Ratios Folks.  It is all about ratios with care giving.  The lower the ratio, the better the care, period.  One-on-one is the best ratio available.  Lower ratios mean less problems ranging from dirty diapers to death.  I have seen group homes and day programs go over regulated ratios when no one is looking.  Happens all the time.  An employee calling in sick is all it takes to raise the ratios to unsafe levels.  Not only is the one-on-one ratio inherent in the CD program, but it is also the most affordable program that exists.  This program is being eroded by EVV.