My name is Adrianne Jones-Alston. I am a Virginia home-care worker, community advocate, and Founder and President of the Jones Foundation for Returning Citizens, Inc.

I am submitting this public comment regarding the proposed amendments to Virginia's 1915(c) Home and Community-Based Services Waivers, particularly the proposal to eliminate independent Services Facilitation and replace it with a statewide Support Broker model.

I respectfully oppose eliminating independent Service Facilitators because I believe their role is essential to protecting the independence, dignity, and quality of care of vulnerable individuals and families.

Through my experience providing home-care services within Virginia's consumer-directed care system, I understand that caring for individuals in their homes requires far more than completing assigned tasks. It requires communication, coordination, accountability, and a dependable support system.

Independent Service Facilitators play a vital role in this process. They help individuals and families understand program requirements, navigate administrative challenges, coordinate services, and maintain important communication between caregivers, Employers of Record, and other agencies.

Service facilitators represent the type of independent community-based service providers whose contributions should not be overlooked.

My concern is that shifting these responsibilities exclusively to Support Brokers employed by fiscal-employer agents such as Public Partnerships or Consumer Direct Care Network could reduce consumer choice and remove an important source of independent assistance.

When problems arise involving payroll, service authorizations, enrollment, or communication, individuals and families should have access to knowledgeable professionals who can help them navigate and resolve those challenges independently.

Consumer-directed care should remain truly consumer-directed.

The individuals receiving services, including older adults and people living with disabilities, should remain at the center of decisions affecting their care. Longstanding relationships with trusted Service Facilitators should not be disrupted without clear evidence that the proposed replacement system can provide equal or better support.

I respectfully request that DMAS:

1. Reconsider eliminating independent Services Facilitation as a standalone service.

2. Preserve meaningful choice for Medicaid recipients and families who wish to retain independent Service Facilitators.

3. Engage current Service Facilitators, home-care workers, families, and consumers before implementing major structural changes.

4. Establish clear independent advocacy, complaint-resolution, and continuity-of-care protections for any proposed transition.

5. Publicly explain how the proposed Support Broker system will maintain service quality, accountability, and accessibility without creating additional burdens for families.

My concern is not simply about protecting a professional position. It is about protecting the people who depend on that position.

Virginia has an obligation to ensure that individuals receiving Medicaid-supported home care can continue living safely, independently, and with dignity in their communities.

I ask DMAS to carefully consider the voices of those who work directly with individuals receiving services before making changes that could significantly affect their daily lives.

Thank you for allowing me to share my perspective.

Respectfully,

Adrianne Jones-Alston

Virginia Home-Care Worker and Community Advocate

Founder & President

Jones Foundation for Returning Citizens, Inc.