As  a pediatrician in a large practice in Fairfax County, I have several patients  receiving nursing assistance under the Technology Assisted Medicaid Waiver. I realize, more than most, that this assistance is vital for  both maintaining the life of each patient for whom the care is given as well as  for  the  sustainment  of the families of these children.In brief, I am suggesting the waiver  regulate the number of private nursing hours/week (112/wk)  rather than nursing hours/ day (16/day x7/wk). By alloting the hours weekly, there could be  flexibility in scheduling for missing shifts and for  different needs of families so totally dependent on this care for their special needs child. Thank you for this consideration.