I echo the concerns voiced in the previous comments. It is incredibly concerning that ICFs could possibly be excluded from receiving funds to help them keep pace with economic conditions while providing the best possible care to some of our most vulnerable citizens. Many individuals served in these programs have incredibly complex medical conditions, require around-the-clock staffing and nursing care, and are at high risk for a variety of illnesses and infections due to their compromised health status. The individuals are often unable to communicate with words, and it is essential that they be served by stable staff who get to know them well and can best help monitor their health conditions. As an organization that has operated ICFs for the past 15 years, it has been evident that as individuals age, they need more support. In some cases, this has led to an increase in direct support staff as well as more nursing services and specialty services, such as occupational therapy and physical therapy, to ensure that individuals are able to experience the best quality of life in the community. As we worked to create community capacity for people coming out of the institutions, it was the promise of ICF services being cost-based that allowed many providers to proceed with this model which, although costly, is proven effective in serving some of our most vulnerable citizens. To cap funding on this service as it is intended to be provided is akin to pulling the rug out from under the individuals who have been able to thrive in the community at a time when many did not think it was possible for them to live outside of the walls of an institution. Consider the DOJ Settlement Agreement and the strides that have been made due to the ability of the community to meet the needs of previously institutionalized individuals in the community. The ICF model is a big part of that. It would be unwise to make any decision that would jeopardize the Commonwealth's standing with the DOJ Settlement Agreement. Placing a cap on funding for these programs will undoubtedly lead to consequences such as the inability to staff the programs which places the healthcare of the individuals at risk. This already high-risk population should not be subjected to such a harsh decision. Please consider that these are life-saving services and although they are costly, they work, and people need them. Please do not destabilize a system that has worked well for those who need it the most.