Imposing a strict 40-hour work limit on parent care attendants disregards the individual needs and circumstances of the children under the CCC Plus waiver. Children with complex medical conditions often require round-the-clock care and support, surpassing the prescribed hourly limit. By failing to recognize this reality, the proposed changes risk depriving children of the necessary care they require for their health and well-being. Parents, who possess an intimate understanding of their child's unique needs, are best positioned to provide this specialized care. Restricting their caregiving capacity to a rigid hourly limit hampers the child's development and quality of life and burdens families, who may have to seek alternative and potentially costlier caregiving arrangements.