Definition of the word "Broker" according to Merriam-Webster: Someone who acts as an intermediary, such as an agent who negotiates contracts of purchase and sale (as of real estate, commodities, or securities).

The choice of the word "broker" is highly inappropriate and only serves to diminish the dignity of people with disabilities. Care for human beings is an act of service that should be supported by agencies whose purpose is to ensure that individuals are receiving the care needed to maintain the ability to live in a home setting. We are NOT buying and selling "support."

Would you hire your accountant to determine the care needed for your aging parents or child with disabilities? No, you would not. This is exactly the scenario proposed when you remove Service Facilitation and hand the reins over to Fiscal Agents. Fiscal agents play a valuable role, but their expertise is financial processing, not assessing support needs, identifying risks, connecting families to resources, or ensuring the long-term success of vulnerable individuals living in the community.

Service Facilitation, or perhaps, if a new name is needed, might I suggest Support Facilitation, is an important unbiased intermediary between "the money" and the care individuals receive. This safeguard should be preserved.

There are other areas where money can be saved.

Maybe quarterly Service Facilitation visits are an acceptable compromise.

Maybe Medicaid can stop mailing duplicate paper documents to each member of the household.

Maybe require consistency from MCOs in approving the hours an individual is qualified to receive and stop the madness of constant appeals, wasted time, and wasted money funding this process.

Reducing Service Facilitation may appear to create short-term savings, but any savings could quickly be offset by increased hospitalizations, service failures, preventable crises, or unnecessary institutional placements. Service Facilitators help identify issues before they become emergencies and provide oversight that protects both individuals receiving services and taxpayer dollars.