As an agency-directed personal care provider serving Virginia Medicaid members, we support paid sick leave for our caregivers — but we have no way to cover the cost. Our revenue is set entirely by fixed Medicaid personal care rates, and this mandate is a direct cost increase we can't offset. Providers across the Commonwealth face the same problem: without a corresponding rate increase, agencies will be forced to cut caregiver hours or exit the Medicaid personal care market, reducing access to essential home-based care. We urge DOLI to coordinate with DMAS and the General Assembly to secure a rate adjustment before providers must comply.