I am a grandmother of a 40 year old young man with multiple disabilities. He requires 24 hour care and monitoring .He is on the CL waiver and receives more than 56 hours weekly but requires 24 hour care. His Mom provides the care because it is virtually impossible to hire a caregiver for $13.88 hourly. His care does not stop when the shift ends and the attendant pay is so little that even with any additional approved hours it is important to maintain the lifestyle my grandson is accustomed to . He is prone to seizures during the night as well as frequent changes of bed linen and pajamas as he is incontinent. If he is sick during the night someone is up with him. Therefore his attendant survives on less sleep than they should have nightly. If we were fortunate enough to find an attendant who would work the other hours that are not approved they have to be paid so my grandson’s Mom would have to find a job outside the home  to pay the attendant. That is why many parents stay home with their family members with disabilities because no one is dependable and many parents have had to quit their jobs because of that.They go to work and then their attendant does not show up or calls in sick. The parents who are paid to provide the care for the family members who have disabilities provide the necessary care above and beyond for their  family member  with love and this allows them to thrive unlike institutions where they are neglected and just another person with a disability. You will be forcing many individuals with disabilities into nursing homes and institutions. They have a right to live in the community and receive the care they need to thrive. It has been proven that people who previously lived in institutions can thrive in the community. Please do not take their choice away. The 56 hour cap on attendant hours is unfair to many individuals due to their needs  .

Concerns  about eliminating Service Facilitators and replacing with Support Brokers :

   1. I am concerned that the Support Brokers will not be able to write a plan of care that will be accepted by DMAS.

  2. Who will train the Support Brokers and what kind of training will they  have ?

  3. Will there be an avenue for the Support Broker to challenge decisions made by the fiscal agent on behalf of the consumer ?

  4. How will the Support Broker know the needs of individuals with  disabilities if they only see them several times a year and virtually at that?

  5. Is it a conflict of interest for the Support Broker to be employed by the fiscal agent ?

  6. What will the caseload be for Support Brokers?

   7. Will the support Broker be able to address and correct issues with  attendant pay and authorizations ?

8. Who will address complaints that may arise if we do not agree with the Support Broker?

  9. I hope there will be  reconsideration on both of these matters . The 56 hour cap on attendant hours and eliminating  service facilitators and replacing with support brokers. It is vital to individuals with disabilities to keep these services .It is vital that they receive the services they need to continue top thrive in the community. 

 It should be a choice for people with disabilities!