There is no valid reason to bar parents and spouses from performing attendant care for consumers. Doing so will expose the most vulnerable members of society to abuse and neglect and create an enormous burden on families. No one wants to do this very difficult job for low pay and almost nonexistent benefits and agencies cannot provide the staff necessary to replace family members. The fiscal intermediaries responsible for payroll are already so understaffed and poorly trained that it takes months to process an application, during which time attendants are not paid so they obviously quit because no one wants to work for free. My consumer absolutely will injure herself and others if we are forced to have a revolving door of unfamiliar attendants in our home. As The Commonwealth of Virginia is STILL not in compliance with the Department of Justice settlement agreement of 2012 it would seem they should be attempting to improve this program instead of making worse. Consumer choice should be the first thing considered when hiring a caregiver and is the right of the consumer. Disallowing parents and spouses will result in poorer outcomes and greater financial difficulties for families and higher costs for taxpayers.This is allowed by CMS and should be continued. If you decide to proceed with this cruelty please clarify the language because those of us who are just live-in attendants but not parents, spouses or legally responsible parties are being told that we will no longer be paid. Just knowing that this is a possibility has created enormous stress and worry for thousands of families, please do the right thing and continue to allow families to care for their disabled loved ones with dignity.