The imposition of an inflexible 40-hour work limit on parent care attendants fails to account for the intricate nature of caregiving for children under the CCC Plus waiver. Children with complex care needs require comprehensive and continuous support beyond the confines of a predetermined hourly limit. By enforcing such a rigid constraint, the proposed changes undermine the ability of parents, who possess an unparalleled understanding of their children's nuanced requirements, to provide optimal care. This approach dismisses the multifaceted nature of caregiving, disregards the evidence highlighting the inadequacy of a one-size-fits-all approach, and jeopardizes the children's health outcomes and overall well-being. The proposed 40-hour limit, therefore, runs counter to the principles of patient-centered care and compromises the delivery of comprehensive, tailored support for children with complex medical conditions.