I am writing to express my absolute opposition to Virginia’s proposed elimination of Service Facilitators and transition to Support Brokers in 2027. I am deeply disappointed that the Commonwealth would consider making such a significant change to a program that serves some of our most vulnerable citizens without fully recognizing the dedication, experience, and relationships that Service Facilitators bring to the individuals and families we serve.

I have worked as a Service Facilitator for approximately 10 years and have more than 20 years of caregiving experience. I have dedicated much of my professional life to helping elderly individuals, people with disabilities, and families who are simply trying to keep their loved ones safe and cared for in their own homes.

We are not just people who show up every 30 or 60 days to complete paperwork. We are advocates, educators, problem-solvers, and, in many cases, a lifeline for families who have nowhere else to turn.

We answer phone calls when families are confused, frustrated, or frightened. We help caregivers understand complicated Medicaid requirements, navigate issues with fiscal agents, complete paperwork, and address problems that could interfere with essential care. We listen when families are overwhelmed. We provide reassurance when they feel defeated. We help them find answers when they have been transferred from one agency to another without receiving the assistance they need.

And we do much of this outside our required visits, without additional compensation, because we care about the people we serve.

Some of these families have worked with the same Service Facilitator for years. We know their struggles, their medical challenges, their family situations, and the obstacles they face every single day. We recognize when something has changed, when a caregiver is overwhelmed, or when an individual may need additional assistance.

How can Virginia place a value on those relationships? How can the Commonwealth justify disrupting years of trust and consistency without clearly demonstrating that the replacement system will provide better care?

These are not simply Medicaid cases or numbers on a spreadsheet. These are real people. They are someone’s mother, father, grandparent, child, husband, or wife. Many are elderly, medically fragile, disabled, or unable to advocate for themselves. Their families are already struggling to balance employment, caregiving responsibilities, financial pressures, and complicated Medicaid rules.

Now Virginia is considering another major change that could leave these families confused, overwhelmed, and uncertain about whom they can depend on.

When will the Commonwealth stop making changes that place additional burdens on the very people these programs were created to help?

I am especially concerned about families living in rural Virginia. In communities like the Northern Neck, resources are already limited. Transportation can be difficult, access to services can be challenging, and families often have few places to turn when they need assistance. Service Facilitators provide a familiar, accessible, and knowledgeable connection to the consumer-directed services system.

Eliminating this role without guaranteeing the same level of personal support could create serious gaps in assistance and continuity of care.

I also find it troubling that the knowledge and experience of established Service Facilitators appear to be undervalued. Many of us have spent years learning the Medicaid system, understanding the needs of the people we serve, adapting to constant policy changes, and helping families navigate an increasingly complicated program.

We have remained committed through changing regulations, fiscal agent transitions, authorization issues, electronic visit verification requirements, and countless other challenges.

We have stood beside these families through every change. Now, who is standing up for them and for us?

If the Commonwealth believes the Support Broker model will be better, then it should provide clear, detailed answers. How will this change improve the lives of individuals receiving services? How will families maintain their established relationships? Will they continue to receive in-person assistance? Who will help when problems arise? What protections will prevent interruptions in services? What evidence demonstrates that eliminating Service Facilitators is necessary?

These questions deserve answers before any transition is implemented.

I am not opposed to improvements that genuinely benefit individuals receiving Medicaid services. I am opposed to changes that risk removing experienced, dedicated professionals from the lives of vulnerable people without sufficient evidence that the new system will serve them better.

Progress should mean improving care, not dismantling relationships and support systems that families have depended upon for years.

Virginia needs to understand that Service Facilitators are not easily replaceable. Our work cannot be measured solely by the number of visits completed, forms submitted, or authorizations reviewed. The true value of our work is reflected in the families who feel less overwhelmed because someone answered their call, the caregivers who received guidance when they needed it most, and the individuals who can continue living safely in their homes because someone helped them navigate the system.

I urge Virginia’s leaders and decision-makers to remember the human beings behind these proposed changes.

Please stop treating individuals receiving Medicaid services as though they are simply part of an administrative process. Their lives, dignity, independence, and ability to remain in their homes matter.

Before eliminating Service Facilitators, listen to the individuals and families who depend on us. Listen to the caregivers who call us when they cannot get answers elsewhere. Listen to the professionals who have dedicated years of their lives to making this program work.

I strongly urge the Commonwealth of Virginia to STOP the proposed elimination of Service Facilitators in 2027 and preserve the experienced, personal, and dependable support that individuals and families deserve.

We are more than a title. We are more than a required visit. We are more than paperwork.

We are the familiar faces, trusted voices, and helping hands that families have come to depend on.

Please don’t take this away from them!