Virginia Regulatory Town Hall
Department of Medical Assistance Services
Board of Medical Assistance Services
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3/28/23  6:16 pm
Commenter: Catherine Shelton

Consumer Direct is the Best Option for Care for our Children and Families in Virginia

Please continue to allow the Freedom of Choice under Virginia Medicaid and support Consumer Directed Care. I have worked with many agencies covering more than 15 years in my career. I have seen theft, fraud, and abuse in the Agency Directed Care. Not to mention Agencies cannot keep good aides because they only pay minimum wage ($12.00 per hour), while they pad time entries fraudulently using Respite hours that were never served and award the owners hundreds of thousands of dollars in bonuses annually. Could you afford to work for $12.00 per hour? Agency Directed Care is a fraud and I have seen too much to allow my daughter to be served by any agency, adult daycare program, group home or mental health facility. These aides sit on their phones, rummage through our homes stealing information and items, and sleeping on shift. When they don't show up families are told by the Agencies "We have no one to send and you have to take care of your loved one." Sometimes families go for weeks without service from Agencies. Agency Directed Care should end, not Consumer Directed Care. Families are already caring for their loved ones when the Agency Directed Care lets all of us down. The PCA Class and CNA Classes do not teach employees how to work with clients on the Autism Spectrum and living with other Mental Health issues. 

The best caregiver is a parent who would never harm their child, steel from them, we show up to serve and are always available to help them no matter what time of day or night. I was up until 3:00 a.m. this morning caring for my adult daughter, while she continued to discuss magical powers, parallel universes, her dolls changing facial expressions and had two agitated and aggressive meltdowns. I am the only person who can calm her and reason with her. I love and adore her and will be with her throughout her life. She deserves to have consistency of care, live in her own home environment surrounded by people who love her and will take excellent care of her for the rest of her life. 

Part of me wants to get on my knees and beg you to understand as a parent of a special needs child, but you cannot unless you have walked a day in our shoes as parents. Another part of me wants to scold everyone and tell you, "How could you even think of taking away Consumer Directed Care?!" 

Representatives are being led down the wrong path by the Virginia Association of Personal Care Providers (VAPCP), who are all receiving generous salaries off the backs of Medicaid recipients. They are being paid by Medicaid dollars to attend meetings and eat fancy lunches. Take the money away from the Agencies and their paid Lobbyists and give it to the people who are actually doing the caregiving for people living with disabilities and our elderly. You really need to shine a bright light on Agency Directed Care and ask the VAPCP and Agencies across Virginia how are you paying your scheduler, agency managers, corporate managers? How many raises did your PCAs and CNAs receive over the last 20 years? Maybe mandate that all Agencies to become Non-Profits? There is a lot of fraud in the Agency Directed Care venue, and you won't need to look too far to find it. 

Give the caregivers a raise and allow families to hire who they feel is best for the job.  Support our right to choose. This is a time to show your compassion and support families throughout Virginia. Please find it in your hearts to do the right thing for our Medicaid Recipients. 

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