Thank you for the opportunity to submit comments regarding the draft Family and Individual Supports Waiver Renewal Application. It is my understanding that the purpose of enacting Appendix K was due to difficult challenges presented during the COVID-19 pandemic as loved ones were unable to receive care from individuals outside of the home and needed assistance from a family member instead.  For family caregivers who work, this led to taking time off from work and concerns over financial stability. Having family being able to fill that role and be compensated has been a lifeline for so many families. 

Finding caregivers through an agency or trying to find someone on your own was difficult even before the pandemic.   Now with the public health emergency ending, nothing has changed as far as being able to find qualified and competent people to serve as personal care attendants except that it has gotten more difficult as wages in other service areas have surpassed the rate provided by Medicaid.  A teenager with no prior work experience can start off making $14.50 an hour in a fast food restaurant with far less tasks/responsibilities than caring for a person who qualifies to have a personal care attendant who makes $12.70 an hour with so many more responsibilities.  Many families are unable to find the help that they need and that is through going through an agency as well as recruiting people on their own.  To propose that parents of minor disabled children and spouses of disabled adults to be continued to be paid as providers is commendable.  However, to make it a requirement that they be an employee of an agency makes it almost impossible for many families.  Families already have enough on their plates (i.e. trying to get the medical supplies that they need, scheduling to see a myriad of medical providers, having to travel to see specialists, coordinating physical, occupational, speech and other therapies, working with the schools to get the services that their child needs, meeting with service facilitators, meeting with nursing agencies, checking in with their case manager, trying to get medications filled, and the list goes on….) and to require them to be an employee of an agency and complete all of their paperwork and training on how to care for their own loved one seems overly burdensome, especially for those who live in rural areas.   I hope that the protections that have been put in place through Appendix K can continue and allow family members to be compensated as the need for caregivers continues.  Thank you for your consideration.