The proposed changes will impact our ability to provide this service due to reduced rates and reduced numbers of individuals eligible for this service.  Community Services Boards are required to provide services to eligible consumers regardless of their ability to pay, which means we have to provide these services to Non Medicaid consumers which desire the service, when eligible.  Reducing rates not only impacts Medicaid recipients but also impacts our ability to serve the uninsured population.  Reducing the basic limit to 4 units per day will impact our ability to cover the costs related to travel.  District 19 CSB provides services to nine localities in South Central Virginia covering a large geographic area.  Therefore each trip to a consumer’s location must provide the funding necessary to cover the costs of staffing and travel.