This is more a rant than anything, so... A little over a year ago I requested a PCA for difficult child. I was taking a promotion and it required my hours change. I couldn't take the promotion without having someone to be with difficult child. The first time the public health nurse came to evaluate the need, difficult child was in a bad place and she denied services saying that noone would be safe with my son. Okay, not going there lady. I've been safe as have everyone else. He's got a loud bark and no bite. We (difficult child mhsw, myself, and director of mental health here) demanded a re-evaluation due to the nurse not knowing the entire situation. At the re-evaluation he was given 4 1/2 hours a day. He's had his PCA for a year now. They get along very well. Even though I lost my job in April we've kept PCA working two days a week just to keep things normal for difficult child. About three months ago I got a letter saying it was time to evaluate difficult child for continued PCA services. I called the agency that provides the service, as they have to be the ones to request the evaluation. Three weeks ago the public health nurse finally called saying we had to get it done now. We set an appointment. for the following Thursday. Well, between the day she called and the appointment. I came down with what I was told was H1N1 so I called to change the appointment. We set it for last Friday. She showed up almost 1/2 hour late and says 'do you have documentation for me?'. I asked what kind of documentation she needed. She says 'documentation of behaviors'. Okay, what kind of documentation do you need? I will sign consents for you to have contact with the school, pca, skills worker, whoever you need. But no she needs me to get documentation. difficult children skills worker was here at the time and neither one of us could figure out what she needed. Finally after 10 minutes or so, she finally says she needs a letter from psychiatrist stating behaviors and duration on a daily basis. ARGH his behaviors are quite a bit less often and nowhere near as volatile. I don't know if it's because of maturity, medications or supports in place. She just acted like it didn't matter that I couldn't tell her why his behaviors were better and I should be able to. Excuse me this is an autistic child/teen who is not predictable due to adhd and bipolar. I can't tell you how often he is going to need redirection or how long it's going to take to redirect him.. I was getting so upset with her lack of knowledge about difficult children disorders and why having supports in place helps to keep him stable. Oh and did I tell you she needs the documentation by this Thursday? Oh yeah, lets give people time to get ahold of professionals, the professionals to have time to write letters and mail them! ARGH She has to have it all this week or difficult child will lose all PCA services because his contract ends Monday. She's known for three months that this had to be done and she's the one who put it off to the last minute, but I'm the one who has the added stress of last minute running to get it taken care of. This woman is so unknowledgable as to mental health issues! She was in my home for over 2 hours last Friday. She frustrated the he** out of me and I live with difficult child! I just got off the phone with psychiatrist. She is writing a letter to public health discussing difficult children behaviors and why having a PCA helps to keep his behaviors under control. She was going to mail it to me and have me take it to public health. I asked her to mail a copy to me, but fax a copy to public health nurse so she has it by Thursday. ARGH if there was a way to know why difficult child is so stable I wouldn't be asking for PCA if it wasn't needed. There isn't a way to know for sure without pulling the rug out from under difficult child. Not going to happen! He's stable, he's happy, he's going to stay that way if there's anything I can do about it. I wouldn't remove his medications to see if it's the medications and I'm not going to give up his PCA to see if that's what has done it. People who are evaluating a child should have to know about their disorders and not be so dam* mousey. My son has never injured anyone (okay he did bite a kid in kindergarten, but he was undiagnosed at that time). Having some mousey little old lady come into the house who has no idea of what I'm dealing with while he was unstable last year really may not have been the best idea, but isn't that when you need the additional support?