I spend over thirtyfive years working with the disabled in one form or another and believed in what i was doing. But the way the programs are run these days there is little chance that these folks will reach the independence the providers cliam to be working towards. You see each person now has a dollar amount attached to them and all the providers are working at getting those dollars.Nowhere is there an outcome that would reduce the providers need to decrease services or they loose those dollars. Can you see how this works? In the old days we would pay a job developer to help a disabled person find a job. The first 20 hours of service was paid no question. Nomore payment was made until that person went to work. Now we pay as long as theu send a bill no outcome needed. We now TSC,PSR, workers going into the schools telling teachers how to teach. The schools that are mandated by to provide service now al;so bill Medecaid. it goes on and on. PAYMENT FOR OUTCOMES WOULD MILLIONS