There should not be a soft cap on CD/Agency PA hours. Many parents are struggling with the very limited hours their child (adult child too) is receiving now.  There should be no cap on the hours.  Some parents are up 24/7 working and taking care of their child nighttime hours.  Parents are struggling.    What needs to happen is increase the pay of staff to a livable wage so parents can find competent educated/experienced staff to work with their child.  Most babysitters that work typical children get paid over $25 an hour and attendants get paid a lot less than this.   The same goes with nurses, they need to be paid more per hour.  

Parents who are paid caregivers, still need the 480 respite hours, as they might have someone randomly willing to fill in for them so they can get a break.

If an individual doesn't have a guardian, Virginia needs to add a "person of the know" that can be there for individual to support the person.  

Medicaid should change regulations on who can get Medicaid.  IE it should not be based on parents' income, it should be based on individual have medical/health or mental health concerns.  This would make a huge difference in a person's life. IF they had medicaid, they could get ie ABA services & Epsdt p/a  sooner.  

Parents are struggling, many can't work because of all the support their child needs when they are home (awake over nights) or having to run to school to pick up child due to medical or behavioral issues.   Parents need the supports.

We need MCO nurses to step up and do more of their jobs, such as doing assistive technology and environmental modifications for people ccc+ waiver.