Community Living Supports: how to request more hours
The hours you get are driven by the words in your documentation, not by how tired you sound on the phone. Here is how to word a request so it reads like a level-of-care case instead of a complaint.
Take whatever you were about to say on the phone and turn it into one written sentence naming a specific skill deficit or safety risk. That single rewrite is often the entire difference between “we’ll keep that in mind” and an actual hours increase.
Functional assessments
The specific skills your family member can and cannot do independently drive hour authorizations more than any narrative description.
Safety risk language
Naming a specific, documented safety risk moves a request differently than describing general caregiver fatigue.
The request that gets denied by habit
“We need more hours because we’re exhausted” describes your reality accurately and still gets filed as a wish, not a need.
The request that gets read as a case
“He requires hand-over-hand assistance for meal prep and cannot be left unsupervised near the stove” names a specific, assessable need.
Frame it against the standard
Tie your request to the same level of care language your plan is already measured against.
Attach the documentation
A functional assessment, an incident log, or a provider’s note attached to your written request carries real weight.
Bad wording vs. better wording
“He requires physical assistance for 3 of 5 daily meal-prep steps and has burned himself twice unsupervised.”
“Overnight supervision is currently unfunded and has produced two documented elopement attempts since March.”
“She has lost 2 of 4 previously independent hygiene steps in the last 60 days, per the attached log.”
“Current authorized respite covers 0 of the 20 weekly hours our documented caregiver strain assessment recommends.”
Nadia had asked for more CLS hours twice, verbally, and been told to wait for the annual review both times. Before her third request, she wrote one sentence naming exactly which daily living steps her son could not complete without hands-on assistance, and attached his most recent functional assessment. The same case manager approved an increase within three weeks.
When you’re ready to request more CLS hours, here is how to frame it
Request ladder
- 1Identify the specific functional deficit involved.
- 2Document any related safety risk explicitly.
- 3Rewrite the request using level-of-care language.
- 4Attach a functional assessment or incident log.
- 5Submit the request in writing, not just verbally.
- 6Follow up in writing if you don’t hear back in two weeks.
Have ready
- A specific, named functional deficit
- Documented safety risk or incident history
- A recent functional or behavioral assessment
- A written request using level-of-care language
- A dated follow-up plan if there’s no response
The need was real either way you phrased it. Only one phrasing gets read as evidence.
Nadia asked for more Community Living Supports hours twice, both times over the phone, both times describing how exhausted her family had become. Both times she was told to wait for the annual plan review. Before her third attempt, she wrote a single sentence naming exactly which daily living steps her son could not complete without hands-on assistance, and attached his most recent functional assessment. The same case manager who had twice told her to wait approved an hours increase within three weeks. Nothing about her son’s needs had changed between the second request and the third. Only the words had.
Documentation drives hours. Exhaustion drives sympathy.
Case managers and PIHP reviewers are not measuring how tired your family sounds. They are measuring documented functional need against a level of care standard, whether or not anyone ever explains that standard to you plainly. “We’re exhausted” and “we need more help” describe something completely real, and neither one gives a reviewer anything specific to authorize against. A request built around a named functional deficit or a documented safety risk gives them something they can actually approve.
Bad wording versus better wording, side by side
“He needs more help” becomes “He requires physical assistance for three of five daily meal-preparation steps and has been burned twice while unsupervised at the stove.” “We’re exhausted” becomes “Overnight supervision is currently unfunded under his plan and has coincided with two documented elopement attempts since March.” “She’s regressing” becomes “She has lost two of four previously independent hygiene steps in the last sixty days, per the attached daily log.” Each rewrite says something true that was already true in the vaguer version. It just says it in a form a level-of-care review can actually act on.
Frame the request against the standard your plan is already measured by
Your family member’s eligibility for services already rests on a specific level of care standard. Your hours request should speak that same language back to the system, rather than describing your family’s experience in terms the standard was never built to recognize. This isn’t about hiding the real emotional weight of what your family is carrying. It’s about translating that weight into the specific vocabulary the system is actually built to respond to.
Attach the paper, don’t just describe it
A functional assessment, a dated incident log, or a provider’s written note attached directly to your request carries more weight than the same information described secondhand in a phone call. If you don’t have a recent functional assessment, ask your case manager how to get one scheduled before your next plan review, specifically so you have current documentation in hand when you make your request.
Before your next request. Identify one specific functional deficit or safety risk and write it in a single, specific sentence.
When you submit it. Attach whatever documentation you already have, and put the request in writing rather than relying on a phone call alone.
The need was never in question. Whether it gets read as a case or a complaint depends entirely on which words carry it into the room.
Jim Palasty is the founder of OASIS for Autism and a single father of an adult autistic daughter in Michigan.