For families of children with disabilities, a service facilitator is not simply an administrative middleman. They are often the person who knows our child, understands our family’s circumstances, helps us navigate an incredibly complicated system, and makes sure we actually understand what services are available and how to access them.

Families receiving Medicaid waiver services are already carrying an enormous amount. We are managing appointments, therapies, school meetings, IEPs, medications, behavioral needs, transportation, paperwork, and the day-to-day challenges that come with caring for a child with disabilities. Expecting parents to navigate a broker-based system can make it harder for families to get the help they are entitled to receive.

My concern is that this change could shift the burden from the system onto parents.

A broker may be able to coordinate transactions or connect families with providers, but families need more than a list of services. We need someone who understands the whole picture of our child and can help us navigate the system when something goes wrong.

Children with disabilities are not one-size-fits-all. What works for one family may not work for another. Continuity, relationships, knowledge of the child, and individualized support matter.

Before making a change of this magnitude, I ask that decision-makers listen directly to the families who use these services. Please consider the unintended consequences—not just the administrative efficiency or cost savings.

If the goal is to improve Medicaid waiver services, then improve access, reduce paperwork, increase provider availability, and make the system easier for families to navigate.