Every morning at 6 a.m., Debbi from Eagan, Minnesota, begins her 18-hour shift caring for her son Josh, who was born with a brain hemorrhage that left him with cerebral palsy. For more than 30 years, she's managed his ventilator, feeding tube and medications. She does this without a paycheck or a single day off. It's complicated her ability to work and hopes for retirement. But without her, Josh would require institutional care costing hundreds of thousands of taxpayer dollars.