Virginia Regulatory Town Hall
Department of Medical Assistance Services
Board of Medical Assistance Services
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3/27/23  8:46 pm
Commenter: Vivian Evett


I am the parent of a young man with multiple disabilities who receives services under the FIS Medicaid Waiver. I am writing this public comment to implore the state of Virginia to continue to allow Consumer-Directed services under the Virginia Medicaid Waiver System including the option for parents, spouses, and live-in family members to be paid attendants for people with disabilities.

Consumer-Directed care is essential to the rights of individuals with disabilities as the vital services provided under these waivers are necessarily personally invasive. The special needs of many people with disabilities include intimate care, such as ostomy, toileting, and bathing assistance. This type of care requires a level of trust and confidentiality that cannot easily be found with someone outside the family unit.

Additionally, the hourly wage provided to attendants under the waiver system is not commensurate with services required and the service hours needed are often long and physically draining, eight-hour days/seven days a week. A minimum wage rate for providing essential health and personal care will lead to a predominantly questionable workforce unless family members may be allowed. People who apply for the attendant position because they cannot qualify for other jobs with less responsibility and more pay (or cannot sustain them) may not be suitable for a job attending vulnerable people. Long hours and poor pay may lead to disgruntled workers unless those workers are family members who may work from home with those they love.

Our most vulnerable population needs your help in ensuring that their care is provided by the people of their own choosing, those with whom they feel most comfortable, not by strangers and for-profit agencies. Denying individuals with disabilities the right to Consumer-Directed care will bring hardship to individuals with disabilities receiving services under the Virginia Medicaid Waiver System and their families. With Consumer-Directed Care, parents and spouses may provide care and support to their loved ones in the home setting while providing access to doctor appointments, community activities, and normal daily activities, while earning a wage that will help to maintain the quality of life of the individual with a disability. Please support Consumer-Directed care under the waiver system.

Thank you for your help in this matter. Please feel free to contact me at if you would like to learn more about how Consumer-Directed services benefit our families.


Vivian Evett

CommentID: 214190