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Department of Medical Assistance Services
 
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Board of Medical Assistance Services
 
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10/18/26  11:38 pm
Commenter: Tiffany Joseph

Opposition to 56-hour weekly cap
 

Hello, I'm an autistic adult, an AAC user, and a disability advocate, and I'm writing to oppose the proposed changes to Virginia's DD waivers.

I oppose the 56-hour weekly cap on personal assistance under the Community Living and Family and Individual Supports waivers. A blanket cap treats every person as though their needs fit neatly into eight hours a day — they don't. For the people I know and work alongside, the hours past 56 are the overnight safety checks, the second pair of hands for a transfer, the person who stays close when a seizure or an elopement risk could come at any time. These aren't extras. They're what keep people safe in their homes and communities instead of institutions. Needs already established through multiple layers of eligibility and assessment shouldn't be reduced to meet a budgetary goal.

I also share families' concerns about replacing locally chosen Service Facilitators with a centralized Support Broker model. Trusted, long-term relationships with people who know the community, the regional barriers, and the person — that can't be swapped for an assigned statewide contractor without losing the very thing that makes consumer-directed care work. Families should keep the right to choose, and to fire, the person coordinating their care.

Please reconsider both proposals, and keep listening to disabled people and their families. Thank you.

CommentID: 242728