To the Virginia Department of Medical Assistance Services:

I am writing as the sister and legal guardian of an adult with an intellectual disability who receives services through Virginia’s Community Living Waiver.

I am concerned about the proposed 56-hour weekly limit on personal assistance services and the transition to a statewide support broker model. While I recognize the importance of responsible program administration, these changes must be evaluated not only for their financial and administrative impact but also for their potential consequences on the lives of individuals with disabilities.

People with intellectual and developmental disabilities deserve more than simply having their basic needs met. They deserve compassionate care, dignity, meaningful relationships, personal choice, and opportunities to participate in their communities.

For many individuals, Medicaid waiver services make these opportunities possible. Reducing essential support or creating additional administrative barriers could jeopardize their safety, independence, and quality of life.

I respectfully urge DMAS to ensure that the proposed 56-hour limit does not compromise individualized care. Exceptions must be clear, accessible, and based on documented needs, with safeguards to prevent interruptions in essential services.

Regarding the proposed broker system, I ask that DMAS preserve meaningful choice, continuity of support, and established relationships between families and those who help them navigate waiver services.

Most importantly, no individual should be pushed toward institutionalization simply because adequate community-based services have become unavailable or difficult to access.

Virginia’s waiver programs should continue empowering individuals with disabilities to live safely and meaningfully in their communities, rather than creating circumstances in which institutional placement becomes their only practical option.

Behind every service authorization is a human being whose life matters. Policy decisions must reflect that reality.

I respectfully ask DMAS to prioritize individualized care, continuity of services, and protections against unnecessary institutionalization when considering these amendments.

Thank you for your consideration.

Respectfully,

A Sister and Legal Guardian