Family Advisory Committee – April Meeting Minutes

Virginia Birth-Related Neurological Injury Compensation Program 

Family Advisory Committee Meeting Summary 

April 28, 2026 

Virtual meeting 

1. Welcome and updates 

Program staff provided an update on work to make the Program’s website and communications clearer and more accessible. Staff thanked Family Advisory Committee (FAC) members who provided feedback on potential logo concepts shared as part of this effort. Based on feedback from FAC members and Program staff, the new logo is a medallion concept, which represents a unified central form surrounded by connected elements. The concept is intended to symbolize support, partnership, and many parts that come together to form a whole. A FAC member asked how the logo was designed, noting that there are inexpensive apps available. Staff worked with a vendor to support the design process. Another FAC member suggested trademarking the logo once it is finalized. 

Staff introduced Susan Tlusty, who recently joined the Program as Policy and Quality Manager. Staff noted upcoming events, including a Bridge family call on April 30 and a meeting of the Board of Directors on May 12. 

2. New legislation and rapid policy review process 

Program staff noted that legislation recently passed by the Virginia General Assembly will make changes to Program governance and benefits administration, effective July 1, 2026.1 In response to the legislative changes, the Program is undertaking a rapid review process across approximately 15 benefit types. The goals of the rapid review process are to: 

1. Ensure that benefits administration complies with the legislation when it takes effect on July 1 
2. Promote consistent and efficient benefits administration; and 
3. Minimize administrative burdens and streamline processes for families 

The process includes analyzing the legislation, regulations, handbook, and other programmatic rules and forms and drafting interim policies and revised forms. The interim policies will guide benefits administration from July 1 to align Program practices with the new laws going into effect that day. Because the interim policies align with the new laws, they will supersede any contradicting information in the regulations2 and handbook3 which will require a longer timeframe to update. The interim policies will apply until they are replaced by amended regulations or final policies, which will be developed in collaboration with the FAC. The Program will share draft interim policies with the FAC during meetings in May and June and welcomes FAC members’ feedback and input to ensure the interim policies align with the legislative changes and are accessible and workable for families. 

Staff gave an example of the rapid review process in the context of the nursing and attendant care benefit. In alignment with the legislation, the interim policy on nursing and attendant care will remove caps on reimbursable hours of care and provide reimbursement for care based on care hours and level(s) of care prescribed in the nursing order. The rapid review process is also considering current requirements on caregivers (e.g. annual physician review requirement for ongoing nursing needs) and the potential to streamline the number and content of Program forms for caregivers. Staff noted that the recent policy proposal on family-provided care has been integrated into the rapid review process and FAC feedback on that proposal will inform the interim policy on caregiving. 

Staff explained the differences between the rapid review process currently underway and the standard policy development process that will begin in July 2026. The rapid review facilitates changes required by legislation that are not discretionary policy decisions, such as removing hourly and monetary caps on benefits. The standard policy development process will facilitate holistic or targeting reviews involving discretionary changes, such as expanding benefits categories. This will be used as the basis for the formal process to amend regulations. 

A FAC member asked about the Governor’s recommended changes to the legislation. Staff noted that the Governor recommended two changes that were ultimately incorporated into the legislation. The first was removal of a provision allowing the Virginia Worker’s Compensation Commission to levy a penalty of up to three times the cost of the claim for any payments or reimbursements that were unreasonably delayed. The second was to remove one proposed provision that would not require the Governor or Office of the Attorney General’s approvals for the Program to enter into certain settlements with families. Staff noted that the Program’s capacity to enter into those settlements is preserved in another provision of the legislation. 

3. Prioritizing policy development work 

FAC members began the process of reviewing benefits categories for the purpose of prioritizing policy development work beginning July, 2026. 

In relation to claims requirements and processing, several FAC members expressed concern about a previous requirement to submit claims within a year, and one member noted that this had been litigated and the Program was not permitted to enforce this requirement.4 Members called for clearer information on the process for processing claims, so that families can better understand and track their claims going forward, and an escalation process to resolve claims issues at the Program level. A member noted that it is not always possible to use in-network providers and that requiring use of in-network providers is a barrier to access.  

In relation to housing assistance, FAC members criticized the one-time house renovation limitation as unsuitable and unrealistic for many families. Staff noted that the legislation removes the one-time house renovation limitation and provides for reasonable and necessary housing assistance over the lifetime of the participant. Members commented that participants’ needs evolve in different life stages and parents and caregivers’ capacity can also change over time. Members asked whether families that have already had a housing modification could potentially request further modifications and Program staff responded that they are working through this issue and it will be addressed in the interim policy. A member asked whether housing modification projects expected to exceed the current $175,000 cap could be approved and started prior to July 1. Program staff responded that approved projects could begin, though to comply with current regulations, payments should not exceed $175,000 before July 1. 

In relation to vehicles, a member suggested specifying that the Program will cover vehicle maintenance costs and equipment maintenance costs (e.g. lifts). Several members expressed concern about replacing vans at 100,000 miles, noting that this is not always appropriate and there could be circumstances warranting replacement before reaching 100,000 miles. Members suggested covering other costs such as sales tax and personal property tax.  

In relation to education advocates, members were supportive of this new benefit, noting that setting up Individualized Education Programs can be challenging. Members and staff discussed potential training and other support opportunities to ensure that families understand the new and expanded benefits and can access them when needed. 

In relation to medical, hospital, and rehabilitative care, a member suggested that the Program should cover physical therapy for participants as they age, noting that insurance does not typically provide physical therapy for adults. 

In relation to dental care, members supported the Program covering the cost of dental insurance premiums. A member asked if orthodontics are covered and staff responded that they may be covered if medically necessary and related to the birth injury. 

In relation to therapeutic care, members differentiated between experimental treatments and established treatments such as music therapy and equine therapy. Members requested reconsideration of the requirement to notify the Program at least 60 days before commencing experimental treatment. Some members advocated for rolling therapeutic care into the policy on medical care more broadly. 

In relation to medication, supplies, and equipment, members discussed therapeutic toys and suggested that these items do not need a letter of medical necessity and should not be run through insurance. Several members expressed frustration about current requirements and stated that they are not using the therapeutic toy benefit because the requirements are burdensome and inappropriate. Some members requested additional information and support in relation to augmentative communication devices. Members discussed vitamins and supplements and requested that the Program cover these expenses without the need for medical necessity documentation and insurance denials. 

FAC members and staff decided to adjourn the meeting at approximately 6:40pm and add an additional meeting to discuss other benefit areas as part of the prioritization exercise. 

Meeting adjourned.