Winter 2022 Edition

New Legislative Changes/Updates Effective 1/1/2022 (See 2021-2022 Legislative Updates Grid for more details):

AC/EW 3.4% increase to CDCS budgets
Enhanced Rate Eligibility went from 12 hours of PCA eligibility, to 10 hours of PCA eligibility and/or has home care rating EN.
AC/EW-Licensed rates increase for certain services
7.78% increase to Home care nursing, home care agencies, and therapies
Payroll taxes increased to 10.1% due to SUTA increase
Floating Holiday Implementation – ALL staff must be allowed 2 shifts of their choice to be paid 1.5% typical wage. Managing party must budget for this and staff give at least a 2-week notice.
Background Study Implementation – New staff must complete and pass Net Study 2.0 (finger printing) prior to working. Staff hired during pandemic must complete this by July 1, 2020.
COMING SOON! Minimum wage will increase to $15.25/hr. effective July 1, 2022.

2022 Non-Medical Federal Mileage Rate is .58.5 cents per mile. This is the maximum mileage reimbursement rate for staff. The FMS will not pay out more than this even if approved in the plan.

Reminders When Renewing CDCS Plans:
Get CDCS Plans in on Time! Policy states that CDCS services cannot start until a plan is approved. If the plan is late, nothing (incl. staffing) will be approved prior to the date the plan is received by your case manager. Case managers will communicate with the managing party and your FMS whether to suspend staffing until a plan is received and staffing approved. There will be no “back pay” for staffing and your case manager may issue a Notice of Technical Assistance. Any submission of timesheets and employee payment without an approved plan may result in employee having to payback those earnings.

Read the Participation Agreement Each Year. The Participation Agreement is located at the end of your CDCS plan and is a great review of what the expectations of the program and managing party are. When you sign the plan, you are agreeing to follow these rules.

PRIOR APPROVAL, PRIOR APPROVAL, PRIOR APPROVAL! Because CDCS is funded using Medicaid funds, reimbursement for costs can only be completed AFTER they have been incurred. For this reason, we cannot pay ahead for a full year subscription all up front (e.g., monitoring fee, recruitment fee, internet fee, etc.). Any ongoing fees must be broken down into monthly fees and claimed after the service has occurred. If it is cheaper to pay a year upfront, the managing party may choose to front the funds themselves and then get reimbursed a monthly amount ongoingly or at the end of the full 12 months may submit for reimbursement of the full amount.

Medication Administration and Nursing Tasks Cannot Be A Paid Job Duty for Unlicensed Staff: Unlicensed staff hired through the FMS (including PPOM/Spouse) are not allowed to administer medications or perform nursing duties as a paid activity. This is true even if parents or staff ARE qualified (e.g. they are a nurse). Go HERE for more information about what unlicensed paid staff can and cannot get paid for.

What Can I Do When Something in My Plan is Denied and I Feel Strongly it Meets Waiver Criteria? Your case manager will provide you with an explanation of why the county does not feel it meets waiver criteria per statute. If you would like to challenge this decision further, you can ask your case manager to have it reviewed informally by the Waiver Advisory Team. If it is still not approved, and you would like to appeal the decision formally, your case manager will send you a Notice of Action that explains specifically why it was denied and how to appeal the decision.

Shared Services Information Updated: Shared Services is a service that is provided at the same time by the same direct support worker to more than one CDCS participant and who has entered into an agreement (Edoc 6633D) to share CDCS services. In order to approve this service, your case manager will need a Family Schedule that includes a snapshot in time of a typical weekly schedule including all participants receiving services in the household and all staff. See the Anoka County Website for more information in our Anoka County Expenditure Guidelines regarding what your case manager must take into consideration in approving this service. Also in our Forms and Guidelines section there are tools to help determine appropriate shared activities and hours, fillable schedules, and samples.

If Using Licensed Services, Don’t Forget to Complete Alternative Provider Billing (APB) Form. The purpose of this form is to provide clarification to licensed providers about the number of hours/units that are approved and the agreed upon rate. If there are rate increases during the plan year, the rate must be changed in the CDCS Plan and the APB form updated to avoid any overspending. Your case manager will provide rates and copies should go to the managing party, provider, and the FMS.

Support Staff Bonus- Any requested bonuses must relate to an overall compensation package and outcomes achieved by staff (E.g., On time, longevity, specialized training, etc.). Parents, legal guardians, and spouses cannot be paid a bonus. It cannot be used for a “sign on” bonus, COVID bonus, holiday bonus, or to use up unused funds. Please see all the criteria that must be met in our Anoka County Guidelines.

Qualifying to be Paid Through CDCS If You Are a Parent of a Minor or Spouse. The participant MUST be assessed for at least ONE ADL dependency to be eligible. This is determined by the MnCHOICES assessment each year. PPOM/Spouse can only be paid for personal assistance activities, behavioral redirection, and additional supervision above and beyond what is typical for that age.

Qualify For and Need an Increase to the Budget? Following, are 2 options to pursue with your case manager:

30% Exception to the Budget Methodology - If a CDCS participant meets eligibility criteria and needs more than what the assessed base budget will allow for services related to Employment, Behavioral needs, more support for moving into their own home, or coming out of an institution/crisis setting; they can apply for an additional 30% increase to the budget. Eligibility and approval is determined by the Supervisors and CDCS Coordinators. Must be renewed annually.
7.5% Enhanced Budget - If CDCS participant is assessed for at least 10 or more hours of PCA/day or has a home care rating of EN, the case manager can assist you with the process of qualifying and applying for a 7.5% increase to your budget that could be used towards increasing wages/benefits of your qualified/trained workers. Eligibility must be reviewed annually.

Remote Services – Certain services can continue to be provided remotely during the pandemic to meet the needs of the person. See Remote Support Services Functions for examples of how this service may be used. This option is available at least through the summer of 2022 (6 months after Federal Peacetime Emergency Expires). DHS is also seeking permanent approval from the federal government.

Sensory Items and Equipment: It is helpful to get professional recommendations when requesting sensory items and equipment. However, just because a professional recommends the items, does not mean they will be approved. The items still must meet waiver criteria (e.g., be an assessed need and related to the disability, cost effective, not duplicative, not typical parental responsibility). Keep these criteria in mind when asking professionals to make recommendations.

Other Updates:
College Tuition Available for Staff Who Meet Income Guidelines. The Minnesota Future Together Grants offer tuition-free pathways for students in high-need career areas. Many direct support professionals who have not yet earned a bachelor’s degree are likely to qualify for these grants. Go Here for more information.

IT IS TAX SEASON… If you are a paid caregiver and live with a person with a disability, you may be excluded from paying federal/state income taxes on that earned income. We recommend consulting with your tax advisor re: IRS Notice 2014-7 to utilize this benefit. For more information, call the Disability Linkage Line at 866-333-2466.

Electronic Visit Verification (EVV) Is Coming: Projected Summer of 2022. The federal government will soon require FMS providers to use electronic visit verification systems to document that people are receiving the services that are billed to the state. This means that staff will need to use this system to track/document:

Type of service performed
Who received the service
Date of service
Location of service delivery
Who provided the service
When the service begins and ends.

Watch for more information about this and upcoming trainings from your FMS.

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Check out the new Frequently Asked Question Section for Environmental Accessibility Adaptations (EAA)

Website Updates: The Forms and Guides Section of the Anoka County website was updated and reorganized into the following categories:

CDCS Guidelines and General Plan Documents/Samples
Financial Management Service Resources
Writing the CDCS Plan/Support Planner Resources/Tips
Legislative Updates
Multiples and Shared Services Documents/Samples

Resources (not all inclusive list):
Resource for finding staff and making good matches. Care providers who have common interests and people they support tend to enjoy their jobs more and stay longer. Check out the following resources and tools at the Career Force Blog.

All unlicensed staff need to be hired through the FMS, but the following recruitment services may help find them:
Joshin Care https://joshin.com/medicaid-info-page
Care.com https://www.care.com
DHS Direct Support Connect https://directsupportconnect.com/

Post Secondary/Life Skills Programs: Post-secondary school tuition for a degree is NOT fundable, but did you know that CDCS can cover staffing support if staffing is necessary to complete an academic degree? And, if an academic degree is not an option, there are many “Life Skills College Programs” such as Bethel Build, Minnesota Independence College and Community (MICC), and Beyond Limits. These programs offer courses related to life skill development to live as independently as possible. Many times, these programs can be partially covered by CDCS. Courses related to independent living skills and employment skills, as well as staff support are allowable, as long as they are related to an assessed need. CDCS cannot fund room and board, food plans, or courses that are not related to an assessed need. Talk to your case manager for more information!

Wonder if Driving Is an Option? Courage Kinney Drivers Assessment and Training provides a one of a kind, drivers assessment and drivers education for people with disabilities. The assessment determines if driving is a safe option, and the drivers training is adapted for people with disabilities. This is typically an allowable expense under CDCS!

Weighted Blanket Needed? Medical assistance now funds weighted blankets and vests. Contact one of the following Medical supply companies for purchase:

Vests: Total Medical 763-784-6140 & Anodyne 952-546-5334
Weighted blankets: HandiMedical 651-644-9770 & Mesa LLC 612-501-5009

Need help writing a resume? Go to https://careerforcemn.com/resumes

Transportation needed? There are several options when it comes to transportation. Many options are covered by MA or the waiver. Check out the ARC’s Transportation Resources page.

Free or Low Cost Cell Phones For Adults:

Keep Informed. Sign Up For The State E-List. Individuals can sign up to receive information directly from the state when changes are about to happen. Go to http://mn.gov/dhs/media/news-from-dhs

Other General information about CDCS:
Consumer -Directed Community Supports Page (DHS)
CDCS Policy Manual
MHCP Provider Manual (What Does MA Cover?)
Community Based Services Manual (CBSM)
EAA (Home and Vehicle modifications) Frequently Asked Questions

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