Dear members of the Committee, I am writing to you on behalf of NARAL Pro-Choice Virginia in opposition of this bill. No patient should have to wonder whether their medical professional will provide them with complete, accurate and unbiased information. Genetic counseling is no different. A counselor's first duty should be to his or her patients. Part of the responsibility of being a genetic counselor is to put the counselor’s own feelings and beliefs aside and give the patient the information they need to in a timely, unbiased manner to help the patient come to their own decision about the health issues they face. The “conscience clause” enables genetic counselors to discriminate against, and even harm, clients with total impunity. The so-called “conscience clause” in place is a blanket license to discriminate. The law’s current language sets a dangerous precedent for other professions and businesses in Virginia where practitioners/owners want to impose their religious beliefs (or deeply held moral beliefs which are undefined) on their patients or clients and refuse to provide services to people who do not believe the same things that they do. The current statute is so extreme that it shields a genetic counselor from accountability even if the counselor takes purposeful action based only on his or her personal beliefs that result in actual physical harm or death to the patient. Removing the clause does not prevent a genetic counselor from practicing their religion, it just makes it so they have to follow medical ethics/genetic counselor ethics, that every person in the medical field SHOULD be bound to follow. At the end of the day, every patient deserves accurate, timely and unbiased medical information. Thank you for your consideration. Please feel free to reach out if you have any questions, Galina Varchena, Esq. Policy Director, NARAL Pro-Choice Virginia galina@naralva.org.

Chairman Willett and members of the Health, Welfare and Institutions Committee, Good morning, I am an attorney with the Capital Area Immigrants’ Rights (CAIR) Coalition. I am writing today to ask for your support on SB 1220. I provide legal representation at no cost to clients, primarily for residents of Virginia who are detained in immigration detention centers across the state. Each year, the U.S. government detains nearly 400,000 immigrants, including over 600 Virginia residents. Of those residents, more than 700 children were impacted by ICE detaining their parents. We serve over 1,200 people a year detained in Virginia. Of those people detained, over 1,200 children were also impacted by their parent's detention. Our clients are diverse in their backgrounds, with some having resided in the United States as legal permanent residents for years and others having arrived to seek refuge from violence and persecution in their home countries. They are members of our community. They are mothers, fathers, husbands, wives, brothers and sisters, often of U.S. citizens. In relying on CAIR Coalition for legal services, they are also generally of limited economic means and often fill jobs at the front line of our economy as essential workers. Several suffer or have suffered from serious mental illness, often in connection with past trauma they have endured in the places they fled. Providing these individuals with the proper mental health care enables them to get back on their feet, continue supporting their families and, where needed, apply to adjust their status. Weaponizing the state facilities where they seek refuge, on the other hand, worsens their prospects and those of Virginia’s communities as a whole. Immigration court proceedings are civil, not criminal, in nature. However, with the use of jails as ICE detention facilities and the prospects of deportation resulting in prolonged family separation, persecution, or even death, the stakes are equally high. Information sharing between healthcare providers and immigration enforcement breaks community trust in government and goes against ethical principles in public health including patient consent, confidentiality, and non-maleficence, as empirical research has demonstrated. Immigrant detention has also been shown to worsen mental health, with one study broadly reviewing the scientific literature on the issue finding detention duration to be died to worsening symptoms in illnesses such as anxiety, depression, and post-traumatic stress. At CAIR Coalition, we have directly witnessed cases of individuals detained by ICE after being hospitalized, facing the threat of deportation to countries where the mentally ill face violence and lack treatment options. We have also witnessed the desperation and impacts on well-being that many of our clients face while detained. We have also spoken with their families, many of them U.S. Citizens, who are left hurting without individuals who often had been mustering the strength to be the prime income provider in spite of their mental health struggles. Particularly during the economic distress and "mental health pandemic" caused by COVID-19, access to mental health treatment must be encouraged regardless of national origin. For all of the foregoing reasons, I respectfully support SB1220. Alice N. Barrett, Staff Attorney CAIR Coalition Phone: (202) 381-9004 alice@caircoalition.org

SB 1220 -- The disAbility Law Center of Virginia supports this legislation. The reporting requirements in current law act as a dangerous disincentive, deterring people from seeking necessary mental health treatment. We thank Senator Favola and the committee. SB 1304 -- The disAbility Law Center of Virginia supports efforts to improve discharge planning for the state hospitals. We would be willing to bring our substantial experience in discharge representation to this work group.

This is just one example of why we need contraceptives for all people.... I am a single mother of two children. Both children are adopted through Alexandria Social Services. My kids are half-siblings and have 3 other full or half siblings. .ALL 5 children were removed from their birth family. If you didn't know, there are approximately 400,000 (FOUR HUNDRED THOUSAND!!) children in foster care, right now, wishing for a forever home. My take on all this is PREVENTION. We cannot house the kids we have in Foster care and unless you all are willing to adopt multiple children each, you should stay out of other peoples business and permit contraceptives for everyone, no matter what insurance they are on. The state should be the first to understand the cost of prevention vs the cost and challenges of a child in foster care.

My name is Nicole Liberatore and I live in Annandale, Virginia. I began taking hormonal birth control when I was a sophomore in high school. There have been times when I was unable to fill my prescription because of lack of transportation, being unable to make it to the pharmacy before it closed, or waiting multiple days until my prescription could be filled. I didn’t have a car when I attended George Mason University, which meant that I had to rely on public transportation to obtain my birth control once a month. At one point close to finals my sophomore year, I missed taking my pills with consistency and because of my hectic study schedule, was unable to get to a pharmacy. When my period arrived later that week, my cramps were so bad that I fainted during my Arabic language class. I had to miss the rest of my classes for the day and have a friend pick me up from campus. During my senior year, I studied abroad for a semester and went without birth control because I couldn’t get an advanced prescription filled. I now live within a mile of my pharmacy, own a car, and work a somewhat regular schedule when I can arrive to my pharmacy before it closes. I also have insurance through my employer and can get access to 12 months of birth control at a time thanks to a bill passed in 2017. I understand this privilege and recognize from past experiences that there are many in Virginia that do not have this accessibility. Virginians who are on Medicaid deserve the same access to birth control that the rest of us have. Pass SB1227 and make accessible contraceptives a reality for ALL Virginians.

Unfettered access to contraception prevents unplanned and/or unwanted pregnancy In the 1960s, as a young, married woman going into the Peace Corps for a 2 year term of service in Tanzania, East Africa, my forward thinking doctor wrote me a prescription for a 2 year supply of birth control pills and had me fill it before leaving the U.S. Had I become pregnant I would have been sent home. Pass the bill and the budget amendment for Medicaid recipients to improve effectiveness and reduce Covid risks, by reducing the number of trips to a pharmacy or standing around waiting for a prescription refill.

I fully support providing Medicaid insurees access to 12 months of birth control at a time. As a woman who has depended on birth control to both prevent pregnancy and alleviate symptoms from painful periods, I have been forced to receive one month supplies of birth control for years. I can personally attest to running out of my supply and having to quickly set up a doctor's appointment for a new prescription (which not everyone is able to take off work and do) and for missing days of taking my pill while waiting for a new prescription to be filled. I could have gotten pregnant during that time when I did not want to be pregnant. We need to empower women to control their own reproductive future, and this starts with preventing unplanned pregnancy. This bill will give women who need it most greater control of their future and should be passed.

My name is Taylor Bernstein, and I am a resident of Falls Church. I support this bill because I know how important it is to have reliable access to birth control, especially during the pandemic. I have been taking oral birth control since I was 18, but at the start of the COVID-19 pandemic, my prescription ran out. I was in between doctors, but had an appointment with a new OBGYN set for mid-March. Like so much else during this time, my appointment was cancelled because of safety. My prescription for birth control ran out and I was forced to go several months without it until I could find a new prescriber. During that time, I experience longer periods with more cramping, headaches, and mood swings than I normally did on birth control. I support this bill because I know that it would allow Virginians, particularly the most marginalized, to access oral contraceptives more easily and more reliably. No one should struggle to access basic healthcare because of their financial circumstances. I urge you to pass this bill. Thank you

Having a 12-month supply of birth control available for medicaid subscribers is important to me. Having to fill a prescription monthly can become a burden and in a time where lots of mother's are having to work more than one job to make ends meet, this could make a huge difference in avoiding unintended pregnancies. There is literally no downside to allowing this.

Hello. My name is Armani Anderson, and I am a third-year student at the University of Virginia. Thank you for allowing me to share my story in support of Senate Bill 1227 with you. I severed ties with my parents halfway through my first semester of college, leaving me to navigate the complicated world of healthcare completely on my own without insurance coverage, comprehensive information, or adequate support. My experience with birth control has and continues to be a struggle. Without having access to my family history, I experienced many initial health complications once on the pill. I had to find friends to drive me to the doctor and the pharmacy because I didn’t have reliable transportation. I also had to pay out-of-pocket for my birth control, which, as a college student, wasn’t easy. Faced with these financial and logistical barriers, I knew I needed healthcare that would help me pay for the medication I needed. After lots of time and energy, I was able to acquire Medicaid—but my prescription for hormonal birth control expired shortly after. Because of the complications I’ve experienced, I know that I need to work with a culturally competent medical professional to find the hormonal birth control that works best for me. COVID-19, however, has prevented me from being able to see a PCP. This underscores the fact that barriers to birth control access have already been exacerbated during the pandemic, and my insurance coverage shouldn’t compound those difficulties. Once I do have my appointment, I know that being able to receive a full year’s supply of birth control would make my life so much easier, allowing me to focus on my studies and achieve my goals. I shouldn’t be denied the same kind of healthcare access my peers have just because I use Medicaid. I shouldn’t have to schedule my own life around someone else’s schedule so I can get a ride every month to the pharmacy. I shouldn’t have to worry about missing a pill because I can’t get my next pack in time. I shouldn’t have to worry about how I’ll get my birth control when I’m hunkered down studying during finals or being forced to choose my class schedule based on a pharmacy’s hours of operation. Instead, I would have everything I need to care for my health all at once – just like everyone else. Virginia Medicaid recipients, like myself, are equally worthy and deserving of that same kind of healthcare access, no matter what insurance plan we may use. I know first-hand that reproductive freedom isn’t just about having the right to decide what happens to our bodies—it’s about being able to access equitable healthcare once those decisions are made. I am testifying because I understand the institutional barriers to healthcare and coverage that have harmed so many generations of women, including that of my own and those before me—I understand that being forced into a single option because it is the only thing someone can afford is not the same as having an autonomous choice. Bearing that in mind, I strongly urge you to please vote in support of Senate Bill 1227. Thank you for your time and thoughtful consideration.

Because I would want it I support the Medicaid 12 Month Bill knowing that I want coverage lasting a full year when -I- sign up on the exchange. I don’t have this need, but if I did I would want to have it for a year. I support others having it.

I am the mother of a teenager that in a few short years will be off in the world. Preventive reproductive health services should not be something that a young woman has to stress about. I do not want to see my daughter face the same struggles I did as a young woman with no insurance, unable to get screened to keep myself safe. I was limited in the types of contraceptives I could afford and healthcare providers I could see. We need to remove barriers and have reproductive health services with minimal out of pocket costs.

When I was 24 when I made the decision to have an abortion. As a mother, I knew that this was the right decision for me and my family. My son has a developmental disability and lives with low-functioning autism. I was 19 years old when my son was born; he is the light of my life and I worship the ground that he walks on. While I love my son tremendously, having a child who is developmentally disabled, especially at such a young age, has been an overwhelming emotional and financial struggle. I do my absolute best to be the parent my son deserves and needs, but it takes everything I have and more. As a mother, I knew I could not continue to give my son what he needs if I were to have another child. Access to birth control at the time I had my abortion was not easy. While the medication itself was accessible, I also had to worry about transportation from appointments, the cost of the appointment itself, and furthermore paying for birth control once I had access to it. Due to these obstacles, I fell behind on my birth control and found myself pregnant. No woman desires to have an abortion in her lifetime. If I had had better access to birth control medication through insurance coverage of that medication, it would have been one less obstacle preventing me from needing an abortion in the first place. While political parties differ on whether or not they believe women deserve the right to an abortion, we all can agree that we would like a world in which women do not need one in the first place. Expanding birth control access to low-income women helps to prevent scenarios in which these women find themselves making the choice to abort at all. This is common-sense legislation that would benefit all women (and their families).

My name is Abbie Henrickson, and I live in Sterling, Virginia. I am writing to urge you to support Senate Bill 1227 (12-Month Supply of Hormonal Contraceptives for Medicaid Insurees). At the present time, women in Virginia who get their contraceptives through Medicaid are not eligible for a 12-month supply. Women not on Medicaid are eligible to receive a 12-month supply. This is just wrong. Women in the Medicaid program are in potentially unstable situations that may make it difficult for them to stay in touch with their doctors to keep their prescriptions up to date and are forced to cover any additional expenses that they incur (such as transportation and childcare). I currently volunteer with the New River Abortion Access Fund. (I previously volunteered with the Blue Ridge Abortion Fund for many years.) As an intake volunteer, I speak directly with women who are in need of financial assistance to help pay for their procedures. Not having access to contraceptives is a common reason that they are in need of our assistance. Providing a 12-month supply of hormonal contraceptives significantly reduces both unwanted pregnancies and abortions. It is deplorable that women of extremely limited means are not able to take advantage of a healthcare benefit that women who are not Medicaid insurees have access to. To my mind it truly makes no sense that the state inflicts this burden upon them. I urge you to support Senate Bill 1227. Thank you for your consideration of this important matter.

SB 1220 -- The disAbility Law Center of Virginia supports this legislation. The reporting requirements in current law act as a dangerous disincentive, deterring people from seeking necessary mental health treatment. We thank Senator Favola and the committee. SB 1304 -- The disAbility Law Center of Virginia supports efforts to improve discharge planning for the state hospitals. We would be willing to bring our substantial experience in discharge representation to this work group.

On behalf of the Virginia adoption community - passing this bill is greatly needed. As an adoption practitioner 32+ years, past- president, long-time Fellow and Board of Trustee of the Academy of Adoption & Assisted Reproduction Attorneys & co-author of the VA CLE Adoption Book - we need this law passed to support the legal stability of children in VA. There are so many situations I encounter on a monthly and even weekly basis - a mom co-parenting with an opioid addicted daughter and a deceased biological father, two foster parents not married and not in a romantic relationship co-parenting a child in need of a forever home with both of those parents, a former ex-boyfriend who helped co-parent for ten or more years with the ex-girlfriend still wanting him to be a recognized parent and a deceased biological father. There are so many more examples where kids just need both de facto - that is, in fact, parents made their legal parents but cannot do so under current VA law that requires they be a married couple. That is not the current reality for many children today. We need to bring Va law in line with the current reality of today’s kids and how they are being co-parented in many non-traditional ways - especially with the opioid crisis. This law is very much needed to protect today’s children. Those of us in the trenches can see this most clearly. Thank you.

When two loving parents raise a child they take on a moral and legal responsibility, but unfortunately our current legal system doesn't recognize a second parent and grant them the legal rights they deserve after accepting responsibility of raising the child because they are not of a different sex/gender than the legal parent. This needs to cease for the child's protection and for our community. We need not only to accept everyone to respect them for the roles they fill and give them the legal support they may need! Dani Butler 5800 Up A Way Drive Fredericksburg, VA 22407

I am writing in support of SB1321, in favor of allowing confirmatory adoption in Virginia. I am not personally impacted by this bill, but many in my community are. Children need the security that legally recognized parents can provide, and their lives are made more difficult when barriers exist that keep their parents from advocating on their behalf. I know this all too well, because I know what these barriers have meant for my own children at a different time and place. My young children had very good relations with both me and my spouse prior to, during, and after our divorce. However, a new magistrate who claimed she was "ordained by God to save the children" separated me from my children for the stated reason that I had advocated for marriage equality. She did this by declaring that she would not respect or enforce our shared parenting agreement and threatening to hold me in contempt if I complained, resulting in my ex refusing joint custody/visitation thereafter. I did not see my children again until they were adults. Even though I was a legal parent with full parental rights, these rights were not observed or respected in matters of education, healthcare, mental health, or faith. Eventually I was locked out of all communication and could obtain no further information about my children. I have since reconnected with both of my children as adults. Both suffered extreme psychological abuse, mental anguish and emotional harm because of our loss of contact. I was unavailable to protect them. Precious educational opportunities were also squandered (a full scholarship to a prestigious private school, admission privileges to my prestigious undergraduate university and financial aid at universities where I taught) because of my being blocked from advocating for them. They even suffered needless financial losses because of my inability to manage their educational accounts at particularly critical times. Children need security, and they need their parents, whether they are straight, gay, purple, or polka-dotted. Please give Virginia families the tools they need to ensure continuity of parenting so that that their children do not suffer as mine did. Please support SB1321.

This Bill is about equal rights!!! Different-sex couples are not forced to marry for both parents to have legal rights and responsibilities over their children, and same-sex couples shouldn’t be either. This bill simply extends the legal rights and responsibilities of parenthood to unmarried same-sex couples as well. Thank you for your work and dedication to represent all people in equality.

Only speak if needed. Legislative staff to the Commission on Youth.

Voices for Virginia’s children strongly supports this bill.

Available should questions about the bill arise - 804-495-6880

Coordinated Specialty Care (CSC) is a recovery-oriented, evidence-based treatment program that targets young people with first episode psychosis. The coordinated team approach includes case management, psychotherapy, medication management, family education and support, supported employment and education and peer supports based on the individual’s needs and preferences. There are eight such programs across Virginia, four of which are located in Northern Virginia. As CEO of PRS, Inc., one of the four organization’s operating a CSC program in Northern Virginia, I cannot emphasize enough the positive impact these programs have on young adults and their families. Combined, these eight programs are currently treating just over 230 young adults; however, it is estimated that about 1,700 young adults will experience their first episode of psychosis each year. The Advisory Board proposed in this legislation will work with the Department of Behavioral Health and Developmental Services (DBHDS) to establish fidelity standards for CSC programs and look for resources to enhance existing programs and expand services to underserved areas in the state.