Family Advisory Committee – May Meeting Minutes

Virginia Birth-Related Neurological Injury Compensation Program 

Family Advisory Committee Meeting Summary 

Virtual meeting  

May 26, 2026  

1. Welcome and updates 

Staff opened the meeting and outlined the primary topics for discussion, including program updates, prioritization of policy development work, and continued review of draft interim policies. 

Staff reminded members of the upcoming Bridge Call on Thursday, May 28, which will introduce the new Executive Director and provide updates on interim policies and the program website. 

Staff also shared that a leadership transition survey was distributed to families, with responses requested by June 5. 

Staff announced rate increases to family and independent caregiver reimbursement rates based on the Bureau of Labor Statistics wage rate updates that were published May 15. The Program’s updated reimbursement rates are effective May 15, including retroactive adjustments where applicable. 

Staff noted that family caregivers who obtain a Certified Nursing Assistant (CNA) certification will be eligible for reimbursement at the CNA rate. 

Family Advisory Committee (FAC) members raised concerns about applying standardized rates to independent caregivers and discussed whether caregivers with other professional credentials should qualify for higher reimbursement without additional certification. 

2. Prioritizing policy development work 

FAC members continued discussion of priority policy areas for work beginning July 1 following completion of the rapid review process. 

Staff reviewed the current dispute resolution processes, including escalation from the Executive Director to the Board of Directors and, if necessary, to the Workers’ Compensation Commission and the Virginia Court of Appeals. 

FAC members emphasized the need for clearer timelines for escalation, particularly for urgent or emergency situations, and requested that expectations be defined in policy. 

Staff indicated that interim policy language will seek to clarify escalation timelines and reduce pre-authorization requirements, particularly in emergent situations. 

FAC members discussed potential priority topics, including caregiver pay rates for certified and qualified family caregivers and options for advance payment of caregiving costs, subject to reconciliation. 

Members also suggested exploring reimbursement for payroll and tax services, as well as potential program-administered payroll models. 

FAC members raised concerns about long-term fund sustainability given expanded benefits. Staff noted that program financial sustainability is actively monitored through ongoing actuarial review and oversight. 

Staff will distribute a survey to FAC members to rank priority policy areas and will report back on results at a future meeting. 

3. Draft interim policies (continued discussion) 

Staff reiterated that interim policies are being developed to align benefits administration with legislative changes effective July 1 and will later be refined through the formal regulatory process. 

Draft interim policies will be shared with FAC members in advance of the June meeting for review and comment. 

Housing 

Staff presented draft policy language for housing assistance, which would cover reasonable and medically necessary expenses including rent contributions, home modifications, new construction, repairs to accessible components, and relocation costs. 

FAC members discussed how to distinguish between baseline housing costs and those attributable to accessibility needs. 

Staff confirmed policy would fully cover areas required for the participant’s housing needs including areas such as wheelchair and ceiling lifts, generators, and flooring modifications. For shared spaces, the part(s) required for use by the participant would be covered, for example counter levels that are accessible. The benefit would also cover repairs to accessible areas or components of the home used by the participant, if not covered by an insurance policy or other means.  

General home improvements, repairs to non-accessible areas of the home not used by the participant, modifications that exceed what is needed to meet medical or functional needs, and aesthetic or luxury upgrades would not generally be covered.  

Staff presented proposed processes for routine and complex housing projects, with streamlined requirements for smaller projects and additional assessments, bids, and potential Board approval for larger projects. It was explained that the Executive Director has some delegation of authority from the Board and can approve expenses up to certain threshold. Over the threshold expenses require Board involvement. 

FAC members emphasized the need for flexibility in selecting qualified professionals and raised concerns about timelines and communication associated with Board review of high-cost projects. 

Members suggested improving transparency, providing additional context to the Board, and allowing family participation in Board discussions when appropriate. FAC members were reassured that families would be able to attend and present a summary of rationale. 

Vehicles 

Staff presented draft policy language expanding coverage of vehicle-related expenses to include purchase, registration, insurance, maintenance, accessible equipment, warranties, and temporary transportation when primary vehicles are unavailable. 

Staff proposed moving away from fixed mileage thresholds for vehicle replacement toward an individualized assessment based on vehicle condition and participant needs. 

FAC members expressed strong support for the expanded benefit and suggested including provisions for emergency transportation when a vehicle is unexpectedly unavailable. 

FAC members also provided feedback on realistic vehicle replacement timing and mileage ranges. 

Medications, supplies, and equipment 

Staff proposed an optional form that could be completed by a primary care provider to streamline reimbursement for non-prescription medications, vitamins, dietary supplements, and commonly used supplies and equipment. 

The proposed approach would eliminate the need for insurance denials for items not typically covered and allow ongoing use of the form, with updates as participant needs change. 

Staff clarified that durable medical equipment will continue to follow the existing vendor-driven process. 

Open discussion and closing 

FAC members expressed appreciation for the progress made in policy development and expanded benefits. 

Staff confirmed that the new Executive Director will begin on June 22 and will be introduced to families during an upcoming Bridge Call. 

Staff thanked FAC members for their continued participation and feedback, and the meeting adjourned.