While the MPAI is designed to be given by wide variety of individuals, it specifically states scoring and interpretation of results should be done by professionals with "training and experience" in tests, measurements, and ABI. As currently written, the QBIS qualifications for a case manager is not remotely close to enough training to have a working knowledge of neuroscience and brain injury. This tool is meant to be administered by an individual who has a good understanding of the person who is being evaluated. Using it as an assessment on initial contact will inevitably result in flawed results. Further more, it can be manipulated based on the interpreter to include or exclude a person based on external circumstances.

The requirement for this assessment to be completed in the residence has not been addressed and is still flawed. This is not always the best practice and is in direct conflict with similar local organizations. Not only do they not require in-home visits but they are directly prohibited due to safety concerns.

The MPAI also states that "People with severe cognitive impairment should not be given the MPAI." How would an individual with severe cognitive impairment be able to receive services when the assessment contraindicates using it at all?