Dear Virginia Department of Medical Assistance Services,

I am writing as a mother of an adult son with significant developmental disabilities to strongly oppose the proposed Medicaid Waiver changes, especially the 56-hour weekly soft cap and the elimination of independent Service Facilitators.

My son requires extensive assistance with everyday activities, including bathing, dressing, personal hygiene, preparing meals, and communication. He cannot live independently and needs continuous supervision and support to remain safe.

As a parent and caregiver, I know firsthand how physically and emotionally demanding it is to care for a family member with significant disabilities. As I grow older, providing this level of care becomes increasingly difficult.

I am deeply concerned that the proposed 56-hour limit, even with an exception process, could make it harder for families to receive the care they truly need. Care needs should be determined by each individual's circumstances, not by an arbitrary weekly limit.

I am also concerned about eliminating independent Service Facilitators. Families need experienced, trusted professionals who understand their situations, provide guidance, and advocate for individuals with disabilities.

I respectfully ask Virginia to:

- Reconsider the proposed 56-hour weekly soft cap.

- Preserve independent Service Facilitators and family choice.

- Protect access to necessary personal care services based on individual needs.

- Ensure that individuals with disabilities can continue living safely and with dignity in their homes and communities.

Families like mine already face many challenges. Please do not make caring for our loved ones even more difficult.

Thank you for considering the voices of families who depend on these essential services.

Sincerely,

A Concerned Mother and Caregiver in Virginia