Request for Participant Choice and Continuity Protection under the New Support Broker Model
As a family utilizing consumer-directed Medicaid waiver services in Virginia Beach, I am writing to express my deep concern regarding the elimination of participant choice in the transition to the Support Broker model. We have relied on service facilitation to navigate the complex system of services and support our loved one needs to live safely and with dignity. This relationship provides consistency, guidance, and advocacy that cannot simply be replaced by auto-assignment.
While the administrative restructuring may be decided, the operational rules must protect vulnerable individuals. Under the current Services Facilitation model, our family has the right to interview and select a provider we trust—one who deeply understands our dynamic, our location, and our specific disability needs. Forcing families into a system of blind corporate assignment by an MCO or Fiscal-Employer Agent (PPL/CDCN) completely strips away participant autonomy (choice and control over services), voiding the person-centered plan of care.
Furthermore, having a Support Broker assigned and paid directly by the entities managing the financial budgets creates an inherent conflict of interest. Families need independent advocates, not corporate overseers.
If DMAS proceeds with this transition, I urge the department to mandate the following protections in the final waiver language:
The Right of Refusal: Allow families to view a roster of available brokers, interview them, and request a reassignment if a match is poor.
Continuity of Care: Allow existing, trusted Services Facilitators who transition into the new framework to be explicitly requested by their current families.
Subcontracting Paths: Permit existing community-based facilitation agencies to operate as subcontractors so local expertise is not entirely lost.
Self-determination is the core pillar of consumer-directed care. Consider the real and lasting impact this decision will have on individuals who depend on these services and do not remove the family's voice from the care coordination process. Please protect our right to choose the providers who know us, understand our needs, and help our loved ones live their best lives.
