Virginia Regulatory Town Hall
Department of Medical Assistance Services
Board of Medical Assistance Services
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3/24/23  4:20 pm
Commenter: Kathleen Dillon

Termination of Appendix K Flexibility Allowing Parents of Minor Children to Provide Care

Preventing family members to care for special needs children and the elderly is inhumane.  The proposal so to do is ill informed and is an unconscionable breach of the responsibility of legislators in the State Legislature to support the people of the Commonwealth of Virginia.  Appendix K allows a parent or spouse who is not an Employer of Record (EOR) in an agency company to hire attendants under the Consumer Directed Care option.  Their hours have already been justified, approved and budgeted by the state for special needs individuals on the CCC+ Waiver and on the DD Waiver wait list.  The hiring family member keeps detailed records of hours spent and submits them as documentation prior to any payment. 

It is obvious that the Virginia Legislature intends to terminate Appendix K for families using Consumer Directed Care unless the parent or spouse is already an employee of an Agency Directed company.  Appendix K has been in use in other states - long before the Public Health Emergency (PHE) for Covid-19 was in place.  The provisions of Appendix K is NOT a new concept.

Terminating the flexibility of families to continue caring for their special needs members under Consumer Directed Care is neither cost efficient nor care effective.  There were many anecdotes during the Pandemic about care giver companies suffering financial losses during the Pandemic because they were unable to maintain staff during the emergency.  This put the burden on families to provide continued care for their special needs loved ones and they rose to the occasion.  They succeeded with the assistance of Appendix K and the Consumer Directed Care provision in the PHE allowing that action.  The provisions of Appendix K made that possible and those provisions should be continued for the future to ensure that special needs individuals receive the care they need and deserve.

Our family's futile search for outside care givers came to end when the PHE took effect.  Finding even adequate outside care givers is difficult to impossible and expensive beyond the ability of many to afford.  

Appendix K provisions allowing family members to care for special needs members must be extended and made permanent.  It is vitally essential to the care of our most vulnerable citizens.    



CommentID: 213496