I have 70 hours currently approved through my MCO and service facilitator, but I am still encountering significant barriers. I've had phone interviews with several candidates, and most have not shown for the face to face interview. Transfers are a vital ADL next to bathing, dressing, and toileting; I have a walker in my home in addition to my power wheelchair, but I can't use a gait belt, transfer board, or Hoyer lift in or out of my house due to space constraints. I am aware of the safety risks that may occur and have been working to identify other alternatives, but accessibility is still a barrier and not always guaranteed. The hourly rate paid to a Consumer-Directed Attendant is $10.50 per hour (which is some progress in the last 17 years as a recipient) but Medicaid regulations only allow one caregiver to work a 40-hour max per week. Right now, both of my parents are working that max between 6AM-11PM, which means she can fully enjoy her retirement.