Virginia Regulatory Town Hall
Department of Medical Assistance Services
Board of Medical Assistance Services
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3/17/23  3:42 pm
Commenter: Elisa Fleming

Bad for the disabled, their families, and taxpayers, but a big win for agencies' pocketbooks?

It’s incredibly sad that Virginia is putting the wealth of agencies over the health and welfare of those with disabilities. Since it costs the state more money to support agency care, and every study out there shows that agency care is worse for the disabled than family care, it really begs the question of why they would do this.

I understand that family members would still be able to be paid caregivers if they go through training and get hired by agencies, but there are several issues with this. For one, there is already so much burden on families of the disabled, adding more for no benefit to them or the disabled person they care for is uncalled for. There’s already so much paperwork and so many logistical things to do on a regular basis when a loved one is disabled. The only party to benefit from that sort of arrangement is the agency. Also, who’s to say that the agencies are required to hire those family members or allow them to exclusively care for their own family members? Nothing in this policy suggests that agencies have any obligations or responsibilities to the family-member caregivers of the disabled.


Why enact a policy that exclusively benefits agencies when:

- Agency care costs taxpayers more

- Agency care is exclusive, so if a family member is able to work through them, the disabled person will lose any consumer direct aides that they have, some who’ve been caring for their loved ones for years

- Agency care is fraught with neglect and abuse

- Agency care is worse for the health and welfare of the disabled than family care

- Agency care is less flexible in hours and tasks than family care

- Agency workers don’t have the authority to make many important decisions for the disabled in cases of emergencies

- Agency workers introduce viruses every time they enter a house. For the immune compromised and immobile, it has never just been about covid. Any virus can be a death sentence. When a family caregiver has to leave the house daily for work, and an agency worker is bringing new viruses in daily, that’s two major sources of illness and possibly death for the disabled person.

- Agency workers do not care about the disabled person as much as their family members do. That affects the quality of care.


Please reconsider this policy, as it is unethical and clearly only benefits agencies, not the disabled, not the families of the disabled, and not the taxpayers of Virginia. Making families jump through yet another hoop—and one so uncertain since the agencies have no obligation to them, is wrong.

CommentID: 212416