On page 11, it is stated that we must provide the MCO with updates and alert of concerns and issues, which what that could entail is not clear. This does not bring into consideration consent to exchange information (unless there was an emergency that would allow consent to be revoked). Reporting to others the relationship with the individual is not person centered if they do not wish to share in that information sharing. Ensuring access to care and service delivery is dependent on client participation in services, which cannot be ensured as a person centered approach.