As caregivers for our 34 year old developmentally and physically disabled son, we have strong concerns regarding the proposed changes to personal care services under the Medicaid Waiver Program.  Why is is it that disabled individuals and their families are always subjected to cuts and feel as if they are invisible in this state.  We urge DMAS to:

• Preserve meaningful access to the hours of care that individuals have demonstrated they need;

• Maintain safeguards against erroneous reductions or terminations of services;

• Make exception and review processes simple, transparent, and family-friendly;

• Provide substantially more information and stakeholder input before replacing established consumer-directed systems;

• Ensure that consumer direction continues to provide meaningful choice;

• Provide clear guidance regarding EOR responsibilities and LRI requirements;

• Avoid creating additional administrative burdens for family caregivers; and

• Delay implementation of EVV for live-in caregivers until the concerns of affected families have been fully addressed and appropriate protections are in place.

The success of Virginia's waiver system should ultimately be measured by whether people with disabilities can remain safely in their homes and communities with the support they need. Administrative changes should strengthen that goal, not inadvertently make it harder for families to achieve it.