I have read the budget content referenced for this proposed change.  I have not seen any fiscal data that may support the change from the Service Facilitator model to the broker model.  It is stated that any changes have to be budget neutral so there is no immediate fiscal impact.  DMAS has the authority to make changes regarding compliance within the framework of the program so there is no need to scrap the current model that "handcuffs" DMAS and prevents them from holding accountability over any operations within the current model.  

So, what is the real purpose of this proposed change?  I currently have Service Facilitators that have worked with my family for several years.  They are present, in person, several times a year to perform their assessments and proffer advice based on the trend data discussed.  They were very instrumental early on in passing along information regarding community assistance, programs, and resources available in our area.  They have continued to update us with any new information as it comes available.  They are personally familiar with our needs, the conditions of the individuals in need, and provide a consistent role in their care.  As they are always collecting information on progress and changes over time, it would appear that they are doing their due diligence in being compliant in obtaining supporting information for those in need of the program.  What more would a broker, new to the family, new to those with the need, provide that could not be adjusted for within the framework of the services of and/or requirements of the current services provided?  

What risk or actual problem with the current Service Facilitator model is actually being mitigated or corrected? 

Better controls can be implemented under the current model if that is an issue.  Oversight regarding new admissions, current assessments of needs and care can also be included.  If this is a matter of future fiscal concern, this is not the area the Commonwealth should be looking to make cuts regarding service, hours of support, in-home caregiver support, or implementing any changes that prevent care.  Only safeguards against fraud or abuse should be considered and implemented.  The care for the needy is a 24/7/365 job.  It is not an 8 hour per day and free on the weekends job.  

As this currently stands there is no actual or perceived value in this change from this participant's viewpoint.