The potential reversion to a process where legally responsible individuals must navigate a maze of CMS requirements—including the definition of extraordinary care and the mitigation of conflicts of interest—would be a regressive step undermining the quality of care for vulnerable individuals. The current rules sensibly streamline this process, recognizing that family members often provide the most appropriate and effective care without the need for excessive documentation or bureaucratic oversight. Returning to a system requiring families to justify their roles as caregivers and prove the absence of conflicts adds an undue burden, distracting from the daily hands-on care these individuals need. Such a shift would also introduce unnecessary delays in service provision, as proving compliance with these rigid requirements is time-consuming and stressful. This would ultimately harm the individuals the waiver program is designed to protect, as their care could be compromised by the added administrative hurdles placed on their caregivers. It is in the waiver individual’s best interests to maintain the current, more efficient system, which prioritizes care over paperwork.