I would like to echo the comments made by VACIL as well as advocate for support and an increase in reimbursement for Service Facilitation. VAIL's Service Facilitators are critical to the success of Waiver Services in our area.  VAIL staff perform a tremendous job in advocating for what consumers need, being the consistent person that the consumer sees and connects with.  Prior to the MCO's coming access to home modifications was a smooth process with the exception of being able to secure a contractor.  Flexibility for contractors or approval of a contractor needs to be in place.  Service Facilitation is a critical service that empowers the consumer and keeps the consumer out of the medical model which is the purpose of consumer direction.  Thank you for the opportunity to share these thoughts.