My service facilitator has always told me that there is a hard 56 hour cap for services under the CL waiver, as well as a daily cap of 8 hours.  So I was surprised to learn that DMAS is just now proposing a "soft" cap.  Frustrated to have been given the wrong information for so long.

I oppose the soft cap.  Let the consumer's disabilities drive the number of hours based on need.  And if you impose the cap anyway, do not make the "exemption" process so arduous that no one can even get thru the process.  Individuals with intellectual, medical, or physical disabilities can have similar or very different needs and support requirements.  So don't make medical documentation be the driving force in determining hours or exemptions -- factor in intellectual disability issues as well.  My son with Down syndrome may not have debilitating physical needs, but he cannot be left alone, he needs supervision, help with ADLs/IADLs, etc. for the entirety of each day -- not just 8 hours of it.