The oversimplification of the posted proposals and rationales completely ignores the dilemma and complexities around providing personal care and supervision for our family members in need. We have always remained self-directed for reasons of safety and security. Being self-directed provides us the opportunity to ensure that the people that come into our homes (read that again - into our homes, personal space and lives) are adequate, dependable and safe. The difficulties around hiring staff are not complicated by this dilemma - Direct care givers are paid better than agency. However, hiring is complicated by the necessity to find willing, available, qualified individuals that are also fit and up to the job. Our Daughter is an ID autistic that can often times be behaviorally combative. As a result, we must be selective in whom we bring in to care for her, even more complicated for her as a teenager. Allowing her mother to be her paid caregiver has lessened the burden, and improved our quality of life and our ability to provide for her not only today, but with fiscal planning for future.

There is enough governmental agency involvement in our lives. In our homes we face endless paperwork and reviews and meetings between school IEP's, Therapy programs and ISP's, the case workers, agency representatives, not to mention just the daily anxieties and challenges of helping our daughter be safe and grow into the best person that she can be. What has worked for the last couple years has done just that - it has worked. Why  complicate the current process with more bureaucracy when it has worked as-is under schedule K? The fact that is has worked for so many family's is all the proof that is needed.

The Service Facilitator is already in place to check on consumer condition and welfare as well as provide resources and information. The patient care coordinator from the Medicaid provider is already managing the case from the medical needs perspective and in our case the county Services Board (RACSB) has an involved caseworker to further check on and advocate for our daughter. I would suggest that the mechanisms are in place already for our daughter's well-being, fiscal, safety and security oversight - there are enough systems and protocols. Don't oversimplify our challenges with the proposed changes and rationale.