Speech of the Chamber of Deputies (2023)

Last name: Gary Location: Stafford

Good morning, Thank you all for reviewing and considering Delegate Tata's bill to address the care and recognition of victims of human trafficking. I am a survivor of domestic trafficking and have seen many varieties of trafficking during my time working in nightclubs in Washington D.C. Many years ago. Victims of trafficking are invisible to most people, but they are all around us every day. Each trafficked person was isolated from their neighbors, friends and family. It is a rare opportunity to be seen as intentionally as someone else when seeking medical attention. It is a rare opportunity for a trafficked person to be recognized and receive help. I understand the additional burden that the need for this type of training can place on medical personnel, but I also believe that most of them would consider that the lives and dignity of our fellow human beings who are neglected and severely abused are worth it. the penalty without anyone coming to save them.you. To remain silent is to participate in the violence and atrocities of human trafficking. To refuse to delve into your circumstances and red flags is to turn your head and allow it to continue. I left my abuser/dealer after a 12 hour ordeal during which I was held hostage in my basement apartment while being beaten and suffocated, with breaks to witness the destruction of my property, etc. I finally managed to escape and call the police, but I ran out of the judge's office when it was time to give my statement. I didn't want my dealer to go back to jail. I ran away, as if I were the offender, and called him from a public phone, desperately asking for his forgiveness. Law enforcement are trained but often ill-equipped to help trafficked persons escape due to this Stockholm mentality. However, caregivers, like medical professionals, have a unique ability to calm traumatized individuals and provide important information that can save a trafficked person's life. During my tormented years, I was at various medical centers and received care for injuries, but no one asked me if I needed help or provided me with resources. It was the owner of a nightclub where I worked who took me to his office the day after the event I described. He examined the bruises on my neck, shook his head, and said, “You'll be back. They always do it. I give him credit for helping save my life. He was the only person who knew what to look for and the nerve to say it out loud, even if he wasn't perfect. I decided not to be a statistic and chart my path to freedom. Soon after, I met my now-husband, who also saw the warning signs and protected me while he distanced me from the drug dealer. We have been married for 13 years and have a blended family with seven wonderful children, two of whom are now young soldiers in the Army and USMC. My story is weird. It does not have to be like that. Vote yes on HB 1426, or make it even better if necessary, so that we can shed a light of hope in the lives of those who have seen much damage. Please help rescue people like me. we are worth it Respectfully, Monica Gary

Last name: collect Organization: Virginia Coalition Against Human Trafficking and Freedom 4/24 Location: Lynchburg

Mister. Chairman and members of the subcommittee, as a member of the Virginia Coalition Against Human Trafficking and president of Freedom 4/24, an anti-human trafficking organization in Virginia that focuses specifically on implementing preventive education, I ask for your support for HB 1426 Approximately 70-90% of trafficking victims who receive medical care while trafficked do not identify themselves as such and are essentially returned to these exploitative situations with no support/resources/options. Requiring hours of continuing education on this topic ensures continuity of information and improves the best outcomes for victims. A key part of this bill is the mandatory component. We want to make sure that medical providers are properly equipped to identify and support survivors of trafficking. When training is voluntary rather than mandatory, the health workers who need it most often do not receive such training. The medical community is one of the few that may have the opportunity to directly interact with and access victims of trafficking in a way that allows them to understand the deeper problem…if they have been trained to recognize these signs and warning signs . Dr. Kanani Titchen, a board-certified physician in pediatrics and adolescent medicine, said in her TEDx talk titled "How to Identify Human Trafficking: 'The eye does not see what the mind does not know.' We want to make sure knowledge is provided , that human trafficking education be put in place for our medical community so they have the "eye" to recognize the signs of someone who has been affected by this atrocity and can respond accordingly Thank you for taking the time to read this Joy Cover Freedom President 4/24 VCAHT Board Member and Treasurer

Last name: Dunn Organization: Safe House Project Location: Virginia Beach, Virginia

In the United States, human trafficking primarily affects women, girls, and boys who are exploited by the sex industry. In 2018, the National Human Trafficking Hotline identified 23,078 victims of TP in the US. More than 15,000 of these victims were women, 16,137 were sex trafficked, and approximately 5,000 were minors. Trafficked persons receive health services, but health care providers often miss opportunities to identify them. The most common care providers were emergency and urgent care providers, primary care providers, and obstetricians and gynecologists. There are barriers to the identification of victims. Trafficked people often have difficulty identifying themselves out of mistrust, fear or shame. Psychological barriers, involvement of traffickers, lack of awareness among health professionals, and lack of detection create a high proportion of missed opportunities to effectively identify and care for survivors of trafficking. Research indicates that health professionals do not feel equipped to identify trafficking. One study found that 4.8% of doctors reported feeling confident in their ability to identify a victim of trafficking. A 2014 study found that 90% of trafficking victims received medical attention during their trafficking experience, although victim identification rates indicate that these victims are unlikely to be identified despite receiving care. , multiple Adverse Childhood Experiences (ACEs) and have a high probability of reexploitation without specialized and culturally appropriate services. Therefore, it is essential that health professionals know how to identify, report, and provide resources to trafficking survivors because, without their intervention, victims will continue to circulate through the hospital system. A study shows that people who go unserved will cost taxpayers $5.3 million over their lifetime, and many of those dollars are incurred by health networks that deliver frequent care to the same people without compensation. Effectively identifying and referring trafficking survivors to support services will not only help break survivor victimization cycles, but also reduce cost to the health network. We ask that you vote for HB1426 to not only empower our healthcare professionals to feel better equipped to identify and support survivors of trafficking, but also to give one of the most underserved populations in our communities the opportunity to receive the services they need to prevent reexploitation.

Last name: leader Organization: global centurion Location: glen allen

Human trafficking is a serious problem in the United States and abroad. Its effects involve issues related to law enforcement and human rights. Furthermore, as research shows, human trafficking is also a health problem. Victims of human trafficking have serious physical and mental health problems, including acute and chronic illnesses, injuries, and disabilities, such as substance use disorders. A landmark study in 2014 found that 87.8% of survivors indicated that they sought medical care while trapped in the trafficking situation. Health professionals are often the first point of contact for victims of human trafficking. As first responders, they must be able to identify the signs and indicators of human trafficking and respond effectively. New research shows that relevance is critical to the success of any training. Health professionals need specialized training that covers the basic skills of human trafficking and, in addition, specialized information on health and human trafficking, including the following: Research results on the health problems of the Survivors of Human Trafficking · Signs and Indicators of Human Trafficking, tailored to different roles within the health care provider environment. For example, the signs seen by the receptionist, the signs during the main symptom, the signs during the medical history, and the signs during the medical examination may all be different. for victims, both victim-specific internal barriers and external barriers commonly found in professional health settings. · Implicit bias related to human trafficking in health care settings that may prevent effective care by a health professional for victims of human trafficking. · Patient-centered, victim-centered, and trauma-informed care. · How to build community connections to meet the multidisciplinary needs of survivors through a robust system of referrals and "warm transfers" · Medical documentation practices, such as the ICD-10 codes on human trafficking and how to use them · Mandatory reporting, addressing the needs of migrant victims and survivors and the use of electronic medical records in trafficking cases · Active participation and practical application of the material through what-if scenarios ensures a proficient understanding of the training concepts. A good practice in health training is to ensure a process by which NGOs and other entities can produce certified training, through an agency in the Governor's office, such as DCJS. Any NGO producing accurate and up-to-date training covering core competencies as determined by DCJS should be listed. Laura Lederer, Subject Matter Expert, US Department of Health and Human Services 6828llederer@globalcenturion.org

Last name: Willis Organization: auto Location: roanoke city

I am a Certified Peer Support Specialist. I have a felony charge for a charge I committed in 2014 and was indicted in 2016. I got clean on 12/30/2015. I have changed my life completely and I am no longer the person that I was. I worked for NRVCS in Radford Va. I was a CPRS with a qualified mental health professional from Pará. I mainly worked as a case manager. I trained a few case managers with college degrees, applied for a peer support expert supervisor position. The other agency really wanted to hire me and did so only to decline the offer due to my criminal barrier. Then they called me back 2 weeks later and they still wanted to sign me. They contacted NRVCS to find out how they hired me, hoping to find a loophole. They could not. I now work for a non-profit organization where barrier crime is not a barrier and I am grateful. My job at NRVCS was in jeopardy because they hired me illegally. When trying to go through the process with DBHDS, my supervisor at NRVCS told me they didn't want to change course. I had already started the process, but I didn't have a backup to complete the process. This crime prevented me from pursuing many different careers. If you read this, I appreciate it. Thank you! We need some changes to this bill. I understand that there must be some recommendations, however it must not be so difficult and stressful. Most addicts will have drug charges. That is a fact. That doesn't make me a bad person, however my experience, strength, and hope have helped more people than most people who don't. If you want to talk to me, my phone number is 5402504804.

Last name: nicholls Location: Chesapeake

Bill Del. Tata is needed to protect and help trafficked people. The average age is 12 years old, we need to make sure these people are taken care of.

Last name: McCoy Organization: Virginia Coalition Against Human Trafficking Location: Arlington

See attached comments in support of HB 1426.

Last name: amaya Location: Arlington

Please see the comments in the attached PDF.

Last name: Williams Organization: Nolef gira Location: richmond

Our organization strongly supports this bill. We work with hundreds of people with life experience who should be allowed to support others going through similar situations. For a long time, people with a history of substance use and/or in recovery were prohibited from receiving certification. They are often allowed to do unpaid work, but are often unable to work in the fields due to outdated laws against barrier crime. Whoever is closer to the problem is closer to the solution. As a peer recovery specialist and harm reduction organization, we believe that no one can assess and resolve a problem like a person who has overcome it on their own. Peer recovery support training is provided within the Department of Corrections in the cognitive community and many of our staff and volunteers have had the honor of working alongside individuals in need of support. Virginia, like many other states, is dealing with an unprecedented number of overdoses and deaths. It is time to employ non-traditional means to deal with the crisis in which we currently find ourselves. I trust my fellow recovery specialists, especially those with prior convictions and/or a history of substance use. Having guardrails is nice, but not allowing a person with lived experience to serve others in those roles is a disservice to our neighbors struggling with substance use.

Last name: fry Location: fairfax county

As a Certified Peer Recovery Specialist (CPRS) and Registered Peer Recovery Specialist (RPRS) for the past three years and now a Regional Coordinator of Peer Support Services, I see the positive impact Peer Support has as another recovery tool. Support for people in recovery from substance use and mental health. Those who have been through the experience of being incarcerated or going through the justice system are some of the best living examples that recovery is possible. With over 130 specified barrier offenses in existence for those with criminal histories trying to get into the peer support field and just over 20 that are even traceable, the state contradicts its position on rehabilitation and recovery and is robbing those who are currently fighting opportunity. to work with someone who has walked in your shoes. Peer Recovery Specialists are more than people with lived experience: we are professionals, with our own code of ethics, certification process, and scope of work. We are so much more than our diagnosis and the bottom we hit, and we have a lot to share so others don't have to go through what we go through. I think about my own experiences with substance use and mental health challenges: I've been in and out of recovery since I was 16, used a lot of substances, was hospitalized multiple times, and even dropped out of school before the ages. 21. I was in various mental health and detox programs, but my substance use and mental health still got worse. But there wasn't a day that went by that I didn't want more for myself, that I knew that the way I was living would eventually kill me; but did not know how. Now, six years later, I have not only earned my bachelor's, but also my master's, after 6 years of recovery from substance and mental health issues, and am working for the local community service board. But that would never have happened to me if I had been written off in those dark years when I was at my lowest. The substantial number of existing barrier crimes in the Commonwealth of Virginia must be significantly reduced to more closely align with rehabilitation/remediation, promote employment and continued recovery for those with a history of incarceration, and improve overall prison outcomes. with mental health and substance use disorders. The attached file that I have included is my last photo taken last fall. I am so proud of the girl in that photo and how far she has come. The least that can be done is to expand the number of opportunities for others to have the same chance of recovery and happiness.

Last name: Mitchell Organization: HRCSB Location: harrisonburg

I am writing in support of HR1525. I am a specialist in recovery between equals without barrier crimes. However, I know from experience that those who can best help people with substance abuse problems also have a history of substance abuse, and that often includes barrier offenses. I think it is unnecessary and immoral to prevent recovered people from helping others because of the very experience that makes them effective in helping. In other words, when we say that a Peer cannot have a criminal record, we are saying that they do not care to help those who may have committed similar crimes. It's yet another way to perpetuate the addiction-incarceration cycle.

Last name: Willis Organization: auto Location: roanoke city

I am a Certified Peer Support Specialist. I have a felony charge for a charge I committed in 2014 and was indicted in 2016. I got clean on 12/30/2015. I have changed my life completely and I am no longer the person that I was. I worked for NRVCS in Radford Va. I was a CPRS with a qualified mental health professional from Pará. I mainly worked as a case manager. I trained a few case managers with college degrees, applied for a peer support expert supervisor position. The other agency really wanted to hire me and did so only to decline the offer due to my criminal barrier. Then they called me back 2 weeks later and they still wanted to sign me. They contacted NRVCS to find out how they hired me, hoping to find a loophole. They could not. I now work for a non-profit organization where barrier crime is not a barrier and I am grateful. My job at NRVCS was in jeopardy because they hired me illegally. When trying to go through the process with DBHDS, my supervisor at NRVCS told me they didn't want to change course. I had already started the process, but I didn't have a backup to complete the process. This crime prevented me from pursuing many different careers. If you read this, I appreciate it. Thank you! We need some changes to this bill. I understand that there must be some recommendations, however it must not be so difficult and stressful. Most addicts will have drug charges. That is a fact. That doesn't make me a bad person, however my experience, strength, and hope have helped more people than most people who don't. If you want to talk to me, my phone number is 5402504804.

Last name: Leeward Location: Sofa

Good day. My name is Elijah Lee and I am a community activist for 15 years. I had the great honor of being a part of the process of writing this legislation, as it is more important than ever. This legislation is necessary as we continue to fight the terrible effects of the opioid epidemic while ensuring that all Virginians have the opportunity to live long, healthy, and successful lives. Too often, we see peer recovery support specialists, people who know best how to help people with substance use disorder who are removed from jobs where they would use their lived experience to help others. Right now, our communities are suffering. Every county in Virginia has citizens experiencing the pain associated with addiction and now, by suspending a specific set of barrier crimes, we have an opportunity to help ease some of that pain. We know this legislation would help thousands if Virgos, by not only making sure those who have overcome Substance Use Disorder have a good job, but also making sure those who need our support the most get it, so they have the ability to return to the things and people they love. By supporting those in need, this bill would also increase employment by offering experience-based jobs to those who have been disenfranchised due to their past addiction. It is critical to understand that this bill would expand PRS services, which is an evidence-based approach to LDS treatment. I hope this committee is in favor of passing the bill. Thank you.

Last name: cruise Organization: Mental Health Virginia America Location: richmond

We support providing reasonable exceptions to the barrier offense statutes for peer recovery specialists when the employer wants to hire them. The passage could help address at least a small part of Virginia's severe behavioral health staffing shortage, while also giving a specialist the ability to help someone going through the same experience as him. Peer work has shown good results and we need them working when the employer wants them on board.

Last name: Higginson Location: Loud speaker

Please vote YES. A person who has paid off their crime debt, recovered from past trauma, and overcome symptoms of mental health and/or substance use issues (and later became a peer support professional) should be able to work and use these lived experiences to help. the many citizens of the Community who are in crisis. Restricting people who are uniquely positioned to do good is pointless and would only add to the mental health provider crisis in Virginia. Vote yes and be part of the solution.

Last name: crunch Organization: N / D Location: wytheville

Dear Sir and/or Madam, My name is Almetta Cruff, I have been associated with many peer support recovery people in my past, they have even helped me. while dealing with my father's death from late-stage leukemia in 2003. Without many of them, I don't know if any of my friends would be here today. That's all I can think of right now. thank you and please vote YES. Thank you, Almetta M. Cruff

Last name: trento Location: Henrique

Expand the scope of "Peer Recovery Specialist" to further include "any person who meets the definition of RPRS-"Applicant" as defined in 18 VAC 115-70-10 et seq.

Last name: Mix Organization: virginia voice Location: Roanoke, Virginia

My name is Martin Mash and I am the Network Program Director for Vocal Virginia, the only statewide nonprofit mental health education and advocacy organization in the Commonwealth. I would like to speak in support of this important legislation that will help address two concerns facing the mental health community. First, this legislation will help Community Service Boards and other providers across the state deal with the worsening workforce crisis. Second, this bill gives people the opportunity to use their lived experience to improve the life of another person through a recovery-oriented system of care that is centered on the person and their recovery at the peer level. , which has proven to be an effective method of helping such people. who struggle with mental health issues maintain their recovery. For these reasons and more, we urge you to join our network of 2,000 members in supporting this legislation. Thanks for your time.

Last name: Spouse Organization: True RVA Recovery Location: Richmond VA

Expand the scope of "Peer Recovery Specialist" to further include "any person who meets the definition of RPRS-"Applicant" as defined in 18 VAC 115-70-10 et seq.

Last name: they kill Organization: Laurie Mitchell Empowerment and Career Center Location: CHARLOTTESVILLE

Best wishes, distinguished GA officials and delegates, vote YES on HB1525 and promote this life and health maintenance legislation that is sure to strengthen people's mental health and addiction recovery while alleviating some of the handicap shortage. of behavioral health work. YES on HB1525 will make it possible for more Virgos to live healthy lives, through empowered peer and family support, recovery, and wellness training. Thank you very much for your service to Virgos! Healthy 2023, Heather Peck Executive Director Laurie Mitchell Empowerment and Career Center

Last name: Brown Location: Alexandria

Please vote YES on HB1525. This bill will help many people get the support they need from a person with lived experience, giving them hope for change. Who better than someone who has lived and managed to change her own life to give others the opportunity to change. Peer relationships are extremely unique in that you have experiences to share in detail with a partner. As an FSP Family Support Partner, I use the heartbreaking experiences of our families to help guide others and provide hope for a better way of life for those seeking better outcomes. Many other PRS have barrier offenses that prevent them from working, based on their past. Giving them the opportunity to be employed and to use that experience that cannot be taught or learned. You have to suffer the experience and decide to change. To have that person who once walked in your shoes and is now helping you find your way is extraordinary to witness. Many PRS were jailed. They chose to change their lives and now they want to give back to the community. What an example of redemption and hope this person brings to the community. Building stronger people benefits the community. It makes our communities safer for everyone. PRS undergoes professional training and passes a difficult exam before becoming Certified Peer Recovery Specialists. They bring to the table the necessary link between clinical staff and the client served. We connect regularly, continue to train, find solutions to our peers' worst problems by walking with them as they change, giving them the tools and hope they need. As PRS, we delve into our own past and experiences to help others. This is self-love with conscience and responsibility. Vote yes on HB1525.

Last name: coleman Location: Sofa

Expand the scope of "Peer Recovery Specialist" to further include "any person who meets the definition of RPRS-"Applicant" as defined in 18 VAC 115-70-10 et seq.

Last name: Worthington Location: Williamsburg

Expand the scope of "Peer Recovery Specialist" to further include "any person who meets the definition of RPRS-"Applicant" as defined in 18 VAC 115-70-10 et seq.

Last name: My sister Organization: virginia voice Location: city ​​of richmond

Please support this bill. It is very essential in mental health reform. This is essential for the rehabilitation of mental health consumers in society as it is very vital in mental health recovery. Being able to have gainful employment during recovery. HB1525. And also allow the couple to help their partners in recovery.

Last name: McClelland, LPC, LSATP Organization: River City Home Services, LLC Location: richmond

While the process of change is slow, the intent of this legislation is to provide a direct path for "peer recovery specialists" to participate in a fair selection process: Prior felony convictions have TWO SIGNIFICANT OBSERVATIONS in the language . In addition to serving all terms of prison, probation, and financial restitution + 5 years after conviction, which is actually 5.5-7 years after the date of the offense, Peer Recovery Specialists must complete 500 hours of training supervised experiential course under the weekly supervision of a certificate holder. DBHDS Supervisory Recovery Specialist (RPRS, CSAC, or LMHP), before you are allowed to take the VA State Exam. The target population of potential peer recovery specialist job applicants that this legislation is intended to impact through increased assessment eligibility will NOT be able to complete the required 500 hours. (3 to 4 months) experiential training in these positions because the language only refers to fully credentialed and registered peer recovery specialists defined in §54.1-3500. RECOMMENDED REVISION: Expand the scope of "Peer Recovery Specialist" to further include "any person who meets the definition of RPRS-"Candidate" as defined in 18 VAC 115-70-10 et seq. in addition to RPRS as is defined in § 54.1-3500 A “Candidate” completed the DBHDS Peer Education Didactic Training Course and Certificate of Completion uploaded for DHP Online Registration / Registration Fee Paid - (VALID FOR 1 YEAR) This will allow substance abuse providers to employ these individuals, providing supervision/supervision and enhanced career development, which should improve outcomes related to the intent of this legislation Consider reducing the 5 year post-conviction requirement to 3 years with evidence of successful good deal as RPRS wages are still between $17-22 /hr range Beer paysc Strong job seekers are generally above salary or initial 5 years after conviction.

Last name: Mathews Location: Chesapeake

Vote yes on HB 1525. Peer recovery specialists are an important part of the recovery process for so many Virgos, and barrier crimes prevent so many good colleagues from working in the field and helping others like them.

Last name: Madeira Location: Ashburn

HB 2276 immunization; vaccinate children against COVID-19 Informed consent is the basis of medical ethics. Parents must make decisions about the health and well-being of their children. COVID-19 vaccines do not prevent viral transmission, so requiring these vaccines as a requirement for school attendance is not justified. This bill specifies that parents will not be required to immunize their children against COVID-19 in the same way that current Virginia law allows them to determine whether to administer the Haemophilus Influenzae type b vaccine. be considered, legislators and their experts confirmed the legislator's support for keeping parents in charge of their children's immunization schedule. In 2021, the Virginia Department of Health proposed a regulation requiring the COVID-19 vaccine as a requirement for school attendance. More than 15,000 Virginians commented on the regulation, with overwhelming opposition (93%) to ordering the shot. Medical professionals around the world agree that there is no scientific justification for continuing COVID-19 mandates through 2023 and beyond. HB 2280 Parental Consent for Surgical and Medical Treatment of Certain Minors This bill requires parents and guardians to consent to medical interventions on their children, including medical decisions for their children. Several cities have tried to pass ordinances and laws that allow children as young as 11 years of age to consent to immunizations without their parents' knowledge! Please don't let this happen to Virginia. Support this bill to send a clear message that in Virginia, parents are in control and decide what medical interventions their children receive.

Last name: nicholls Location: Chesapeake

After the 7 am meeting, then this. HB 1689 - Move to report. No one should die without the benefit of spiritual help. * HB 1864-No person should be forced to put something he doesn't want on his body just to keep his job. We are not North Korea. *HB 1889 - Data shows not at high risk of disease. HB 2057 - Why are people who worked and paid thousands of dollars for decades denied Social Security because those who broke the law came here? Why shouldn't we put infrastructure and improve schools for African American communities FIRST BEFORE anyone else? Why do they deserve something in front of our veterans? Please PBI this bill. HB 2160 - In honor of those who lost family/friends and were not allowed to see them at the end, please report. HB 2276 - The data is clear: Children are not at risk of dying from COVID. HB 2293 - https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/comparing differentinternationalmeasuresofexcessmortality/2022-12-20 Sweden and Norway were essentially tied for lowest "scores" of "proportional excess mortality" from all causes" (which "measure [] the percentage change in the number of deaths compared to the expected number of deaths (based on the five-year average [from 2015 to 2019])" among the listed European countries, analyzing data from January 2020 to June 2022: excess mortality increased by 2.7%, compared to, for example, 5.2% for Denmark, 7.1% for Finland and 11.8% for the Netherlands Lowest all-cause death rate since COVID hit and not doing these long, long lockdowns Sweden had a lower average rate Excess death rates: https://reason.com/wp-content /uploads/2023/01/ERGExcessMortality.xlsxhttps://www.baconsre bellion.com/wp/ c ovid-19-update-still-lots-idle-hospital-capacity/ noted on 4/25/2000 Roanoke Valley had 80 cases, 6 hospitalizations, and 0 deaths compared to Arlington with 764 cases, 137 hospitalizations, 29 deaths. Elective surgery has been banned in both, though the entire Roanoke Valley has 0 deaths. HB2489 - Please come forward so men can be supported in becoming strong fathers.

Last name: nicholls Location: Chesapeake

HB 1689 - Move to report. No one should die without the benefit of spiritual help. * HB 1864-No person should be forced to put something he doesn't want on his body just to keep his job. We are not North Korea. *HB 1889 - Data shows not at high risk of disease. HB 2057 - Why are people who worked and paid thousands of dollars for decades denied Social Security because those who broke the law came here? Why shouldn't we put infrastructure and improve schools for African American communities FIRST BEFORE anyone else? Why do they deserve something in front of our veterans? Please PBI this bill. HB 2160 - In honor of those who lost family/friends and were not allowed to see them at the end, please report. HB 2276 - The data is clear: Children are not at risk of dying from COVID. HB 2293 - https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/comparing differentinternationalmeasuresofexcessmortality/2022-12-20 Sweden and Norway were essentially tied for lowest "scores" of "proportional excess mortality" from all causes" (which "measure [] the percentage change in the number of deaths compared to the expected number of deaths (based on the five-year average [from 2015 to 2019])" among the listed European countries, analyzing data from January 2020 to June 2022: excess mortality increased by 2.7%, compared to, for example, 5.2% for Denmark, 7.1% for Finland and 11.8% for the Netherlands Lowest all-cause death rate since COVID hit and not doing these long, long lockdowns Sweden had a lower average rate Excess death rates: https://reason.com/wp-content /uploads/2023/01/ERGExcessMortality.xlsxhttps://www.baconsre bellion.com/wp/ c ovid-19-update-still-lots-idle-hospital-capacity/ noted on 4/25/2000 Roanoke Valley had 80 cases, 6 hospitalizations, and 0 deaths compared to Arlington with 764 cases, 137 hospitalizations, 29 deaths. Elective surgery has been banned in both, though the entire Roanoke Valley has 0 deaths. HB2489 - Please come forward so men can be supported in becoming strong fathers.

Last name: Kellner Location: Brambleton

In May 2020, I was admitted to the ER for kidney stones. Due to the pandemic, my husband was not allowed to stay with me. During the ER stay, I was overdosed on Fentanyl and revived with NARCAN. The next day they transferred me to a hospital to have an operation and remove the stones that were covering my kidney and another remained lodged in my urethra. I am Roman Catholic. I was scheduled to have surgery under full anesthesia to remove the stones. As such, I am entitled under Canon Law to receive the Anointing of the Sick. The Anointing of the Sick is not intended only for those who are "on the verge" of death or with "one foot in the grave", but is a Sacrament of Healing, intended not only to prepare the faithful for death, but to ask God for Healing if that is his will. I asked the hospital to contact a local priest to attend to my spiritual needs. The "chaplain" (a woman named Deb) informed me that "no priest will come for you." She said that since she was not actively dying as a priest, she would not be coming due to COVID-19. I asked him if that was the hospital's policy. She said yes and even if she didn't, "no priest will come for you". (Is not true). I argued with her for almost an hour, in a lot of pain (with morphine), and she finally agreed that if she found a priest she would let me go to the lobby. I had a priest. The wine. He had to wait in the lobby while I was disconnected from the machines, wrapped in blankets, and carried out into the lobby, still in severe pain. He performed the Anointing and the Sacrament was completed. It was a risk taking me into a hallway instead of allowing dad to come to me. It later turned out that he had the onset of sepsis and was, in fact, in danger of dying. If the "chaplain" had been successful, he could have died because I was denied my last sacrament. When trying to contact a priest, my husband received feedback from a pastor who said that "the hospital wouldn't let them in." He was just a priest I had a working relationship with for years that he was willing to take the risk of being denied entry by the hospital. I am available for further clarification and comments, if you wish.

Last name: Miller Location: Ashburn

Denying people access to their religious leaders during the last moments of their lives is cruel and inhumane treatment. Religious leaders are perfectly capable of taking the same precautions as patient-caring medical personnel and medical facilities, and the state health department must not interfere with the free exercise of religion. For people of faith, being able to visit their rabbi, shaman, priest or pastor is just as important, if not more so, than the care they receive from medical personnel. At the time a doctor or nurse is allowed to enter the room with the patient, there is no justification for interfering with the religious practices of the sick and dying by prohibiting religious leaders from entering the room and the legal code of VA needs to make this clear so there is no question if another health pandemic or other health emergency were to hit VA. Take this bill to a vote in committee and then to the full House of Representatives to make it law and clarify how, in these situations, the rights of people in VA will be protected and respected.

Last name: Grover Location: Loudoun County

This bill must be put to a vote in the House and the Senate. It was absolutely outrageous how people's most basic religious rights were completely destroyed during the covid madness imposed on Virginia. This can NEVER happen again. And legislators must register this issue, which means a roll call vote. Make it happen.

Last name: closing Location: richmond

Support HB1512. Currently, there are approximately 20 states in the US that allow Medicaid billing for complex rehabilitation technology (custom power and manual chairs) in skilled nursing facilities; including Texas and Mississippi. These states are already realizing the economic benefits of injury and fall prevention that custom wheelchairs offer, in addition to the reduced burden on facility personnel. When a non-customized manual wheelchair is provided, the chair is not optimally configured for safe independent propulsion, requiring the user to be staffed to move the user around the facility, manage pressure to prevent injury, and contribute to the installation crashes. The average cost to treat a pressure ulcer is $70,000 and this occurs in nursing facilities at a rate of 24% (National Pressure Ulcer Advisory Panel). Proposition 1512 supports value-based care through preventative measures to reduce preventable comorbidities while improving the quality of life for nursing home residents.

Last name: Hofford Organization: Virginia Academy of Family Physicians Location: Roanoke

RE: HB 2274 (2023) Dear Mr. Chairman and Committee Members: I am against HB 2274. I have been teaching outpatient laboratory medicine to medical students, nursing students, nurse practitioners, and physicians in training since 1995.1. Pharmacists are less well trained in this area of ​​medicine. They don't have time to restock drugs, restocking drugs and providing vaccinations is well documented by many news articles and personal observations.2. Diagnosis of strep throat requires a good history and physical examination, as well as tests, if indicated, according to evidence-based medicine criteria. If a patient has a sore throat, there are many causes besides strep, such as infectious mononucleosis (an enlarged spleen in a student athlete can be disastrous) or peritonsillar abscess (which can be fatal if not diagnosed and treated with antibiotics). and surgery). Pharmacists do not have adequate training in this area. 3. Pharmacists do not have access to a patient's recent laboratory tests regarding her kidney function. Many medications require this information before prescribing the correct dosage and dosage.4. It would make more sense if the burden of dispensing drugs in a doctor's office was significantly reduced. have a lot of worries. 1. Will you collect a fresh, clean sample on site or will patients bring in an old sample? The older the sample is and it is not refrigerated, the more likely the sample is to be a false positive. 2.If you are a male patient, will the pharmacists do the necessary prostate exam? 3.If a patient has a bad reaction to the treatment, can you access the pharmacist after hours? Can drinking too much fluid result in a false negative test? 5. Urethritis has symptoms similar to those of a bladder infection. Many of these patients have sexually transmitted diseases, such as chlamydia, that do not respond to the more common UTI antibiotics. 6. I often see dehydrated patients with urinary burning and bladder spasms/frequency who are not infected but are being treated for UTI at urgent care sites. 7. In this state, we have a big problem with increasing resistance to antibiotics. I am concerned that antibiotics are being over-prescribed. Do pharmacists know the latest antibiogram in your area? Bactrim does not work well for many common E. coli infections in our area. Cipro is no longer useful now. 8. Will pharmacists recognize any other abnormalities on a urine test strip? Will they miss bladder cancer, kidney cancer, or glomerulonephritis? 9. If there is blood on the test strip, will you centrifuge the urine and look at it under a microscope to confirm if it is blood, hemolysis, or myoglobin? Thank you for your support in opposing this bill. Sincerely, Roger A. Hofford, M.D. FAAFP, CPERoanoke, VAPast President, Virginia Academy of Family Physicians Associate Professor, Family Medicine, Virginia Tech Carilion School of Medicine Clinical Professor, Family Medicine, Virginia College of Osteopathy Medicine Clinical Professor, Family Medicine and Population Health, Virginia Commonwealth University

Last name: Hofford Location: Roanoke

HB 1764 I object to HB 1764 as a filed original for the following reasons: 1. Proposed Section E requests that practice agreements be deleted. I disagree. A practice agreement is a job description between an attending physician and supervising physicians. I don't know many employed people who don't have a job description. It is good that these agreements are reviewed and updated every two years to ensure that everyone is on the same page regarding responsibilities. ” are removed from deleted medical contracts. Otherwise, the hospitals will have a great influence on the doctor. 3. Maintain the medical supervision ratio at no more than six physicians and nurse assistants for all physicians in the hospital. In graduate medical education, the Graduate Medical Education Accreditation Board does not allow a faculty member to supervise more than 4 residents/interns at a time to ensure patient safety. In the hospital setting, many of the (hospital) supervising physicians are recent graduate residents who are uncomfortable supervising more than four people at a time. Supervising six is ​​increasing your comfort level regarding patient safety. Supervising more than six people is stressful and generates moral anguish, since the safety of the patient is put at risk,

Last name: Madeira Location: Ashburn

HB 2276 immunization; vaccinate children against COVID-19 Informed consent is the basis of medical ethics. Parents must make decisions about the health and well-being of their children. COVID-19 vaccines do not prevent viral transmission, so requiring these vaccines as a requirement for school attendance is not justified. This bill specifies that parents will not be required to immunize their children against COVID-19 in the same way that current Virginia law allows them to determine whether to administer the Haemophilus Influenzae type b vaccine. be considered, legislators and their experts confirmed the legislator's support for keeping parents in charge of their children's immunization schedule. In 2021, the Virginia Department of Health proposed a regulation requiring the COVID-19 vaccine as a requirement for school attendance. More than 15,000 Virginians commented on the regulation, with overwhelming opposition (93%) to ordering the shot. Medical professionals around the world agree that there is no scientific justification for continuing COVID-19 mandates through 2023 and beyond. HB 2280 Parental Consent for Surgical and Medical Treatment of Certain Minors This bill requires parents and guardians to consent to medical interventions on their children, including medical decisions for their children. Several cities have tried to pass ordinances and laws that allow children as young as 11 years of age to consent to immunizations without their parents' knowledge! Please don't let this happen to Virginia. Support this bill to send a clear message that in Virginia, parents are in control and decide what medical interventions their children receive.

Last name: Madeira Location: Ashburn

HB 2276 immunization; vaccinate children against COVID-19 Informed consent is the basis of medical ethics. Parents must make decisions about the health and well-being of their children. COVID-19 vaccines do not prevent viral transmission, so requiring these vaccines as a requirement for school attendance is not justified. This bill specifies that parents will not be required to immunize their children against COVID-19 in the same way that current Virginia law allows them to determine whether to administer the Haemophilus Influenzae type b vaccine. be considered, legislators and their experts confirmed the legislator's support for keeping parents in charge of their children's immunization schedule. In 2021, the Virginia Department of Health proposed a regulation requiring the COVID-19 vaccine as a requirement for school attendance. More than 15,000 Virginians commented on the regulation, with overwhelming opposition (93%) to ordering the shot. Medical professionals around the world agree that there is no scientific justification for continuing COVID-19 mandates through 2023 and beyond. HB 2280 Parental Consent for Surgical and Medical Treatment of Certain Minors This bill requires parents and guardians to consent to medical interventions on their children, including medical decisions for their children. Several cities have tried to pass ordinances and laws that allow children as young as 11 years of age to consent to immunizations without their parents' knowledge! Please don't let this happen to Virginia. Support this bill to send a clear message that in Virginia, parents are in control and decide what medical interventions their children receive.

Last name: hacks Organization: Virginia Assisted Living Association (VALA) Location: Virginia

VALA opposes HB1906 expanding the AG program in its current form and funding levels to include another configuration. Virginia's Auxiliary Grant (AG) program is not adequately funded or supported for current eligible configurations of assisted living and supportive living facilities. The AG program must be patched to the current configuration before expanding it. Additionally, independent community living settings are not regulated and there is confusion as to which settings it specifically refers to. According to the 2018 report to the VA General Assembly on the Regulation of Independent Living Communities, "Within the senior housing market, there is ambiguity surrounding the term 'independent living.'" The consultants found that the term is used inconsistently to define everything from apartments for people 55 and older to assisted living facilities. This can lead to confusion among consumers looking for a community that meets their individual needs.” The tax impact on the bill may not provide a specific VDSS impact number, but it would be substantial. deadlines for assisted living facilities, leave some ALFs in operation after the expiration of their licenses pending inspections Adding another setting for them to regulate as required by HB1906 per language at 51.5-160.1 would further delay the inspection process critical inspections and could compromise health, safety and ongoing operations ALFs operating beyond the license date pending inspectors could be detrimental to their ongoing operations due to management oversight, insurance and financing requirements. VDSS is already short-staffed and HB 1906 would further affect the availability of staff for licensure operations. gum. nto. Thank you for considering these concerns. Once again, VALA opposes HB1906 expanding the AG program in its current form and funding levels to include another scenario.

Last name: Madeira Location: Ashburn

HB 2276 immunization; vaccinate children against COVID-19 Informed consent is the basis of medical ethics. Parents must make decisions about the health and well-being of their children. COVID-19 vaccines do not prevent viral transmission, so requiring these vaccines as a requirement for school attendance is not justified. This bill specifies that parents will not be required to immunize their children against COVID-19 in the same way that current Virginia law allows them to determine whether to administer the Haemophilus Influenzae type b vaccine. be considered, legislators and their experts confirmed the legislator's support for keeping parents in charge of their children's immunization schedule. In 2021, the Virginia Department of Health proposed a regulation requiring the COVID-19 vaccine as a requirement for school attendance. More than 15,000 Virginians commented on the regulation, with overwhelming opposition (93%) to ordering the shot. Medical professionals around the world agree that there is no scientific justification for continuing COVID-19 mandates through 2023 and beyond. HB 2280 Parental Consent for Surgical and Medical Treatment of Certain Minors This bill requires parents and guardians to consent to medical interventions on their children, including medical decisions for their children. Several cities have tried to pass ordinances and laws that allow children as young as 11 years of age to consent to immunizations without their parents' knowledge! Please don't let this happen to Virginia. Support this bill to send a clear message that in Virginia, parents are in control and decide what medical interventions their children receive.

Last name: Madeira Location: Ashburn

HB 2276 immunization; vaccinate children against COVID-19 Informed consent is the basis of medical ethics. Parents must make decisions about the health and well-being of their children. COVID-19 vaccines do not prevent viral transmission, so requiring these vaccines as a requirement for school attendance is not justified. This bill specifies that parents will not be required to immunize their children against COVID-19 in the same way that current Virginia law allows them to determine whether to administer the Haemophilus Influenzae type b vaccine. be considered, legislators and their experts confirmed the legislator's support for keeping parents in charge of their children's immunization schedule. In 2021, the Virginia Department of Health proposed a regulation requiring the COVID-19 vaccine as a requirement for school attendance. More than 15,000 Virginians commented on the regulation, with overwhelming opposition (93%) to ordering the shot. Medical professionals around the world agree that there is no scientific justification for continuing COVID-19 mandates through 2023 and beyond. HB 2280 Parental Consent for Surgical and Medical Treatment of Certain Minors This bill requires parents and guardians to consent to medical interventions on their children, including medical decisions for their children. Several cities have tried to pass ordinances and laws that allow children as young as 11 years of age to consent to immunizations without their parents' knowledge! Please don't let this happen to Virginia. Support this bill to send a clear message that in Virginia, parents are in control and decide what medical interventions their children receive.

Last name: neil Organization: City of Portsmouth, VA Location: hampton

The City of Portsmouth supports this bill. It would provide consistent regulations throughout the community. However, we understand that the Sanitary Surveillance already supervises the swimming pools for their regularization.

Last name: tap Location: norfolk

Working in the pool industry, both retail and distribution, and also having used public pools, I think the HB1917 should be a definite yes.

Last name: Durkee Location: Playa Virginia

As a long-time industry professional, I am writing in support of this bill. My company, AAA Pool Services, manages and operates nearly 50 seasonal pools at all Tidewater area locations. We have to deal with various sets of codes and standards, and then the groups in Suffolk have no codes or standards other than the VHD code that doesn't apply to these groups. I encourage you to vote YES on HB1917 to begin standardizing public pool requirements to facilitate business and swimmer safety. James DurkeeVice PresidentAAA Pool Services

Last name: lynn Location: City of Alexandria, VA

I live in Alexandria and am concerned about the health and safety of our public pools. I've heard that showering before getting into a pool means germs are less likely to be in the water. My friends and family do not want to get sick when we are in the pool! And it's important to keep the pool environment and equipment up to date. An inspection of a facility would ensure that we are protected from damage due to lack of maintenance or problems with handrails, electrical elements, fences, trampolines or signage, for example. Help us enjoy our pools.

Last name: vaughan Organization: Roanoke National Pools Location: Roanoke

A letter in support of HB1917 is attached. As a VA pool builder, contractor and retailer for 45 years, we believe it is important that all commercial properties meet minimum requirements for water quality and proper pool function.

Last name: coleman Organization: Fluid Design Concepts, LLC Location: Waynesboro

As a Virginia citizen of over 20 years, husband, father of 4, grandfather of 11 to now, and pool professional for the past 50 years, I want to express my full support for VA HB 1917. My career in aquatics began in neighboring Maryland at my local community pool. There I learned to swim with certified water safety instructors, supervised during the summer months after passing the pool test by licensed rangers. It was my refuge, my safe place to go. I later learned how it was regulated by the Department of Health. In '73 I became part of this team and at the end of the summer I was a lifeguard. Over the next four years I became a water safety instructor, swim coach, licensed pool operator, scuba diver and eventually earned 2 degrees in recreation. My career spans public pool management, service, renovation, construction, and now design. At one point, I held a management position for the largest commercial pool builder in the mid-Atlantic, traveling across 6 states and DC. It was there that I discovered the vast disparity in state and local regulations regarding the health AND safety of pools, spas, water parks, and Splashground. Part of my job description was to determine what regulations and codes needed to be followed to serve our customers. Unfortunately, the VA had and still has the lowest health and safety standards in this region and perhaps the country. What the Ministry of Health has, with reference to current regulations, is extremely outdated, around 1962, and has very little application. Fortunately, the VA Department of Building, since 2014, now uses the ICC code, which has replaced a nearly non-existent design and construction code for swimming pools. This was likely the result of deaths and near drownings due to poor design, construction, renovation, and service practices that led to federal standards like the VGB ACT of 2008. While working or vacationing in Virginia at the time, I would have been horrified at the unsanitary and unsafe conditions you would find in commercial aquatic venues in these jurisdictions without oversight from the Department of Health. Certainly a RED FLAG was raised every time my kids wanted to swim in a man made boat. Today, I assist design professionals with the mechanical, construction, and health and utility needs of new and existing water facilities in VA. I am frequently asked about compliance with Department of Health regulations and find that developers, general contractors, designers, and consultants are shocked and in disbelief that most of the VA does not have Department of Health regulations like other states and jurisdictions. The regulations of the Ministry of Health are restricted to "Tourist Establishments". Unfortunately, for VA citizens, including my grandchildren, the VA until this time felt it was more important to protect "tourists" than Commonwealth citizens. Like vehicle safety, water safety must be regulated for the good of the public. Otherwise, profits would bypass the need for seat belts and airbags, or proper filtration and sanitation. Can you imagine what could be served and what the cleaning conditions would be, if restaurants were not regularly regulated and inspected by a qualified and properly regulated Health Department? Public health and safety would be compromised. The same is currently the case in most of Virginia with its swimming pools.

Last name: Central VA PHTA Organization: Pool and Hot Tub Alliance (PHTA) Location: NORFOLK

Re: Consideration of House Bill 1917 – Public Swimming Pools; Board of Health to Adopt Regulations. We are writing to let you know that we, as the Central Virginia PHTA, support the bill directing the Virginia Department of Health to promulgate regulations governing pools and spas for public use. Our chapter covers most of the state of Virginia, from Virginia Beach to Jonesville in the west and as far north as Charlottesville. Our members have spent years upholding standards for pool and spa safety, operations and maintenance. We strongly believe that HB 1917 will greatly improve the safety and well-being of public swimming pools in Virginia and protect the Virginians who use them. Currently, the Virginia Department of Health only has enforcement authority for swimming pools and spas at campgrounds, summer camps, and hotels. Additionally, only 20 local jurisdictions in Virginia have a code that regulates the operations, maintenance, and safety of public swimming pools. Our members have an amazing relationship with the Virginia Department of Health, working with them on pool and spa regulations that may apply. As a chapter, we support PHTA National Offices by providing recommendations related to regulations to adopt. We want to make sure Virginians have safe public pools and spas to enjoy. On behalf of our many members, we respectfully request that you consider removing this important legislation from your committee. Sincerely, Vicki HudsonChapter PresidentCentralva.apsp@gmail.com

Last name: davidson Organization: Pool and Jacuzzi Alliance Location: Alexandria

Dear Chairman Walker: This bill, directing the Virginia Department of Health to promulgate regulations governing pools and spas for public use, is supported by the Pool & Hot Tub Alliance (PHTA). PHTA's headquarters are located in Virginia and many of its employees are from Virginia. Currently, the Virginia Department of Health only has the authority to govern and promulgate regulations for pools and spas at campgrounds, summer camps, and hotels. Additionally, only 20 local jurisdictions in Virginia have a code that regulates the operations, maintenance, and safety of public swimming pools. HB 1917 will begin the process to dramatically increase the safety and well-being of public swimming pools in Virginia and further protect Virginians. The PHTA, its Virginia members, and other industry stakeholders have an excellent relationship with the Virginia Department of Health and provide recommendations regarding regulations that should be adopted. Additionally, this relationship has created an environment for industry leaders and the Virginia Department of Health to discuss current and recommended practices and opportunities for future collaboration. On behalf of the many Virginia pool and spa professionals represented by the PHTA, as well as neighboring states that do business in Virginia, we respectfully request that you consider removing this important legislation from your committee. Sincerely, Jason DavidsonPHTA, Director of Government Relationsjdavidson@phta.org About Us The Pool & Hot Tub Alliance was formed in 2019 by a combination of the Association of Pool & Spa Professionals (APSP) and the National Swimming Pool Foundation (NSPF). With the mission of "Celebrating Water," the PHTA facilitates the expansion of swimming, water safety, and related research and outreach activities with the goal of introducing more people to swimming, making swimming environments more safer and keep pools open to serve communities. APSP, now PHTA, is the world's oldest and largest association representing manufacturers, distributors, manufacturers' agents, designers, builders, installers, suppliers, retailers and service professionals of swimming pools, hot tubs and spas. Dedicated to growing and developing its members' businesses and promoting the enjoyment and safety of pools and spas, the PHTA provides a range of services ranging from professional development to advancing important federal laws and regulations. and local, to the reach of consumers and public safety. PHTA is the only industry organization recognized by the American National Standards Institute for developing and promoting national standards for swimming pools, hot tubs, and spas. For more information, visit PHTA.org.

Last name: Phipps-Hawkins Organization: Birth in RGB Colors Location: richmond

Good morning Chairman and members of the Committee. My name is Sequoi Phipps-Hawkins and I am the Director of Marketing and Communications for Birth in Color RVA. I am also a Certified Community Doula by the State of Virginia. As a doula, I have seen firsthand the immense need for proper support during pregnancy and childbirth in our communities. Our organization, and specifically our director Kenda Sutton-EL, has met and interacted with people in the postpartum period and beyond who have already been incarcerated during pregnancy. They shared their stories with us and the burden they unknowingly took on by taking sick leave to deliver their babies, because they were not informed of their right to access emergency Medicaid coverage while on sick leave. disease. This neglect leaves new mothers and fathers with medical bills to face immediately once they are no longer incarcerated. This means that a parent re-entering the community may be simultaneously finding a job, getting used to raising a newborn, and figuring out how to pay medical bills they didn't know they had incurred. On behalf of the nearly 100 midwives that make up the Birth in Color Doula collective and our organization as a whole, we ask that you support HB 1919 incarcerated pregnant individuals on sick leave by preventing gaps in Medicaid coverage so that it is necessary and guaranteed that pregnant women on sick leave are informed of their right to Medicaid coverage.

Last name: Ingvarsson Organization: Virginia Autism Institute Location: Charlottesville

This is a comment on HB1946. My name is Einar Ingvarsson and I work as the Director of Training and Research at the Virginia Institute for Autism (VIA). We employ approximately 40 licensed behavior analysts and typically hire new ones at least quarterly. We serve the entire community, including Charlottesville, Roanoke, Lexington, Lynchburg, and surrounding areas. As things stand now, we would not consider hiring licensed behavior analysts unless they also have a BACB certification. BACB is currently the only certifying agency for behavior analysts that meets the quality criteria we look for, such as the quantity and quality of supervised experience, being a non-profit organization, having the course sequence verified by an independent agency ( Association for Behavior Analysis International), and including competencies in general behavior (i.e., not specific to a particular diagnostic category). that meets these and other minimum requirements.

Last name: lobo Organization: Autism Foundation of Virginia Location: Playa Virginia

Virginia families have benefited greatly from the autism insurance legislation we have carefully crafted over the past 15 years in Virginia. Quality of care and quality of services are essential for our loved ones with autism. This bill to close the gap between statute and regulation is critical to ensuring that we provide professional services that meet our Virginia standards. I ask for your help to pass this bill as written, it's good for Virginia and it's good for our families who have loved ones diagnosed with autism. Thank you, Mark LlobellVirginia Autism FoundationFounder

Last name: Champion Organization: Virginia Autism Project Location: Springfield

The Virginia Autism Project and the Virginia Autism Advocacy Alliance support HB1946, which will provide necessary guidance for the profession. Please vote YES on HB1946.

Last name: Hofford Organization: Virginia Academy of Family Physicians Location: Roanoke

Please support HB 1952. There are several delays, as noted below, because patients are having difficulty receiving their medications. I would suggest a study by the Joint Commission on Health Care after the session to address and suggest future legislation. request for non-prescription drug for five years and the patient has not been seen for five years. 3. Patients receive monthly phone calls letting them know that their prescription is ready after stopping the medication months before. This confuses the patient and increases the risk of overmedication/drug interaction. 4. Offices receive repeated requests to refill a medication after the pharmacy has been notified that the patient and/or physician are not in that office. New drug 90-day refill at the request of the patient when the patient has not requested it. 6. Pharmacies are requesting a medication refill for a patient who has left the office or is now in another office. The pharmacy has been notified multiple times, but continues to send refill requests to the old office, and the pharmacy continues to not update its database.office.8 .Failure of pharmacy chains to make changes to their electronic databases after that problems are raised repeatedly at the corporate level. 9. I have heard of several doctors turning off their fax machines because they were inundated with requests for medication refills, pharmacy to call the office. 10. Pharmacies do not keep their formulary databases up-to-date, causing a physician or staff to waste valuable time requesting unnecessary prior authorization. This delays patients receiving their medications in a timely manner.

Last name: Monti Wohlpart Organization: American Adoption Congress Location: brooklyn

Distinguished Delegates to the Committee on Welfare and Health Institutions, Greetings and I have attached AAC's detailed and continued support memorandum for HB1969 which will restore unrestricted access to original birth certificates for all adult adoptees from Virginia. We are delighted to be working together with our attorney partners at the Capitol Coalition for Adoptee Rights (CCAR) to advance this vital human and civil rights imperative. Hope this helps, thank you so much for all your efforts to promote adoptee equality in the Old Dominion State. Sincerely, Tim. Tim Monti-Wohlparttmw713@gmail.com917-403-8105American Adoption Congress, National Legislative Chairman

Last name: Miguel Organization: Adopted United Inc Location: Ashburn

I support Virginia HB1969 and ask each of you to do the same. Adoptees in Virginia should not be discriminated against or treated as a separate class of citizens. They deserve the same unrestricted rights to their birth certificate as anyone else born in the Commonwealth of Virginia. Under current law, adult adoptees are the only citizens of the Commonwealth of Virginia who do not have a legal right to a personal record of vital statistics documenting their birth. At this time, the release of an original birth certificate of an adopted adult requires a decision by a state agency to release identifying information for cause; or a court order upon showing just cause. The onus falls on the adoptee to prove that she deserves access to her own birth certificate. The current law is ridiculously difficult, complicated, and can be expensive for the adoptee. Instead of paying the typical $20 fee, adoptees must hire lawyers, go to court, etc., unsure if the time and expense they have invested will allow them to obtain their own birth certificate. Stop allowing Virginia-born adoptees to be discriminated against.

Last name: baudian Organization: Virginia Society of Children's Homes Location: richmond

CHSVA supports this bill. Adoptees should have the same rights and access to the same documents as their peers. These adoptees currently need to obtain a court order to access their own birth certificate. They should not have to go through the expense and intricacies of the court system to obtain documentation of their own identity. We ask that you support this bill.

Last name: Monti Wohlpart Organization: American Adoption Congress Location: Brooklyn, Nueva York

Honorable Delegates to the Welfare and Health Institutions Subcommittee, Greetings and I have attached a detailed new memorandum of AAC support for HB1969 that will restore unrestricted access to original birth certificates for all adult adoptees from Virginia. We are delighted to be working together with our attorney partners at the Capitol Coalition for Adoptee Rights (CCAR) to advance this vital human and civil rights imperative. Hope this helps, thank you so much for all your efforts to promote adoptee equality in the Old Dominion State. Sincerely, Tim. Tim Monti-Wohlparttmw713@gmail.com917-403-8105American Adoption Congress, National Legislative Chairman

Last name: Ann Weaver-Melendy Organization: N / D Location: Marion, Salem

I am 100% behind this clean bill that allows adoptees to be able to get into their OBC. These outdated laws must be improved to meet the current needs of ALL citizens, including adoptees. DNA now leads the way and birth parents can be easily found. Technology has advanced and what a great way for Virginia to have advanced as well. When a state values ​​all its citizens with equal opportunity in the face of oppression, the masses will be happier and prosper. Good luck adopting in Virginia from a fellow adoptee in Oregon. Much supported and in favor of this 1969 bill. Ann E Weaver-Melendy

Last name: Sigh Location: richmond

Dear Distinguished Delegates: I fully support Virginia HB1969 and advocate unrestricted access to original birth certificates for all Virginia-born adoptees. Adult adoptees deserve the same rights to their birth certificates as anyone else born in our community. Unlike other Virgos, adoptees can't look up family medical history or disease patterns. Abolish outdated and paternalistic policies that prevent an adoptee from learning essential facts about her own identity. Make the Commonwealth of Virginia more transparent and equitable by supporting adoptee access to birth records.

Last name: Caballero Location: Rockville, Maryland

I was born and adopted in Northern Virginia in 1961. I am writing for Virginia HB1969. I am reunited with my elderly biological mother and have also established family ties with my paternal side. This bill would help put the era of Baby Scoop adoption behind us and create a brighter future for the many adult adoptees who needlessly ignore the basic facts about starting our own lives. What is more basic or fundamental than knowing the identity of your biological parents? In any case, they were never promised anonymity. The search process may be easier without involving DNA-matched cousins, the typical vetting process adult adoptees now go through without access to the OBC.

Last name: Miguel Location: Ashburn

Dear Distinguished Delegates, I fully support Virginia HB1969 and I implore each of you to do the same. Under current law, adoptive adults are the only citizens of the Commonwealth of Virginia who do not have a legal right to a personal record of vital statistics documenting their birth. At this time, the release of an original birth certificate of an adopted adult requires a decision by a state agency to release identifying information for cause; or a court order upon showing just cause. The onus falls on the adoptee to prove that she deserves access to her own birth certificate. Restore unrestricted access to original birth certificates to all adoptees born in Virginia. They deserve the same rights to their birth certificates as anyone else born in the Commonwealth of Virginia. Adoptees should not be discriminated against or treated as a separate class of citizens.

Last name: moura Location: Henrique

My name is Tonya Moore, who found out that I was adopted when I was 31 years old. This was devastating for me. So when I went to get my birth certificates, finding out that wasn't possible was even worse for me. I was only able to get my non-identifiable information. I started to regret the records I couldn't get. I believe that everyone should have access to their birth certificates. Access will help. to put the pieces together, especially when it comes to medical issues. I am now 51 years old and have no idea of ​​my family's medical history. When you talk to doctors to just say "I'm adopted," it's hard to feel different from others and fight for your identity every day.

Last name: Weiss Location: Maryville, Tennessee

My name is Jamie Weiss, but I wasn't always like that. In February 1979 I was born. Where, for whom and when? Well, that's a big question that I haven't been able to answer in 30 years. After I was adopted at 6 months old, my original birth certificate, which recorded the facts of my birth, was taken from me and replaced with a forged birth certificate, with a different name, different mother, different father, a different city of birth, and even a completely different state! As an adult, I thought I would be allowed to get my birth certificates. Unfortunately, I found out that I couldn't, as my own birth certificate is required by law to be sealed and hidden from me. This was only done due to the fact that I was adopted. It was not done at the request of me or my biological mother. None of us would have chosen to seal my birth certificate. Actually, it was my biological mother who was able to provide me with the information about myself that I did not know once I was able to connect with her. Then, at age 30, I found out that Jamie from Georgia is actually Hope from Virginia. If a birth certificate is such a "vital" record, why was I denied access to mine? I am not a child. I'm not dangerous. I'm not a criminal. I am a wife, mother, caregiver, neighbor, businesswoman, daughter, sister. No one gets hurt by knowing the truth about myself! Non-adopted individuals can obtain their birth certificate online or in person by completing an application form and paying the $12 fee. It's that simple. Instead, adoptees who want theirs are forced through an arduous and arbitrary process to petition the court and spend thousands of dollars to gamble on the chance to gain access from a judge. Just because they were adopted and for no other reason, Virginia HB1969 will grant adult adoptees the unrestricted right to obtain their own original birth certificate and is essential to ensuring dignity and equality for all. This is a basic right that all other groups of people have except adoptees. It is time for that to change. I ask all members of the subcommittee to support HB1969 and provide a favorable report.

Last name: Aggressor Location: Anne Arundel County

Dear Subcommittee Members: Attached is my letter in support of a favorable report for HB1969. Thanks for your consideration.

Last name: O'Connell Organization: NYARC - New York Adoptee Rights Coalition Location: Orange County, New York

Virginia Representative Wendell S. WalkerChairman, Subcommittee on Health, Welfare, and Institutions Pocahontas Building, Room E304900 East Main Street Richmond, VA 23219 January 18, 2023 Dear Chairman Walker and subcommittee members: I am writing on behalf of New York Adoptee Rights Coalition (NYARC) on Virginia HB1969. New York State recently enacted bipartisan legislation that guaranteed, as HB1969 would guarantee, the right of adult adoptees to obtain certified copies of their own original birth certificates (OBCs). The NYARC was instrumental in guaranteeing that right. Adult adoptees are the only group of people denied access to the original state record of their birth. We were denied this document not because we were abandoned or because our parents' rights were taken away for just cause; but because we were adopted. OBCs are only changed and sealed after adoption. This fact is true no matter what year we were adopted. This applies to child, stepparent, international, and foster home adoptions. If a person had not been adopted, but instead had come out of the adoption system, their name and birth certificate would never have been changed. It is important to note that all children in foster care, such as those adopted, have also been abandoned or their parents have disenfranchised for cause. Getting someone's OBC is a matter of dignity and equality. It is not about looking for the biological family. Adult adoptees do not need a birth record to locate the family. They just need to spit into a jar or rub their cheek. I have personally helped over 200 people locate their birth families through consumer DNA testing and public records. The people I have helped range from 21 to 83 years old. In the technological world of social media and consumer DNA testing, I assure you that the idea of ​​anonymity for anyone is impossible. There are approximately six million adoptees in the United States. We are your neighbors, friends and family. We represent first responders, teachers, military personnel, union workers, corporate professionals, and even legislators. We represent all religions, political parties, sexual orientations and genders. Imagine if current Virginia law stated that military/first responders/teachers/LBGTQ/etc. you must obtain a court order or approval from a state agency to access your original birth certificate. Virgos would never accept such discrimination. We ask that you do not accept either. We expect Virginia, like New York, to allow ALL adults born in the state to request and receive a copy of their original birth certificate without restrictions or court orders. We hope you will join New York and the other 12 states (Alaska, Alabama, Colorado, Connecticut, Kansas, Maine, Massachusetts, New Hampshire, Louisiana, Oregon, and Rhode Island) in allowing full equality in adoption. Vermont will soon become the thirteenth state. You have the potential to hit and match up in Virginia. We hope you will make history happen in your great state, just as we did in New York, make Virginia the 14th state to restore an adopted adult's right to their own birth registration. We request a favorable report from the subcommittee for HB1969. , Annette O'Connell Spokesperson - New York Adoptee Rights Coalition845-821-4303coalition@nyadopteerights.org

Last name: Greiner Organization: Bastard Nation: The Adoptee Rights Organization Location: New Windsor, New York (organization) Corpus Christi, TX (staff)

TO: Delegates, Virginia House Subcommittee on Health, Welfare and Institutions FROM: Marley E Greiner, CEO, Bastard Nation: Adoptee Rights Organization RE: Support HB 1969, Original Birth Certificates of Adoptees DATE: January 18, 2023 Honorable Stewards of Health Welfare and Institutions Subcommittee: Attached are our written comments in support of HB 1969, a bill to restore the right of all Virginia-born adoptees to their original birth certificates without restrictions or conditions. I am happy to discuss any questions or concerns you have about this bill. (614-795-6819 (mobile) or 361-452-1391 (not listed but better due to spam)

Last name: Luce Organization: Legal Center for the Rights of Adoptees Location: Minneapolis Minnesota

Consider the attached letter and supporting materials for a favorable report on HB1969, a bill whose lead sponsor is Del. Walker.Gregory Luce Adoption Rights Law Center

Last name: ricardo Organization: C2Adote Location: Goochlandia

HB1969 Adult Adoptee Access to Your Own Original Birth CertificateI am Rebecca Ricardo, an adoptee, a birth mother who placed a child for adoption, and a licensed clinical social worker who currently serves as the CEO of C2Adopt, an adoption agency based in Richmond. this bill and I can speak on behalf of C2Adopt that the agency also supports this bill. A person who was adopted as a minor should have equal access to the government's documentation of their birth, just as all other adult Commonwealth citizens have access after reaching the age of majority. We must not have the condition of a tenant citizen in relation to the document as important as the verification of our birth data. This is an equality issue that needs to be updated and changed. Thirteen other states have already taken this step to provide adult adoptees with access to this document. Make Virginia the next state to enact this critical change to our Code of Virginia. Thank you. Rebecca L. Ricardo, LCSW Executive Director – C2Adoptrricardo@c2adopt.org or rebeccaricardo65@gmail.com 804-360-0920 Virginia resident of Goochland County

Last name: Hamelman Location: Sofa

Delegates, I was born in Virginia and adopted as a child in 1979. Since we were in the era of closed adoptions, my Original Birth Certificate (OBC) was sealed. Many people who have not been adopted do not realize that people in my situation do not have a legal right to see their OBC. The most we are allowed is one copy of non-identifying information with all names redacted. My position is that adoptive adults have a right to know the names of their biological parents. There are many genetic diseases that doctors cannot detect without knowing a medical history. Adoptees who do not have access to the names of their blood relatives find themselves trapped in a situation where they may be denied essential medical care; this is unnecessary. I have personally known many adoptees in their 80s and 90s whose only hope in life is to find a blood relative before they die. Due to the secrecy built into state laws like Virginia's, their search efforts are often unsuccessful. Please support HB1969. Thank Jose Hamelman

Last name: Monti Wohlpart Organization: American Adoption Congress Location: brooklyn

Greetings to you, and attached you will find a memorandum of support from AAC for HB1969, which will restore unrestricted access to original birth certificates for all adult adoptees from Virginia. We are delighted to be working together with our attorney partners at the Capitol Coalition for Adoptee Rights (CCAR) to advance this vital human and civil rights imperative. Hope this helps, thank you so much for all your efforts to promote adoptee equality in the Old Dominion State. Sincerely, Tim. Tim Monti-Wohlparttmw713@gmail.com917-403-8105 American Adoption Congress, National Legislative Chairman

Last name: We can Organization: Capital of the National Lyme Disease Association Location: McLean

HB: 2008 I speak as General Counsel for the National Lyme Disease Association of the non-profit National Capital based in Northern VA. For more than 20 years, we have championed public awareness of tick-borne diseases. This is no longer a Northeastern United States problem. Tick-borne diseases have spread throughout the US, but the Mid-Atlantic states, and particularly Virginia, have seen the greatest growth in these dreaded diseases. It is imperative that Virgos are educated on how to prevent the spread of these diseases and how to treat them in the event they or a family member does contract the disease. diagnose and effectively treat victims of these diseases. There is a lot of misinformation in the medical community about them and we need this legislation and the task force it will authorize to help bring prominence and resources to the Virginia medical community and the general public. It's time for a working group. In 2002, our Executive Director was honored to participate in Governor Bob McDonald's first Lyme disease task force in the Commonwealth to study this problem. A lot has happened since then, and it's about time we returned to a serious and definitive effort to make a difference in Virginia's home life. I will speak on this matter.

Last name: adams Organization: American Speech-Language-Hearing Association Location: Rockville, MD

On behalf of the American Speech-Language-Hearing Association, I am writing to support HB 2033, which adopts the Interstate Compact on Audiology and Speech-Language Pathology (ASLP-IC). The American Speech-Language-Hearing Association (ASHA) is the national professional, scientific, and accrediting association for the 223,000 members and affiliates who are speech-language pathologists; speech therapists; speech-language-hearing scientists; audiology and speech therapy support staff; and students More than 4,800 ASHA members reside in Virginia. ASHA members often have difficulty obtaining multiple state licenses to practice due to administrative burdens. These charges hinder their ability to provide quality services and restrict access for consumers in rural and underserved communities. I am pleased to support HB 2033, which will address these issues by: •Increasing access to care for clients, patients, and/or students; and • Facilitate continuity of care when clients, patients, and/or students move or travel to another state, specifically with military personnel and their spouses. Another compact Virginia has joined, including Nursing, Physical Therapy, EMS, psychology and occupational therapy. The Pact Commission will have the ability to charge and collect an annual assessment from each member state to cover the cost of operations. The amount will be formulated by the Commission and will be binding on all member states. At this time, it is not known how much, if any, will be charged to each state's budget. If Virginia passes this legislation, they will be among the group of delegates making that determination. Currently, the Nursing Pact and the Psychology Pact are the only pacts that charge an annual fee. The Nursing Compact charges $6,000 and the Psychology Compact rates states on a sliding scale. The ASLP-IC Commission sees these numbers as guardrails for what this Commission can implement. Virginia is also a member of several national conventions that charge an annual fee from the state. ASLP-IC member states have indicated they will seek input from the Health Resources and Services Administration, the Department of Defense, and other relevant funders to help avoid a state review. In addition, the American Speech-Language-Hearing Association, the Academy of Doctors of Audiology, and the American Academy of Audiology have pledged financial support. The Compact also allows states to charge a fee for the privilege to practice and its renewal to offset any costs. These numbers do not include the tax benefit that the Commonwealth can obtain for recruiting and retaining qualified suppliers. Passage of this bill would allow Virginia to enjoy the same benefits as the other 23 member states of the ASLP-IC, including the neighboring states of Maryland, West Virginia, Kentucky, Tennessee, and North Carolina. The US Department of Defense State Liaison Office joins ASHA in supporting HB 2033. If you or your team have any questions, please contact Susan Adams, ASHA Director of State Legislative and Regulatory Affairs, at sadams @asha.org.

Last name: arnaldo Organization: United States Department of Defense Location: Arlington, Virginia

My name is Christopher Arnold. I am the Mid-Atlantic Regional Liaison for the US Department of Defense State Liaison Office. Joining the 23 states that have enacted the compact before you today over the last 24 months will improve access to care and allow military personnel and their spouses have easier access to maintain their certifications when they relocate. Federal law requires military departments to produce annual strategic scorecards, considering factors such as participation in furlough agreements and the quality of medical care near bases. Future grassroots decisions made with a consistent framework will ensure optimal conditions for service members and their families. Common misinformation about compacts is that they lower or raise occupancy standards, when in reality compact states have the option of issuing either a "license compact" or a "state exclusive license." As 45 states have joined hundreds of DOD compacts, including five here in the Greater Commonwealth of Virginia, academic research and real-world experience have shown that reservations initially expressed by some groups, such as lost revenue for state advice or security concerns, did not materialize. The Department of Defense has pivoted in its licensing approach after 2017 to view occupational license agreements as our ideal end state. The agreements establish a common understanding of competence and its measurement within the occupation and provide for continued reciprocity for spouses of military personnel in an occupation. House Bill 2033, the Interstate Compact on Audiology and Speech Therapy, addresses these issues affecting our service members and their families and facilitates the interstate practice of audiology and speech therapy with the goal of improving public access to services and preserving the regulatory authority of the states to protect public health and safety through the current state licensing system. Portable employment opportunities support the career development of the military spouse. The language of the agreement allows an active duty service member, or their spouse, to designate a home state where the individual has a current and unexpired license. This state serves as the individual's home state while the military is on active duty, while complying with the laws, rules, and scope of practice in Virginia. This is particularly important since, outside of the interstate compact, there is no specific state law Virginia could pass to assist Old Dominion residents who are stationed in other states and involuntarily relocate to other states to obtain a license. military service member or spouse, except for leave from your home state, and these are reimbursed for military service in accordance with federal law. We appreciate the opportunity to support the military spouse support policies outlined in House Bill 2033 and are especially grateful to Delegate Sewell for his leadership and patronage in moving this initiative forward and grateful to the committee for their careful consideration and all your support. service members and their families. can have.

Last name: of echo Location: Prince William County

I have been a licensed speech therapist in Virginia since 2004, when my husband resided in Quantico, Virginia. I have worked in Virginia schools, private practice, and outpatient rehab. When my husband was serving outside of Virginia, I kept my Virginia license, but he could not work out of state unless he applied for and paid for a different state license. In Florida it took me over 6 months to get a license. In North Carolina, I only got a job at a military station because I didn't have a North Carolina license. The time and cost of obtaining and maintaining licenses for each state we moved to was prohibitive and a barrier to work. Now that my husband has retired from active duty, we remain in Virginia so our children can graduate from high school and attend one of Virginia's many accredited state universities. I look forward to championing speech therapy and speech therapy services for Virgos. https://aslpcompact.com/compact-map/ includes states that allow an audiologist or audiologist to practice without obtaining and maintaining another state license. This is important because we have military wives in Prince William County. We have a shortage of speech therapy service providers. Virgos with hearing loss need access to quality audiology services. With the interstate compact, the expansion of services for residents in rural areas near West Virginia and North Carolina and Maryland have access to more providers and options for telehealth services. Speech therapists and audiologists are trained to identify, assess, treat, and manage speech, language, feeding/swallowing, cognitive, hearing, and balance disorders. It is critical that the interstate compact for audiology and speech-language pathology be successfully operationalized and expanded, that licensing and certification requirements be maintained, and that the ability to practice to the fullest extent of their education be supported. and training. Please support the Interstate Compact on Audiology and Speech Therapy.

Last name: arnaldo Organization: United States Department of Defense Location: Arlington, Virginia

On behalf of military families and the Department of Defense, I am writing to comment on the proposed policy changes in Virginia House Bill 2033, the Audiology and Speech-Language Pathology Interstate Compact (ASLP-IC ), which addresses license issues affecting our service. members and their families. I would like to thank you for considering this item in the 2023 legislative session. My name is Christopher Arnold. I am the US Department of Defense Mid-Atlantic Regional Liaison State Liaison Office, operating under the direction of the Assistant Secretary of Defense for Personnel and Preparedness. Our mission is to be a resource for state legislators as they work to address quality of life issues for military families. The ASLP-IC increases transferable career opportunities for military spouses by providing consistent rules that allow licensed members to work in other states through "policy practice privilege" or more easily transfer their license to a new state. Frequent changes and complicated licensing and certification requirements limit career options for military spouses. The enactment of the ASLP-IC will serve to alleviate one of the many stressors of a military move, making it easier for service members and military spouses to maintain their profession when they move. We appreciate the opportunity to support the policies outlined in the ASLP-IC presented at this session. Feel free to contact me with any questions you may have.

Last name: adams Organization: American Speech-Language-Hearing Association Location: Rockville, MD

On behalf of the American Speech-Language-Hearing Association, I am writing to support HB 2033, which adopts the Interstate Compact on Audiology and Speech-Language Pathology (ASLP-IC). The American Speech-Language-Hearing Association (ASHA) is the national professional, scientific, and accrediting association for the 223,000 members and affiliates who are speech-language pathologists; speech therapists; speech-language-hearing scientists; audiology and speech therapy support staff; and students More than 4,800 ASHA members reside in Virginia. ASHA members often have difficulty obtaining multiple state licenses to practice due to administrative burdens. These charges hinder their ability to provide quality services and restrict access for consumers in rural and underserved communities. I am pleased to support HB 2033, which will address these issues by: •Increasing access to care for clients, patients, and/or students; and • facilitate continuity of care when clients, patients, and/or students move or travel to another state, specifically with military personnel and their spouses. Passage of this bill would allow Virginia to enjoy the same benefits as the other 23 ASLP-CI member states, including neighboring states Maryland, West Virginia, Kentucky, Tennessee, and North Carolina. The US Department of Defense State Liaison Office joins ASHA in supporting HB 2033. If you or your team have any questions, please contact Susan Adams, ASHA Director of State Legislative and Regulatory Affairs, at sadams @asha.org.

Last name: Madeira Location: Ashburn

HB 2276 immunization; vaccinate children against COVID-19 Informed consent is the basis of medical ethics. Parents must make decisions about the health and well-being of their children. COVID-19 vaccines do not prevent viral transmission, so requiring these vaccines as a requirement for school attendance is not justified. This bill specifies that parents will not be required to immunize their children against COVID-19 in the same way that current Virginia law allows them to determine whether to administer the Haemophilus Influenzae type b vaccine. be considered, legislators and their experts confirmed the legislator's support for keeping parents in charge of their children's immunization schedule. In 2021, the Virginia Department of Health proposed a regulation requiring the COVID-19 vaccine as a requirement for school attendance. More than 15,000 Virginians commented on the regulation, with overwhelming opposition (93%) to ordering the shot. Medical professionals around the world agree that there is no scientific justification for continuing COVID-19 mandates through 2023 and beyond. HB 2280 Parental Consent for Surgical and Medical Treatment of Certain Minors This bill requires parents and guardians to consent to medical interventions on their children, including medical decisions for their children. Several cities have tried to pass ordinances and laws that allow children as young as 11 years of age to consent to immunizations without their parents' knowledge! Please don't let this happen to Virginia. Support this bill to send a clear message that in Virginia, parents are in control and decide what medical interventions their children receive.

Last name: cleveland Location: manassas

I support this bill.

Last name: Chesarek Organization: My children Location: manassas

I strongly support this bill.

Last name: Peterson Location: Scott County, Iowa

I support this bill

Last name: Flamengo Location: Stafford

I am writing in support of the Universal License Agreement for Audiology and Speech Therapy. As a speech therapist for over 26 years, a military spouse, it has been a challenge to apply for and receive my license in a timely manner; thus impacting work and financial well-being. Each state requires different administrative items, so it is time consuming and administrative burden. Post-Covid, the ability to offer telehealth across state lines for a short period of time because governors allowed this reciprocity, allowed patients to be cared for more freely. An example, a military family returning to their family because the spouse was deployed and the child could continue to receive telehealth and maintain continuity of care. Imagine this is an always available event if the universal license is approved. I urge that this pact and the single license in all states for speech therapists and audiologists be approved.

Last name: Romanowski Location: Bethesda, MD

To Whom It May Concern: I am a speech therapist who fully supports this bill as I currently hold a separate VA license and MD license. I recently moved from the VA to MD and currently reside in an area where I could easily serve patients in need in DC, MD, and the VA. I considered keeping both state licenses due to my location, however the additional cost without a compact license option is a greater financial burden on me and my practice. I would greatly benefit from the passage of this bill and believe it would be a great step toward progress toward more universal, state-by-state compact licensing and regulation. Thanks in advance for your consideration!

Last name: gilani Location: Principe William

I support this bill.

Last name: of echo Location: manassas

I have been a licensed speech therapist in Virginia since 2004, when my husband resided in Quantico, Virginia. I have worked in Virginia schools, private practice, and outpatient rehab. When my husband was serving outside of Virginia, I kept my Virginia license, but he could not work out of state unless he applied for and paid for a different state license. In Florida it took me over 6 months to get a license. In North Carolina, I only got a job at a military station because I didn't have a North Carolina license. The time and cost of obtaining and maintaining licenses for each state we moved to was prohibitive and a barrier to work. Now that my husband has retired from active duty, we remain in Virginia so our children can graduate from high school and attend one of Virginia's many accredited state universities. I look forward to championing speech therapy and speech therapy services for Virgos. https://aslpcompact.com/compact-map/ includes 15 states that allow an audiologist or audiologist to practice without obtaining and maintaining another state license. This is important because we have military wives in Prince William County. We have a shortage of speech therapy service providers. Virgos with hearing loss need access to quality audiology services. With the interstate compact, the expansion of services for residents in rural areas near West Virginia and North Carolina and Maryland have access to more providers and options for telehealth services. Speech therapists and audiologists are trained to identify, assess, treat, and manage speech, language, feeding/swallowing, cognitive, hearing, and balance disorders. It is critical that the interstate compact for audiology and speech-language pathology be successfully operationalized and expanded, that licensing and certification requirements be maintained, and that the ability to practice to the fullest extent of their education be supported. and training. Please consider supporting the Interstate Compact on Audiology and Speech Therapy. Thank you for taking the time to read my comments in support of this bill to support the people I love and the profession I love. I work with children who do not communicate verbally. I work with patients who will need lifelong care. My patients deserve access to care for life. This bill would guarantee access to more providers and put Virginia on board with neighboring states.

Last name: right Location: prince william county

I support this bill.

Last name: struggle Location: Prince Guillermo, Manassas

I support this bill

Last name: I go Organization: speech therapist Location: manassas

As a VA-licensed SLP, consider allowing SLPs licensed in other states to receive a reciprocal license in our state. I work at a public school in VA and it has been very difficult for us to staff due to licensing issues and a general shortage of SLPs and it is affecting all current SLPs in the state. Not having to worry about applying for an additional license would ease the burden on many SLPs and allow more potential people to work in our state and help with the shortage. Children really need our services post-pandemic and that would make SLPs one less thing to get. Thanks for your consideration. Please contact us if you have additional questions or concerns.

Last name: sanders Location: manassas

I support this bill as an SLP in the City of Manassas

Last name: dugan Location: Stafford

As a military spouse, the interstate compact would change the way I can function as a working member of society and help support my family. I had to apply for licenses in 4 different states and was unable to work for several months after each post due to waiting for a new license. Each time, I also have to pay a large sum of money for the license, which will probably only be used for a short period of time. Consider passing this bill to allow spouses more freedom in the workplace.

Last name: arnaldo Organization: United States Department of Defense Location: Pentagon, VA

Attached, please find the opinion of the United States Department of Defense on written testimony supporting the policies reflected in House Bill 2033, the Audiology and Speech Therapy Interstate Compact. Congress required the Department to enter into a cooperative agreement with the Council of State Governments to develop leave agreements and alleviate barriers military families face to interstate mobility.

Last name: adams Organization: American Speech-Language-Hearing Association Location: Rockville, MD

On behalf of the American Speech-Language-Hearing Association, I am writing to support HB 2033, which adopts the Interstate Compact on Audiology and Speech-Language Pathology (ASLP-IC). The American Speech-Language-Hearing Association (ASHA) is the national professional, scientific, and accrediting association for the 223,000 members and affiliates who are speech-language pathologists; speech therapists; speech-language-hearing scientists; audiology and speech therapy support staff; and students More than 4,800 ASHA members reside in Virginia. 1ASHA members often have difficulty obtaining multiple state licenses to practice due to administrative burdens. These charges hinder their ability to provide quality services and restrict access for consumers in rural and underserved communities. I am pleased to support HB 2033, which will address these issues by: • Increasing access to care for clients, patients, and/or students; and • facilitate continuity of care when clients, patients, and/or students move or travel to another state, specifically with military personnel and their spouses. Passage of this bill would allow Virginia to enjoy the same benefits as the other 23 ASLP-CI member states, including neighboring states Maryland, West Virginia, Kentucky, Tennessee, and North Carolina. The US Department of Defense Office of State Liaison joins ASHA in support of HB 2033.

Last name: adams Organization: American Speech-Language-Hearing Association Location: Rockville, MD

On behalf of the American Speech-Language-Hearing Association, I am writing to support HB 2033, which adopts the Interstate Compact on Audiology and Speech-Language Pathology (ASLP-IC). The American Speech-Language-Hearing Association (ASHA) is the national professional, scientific, and accrediting association for the 223,000 members and affiliates who are speech-language pathologists; speech therapists; speech-language-hearing scientists; audiology and speech therapy support staff; and students More than 4,800 ASHA members reside in Virginia. ASHA members often have difficulty obtaining multiple state licenses to practice due to administrative burdens. These charges hinder their ability to provide quality services and restrict access for consumers in rural and underserved communities. I am pleased to support HB 2033, which will address these issues by: •Increasing access to care for clients, patients, and/or students; and • facilitate continuity of care when clients, patients, and/or students move or travel to another state, specifically with military personnel and their spouses. Passage of this bill would allow Virginia to enjoy the same benefits as the other 23 ASLP-CI member states, including neighboring states Maryland, West Virginia, Kentucky, Tennessee, and North Carolina. The US Department of Defense Office of State Liaison joins ASHA in support of HB 2033.

Last name: nicholls Location: Chesapeake

Very expensive and time consuming. Pharmacists are far and away in the middle and that's just a busier job for them. Not all technicians can do this either and they are also hard to find.

Last name: Madeira Location: Ashburn

HB 2276 immunization; vaccinate children against COVID-19 Informed consent is the basis of medical ethics. Parents must make decisions about the health and well-being of their children. COVID-19 vaccines do not prevent viral transmission, so requiring these vaccines as a requirement for school attendance is not justified. This bill specifies that parents will not be required to immunize their children against COVID-19 in the same way that current Virginia law allows them to determine whether to administer the Haemophilus Influenzae type b vaccine. be considered, legislators and their experts confirmed the legislator's support for keeping parents in charge of their children's immunization schedule. In 2021, the Virginia Department of Health proposed a regulation requiring the COVID-19 vaccine as a requirement for school attendance. More than 15,000 Virginians commented on the regulation, with overwhelming opposition (93%) to ordering the shot. Medical professionals around the world agree that there is no scientific justification for continuing COVID-19 mandates through 2023 and beyond. HB 2280 Parental Consent for Surgical and Medical Treatment of Certain Minors This bill requires parents and guardians to consent to medical interventions on their children, including medical decisions for their children. Several cities have tried to pass ordinances and laws that allow children as young as 11 years of age to consent to immunizations without their parents' knowledge! Please don't let this happen to Virginia. Support this bill to send a clear message that in Virginia, parents are in control and decide what medical interventions their children receive.

Last name: Dance Organization: Virginia Tech Hokies for LDS recovery Location: Christiansburg

HB 2192- Good afternoon, my name is Jon Dance and I am a person in recovery. I am writing in support of HB 2192 as a member of Recovery Communities in Virginia, a resident of Montgomery County. The need for more support services like Cawtaba Hospital is a necessity in our area for those suffering from substance abuse and/or mental health disorders. Speaking from experience of the benefits of treatment and receiving the support and resources I need, I am 5 years into my own recovery and 2.5 years substance free. Thanks to the support and resources of a treatment center like Catawba Hospital Bill, I was able to return to Virginia Tech to earn my Bachelor's Degree in Human Development and graduate in May 2023 and also enrolled in a public Master of Health Graduation Program in May . 2024. My hopes are to continue supporting and advocating for those who still suffer. I have worked with adults and students who are in recovery or curious about recovery as an R-CPRS and am involved with the Virginia Tech Recovery Community, Hokies for SUD Recovery, and also helped start the Southwest Community College Student Recovery Organization from Virginia. Consider this mine and many others in SWVA's support of this bill.

Last name: Durkin Organization: Roanoke Regional Chamber Location: Roanoke

The Roanoke Regional Council strongly supports the passage and funding of HB 2192. The renovation of Catawba Hospital as a state-of-the-art facility for substance abuse and mental health treatment is badly needed to address the results of the crisis of opioids and the prevalence of mental health/behavioral disorders. Its location in a region where substance abuse and mental health disorders are on the rise makes it an ideal location to treat these conditions. We thank the committee for their consideration and request support for this vital project.

Last name: Arenque Rosie Allen Organization: United Way of the National Capital Area Location: Washington

See attached letter of support from the United Way of the National Capital Area.

Last name: Cobb Organization: roanoke city Location: roanoke city

In her book, Raising Lazarus: Hope, Justice, and the Future of America's Overdose Crisis, Roanoke writer Beth Macy cites that “The Centers for Disease Control and Prevention estimates that more than one million Americans have died from drug overdoses. since 1996, the most important factor, by far, in the decline in American life expectancy. Since the publication of his groundbreaking book, Dopesick, and during the covid-19 pandemic, overdose deaths have increased by more than 50%, noting that “addiction has become the leading cause of family destruction in our time , with almost a third of Americans reporting it as a serious cause of family conflicts and drug overdoses that claim the lives of more than 100,000 Americans in a year. In the Roanoke Valley and parts of southwestern Virginia, we have seen overdose deaths in the range of four times the deaths from gun violence. In 2019, in response to this growing epidemic, more than two hundred community partners joined forces to create the Roanoke Valley Response Collective and developed an Action Plan that includes key grassroots and government responses to comprehensive continuum of care to address addiction and create a sustainable recovery. models, including recovery care, health care, and housing. According to a report released by the Secretary of Health and Human Services, State Data indicates that between 35% and 55% of all state hospital patients analyzed in the report prepared for the Commonwealth had both a substance use disorder and a mental health illness. The report further acknowledged the immediate need for approximately 100-150 acute behavioral health beds, 80-120 residential substance use disorder treatment beds, and 16 detoxification beds in the area surrounding Catawba Hospital. the Catawba Campus for addressing these critical recovery needs in our region and as a role model for the state, and to the Governor and General Assembly for championing the connection between substance use disorder, mental health support, and a increased access to recovery services in a health setting. care environment. These actions are bold and combined with local grassroots efforts through ongoing care from effective harm reduction, addition and recovery education, recovery housing, and restoration of health and wholeness, we will see a comprehensive reduction and slowdown of this epidemic. HB2192 and its full funding from the state budget. Vice Mayor Joe Cobb

Last name: Meal Organization: roanoke city Location: roanoke city

The report presented by the Secretary of Health and Human Services to the Senate Finance and Appropriations Committee and the House Appropriations Committee in December and January clearly demonstrates the need to transform the Catawba Hospital Campus into a world-class expanded facility. As noted in the report, more than 100,000 people in the United States died of drug overdoses in 2021, 2,656 of them were from Virginia, and sadly, the Roanoke region is one of the hardest-hit areas in Virginia. Our local coordinated response to the opioid epidemic, the Roanoke Valley Response Collective, recently completed a white paper: "Building on Hope" that looks at the impact of COVID-19 on the opioid addiction crisis in the Roanoke region. Roanoke. The report notes significant increases in overdoses, cases of depression or anxiety, and fatigue experienced by caregivers in the region. State data indicates that between 35% and 55% of all patients in state hospitals analyzed in the report prepared for the Commonwealth have both a substance use disorder and a mental illness. The report further acknowledged the immediate need for approximately 100-150 acute behavioral health beds, 80-120 residential substance use disorder treatment beds, and 16 detoxification beds in the area surrounding Catawba Hospital. A bold and meaningful response to this crisis is needed. The Governor and the General Assembly took the critical first step by commissioning such a study and report. Delegate Rasoul took the critical next step by requesting funds to fulfill the report's recommendations. Our region, through its Collective Response, has been on the ground providing resources, services and aid to those in need. And many of our region's elected and appointed officials are here today to express their support for further action. HB2192 has the ability to take this bold and meaningful response and turn it into real action, much-needed action, and for that reason, as Mayor of the City of Roanoke, I fully support the bill and ask for your support.- Mayor Sherman Q. Lea, Mr.

Last name: Cowell Organization: roanoke city Location: roanoke city

I am writing to express the City of Roanoke's support for HB2192, with the goal of transforming Catawba Hospital into a state-of-the-art facility, addressing the full spectrum of substance use disorder treatment, recovery services, and behavioral health services. necessary to meet the growing need in our region. As you know, in 2021, thanks to financial support from the City, the Roanoke Valley-Alleghany Regional Commission became home to a formalized Roanoke Valley Response Collective, under the leadership of an Advisory Committee representing organizations that have led the Collective since its creation. The City of Roanoke supported last year's bill to study the potential expansion of Catawba Hospital to meet its vision and the critical needs of the region. Roanoke Valley Collective Response recently completed Building on Hope, a white paper that looked at the impact of COVID-19 on the opioid addiction crisis in Roanoke Valley. The report points to a 30% overall increase in overdose rates across the country, a 9% increase in adults reporting problems with depression or anxiety in 2021 compared to 2018, as identified in the Community Health Survey of Carilion Clinic, and a marked increase in compassion fatigue experienced by area caregivers and public safety teams, just to list a few of the many impacts. Overall, the City and the collective response recognize that all aspects of this crisis, from prevention to treatment to re-entry into the workforce, have become more critical and need more and better services to help people in our city ​​and region struggling with substance use disorder. . A revitalized and well-resourced Catawba Hospital would be a vital tool in meeting this need. As Mayor of the City of Roanoke, I am ready to support this effort to further the development of Catawba Hospital. I appreciate your leadership in this effort. If you need anything else, don't hesitate to contact me. Bob Cowell City Manager Roanoke Virginia

Last name: Jaime Organization: Virginia Tech Location: Earlysville

Thank you to the members of this committee for taking the time to listen to this bill. My name is Brittany James and I am a student at Virginia Tech. I am currently the lead organizer for Hokies for LDS Recovery at Virginia Tech and I am asking you to support HB2192. This bill prioritizes the needs of Southwest Virginians. Rebuilding Catawba Hospital into a state-of-the-art LDS recovery center would bring treatment, resources, and long-term care to a centralized location that would be easily accessible to many people. I have heard many stories from members of the Virginia Tech Recovery Community and I want to emphasize how important this bill is to Southwest Virginia. This bill would greatly benefit a number of constituents, particularly those recovering from a substance use disorder. This bill would also improve existing mental health systems at Catawba Hospital, providing people in recovery with a safe environment, as well as possible long-term care. Once again, I want to speak on behalf of the thousands of voters across Southwest Virginia who can benefit from HB2192 and ask for your support for HB2192.

Last name: Arabic Organization: Botetourt County, VA Location: County of Botetourt

On behalf of the Botetourt County Board of Supervisors, I am writing to express my support for HB2192. Transforming Catawba Hospital into a state-of-the-art facility that addresses the full spectrum of substance use disorder treatment, recovery services, and behavioral health services is necessary to meet the growing need in our region. A recent report from Roanoke Valley Collective Response documented an overall 30% increase in overdose rates across the country. The many consequences of substance abuse and the costs associated with lost productivity and economic performance, and health-related and social costs to individuals, families, communities, the Commonwealth, and our nation are devastating in all the senses. HB2192 offers a realistic opportunity to begin mitigating and preventing these losses to our economy and society, an opportunity that may not be available in less favorable budget times. Botetourt County encourages your strong support of HB2192 and stands out as a willing partner to help address this critical need in our community. Thank you.

Last name: Hamilton Organization: Roanoke Valley United Trail Location: Roanoke County

ABOUT HB2192 | Rasoul | Catawba Hospital, Substance Abuse Treatment and Recovery Services January 25, 2023 Delegate Sam Rasoul Virginia House of Delegates, District 11 P.O. Box 13842 Roanoke, Virginia 24037 Dear Delegate Rasoul: On behalf of the United Way of Roanoke Valley Board of Directors, I am writing to express our support for HB2192, with the goal of transforming Catawba Hospital into a state-of-the-art hospital. state-of-the-art hospital facility that addresses the full spectrum of substance use disorder treatment, recovery services, and behavioral health services necessary to meet the growing need in our region. Roanoke Valley Collective Response recently completed Building on Hope, a white paper that looked at the impact of COVID-19 on the opioid addiction crisis in Roanoke Valley. The report points to a 30% overall increase in overdose rates across the country, a 9% increase in adults reporting problems with depression or anxiety in 2021 compared to 2018, as identified in the Community Health Survey of Carilion Clinic, and a marked increase in compassion fatigue experienced by area caregivers and public safety teams, just to list a few of the many impacts. Addiction, substance use disorders, and mental illness are often among the most significant barriers to housing and employment, which are critical to achieving financial stability. A revitalized and well-resourced Catawba Hospital would be a vital tool in meeting the growing need for mental health services and facilitating access for others. Our United Way vision of bringing 10,000 families to self-sufficiency is intended to impact residents in the geographic area adjacent to Catawba Hospital and would certainly be an asset to many we serve. Our United Way is fully compliant with HB2192. We are happy to participate in the next steps of the process as much as possible and look forward to seeing the results of this important and timely work. Thank you for your leadership in this area of ​​need. Sincerely, Abby V. Hamilton President and CEO

Last name: Prostitute Organization: Roanoke County Location: salem

My name is Martha Hooker, President of the Roanoke County Board of Supervisors. As a representative of the Catawba District, I know that our community is very proud of the work that Catawba Hospital provides in this region. With the area provided on the Catawba Hospital campus, I believe the added additional footprint for substance use disorder and rehabilitation would work well with their current mission. The need for this type of care is great in our area and we want all of our citizens to be able to once again be productive in the community and have healthy family experiences. I believe the addition to Catawba Hospital will help fill that need. Additionally, regional support extends to area House members as co-sponsors of HB 2192. We ask the committee to pass this bill and appreciate the support.

Last name: Norte Organization: Roanoke Valley Allegheny Regional Commission Location: Roanoke County

My name is Phil North, Chairman of the Roanoke Valley Allegheny Regional Commission and a member of the Roanoke County Board of Supervisors. Before the pandemic, the overdose rate in our area was 21.5 per 100,000 inhabitants. As a result of the pandemic, overdose rates increased to 30.7 per 100,000, or 43%. The need in our area for ongoing care to address substance use disorder is great and the Catawba Hospital location will meet that need. Additionally, regional support extends to area House members as co-sponsors of HB 2192. We ask the committee to pass this bill and appreciate the support.

Last name: muelenaer Organization: Roanoke Valley Collective Response Location: Roanoke County

I think the plan to turn Catawba Hospital into an additional council. Center for recovery and maintenance of mental health services is an excellent idea. I believe that Catawba would be well equipped to treat people with addiction during the acute phase and will need a well thought out transition plan for these same patients as they transition from acute rehab (6-8 weeks) to sober living and intensive outpatient care. when they will need access to transportation and jobs. The remote location of the Catawba hospital allows for accessibility to jobs and transition to the normal environment.

Last name: Madeira Location: Ashburn

HB 2276 immunization; vaccinate children against COVID-19 Informed consent is the basis of medical ethics. Parents must make decisions about the health and well-being of their children. COVID-19 vaccines do not prevent viral transmission, so requiring these vaccines as a requirement for school attendance is not justified. This bill specifies that parents will not be required to immunize their children against COVID-19 in the same way that current Virginia law allows them to determine whether to administer the Haemophilus Influenzae type b vaccine. be considered, legislators and their experts confirmed the legislator's support for keeping parents in charge of their children's immunization schedule. In 2021, the Virginia Department of Health proposed a regulation requiring the COVID-19 vaccine as a requirement for school attendance. More than 15,000 Virginians commented on the regulation, with overwhelming opposition (93%) to ordering the shot. Medical professionals around the world agree that there is no scientific justification for continuing COVID-19 mandates through 2023 and beyond. HB 2280 Parental Consent for Surgical and Medical Treatment of Certain Minors This bill requires parents and guardians to consent to medical interventions on their children, including medical decisions for their children. Several cities have tried to pass ordinances and laws that allow children as young as 11 years of age to consent to immunizations without their parents' knowledge! Please don't let this happen to Virginia. Support this bill to send a clear message that in Virginia, parents are in control and decide what medical interventions their children receive.

Last name: They are Organization: Virginia Immigrant Voices Location: bridge water

I'm a nurse from Iraq and I'm trying to get certified to practice here and contribute my skills and experience in the healthcare field, but I couldn't. I hope I get the opportunity to do that through HB2211 presented by Delegate Kathy Tran because I want to help lives.

Last name: Madeira Location: Ashburn

HB 2276 immunization; vaccinate children against COVID-19 Informed consent is the basis of medical ethics. Parents must make decisions about the health and well-being of their children. COVID-19 vaccines do not prevent viral transmission, so requiring these vaccines as a requirement for school attendance is not justified. This bill specifies that parents will not be required to immunize their children against COVID-19 in the same way that current Virginia law allows them to determine whether to administer the Haemophilus Influenzae type b vaccine. be considered, legislators and their experts confirmed the legislator's support for keeping parents in charge of their children's immunization schedule. In 2021, the Virginia Department of Health proposed a regulation requiring the COVID-19 vaccine as a requirement for school attendance. More than 15,000 Virginians commented on the regulation, with overwhelming opposition (93%) to ordering the shot. Medical professionals around the world agree that there is no scientific justification for continuing COVID-19 mandates through 2023 and beyond. HB 2280 Parental Consent for Surgical and Medical Treatment of Certain Minors This bill requires parents and guardians to consent to medical interventions on their children, including medical decisions for their children. Several cities have tried to pass ordinances and laws that allow children as young as 11 years of age to consent to immunizations without their parents' knowledge! Please don't let this happen to Virginia. Support this bill to send a clear message that in Virginia, parents are in control and decide what medical interventions their children receive.

Last name: Boudali Organization: Virginia Affiliate of the American College of Nurse Midwives Location: richmond

I am writing to you as a certified nurse midwife providing delivery services in Richmond outside of the hospital. My clients who choose home birth and birthing center deserve unrestricted access to this vital exam without the high cost of testing. This is a government-required test, but the burden of cost falls squarely on the patient or provider. These costs add up even in the large practice setting of a hospital. The cost for a small-scale midwifery business can easily be added or subtracted from the results. Practices like mine in Richmond are on the decline. It is so difficult to keep the doors open in these small practices with the many costs and barriers to practice that currently exist. Removing this cost barrier to newborn screening would have a positive impact on the growth of small businesses in Virginia, as well as increase patient access to the desired form of high-quality, personalized care.

Last name: hernandez Organization: American College of Nurse Midwives of Virginia Location: Stafford

I would like to offer my support for House Bill 2224, which seeks to eliminate the neonatal metabolic screening fee. Newborn metabolic screening is required by law and is an important first step in newborn care, helping to identify serious but rare health problems at birth. The cost of the test can be prohibitive for families without adequate health coverage or for those who deliver in a birthing center or at home and must present to a lab or hospital for testing. It would be a great advance in newborn and pediatric care if newborn screening were performed at no cost to parents, guardians, hospitals, or health care providers.

Last name: Wardlaw Organization: VA ACNM Location: Chesapeake

My name is Nichole Wardlaw and I am a Certified Nurse Midwife speaking up for HB 2224, which will eliminate the cost associated with newborn metabolic screening. As an American Board of Midwifery Certification midwife with 17 years of experience and training at the Medical University of South Carolina, I have chosen to work in communities of color where my presence as a Black midwife has been most effective. I also opted to leave the hospital system in 2020 to deliver at home or in the community so that low-risk parents can choose where they would like to deliver. It is in this scenario that parents are forced to decide if they can afford metabolic screening. The cost is $137 and all insurance companies do not cover the cost. That leaves my colleagues and I to either absorb the cost or pass the cost on to the parents. It is unfair that a state-mandated test that is beneficial in detecting disabilities is not available to all children born here. The cost is prohibitive and not all children can be tested. If we want to reduce disparities, we need to offer these kinds of screenings for free. In conclusion, I thank you for your time and I leave you with this phrase “Change will not come if we wait for someone else, or if we wait for another moment. We are the ones we have been waiting for. We are the change we seek." Barack Obama

Last name: Payne Organization: Virginia Midwives Alliance Location: Lynchburg

Good day! I'm Leslie Payne, a community midwife working in Central Virginia. I would love for her to support HB 2224. As she knows, newborn metabolic screening in Virginia saves lives and is extremely important to children and families in the Commonwealth. I serve families in 4 different Amish communities. This assessment is particularly important in their communities, where the gene pool is small and these disorders appear more frequently than in my "English" (as the Amish call the rest of us) families. Over the years, I have seen many children who now live normal lives because their condition was discovered through the Newborn Screening Program and they are being successfully treated at a young age. These families have very little money. To make sure your babies are screened, I often have to pay the bill (over $150 for the screening card and testing equipment). Since about 75% of my clientele are Amish, this costs a hefty sum each year. I feel compelled to do this because evaluation is very important to these families and the impact of a child without treatment is significant financially, medically, and emotionally. But it is a financial burden for me. Thank you for considering this bill that would benefit so many families that I and other midwives serve. Sincerely, Leslie M. Payne, CPM Lynchburg, VA

Last name: wylie Location: suffolk

Charging for legally required newborn screening cards places an undue financial burden on providers. Many independent providers are not in network with health insurance, and even when they are, the insurance does not cover the tests or reimburses for much less than the cost of the test. We lost money on every one of them.

Last name: verdes Organization: Obstetric care of seven cities Location: Playa Virginia

The additional costs for state-mandated newborn screening can be a financial burden for families delivering outside of a hospital or without insurance coverage. These families may choose not to consent to neonatal metabolic screening due to testing costs. If VA status is a mandatory test, then this financial burden should not fall on the parents. It should be the responsibility of the state to provide and cover the costs of the tests. I support HB 2224 so that my clients can have affordable and affordable neonatal metabolic screening.

Last name: Madeira Location: madison county

Support state funding for HB 2224! The cost of newborn screening is a legitimate and prudent use of taxpayer funds. Every newborn VA citizen should have access to this important screening tool, regardless of place of birth and ability to pay. Testing and identification of disorders and diseases detected at birth will save state funds in the long run. Thank you!

Last name: sicilians Location: albemarle county

*Support HB 2224 to provide newborn screening at no cost to parents, guardians, hospitals or health professionals. This is especially a barrier for Virginia-licensed midwives who serve families on Medicaid, as Medicaid reimburses these providers for only 75% of the actual fee. That means you're actually costing certified midwives $34.50 each time they perform this important newborn screening test; and are not receiving any compensation for the time/skill required to provide this critical service. As a certified nurse midwife, I am rarely reimbursed by private insurers for this state-mandated service.

Last name: Williams Location: Mt. Airy MD

I am a CPM Licensed Community Midwife in Maryland and Virginia and also practice in West Virginia and Pennsylvania. I have seen firsthand the impact of screening rate on families' decision making regarding screening rate. The vast majority of my MD, WV, and PA clients choose to get newborn screening because there is no financial burden on their part; clients more often decline newborn screening for financial reasons when given the option in Virginia, even when there is risk/benefit and informed choice. Families who were born out of hospital are already taking on the increased responsibility of paying out-of-pocket or with little network coverage for their safe option for out-of-hospital birth. Let them continue to make safe, evidence-based decisions with no further financial burden involved.

Last name: Willis Organization: auto Location: roanoke city

I am a Certified Peer Support Specialist. I have a felony charge for a charge I committed in 2014 and was indicted in 2016. I got clean on 12/30/2015. I have changed my life completely and I am no longer the person that I was. I worked for NRVCS in Radford Va. I was a CPRS with a qualified mental health professional from Pará. I mainly worked as a case manager. I trained a few case managers with college degrees, applied for a peer support expert supervisor position. The other agency really wanted to hire me and did so only to decline the offer due to my criminal barrier. Then they called me back 2 weeks later and they still wanted to sign me. They contacted NRVCS to find out how they hired me, hoping to find a loophole. They could not. I now work for a non-profit organization where barrier crime is not a barrier and I am grateful. My job at NRVCS was in jeopardy because they hired me illegally. When trying to go through the process with DBHDS, my supervisor at NRVCS told me they didn't want to change course. I had already started the process, but I didn't have a backup to complete the process. This crime prevented me from pursuing many different careers. If you read this, I appreciate it. Thank you! We need some changes to this bill. I understand that there must be some recommendations, however it must not be so difficult and stressful. Most addicts will have drug charges. That is a fact. That doesn't make me a bad person, however my experience, strength, and hope have helped more people than most people who don't. If you want to talk to me, my phone number is 5402504804.

Last name: Do Organization: Children's Health Advocacy Location: Foment

Dear Committee Members: Many years ago, my husband and I had notarized religious exemption certificates provided by HEAV stating that the administration of immunizing agents conflicts with our children/our religious principles and practices. The documents say that "we understand that, in the event of an outbreak, possible outbreak, or epidemic of a vaccine-preventable disease, the State Health Commissioner may order the exclusion of our children from school, for the protection of our children/our own until the danger has passed. This law, HB2306, "exempts a person, including a parent or guardian on behalf of a child, who opposes the administration of a vaccine on religious grounds from mandatory immunization requirements issued by the Commissioner of Health during an epidemic." . Epidemics do not change our religious convictions. We believe that our bodies are temples of the Holy Spirit based on the Word of God and therefore we must choose what goes inside them. We believe that vaccines should never be imposed on anyone because they can cause injury and death. We ask that you support HB 2306 for our religious freedom as well as medical freedom to protect those of us who are more at risk from vaccination than from an epidemic. Thanks for your consideration.

Last name: Franz Organization: Virginia Medical Freedom Alliance Location: Williamsburg

I urge you to support HB 2306. Religious freedom and medical freedom are human rights. We should be allowed to exercise these rights when and if we decide not to get vaccinated. Injections should never be forced on anyone. Public health emergencies should not be used as reasons to take away these basic rights. During the COVID situation and until now, people have been denied these basic rights. This bill would protect our freedom to exercise those rights. Please support this bill. Thank you, suzanne franz

Last name: Gassner Location: Stafford

Dear Delegate, I am contacting you to request your support for Bill 2306 of Deputy Freitas, which will be considered tomorrow, Tuesday, January 24. themselves or their children. Vaccines can and do cause injury and death and should never be imposed on anyone. Religious and medical freedom are basic human rights and should never be denied, even in the event of an epidemic. medical decisions based on your religious beliefs and practices. Thank you.

Last name: Arnold's Organization: Mothers for Freedom Fairfax County Location: fairfax county

I support this bill. Medical freedom is our fundamental right. Our country is not even recognizable. The government has no right to demand any medical procedure against my will!

Last name: Nartowicz Organization: Americans United for Separation of Church and State Location: Washington DC

On behalf of Virginia members and supporters of Americans United for Separation of Church and State, we oppose HB 2306, which would allow people to have religious exemptions from vaccination requirements during an epidemic, just when vaccines are most important to protect the public health. La Primera Enmienda de la Constitución de los EE. UU. it does not require, and it is forbidden to grant, a religious exemption such as this draft law. Therefore, I urge you to oppose HB 2306.

Last name: boyfriend Location: Playa Virginia

This bill gives physical therapists the freedom to treat what we are trained to treat. This eliminates unnecessary follow-up trips for doctors (which have already been fully booked for months). Physiotherapy is a doctoral level profession. We are trained to treat musculoskeletal problems. This bill will save money and increase the efficiency of healthcare.

Last name: Tinsley, MD Organization: Lighthouse direct primary care Location: newport news

"To date, only two hospitals in the country have been fined for failing to meet federal price transparency standards, both in Georgia. Northside Hospital Atlanta was fined $883,180 and Northside Hospital Cherokee was fined $214,320. fines, both hospitals have reformed their pricing transparency policies, and the PRA has acknowledged that both are in compliance.” - 08/18/22https://www.thecentersquare.com/virginia/hospitals-patient-group-dispute-virginia- price-transparency-compliance/article_2a320b84-1f1f-11ed-8583-df44a918a34b.html

Last name: Lucas Organization: independent female voice Location: Fairfax County, Great Falls, VA

On behalf of Independent Women's Voice, an organization that advocates for women and their loved ones by advocating for policy solutions that enhance freedom, opportunity, and well-being, I urge you to pass HB 2427, the Transparency in Pricing of Care Act. doctor.

Last name: Durkin Organization: Roanoke Regional Chamber Location: Roanoke

The Roanoke Regional Council is concerned that HB 2427 could increase health care costs by providing a new civil cause of action against hospitals. Legislation seeking to remedy the price transparency issue has already passed in the General Assembly in 2022 (unanimous vote), with an effective date of July 1, 2023. We believe the private right of action in HB 2427 will open . hospitals, many of which are still battling the pandemic, to the possibility of additional financial burden, even as hospitals are already required to provide price transparency under state and federal law. We respectfully ask the committee to oppose the bill.

Last name: nicholls Location: Chesapeake

Patients need to be able to get the right information to make a decision about their health care.

Last name: Tinsley, MD Organization: Lighthouse direct primary care Location: newport news

"To date, only two hospitals in the country have been fined for failing to meet federal price transparency standards, both in Georgia. Northside Hospital Atlanta was fined $883,180 and Northside Hospital Cherokee was fined $214,320. fines, both hospitals have reformed their pricing transparency policies, and the PRA has acknowledged that both are in compliance.” - 08/18/22https://www.thecentersquare.com/virginia/hospitals-patient-group-dispute-virginia- price-transparency-compliance/article_2a320b84-1f1f-11ed-8583-df44a918a34b.html

Last name: Memphis Organization: Health Distribution Alliance Location: Washington DC

The Healthcare Distribution Alliance (HDA) is the national trade association representing wholesale healthcare distributors, the vital link between the nation's pharmaceutical manufacturers and more than 200,000 customers: pharmacies, hospitals, long-term care facilities, clinics and others across the country. In Virginia, our members serve more than 1,400 of these customers. The HDA opposes HB 2465. We believe the language would jeopardize the integrity of the drug supply chain and could further exacerbate drug shortages. The language: lacks the necessary clarity; Does not reflect existing drug take-back systems in Virginia and all but two other states which may give rise to unfair business practices and liability issues; could create drug safety concerns; and could ultimately lead to practices that could exacerbate drug shortages for Virginia patients. Therefore, we respectfully request that HD 2465 not be brought forward. Please see our filed opposition letter for more information on our concerns.

Last name: Memphis Organization: Health Distribution Alliance Location: Washington

The Healthcare Distribution Alliance (HDA) is the association that represents the wholesale distributors of pharmaceutical products in the country. The safety, integrity, and resilience of the drug supply chain are top concerns for our members. On their behalf, the HDA is concerned that the proposed change in HB 2465 will disrupt the supply chain. Its wording needs more clarity and does not appear to be compatible with the existing supply chain structure. Additionally, extending the drug return window to 6 months past the expiration date can lead to over-purchasing and overstocking, exacerbating drug shortages. Therefore, we respectfully request that the subcommittee oppose this legislation. Please see our letter for more details. Thank you!

Last name: Madeira Location: Ashburn

HB 2276 immunization; vaccinate children against COVID-19 Informed consent is the basis of medical ethics. Parents must make decisions about the health and well-being of their children. COVID-19 vaccines do not prevent viral transmission, so requiring these vaccines as a requirement for school attendance is not justified. This bill specifies that parents will not be required to immunize their children against COVID-19 in the same way that current Virginia law allows them to determine whether to administer the Haemophilus Influenzae type b vaccine. be considered, legislators and their experts confirmed the legislator's support for keeping parents in charge of their children's immunization schedule. In 2021, the Virginia Department of Health proposed a regulation requiring the COVID-19 vaccine as a requirement for school attendance. More than 15,000 Virginians commented on the regulation, with overwhelming opposition (93%) to ordering the shot. Medical professionals around the world agree that there is no scientific justification for continuing COVID-19 mandates through 2023 and beyond. HB 2280 Parental Consent for Surgical and Medical Treatment of Certain Minors This bill requires parents and guardians to consent to medical interventions on their children, including medical decisions for their children. Several cities have tried to pass ordinances and laws that allow children as young as 11 years of age to consent to immunizations without their parents' knowledge! Please don't let this happen to Virginia. Support this bill to send a clear message that in Virginia, parents are in control and decide what medical interventions their children receive.

Last name: nicholls Location: Chesapeake

After the 7 am meeting, then this. HB 1689 - Move to report. No one should die without the benefit of spiritual help. * HB 1864-No person should be forced to put something he doesn't want on his body just to keep his job. We are not North Korea. *HB 1889 - Data shows not at high risk of disease. HB 2057 - Why are people who worked and paid thousands of dollars for decades denied Social Security because those who broke the law came here? Why shouldn't we put infrastructure and improve schools for African American communities FIRST BEFORE anyone else? Why do they deserve something in front of our veterans? Please PBI this bill. HB 2160 - In honor of those who lost family/friends and were not allowed to see them at the end, please report. HB 2276 - The data is clear: Children are not at risk of dying from COVID. HB 2293 - https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/comparing differentinternationalmeasuresofexcessmortality/2022-12-20 Sweden and Norway were essentially tied for lowest "scores" of "proportional excess mortality" from all causes" (which "measure [] the percentage change in the number of deaths compared to the expected number of deaths (based on the five-year average [from 2015 to 2019])" among the listed European countries, analyzing data from January 2020 to June 2022: excess mortality increased by 2.7%, compared to, for example, 5.2% for Denmark, 7.1% for Finland and 11.8% for the Netherlands Lowest all-cause death rate since COVID hit and not doing these long, long lockdowns Sweden had a lower average rate Excess death rates: https://reason.com/wp-content /uploads/2023/01/ERGExcessMortality.xlsxhttps://www.baconsre bellion.com/wp/ c ovid-19-update-still-lots-idle-hospital-capacity/ noted on 4/25/2000 Roanoke Valley had 80 cases, 6 hospitalizations, and 0 deaths compared to Arlington with 764 cases, 137 hospitalizations, 29 deaths. Elective surgery has been banned in both, though the entire Roanoke Valley has 0 deaths. HB2489 - Please come forward so men can be supported in becoming strong fathers.