Page 3-after line 21    Insert and renumber:


"(iv)  The study shall examine the current disability waiver programs for increased efficiencies.  The examination shall include the following items:


(A)  Alternative service delivery methods;


(B)  Means testing for household units of applicant children with developmental disabilities;


(C)  Identification of essential versus optional services;


(D)  Participation of clients in the cost of services through a sliding scale income qualification program;


(E)  Identification of efficiency improvements that can be implemented currently versus those that can be implemented only upon renewal of waiver approval by the Centers for Medicare and Medicaid Services;


(F)  The possibility of operating dual waiver programs simultaneously with differential eligibility and services features for current and new enrollees.".  BUCHANAN, GINGERY