Virginia Regulatory Town Hall
Department of Medical Assistance Services
Board of Medical Assistance Services
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3/27/23  11:41 am
Commenter: Gayla Timm

Allow Parents to Continue to be Paid Consumer Directed Attendants

To whom it may concern:

I am writing to oppose any changes to the Virginia Medicaid waivers which would prohibit families from being paid as caregivers through consumer directed services.  I have a daughter with the DD-FIS waiver and she requires 24-7, 1:1 care.  While we are not approved for 24 hours of coverage, it is impossible to find enough staff to cover all the waking hours when we do need coverage.  She is also often sent home from school for self-injurious behaviors and has unexpected absences from school due to behavior issues.  Because of her high needs, it is impossible for me to have any type of consistent job outside of being a caregiver for her.  I rely on the income I can make as her caregiver to be able to be there for her and take her to appointments or pick her up from school as is necessary.  It is impossible to have a caregiver who is just "on standby", waiting to see if she needs to work and then be available to care for my daughter.  In order for me to not be paid as a caregiver, I would need DMAS to allow me to employ an attendant during all waking hours (even when she is at school) so that somebody is available should she need to be picked up from school (which is not allowed). 

The money provided by the waiver to be a consumer directed attendant is completely necessary to be able to care for our disabled children and afford to live in Virginia, northern Virginia in our case.  As is, the rate being paid to be a consumer directed attendant is well below what a qualified special needs attendant should be making (and thus part of the reason it is so hard to find anyone willing to work as a special needs care attendant). I am a graduate degree educated person that could make many times the amount of money that I am making as an attendant if I was able to find full time (and flexible) help for my daughter.  But it is virtually impossible for me to hold any type of work that isn't completely flexible and generous with a lot of time off.  I minimally need the money I can make as an attendant for my disabled daughter to continue to be able to care for her.  
This change would create a financial burden on the families of disabled Virginians and I strongly believe would cause the state more financial burden by more children needing to be placed in residential facilities because caregivers will not be able to care for their child and provide income for the family.  Caregiving is often a full-time job, and many families rely on the income they receive from Medicaid to make ends meet. By forcing them to become employees of a licensed homecare agency, they may lose their income, leaving them unable to support themselves and their loved ones.  Due to the pandemic and changing landscape of the economy, it is often impossible to 

I urge you to reconsider these proposed regulations and find a solution that does not harm the families of disabled Virginians. Instead, we should be supporting them and ensuring that they have the resources they need to provide the best possible care for their loved ones.

Thank you for your consideration.

Gayla Keenan Timm
(773) 263-6000
CommentID: 214000