I support comments that speak to eliminating the requirement for 24/7 nursing for CSUs, especially for smaller units and those that serve youth, as the need for this level of care has not been demonstrated in most of these settings; the use of medication and first-aid trained staff with access to on-call nursing/other emergent care responses that can fulfill a similar need and has been demonstrated as successful for these programs; and the severe shortage of nurses in the Commonwealth will not soon be alleviated. The cost of 24/7 nursing in relation to the per diem reimbursement is also cost prohibitive, especially for smaller units.