While I appreciate much of the proposed policy, I must insist on the elimination of OWD. This requirement is a tremendous burden on both families and EORs, forcing us to endure a bureaucratic maze that only adds stress. Attendants already face low pay and difficult working conditions, making it almost impossible to recruit anyone when they can easily find better-paying jobs with benefits elsewhere. DMAS is fully aware of the chronic provider shortage but continues to ignore the problem. Instead of treating families with trust and understanding, DMAS and DBHDS operate as if we’re trying to exploit the system. Most of us are simply trying to cope with the challenges we face. Waivers are hollow if there are no providers to deliver the services—they are built on a foundation that is destined to collapse.