Thank you for providing us with the opportunity to make comments and to seek clarification of the proposed Coordinated Specialty Care policy changes. We do seek reconsideration for the proposed changes within Section 5. Medical Necessity Criteria, specifically regarding subsection 5.1.2. Age Requirements.  Expanding the eligibility criteria to include individuals up to 30 years old is expected to significantly increase the volume of referrals and service recipients. This change may challenge the capacity of established CSC teams to maintain the required staff-to-participant ratio of 1:20. Meeting this requirement would likely necessitate hiring and training additional CSC team staff, which could create operational strain and affect service quality. We recommend reassessing the proposed age expansion to ensure programming integrity, workforce sustainability, and continued compliance with staffing standards.