Agencies should be paid more than Consumer directed...We are required to pay out large amounts of money for comp insurance, Dept of Health Licensure, Registered Nurses, Brick and Mortar Building, mileage. The Consumer Directed Aides are paid more than we can pay our aides. All Agencies are having trouble getting staff because of this and 90 % of the Consumer Directed patients can't even get their Aide to show up and do the visit. We are held accountable and they are not..but they get paid a higher rate.