Anoka County CDCS Coordinator's Corner Newsletter

WHAT'S NEW IN THE LAST 12 MONTHS???? April - August 2018


MAKING CHANGES TO YOUR PLAN?  Additions/Addendums are limited to one time a month unless it if for an immediate health or safety need.

MAKE THE SWITCH TO FEA/PAYROLL MODEL UPON RENEWAL – If you have not yet switched from Agency with Choice Model (AWC) to FEA/Payroll Model, please do so by renewal time. AWC model will no longer be available as an option in the near future.

CTIC RESOURCE FAIR Resource booths with information on services for transition aged individuals with disabilities. October 25, 2018 from 4 – 7 p.m. at the Blaine Human Service Center, 1201 89th Ave. NE, Blaine, MN 55434

FISCAL NAME CHANGE, SERVICES THE SAME – In the near future, your FSE (Fiscal Support Entity) will be renamed FMS (Financial Management Service). You should not notice a difference in services. There will be new providers to choose from.

$500 STIPEND AVAILABLE TO ALL PAID STAFF (Incl. paid parents/spouse)– In an effort to encourage better trained staff, the first 5000 staff that go through qualifying training will receive a $500 stipend (expires June 30, 2019). View E-Module for more information: http://pathlore.dhs.mn.gov/Courseware/DisabilityServices/3-DirectAccess/accessing/multiscreen.html

ENHANCE RATES FOR TRAINED STAFF  (5% increase to CDCS budget) to staff wages is not currently available for CDCS because federal approval is needed. Workers are Only eligible if the participant is assessed for 12+ hours of PCA hours. More information to come after approved.

UPDATES TO CDCS GUIDELINES. CDCS guidelines are subject to change throughout the year. The most current guidelines are located on our website at www.anokacounty.us/cdcs  (Go to Guidelines). Some of the recent updates include but are not limited to the following:
  •               Only one addendum is allowed per month unless immediate health and safety issue
  •               Shared care is only allowed as a licensed PCA service
  •               Adapted clothing – tagless is not considered adapted
  •               Adapted Swim Lessons – NEW FORM required. For SAFETY and progress reports
  •               Memberships to disability organizations allowed (e.g. Autism Society)
  •               Tutoring – case manager may request progress reports
  •               Weighted Blankets/Vests – only allowed with MA denial
  •               Camp – There must be assessed skills work at camp, not caregiver relief
  •               New suggested limits: Laundry services, fence internet costs
MULTIPLE PARTICIPANTS ON SELF-DIRECTED PROGRAMS IN THE SAME HOUSEHOLD? You must use the same FSE/FMS, cannot exceed 40 hours/week/worker and/or household, may require a family staffing schedule. Notify your case manager and your FSE/FMS in this situation for details.

PAID PARENT OF MINOR/SPOUSE SCHEDULE – Specific times are not needed in CDCS plan, just number of hours in the morning (a.m.) and afternoon/evening (p.m.). DO NOT EXCEED APPROVED NUMBER OF HOURS IN BUDGET SECTION.

WATCH THE VIDEO - DHS has new video explaining the basics of CDCS .  This is a great refresher. http://pathlore.dhs.mn.gov/courseware/DisabilityServices/3-DirectAccess/CDCS/multiscreen.html

DHS CULTURE SPECIFIC AUTISM VIDEOS AND RESOURCES PORTAL. Check it out!
NEW LICENSED EMPLOYMENT SERVICES IMPACT TO CDCS BUDGETS – With rate management service rate changes to these services, CDCS budgets will be impacted in some cases with higher rates for services or needing to add additional transportation costs. You may have to be creative with staffing and transportation services in order to still get needs met through CDCS. Talk to your case manager and/or support planner about creative options.

YOU HELPED BRING Vitals™ Aware Services TO ANOKA COUNTY! You let the community know that this was a need in Anoka County and now it is. This is a new technology service designed to improve interactions between law enforcement and people living with intellectual, behavioral and developmental challenges. Check it out and sign up.  https://thevitalsapp.com/ 

BUDGET DECREASED?  Talk to your case manager about your options. Recommend using lower budget if you decide to appeal otherwise may have to pay funds back or significantly reduce remaining services if the judge upholds lower budget.

EAA CONSULTATION SERVICES REQUIRED FOR HOME MODIFICATIONS
 - For major home modifications (over $1000) discuss process with your case manager. The first $5000/project must come out of your CDCS budget. Consultation services are required unless you get approval from a supervisor to bypass. $40,000 limit/service plan year (if funds available) for assessed needs that are essential in the areas of health, safety, accessibility, and promoting independence.

...............................MARCH NEWLETTER (below and updated)...................................................

NEW LOOK AND INFORMATION ON OUR WEBSITE - Go to www.anokacounty.us/cdcs  for more information about MnCHOICES assessments, Disability and Aging Services, and much more...

HAVE A SAY IN FUTURE SERVICES - "WAIVER REIMAGINE" Project - DHS has contracted with The Human Services Research Institute (HSRI) and the U of MN to conduct 2 studies and facilitate focus groups to:
Study 1: Provide recommendations on reconfiguring 4 waiver programs (BI, CADI, CAC, DD) to find efficiencies, simplifications, and improvements through reconfiguring program structures.
Study 2:  Provide recommendation on an individual budgeting model.
Go to Waiver Reimagine Focus Group webpage  for more information.

POSTPONED TO 2020 Electronic Verification For Staff Performing ADL’s and iADL’s. Staff will be required to report on the following:
(1) type of service performed;
(2) individual receiving the service;
(3) date of the service;
(4) location of the service delivery;
(5) individual providing the service; and
(6) time the service begins and ends.
More information and Training to come...

HELP BRING Vitals™ Aware Services TO ANOKA COUNTY
! Dakota County was the first county to launch Vitals Aware Service to their county.  This is a new technology service designed to improve interactions between law enforcement and people living with intellectual, behavioral and developmental challenges. Check it out and sign up.  https://thevitalsapp.com/ 

GRADUATES ARE ELIGIBLE FOR A 20% INCREASE TO THEIR CDCS BUDGETS IF:

  • There is a need for more CDCS services to either increase the amount of time he/she works or improve his/her employment opportunities
  • Is unable to meet those needs without the budget exception
  • Would have to stop using CDCS and use other, licensed services without the budget exception
  • If a current waiver recipient who currently does NOT use CDCS can demonstrate that upon choosing CDCS, his/her services would cost less annually than the licensed-day services or employment supports he/she currently uses. BE CREATIVE!!!! Ask your case manager whether you qualify.
 
WEIGHTED BLANKETS AND VESTS ARE NOW COVERED BY MA FOR DEVELOPMENTAL DISABILITIES PARTIPANTS AND THOSE WITH AUTISM -
Must have Occupational Therapist evaluation of medical necessity. Work with your medical supply company to order (Code: E1399 NU)

OPTIONAL WAGE INCREASE - Beginning January 2018 Anoka County will allow the "customary and reasonable rate" to be $12-$16.95/hour for direct care staff and the "specially trained/experienced rate" to be $16.95-$20/hour (rationale for the higher wage must be clearly documented in the plan or in an addendum). The maximum for paid parents of minors/spouse on the payroll model remains at $16.95/hour.

OPTIONAL MILEAGE RATE INCREASE FOR 2018 - The federal mileage rate is increasing from 53.5 cents/mile to 54.5 cents/mile beginning January 2018. You may pay your staff at or anything below this rate as agreed upon.

BUDGET CHANGES WITH MnCHOICES ASSESSMENT (DD ONLY) - All renewals require a MnCHOICES assessment moving forward by a Long Term Services & Supports (LTSS) assessor from Anoka County.  An assessor will contact you 1-2 months prior to when your new plan starts. Remember that accuracy is very important as this assessment is what ultimately determines your CDCS budget. You may notice a significant increase or decrease in your budgets. If your budget amount changes significantly, you may ask your case manager to look into it.  This is a new process with a large volume of cases; you may be delayed in getting your budget amount.  If so, you can still begin the renewal process by working off of the previous year's budget and then adjust it when the new amount comes in.

ELIGIBILITY REMINDER - Following are requirements in order to participate in the CDCS option:  Open to MA; participant/managing party not ever been on the DHS Restricted List; all direct care staff pass background study and be eligible for employment; not open to child/adult protection; not residing in a licensed facility/home (hospital, nursing home, jail, group home).

PPOM/SPOUSE = Personal Assistance Activities and Supervision ONLY - PPOM and Spouse MUST have at least ONE ADL dependency to be eligible to be paid.  They should only be getting paid to provide assessed ADL (iADL) activities and supervision above and beyond what is typical. On your work schedule indicate how many hours on average "above and beyond" you are working in the AM and PM (not specific times).

MAJOR ANOKA COUNTY GUIDELINE CHANGES IN 2017:
  • Internet now allowed - $10-$20/mo.(see specifics in guidelines)
  • Bio and adopted children of foster care providers may use CDCS (see specifics about whether parents may get paid)
  • Added:  Person Centered Planning
  • Added:  Language around restraints and seclusion
  • Community Activities - WAC may decide to pay for all or partial activities on case by case basis
  • SEIU changes - 1.5 for holidays ( Labor Day, Thanksgiving, New  Year's, MLK, Memorial Day), 20% increase for grads, PTO increase, minimum wage increase, etc.
ENVIRONMENTAL MODIFICATIONS REMINDERS:
  • Consultation Services is required for all major home modifications (except AC/EW)
  • $5000 is required to be taken out of your CDCS budget each plan year that you are doing home or vehicle modifications. Be planful.
  • $40,000 of needed modification funds are available each plan year (or a NEW exception process may be approved by DHS to borrow into the next service plan year).
YOU SPOKE. WE LISTENED.  Thanks for those responding to the participant survey. In 2017, the following changes occurred:
  • increased the length of orientation class to allow for more questions/interaction,
  • communicated more information regularly through our monthly newsletter,
  • provided other contacts/resources to you to improve awareness of what is going on legislatively and so you have more of a voice (See below)
In 2018, we are proposing the following, so stay tuned...
  • Online and evening training options
  • Quarterly Advance Training and/or Speaker
  • Multi-Lingual handouts
PPOM/SPOUSE INCOME MAY AFFECT OTHER PROGRAMS - Even though your income through CDCS may be excluded from paying income tax (IRS Notice 2014-7), other cash and food based programs may still count it as income.  Please check with each individual program and/or your Economic Assistance worker about how this income may affect your benefits.  PTO is taxable income.

PARENTAL FEE FOR TEFRA (FOR CHILDREN) DECREASE BY 13% (passed Summer 2017)

NEW MEDICAL MILEAGE REIMBURSEMENT PROCESS (beginning Sept. 1, 2017) - You will need to contact MTM to get a trip number prior to the appointment to record on the trip log. Logs will need to be turned in for reimbursement within 60 days.  Go to www.mtm-inc.net for more information. The number can be found on the back of your card or call member services.

ALTERNATIVE TREATMENT FORMS -
  • Please have physician or nurse practitioner initial the boxes or form is considered incomplete
  • Must be completed annually
  • Service not approved until form completed and approved by case manager
CHECK OUT THE NEW "RECOMMENDED" RESOURCES ON OUR WEBSITE - Go to http://www.anokacounty.us/2783/Resources and check out all the cool new resources that CDCS participants have recommended in the past several months. It includes different therapies, apps for autism and transition skills, summer programs, GPS trackers, adaptive clothing, and more.

ARE YOU WORKING WITH MULTIPLE PARTICIPANTS ON CDCS? If you are a paid parent(s) of a minor, you may only work a maximum of 40 hours/week combined between ALL minor children, parents/guardians and their plans. If you have adult children, the maximum is 40 hour/week for EACH parent/guardian. If you have one minor and one adult child you still cannot go over 40 hours/week for an individual parent and cannot go over 40 hours combined for the minor child between multiple parents.  An individual parent is not able to work more than 40 hours/week period based on labor laws.

ON CDCS AND THINKING OF BECOMING A FOSTER CARE PROVIDER?  There has been a policy change.  If your biological or adopted child is using the CDCS option you can get paid to provide foster care AND remain on CDCS, but CANNOT use the paid parent of minor (PPOM) option.  Exception:  You can be paid up to 25 hours/week for your child if you are providing foster care to a relative.  The children you are providing foster care are not eligible for CDCS. Ask your case manager for more information.

THE BUCK STOPS WITH YOU!  CDCS is a self directed program.  As the managing party you are ultimately responsible for making sure you complete your paperwork ON TIME (incl. CDCS plan submission, MA renewals, etc.) and DO NOT OVERSPEND!  Please make sure you are reviewing your spending summary every month to avoid overspending and any consequences. Pay attention to the %'s to make sure you are staying on track so you don't run out of money towards the end of your plan year. Your case manager, FSE coordinator, and/or support planner are there to help and give you the tools to keep you on track but it is ultimately your responsibility.

CONSIDER CHANGING FISCAL MODELS SOONER RATHER THAN LATER – At some point (likely sometime in 2018) everyone on CDCS will need to use the Participant Employer model (currently referred to as the Payroll/FEA Model).  You may want to consider switching to this model upon one of your next renewals if you are not currently using this model.  Please contact your FSE at least 2-4 weeks prior to your renewal if you plan to switch models to allow enough time to complete paperwork and process the change. Your accrued PTO will automatically be moved to the new model upon the switch.  Ask your FSE for more information about the benefits/ramifications of changing models as sometimes it makes sense to stick with AWC model.

INTERESTED IN LEARNING MORE ABOUT WHAT'S GOING ON LEGISLATIVELY IN THE DISABILITY WORLD?  Consider connecting to the following organizations:
- MN Department of Human Services at https://mn.gov/dhs/general-public/publications- 
  forms-resources/bulletins/
 ;
- Autism Society https://www.autismspeaks.org/resource/autism-society-minnesota ;
- PACER http://www.pacer.org/legislation/ ;
- The ARC of Minnesota http://www.thearcofminnesota.org/current-issues/ ;
- NAMI http://www.namihelps.org/nami-minnesotas-2017-legislative-goals.html .

MINNESOTA ABLE PLAN - Minnesotans with disabilities and their families can now save for goods and service to improve their lives under the new Minnesota (Achieving a Better Life Experience) Plan. The plan allows a maximum of $14,000/yr, to a total maximum of $100,000, to be contributed to an account for an individual before the individual's public benefits are affected.  For more information visit https://savewithable.com/mn/home.html

FREE SMARTPHONES AND FREE DATA AVAILABLE FOR QUALIFYING ADULTS - Go to www.safelinkwireless.com  for more information.

GET AN IPAD USING CDCS - Medical assistance will cover the cost of tablets when the primary use is for voice output communication.  Your speech and language pathologist may complete the paperwork needed.  Your case manager may also submit a letter requesting the tablet be "unlocked" in order to use other appropriate applications for such uses as emotional regulation, scheduling, fine motor skills, etc.  Ask your case manager for help with this process.  The waiver may pay for tablets that are denied by MA and still meet Anoka County guidelines (Complete Computer/Tablet Request form).

CDCS FORMS & INFORMATION AVAILABLE ON OUR WEBSITE.  Visit www.anokacounty.us/CDCS.  The new and revised "fillable" forms should now be used.  Toss away the old ones.  New forms include:  Addition/Addendum – general or PPOM/spouse, Computer/Tablet Request, Special Diet Request, Alternative or Specialized Treatment Form, Positive Behavior Plan, Non-Disability Camp Request Form, etc.  See the Forms and Guidelines section.

NON-DISABILITY CAMP REQUEST FORM (NEW) - For day and overnight camps that are not specifically geared towards those with disabilities, a new form must be completed describing how the camp will be adapted to meet the participant's assessed needs and how the health and safety needs of the participant will be met.

CELL PHONES & MINUTES NO LONGER ALLOWED - In today’s world a cell phone is a typical family/personal expense. Waiver funds are for items needed above and beyond what is typical and related to the disability.  Most adults qualify for free cell phones with minutes.  FREE resources include:  www.lifewireless.com or http://www.assurancewireless.com/ Public/Welcome.aspx) , and www.safelinkwireless.com

PLANNING A VACATION? You are still able to utilize staffing, both PPOM/Spouse or support staff along even out of state (not out of the country).  No other supports or services are available besides staffing however outside of the state of MN or its bordering states.

HOSPITAL OR NURSING HOME STAY?  During a hospital/nursing home stay, CDCS services cannot be used.  However, if staff worked prior to admission and/or after discharge on the same day, they can still get paid for their time.
 

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