My name is Tina and live in the Hampton Roads area.  The LRI program allows countless families to take care of their minor children and spouses during and post pandemic. This program allowed countless families to ensure their family member was taken care of. This was without concern for losing their job or facing the need to stay at home. The need for quality care forced families to leave the workforce because someone needed to support their family member. Without a stable income, this would put a strain on services and resources within any community. The goal is to continue to support programs which allow homecare workers to earn a living. Allowing family members to care for their member does not expend any additional costs because they were already approved for services.  We are in favor of LRI's being under the same governance as any other CDC homecare worker. It is also important to reinstate and make these provisions permanent. The proposed amendment - which is consistent with other CMS-approved plans will have a positive impact for families. 

My asks are, to retroactive the start date from 01/01/25 to 03/01/24. March 1st 2024, is the date when the Appendix K waiver expired. This is when the new regulations were enacted. LRI's continue to support and provide for their clients and loved ones, more than 40hours per week. They should be eligible for full reimbursement of the approved hours. Also, respite hours should be included and brought into consideration as with any waiver under the Consumer Direct Care program. 

Thank you for your time and consideration.