Speaking as someone who routinely works with families and invidiuals with challenging medical needs, I think it is a huge mistake to put any restrictions on the usage of nursing hours.  Families are already exhausted, overburdened, and overwhelmed.  Anything we do to make their job harder increases the odds that people with disabilities end up in costly and isolated placements or nursing homes.  

I support amending the langage so that nursing hours are allocated on a weekly basis.  I would also strongly support making it possible for missed shifts to be made up within a week.  If a family has a nurse call out, they are exhausted and to take away their option for nursing relief on an artificial deadline is needlessly cruel.

Thank you for your time.