My child has a severe respiratory condition that requires constant monitoring and the precise administration of oxygen therapy. I have become proficient in managing their ventilator and responding to respiratory distress, ensuring my child’s breathing is stable and safe. A new caregiver unfamiliar with the intricacies of this equipment could cause a fatal error. I should remain the primary caregiver to ensure my child receives the vigilant and expert care they need. Remaining as the first option as the LRI is essential because my immediate response to any changes in my child’s respiratory status can prevent life-threatening complications. Any amendment that changes this priority would put my child at severe risk by introducing caregivers who may not be as skilled or responsive. I strongly oppose the Application for 1915(c) HCBS Waiver: Draft VA.004.05.03, as it jeopardizes the safety and well-being of children with critical needs like mine.