This leads to a greater gap for the child to overcome. As a teacher I also see the large caseloads our intervention teachers work with, and extending EI would allow them to pour more of their time into the students they serve on campus, as families of young children continue to get the flexible support my family relied on. This extension reduces strain on not only our families but our school systems, and brings extreme benefits to the child. Continuity of services and providers creates stronger bonds and higher growth, and by extending EI to age 5 these two systems will be able to greater partner together to set incoming kindergarteners for success with the support they need. EI and school systems will be able to trade notes directly, without progress and notes getting lost from therapist to therapist or company to school as the child grows. I urge you to vote yes on HB 103, and extend early intervention services for the benefit of our children, and our schools. Thank you, Kyle Evans Father of 3 Kindergarten Teacher MCPS

Comments Document

Please see attachment

Good afternoon. My name is Devin Hebble, and I’m a licensed Occupational Therapist providing Early Intervention services in Virginia. I’m here to support HB 103, which would allow eligible children to continue Early Intervention services through four years of age. This is a bipartisan, evidence-based, cost-effective proposal that strengthens school readiness and supports working families. Currently, many children lose services at age three despite ongoing functional need—creating a gap during a critical developmental window. From an occupational therapy perspective, ages three to four are essential for foundational skills that impact participation at home and in preschool: self-care, communication, sensory regulation,attention, motor planning, and mobility. Extending Early Intervention improves equitable access, supports continuity of care, and provides a strong return on investment by preventing more intensive—and more expensive—needs later. This is a targeted, fiscally responsible approach and an efficient use of taxpayer resources. HB 103 is a practical investment in Virginia’s children, families, and communities. I respectfully urge your support. Thank you.

These should be basic right standards. These cause less trauma, less injuries, deaths, and for a better society

As a clinical professional with over 20 years of experience in rehabilitation, I want to highlight the essential role of clinically informed referral resources in the senior living placement industry. Senior living transitions—especially during medical crises—require more than a directory of facilities. They demand clinical insight and local expertise. Online referral platforms often lack the ability to accurately assess a community’s capacity to manage specific acuity levels and focus on contracted locations only. Current “lead ownership” practices frequently lock families into working with an online source. Families should be able to choose their preferred referral partner and have limits placed on how long a referral can be “owned.” Recently, a family using an online service spent days touring communities that ultimately declined admission due to clinical needs. After a brief connection with the family by a rehab case manager, I was able to identify appropriate local matches that accepted the patient within 24 hours. Families deserve the freedom to work with the advocate who best meets their needs—not the one tied to their initial web search. I think that referral entities should disclose how they are compensated while remaining no cost to the client. By prioritizing clinical expertise and protecting a family’s right to choose their advocate, we can help seniors receive the right level of care the first time—reducing stress, preventing unnecessary delays, and allowing families to focus on their loved one rather than navigating a complex system alone. For many families, this support is invaluable.

I am writing to support the spirit behind HB297. As an occupational therapist serving seniors in Virginia for over 24 years, it is important to have safeguards to help protect one of the most vulnerable segments of the population. HB297 is an important step toward protecting older adults’ autonomy and ensuring ethical, person-centered guidance at a time when decisions carry significant financial, health, and emotional consequences. This bill clearly affirms a client’s right to freely choose their senior advisor—and to change advisors at any time without penalty—puts the older adult at the center of the process. This safeguard helps prevent coercive practices, conflicts of interest, and undue influence, while reinforcing informed consent and transparency. Seniors and their families deserve confidence that recommendations are based on their needs and values, not on locked-in contracts or referral arrangements that limit options. I disagree with the provision in lines 48-55, however, because it creates a financial incentive for community-based staff to influence or discourage residents from using referral agencies. Allowing residents to opt out at any time without a referral fee—particularly after substantial coordination, counseling, and placement work has already occurred—may unintentionally encourage staff or affiliated parties to steer residents away from referral services for financial or competitive reasons. This undermines ethical decision-making, compromises resident autonomy, and devalues the legitimate role referral agencies play in supporting informed, resident-centered placement decisions.

Dear Members of the House, As a healthcare provider with more than 20 years of experience, I am writing to express my overall support for HB 297, while also offering several areas for clarification and improvement. As a Senior Living Consultant and Physical Therapy Assistant, I have worked across multiple settings including home health, skilled nursing, inpatient, outpatient, and most recently assisted living as a program manager. This experience has allowed me to observe the continuum of care firsthand—both its strengths and its challenges. I have consistently seen that residents and families who are educated, guided, and supported through informed decision-making tend to fare significantly better than those forced into rapid decisions without adequate support. As a senior living consultant, my role is to assist families during times of stress and uncertainty, providing transparency that is often missing when families attempt to navigate assisted living options on their own. Without guidance, families frequently experience confusion, wasted time and resources, and unnecessary emotional strain. HB 297 provides meaningful transparency for families by clearly outlining how “no cost” referral services are funded and ensuring families maintain choice throughout the process. This is particularly important for families who begin their search online, only to discover later that local referral options may not be accessible due to large chain companies who do not provide the same services as small, local companies. The bill’s provisions allowing residents and families to opt out at any time, along with clearer disclosure of how referrals work, are a significant benefit and align with resident-centered care. Additionally, the bill’s current opt-out provision—which allows families to disengage from referral services as late as the day before move-in while still proceeding with placement—does not fully reflect the scope of work referral agencies perform. This work often includes comprehensive assessments, coordination with multiple providers, facilitation of tours, family education, crisis support, and ongoing guidance throughout the decision-making process. I respectfully recommend that the bill be amended to allow referral agencies to receive compensation if a resident moves into a community that was recommended and toured through the agency within a specified time period, even if the family later opts out of services. Referral agencies that prioritize integrity, transparency, and resident-centered guidance will benefit from the clarity and consistency this bill provides. However, those same agencies should also be protected and fairly compensated for the expertise, time, and guidance provided at no cost to families—particularly when their recommendations are ultimately followed. Without this protection, there is a risk that assisted living facilities may attempt to avoid referral fees despite benefiting from the work performed. Thank you for your consideration and for your continued efforts to support transparency, choice, and quality care for Virginia’s seniors and their families. Sincerely, Angelina M Fortin, MS Ed, LPTA, ATC Senior Living Consultant

I am writing to respectfully share my professional perspective regarding the proposed legislation addressing transparency in senior placement services, particularly those involving compensation from assisted living communities. I have spent many years working in clinical and advisory roles, first as a licensed physical therapist and now as a senior living advisor. Prior to becoming an advisor, I worked extensively in home health, where I frequently encountered seniors who were at significant risk due to the absence of professional guidance when selecting appropriate living arrangements. Too often, families were left to navigate complex decisions alone, resulting in moves that did not adequately support safety, health, or quality of life. As senior advisors, we work collaboratively with case managers, social workers, families, and caregivers to ensure seniors are moving where they can safely thrive. Our services include in-person and virtual consultations, guided tours, transparent pricing discussions, and ongoing support through the move-in process. From the onset, we clearly disclose that our services are provided at no direct cost, and that compensation is paid by the assisted living community. In my professional experience, this transparency has consistently been met with appreciation and trust by families. We are often contacted by families who initially selected an assisted living facility based on online searches or informal recommendations, only to discover later that the placement was not appropriate. In many of these cases, seniors are forced to relocate again—an emotionally and physically taxing process that could have been avoided with proper professional guidance from the beginning. Many families are unaware that local, personalized advisory services exist to walk alongside them throughout this journey. Failing to connect seniors with qualified advisors whose sole purpose is to advocate for their well-being does a disservice to this vulnerable population. Local advisory services provide a level of personal engagement, accountability, and community knowledge that cannot be replicated by large, nationwide referral platforms. For these reasons, I support reasonable oversight measures aimed at ensuring transparency and accountability, particularly among large national companies that do not offer the individualized, hands-on support that local advisors provide. Such oversight will help protect seniors and families while preserving the essential, high-touch services that truly serve their best interests. I do have concerns regarding the opt-out language in lines 48–55. It unintentionally creates a financial incentive for community staff to encourage residents to discontinue using referral professionals after substantial work has already occurred. A simple clarification that the referral fee remains owed if the resident moves into a recommended community after services were provided would protect resident autonomy, ethical consultants, and the intent of the legislation. Thank you for your time, consideration, and commitment to the well-being of our senior population. Respectfully, Heather Doré, DPT, CDP Senior Living Consultant

Please support this important piece of legislation, HB297. Far too often, seniors or their loved ones perform internet searches when initiating their journey to find an assisted living community. In doing so, they search the internet and click what they think is a link to a community they are interested in. However, large referral companies use this as click bait, and it isn't the communities' link, but rather the referral agencies. They are then contacted by that company and unwittingly sign an agreement with that agency. Regardless of if the senior or loved one uses that agency; the agency has their name in their system. We have seen these agencies then try to enforce a "proprietary" claim on that resident and demand payment from the assisted living where the senior moves into. This bill will offer protections from these types of agencies and tactics.

I support House Bill 297. As a former caregiver and a current senior citizen, I think it is important for referral agencies to openly and honestly disclose how they are paid for providing referral services. They say it is free, but I have now learned that it is not free, since they are paid by the assisted living communities. Everyone knows that costs get passed down to the end user, which would be the resident and their family members that pay their bills. I also do not think the referral agencies should have the right to use my name to make money indefinitely.

Navigating senior living options can be overwhelming—I know this both personally and professionally. As a granddaughter, my family was forced to make a difficult decision for my grandmother during a moment of panic and uncertainty. She needed more care than we were able to provide at home, and a decision had to be made quickly. At the time, we didn’t know that quality referral services existed—services that could truly guide us, educate us, and present viable options tailored to her needs. Instead, we chose a community based primarily on location and immediate availability—factors that, in hindsight, should have been among the least important considerations. We didn’t know what questions to ask. We didn’t understand levels of care, the importance of aging in place, or that services such as hospice, home health, or therapy could be brought in. We didn’t know to ask about staffing models, programming, dining, or long-term care planning. Most importantly, we didn’t know how to be better advocates for our loved one. That question still lingers with my family today: Did we choose the right place? Could we have made a better decision? Professionally, I have spent nearly 15 years as a practicing physical therapist. I’ve sat in countless care plan meetings where families are told their loved one is no longer safe to return home alone. In many of these situations, families are handed a single sheet of paper with a generic list of local senior living communities. While well-intentioned, these lists are often outdated, vague, and not personalized to the patient’s clinical, emotional, or social needs. This is where a trusted, local healthcare focused group comes in- Benchmark Senior Solutions. As trusted consultants, we step in to bridge the gap for families during one of the most vulnerable moments of their lives. Our work is not about handing over a list—it’s about truly knowing our clients and their loved ones. We take the time to listen, to understand medical needs, personal preferences, family dynamics, and long-term goals. With our clinical background and deep knowledge of senior living communities, we provide families with meaningful guidance. We educate them on levels of care, advocate on their behalf, schedule and attend tours, assist with the many details of the move-in process, and follow up after placement to ensure each client is set up for success. Our services require time, empathy, and clinical expertise—and that is exactly what we offer. We are deeply committed to the families we serve, and we also value the relationships we build with the communities we partner with. Our goal is always the same: to ensure our clients are well cared for, supported, and positioned to thrive in the right environment.

My name is Whitney Crawley, and I am the owner of Benchmark Senior Solutions, a senior living consulting group serving families throughout Richmond, Charlottesville, and Hampton Roads, Virginia. I want to express my overall support for the intent of House Bill 297. With thoughtful revisions, this legislation has the potential to significantly strengthen trust in senior advising services while protecting Virginia families and improving transparency across the aging services system. This bill is timely, necessary, and an important step toward distinguishing true resident-centered referral professionals from large, volume-driven lead-selling organizations whose business model is based on CRM data and referral quantity rather than individualized guidance. Benchmark Senior Solutions is a member of the National Placement and Referral Alliance (NPRA), and we strictly follow the NPRA Code of Ethics. I have worked in the senior care industry for over 20 years, and each member of the Benchmark team is a licensed healthcare professional with long-standing experience serving older adults. We have all personally worked within CCRC’s, independent living, assisted living, memory care, and skilled rehabilitation settings throughout the regions we serve. That experience allows us to provide families with informed, ethical, hands-on guidance to ensure residents transition into the most appropriate setting for their needs. We build meaningful, lasting relationships with the families we serve, which is reflected in our public reviews and community reputation. Please read our public reviews at : https://g.page/r/CbDdGhpFzBhlEAE/review to better understand how beneficial a local senior living consulting group can be in the communities we serve. *Please see attachment for full summary

Please pass the bill HB297. As a senior citizen, I have the right to own my own name and to know if a company is making money off of my name! It is morally wrong for a referral company to make money off of my name after only giving me referrals that pay them a fee. I don't know how to use the internet to view any terms that they say are in place. They don't pay me to use my name. So please pass the bill HB297. Thank you.

This bill improves transparency and helps protect seniors and families during an already stressful decision-making process. Families deserve to know whether financial relationships may influence referrals, so they can make fully informed choices based on a resident’s needs. HB297 promotes trust, accountability, and person-centered care while preserving consumer choice. I urge support for this important legislation.

It has been my pleasure and privilege to have been working in the senior living industry for the past 25 years. I have been approached by many referral agencies over the years and know that they are not all created equal and not all are in the referral business because they want to serve the senior population as they deserve to be served. Thank you, legislators for giving HB297 the time and attention that it needs to stop some referral companies from trying to collect fees for simply passing names and contacts along when they have never met with the family or potential resident, nor take the time to make a visit with them to a prospective community. Thank you for reminding assisted living communities that they do not have to work with any agency or company that does not have the same level of experience, professionalism, ethics, transparency or compassion as we do.

I support HB297. I have worked in and around senior healthcare services for almost 20 years. Many of these years have been spent as a Sales Director within an Assisted Living Community. I am in favor of HB297 because it provides regulation and standards to an industry that has very little of either. An industry that at its best can help guide seniors and their families through very trying periods, but at its worse can be predatory towards the general public and Assisted Living Communities it claims to be helping. More transparency and oversight are needed.

Comments Document

Requesting the opportunity to speak on behalf of referral services agencies and families. Re: House Bill 297 Summary below... Good morning, Chair and members of the committee, thank you for the opportunity to speak today. My name is Mikelle Rappaport, and I am the owner of a senior care consultant agency who serves the Hampton Roads area of Virginia and specializes in senior living placements, care coordination, and health care advocacy. I am also a member of NPRA and have made a commitment to operate our agency using best practices and under a defined code of ethics. I have also served professionally in the senior care industry for over 25 years. Today, I am here in strong support of House Bill 297. (remaining support of my position is attached and welcome the opportunity to speak today)

HB297 Referral companies like Owl be there, Families Ties, Care Patrol, Oasis Senior are all missed leading clients. They don’t disclose to their clients that they are being paid by the communities one month ( 10k-15k) or one month rent . It’s also on their agreement that we as the providers CANNOT disclose to our clients that we pay them a month rent . As a company, we charge our clients large amount of entrance fee to recuperate from those big expenses that goes to Referral companies. Also, these referral companies would not refer people to other facilities if they don’t have a contract with them. These referral companies does not even visit or assess the community for their services. They just give out the information to their clients. But, they advertise their services as free referral, but in reality.. they are NOT. It’s not fair for clients not to know this arrangement. They all get mad after they found out that we paid the company $12,000 . We need transparency! Grace Kimball Executive Director Vienna Manor

Comments Document

VALA supports HB297. We received support for this bill from numerous assisted living providers and resident family members as well as a placement & referral alliance. Why this bill is needed:  Informed consent should be the standard when seniors are making life-changing housing decisions. Many families do not realize referral agencies are paid by the ALF. Families will finally understand who is being paid and for what reasons. The referral industry has grown rapidly with little oversight. Families often make placement decisions under crisis conditions. Without standards, bad actors can operate unchecked resulting in negative experiences and higher costs. Virginia already regulates assisted living facilities, and this bill closes the regulatory gap affecting the same residents.  This bill establishes basic consumer protections and transparency requirements for resident referral agencies that assist seniors and adults with disabilities as well as their families in finding assisted living facilities in Virginia. It ensures individuals clearly understand financial relationships and referral fees, creates transparency in requiring referral agencies to provide meaningful services before being paid, limits duplicate referral fees per resident, and protects residents’ personal information through a defined look-back period. Overall, the bill creates basic, common-sense consumer protections for Virginia’s seniors and their families, and promotes informed choice, fairness, and accountability during a critical and often stressful housing decision for seniors and their families. Clarification of this bill:  Aligns Virginia with other states that already regulate referral agencies (e.g. WA, OR, AZ, OK, NV)  Does NOT ban referral agencies.  Does NOT cap referral fee amounts.  Does NOT restrict families from using multiple referral resources.  Uses civil penalties only for noncompliance – not criminal sanctions.

America has been dealing the worst opioid epidemic ever since former President Biden and Democrats allowed drugs, cartels, criminals, and traffickers into America. Now taxpayers have to pay for the Left’s failures and selfishness.