The proposed changes to caregiver requirements violate consumer choice and the consumers' right to self-dirent their own care. Forcing members/caregivers to do a song and dance to "prove" they tried to hire certain external staff presents and undue burden and potenial delay in critical care needs. You are going to increase the need for facility/institutional care as a result. Remember, the federal department of justice is  watching these programs closely still, and running the risk in increased institutionalization is going to be an extremely bad look and burdensome for the state. Think again on this one.