I am the mother and legal guardian of an adult daughter with significant disabilities who receives services through the CCC+ waiver. I am also her Employer of Record for her consumer-directed services. I am asking DMAS to reconsider the decision to eliminate independent Services Facilitators.

I have been navigating Medicaid services for my daughter for almost 20 years, and it is not an easy system to understand. Even after all this time, there are situations when I need someone who understands the rules and can help me figure out what is happening. That is one of the reasons having an independent Services Facilitator is so important to our family.

Recently, we had an issue involving my daughter’s attendant hours and respite services. I needed someone I could call, explain the situation to, and ask questions. Our Services Facilitator knows my daughter, knows our situation, and understands the system. That relationship matters.

The recent changes involving Electronic Visit Verification are another example of why families need this kind of support. Technology does not always work the way it is supposed to. Apps fail, phones lose service, GPS does not always cooperate, and people make mistakes clocking in or out. Yet families are being given increasingly strict requirements for how attendant hours must be submitted, with fewer options for correcting a problem when the technology fails. As an Employer of Record, I am responsible for making sure the rules are followed, but I cannot control whether an app or electronic system works properly. An attendant who has legitimately worked should not risk going unpaid because of a technology problem.

At the same time these requirements are becoming more complicated, DMAS is proposing to eliminate the independent Services Facilitator who currently helps families like mine navigate them. That does not make sense to me.

What concerns me most about the proposed change is taking away that independence. The Fiscal/Employer Agent already has an important role in administering consumer-directed services and processing attendant payroll. If I have a problem or question involving those services, I do not want the only person available to help me to work for that same organization. There is value in having an independent person to call who can help a family understand what is happening and what their options are.

My daughter will always need someone to help manage and advocate for her services. That responsibility falls to our family. Consumer-directed services are supposed to give people with disabilities and their families more choice and control over their care. Taking away our ability to choose an independent Services Facilitator does not feel like more choice. It feels like less.

I understand that DMAS may have reasons for creating the Support Broker model, and families who want to use that model should certainly have that option. But creating a new option should not require eliminating one that is already working for families.

Please allow independent Services Facilitators to remain an option. Let families choose whether they want an independent Services Facilitator or a Support Broker through the Fiscal/Employer Agent. We know the people we care for, we know what works for our families, and we should have a voice in deciding who helps us navigate their services.