March 2024 Special Edition - Legislative Update

On 1/30/24 an Elist went out from MN Department of Human Services informing the public of a CDCS policy change “allowing” parents of minors and spouses to potentially exceed working 40 hours in a 7-day period. To “approve” these increased hours, additional information is likely required. See the new MN DHS policy and implementation instructions below:

CDCS policy change about hours of paid personal assistance services

A spouse or parent of a minor is no longer limited to 40 hours of paid personal assistance services in a seven-day period.

The Centers for Medicare & Medicaid Services (CMS) approved DHS’ waiver amendment to increase the number of hours per week a spouse or parent of a minor can be paid as follows:

•   If one parent provides personal assistance services to their minor child(ren), the parent may provide up to 60 hours of paid support in a seven-day period.
•  If more than one parent provides personal assistance services to their minor child(ren), each parent may provide up to 40 hours of paid support in a seven-day period.
•   If a person’s spouse provides personal assistance services, the spouse may provide up to 60 hours of paid support in a seven-day period.

For more information, refer to CDCS Manual – Paying a spouse or parent of a minor for personal assistance.

Implementation instructions

The lead agency is responsible to follow its standard protocol to review and approve plan revision requests. For plan revision requests to increase the number of hours a spouse or parent of a minor can be paid, the lead agency must ensure:

•    Services fall within the description and allowable costs of the personal assistance services category.
•   Service hours meet the basic waiver criteria for allowable expenditures.
•  Paid tasks are not activities a spouse or parent of a minor would ordinarily perform or be responsible to perform.
•    Requested revisions are within the person’s budget amount.

If the lead agency approves additional hours that result in overtime pay, the person is still responsible to adhere to the overtime provisions of the U.S. Department of Labor – Fair Labor Standards Act (FLSA). The person should contact their financial management services (FMS) provider for assistance.

 Suggested Information Needed for Anoka County Approval:

Complete an Addendum or revise your CDCS Plan and submit it to your case manager. (Required) Along with this, it may be necessary to include other detailed information to determine the number of personal assistance hours that may be worked in a household:

• List the disability related needs of the person beyond what is typical for their age and the time/day it takes to accomplish these job duties. You may choose to use our CDCS Job Description Form - Blank found on our website to assist in quantifying the hours needed. 
  • Do not include typical parental responsibilities such as meal prep, cooking, grocery shopping, community activities, transportation to medical appts, etc.
  • Include information about whether personal assistance is needed during the nighttime (e.g., toileting needs, behavior redirection, etc.).
  • Add household duties related to person’s assessed needs (e.g., extra cleanup duties, extra laundry, etc.)
  • Do not include unpaid duties such as performing medical cares. However, staff may be able to be paid for additional health related supervision needs beyond what is typical.
• Determine which staff are best suited to work the needed hours and calculate whether your current budget amount supports the hours. You may have to prioritize and move funds around from other categories.
  • If the participant requires support over 40 hours/week, the participant/managing party may choose a parent/spouse to provide that support, even if it results in overtime.
  • Explain why this is the best plan to meet the needs of the participant.
• Provide an updated schedule including PPOM/Spouse and other Support Staff working throughout the week. (Required)
  • It may be helpful to have a different schedule for the school year vs. summer. 
  • If there are multiple participants receiving services in the household, include ALL staff and participants on the same schedule.
• Do not start submitting additional hours until after the hours are approved. We are unable to backdate. The approval date will be the date you submit the request to your case manager.

Other:

• It’s helpful to examine PCA assessment results and build off those needs to include more of the iADL, supervisory, and behavioral needs. Ensure your Support Planner has the MnCHOICES assessment documents needed to write this up (e.g. PCA Printout/Eligibility Summary or for Revision MnC: Assessment Summary, Supplemental Summary incl. Narrative summary).
• Typically, as a child gets older, if they still need a lot of supervision when their peers may not; it may be easy to document the extra supervisory and behavioral needs.
• For approving spouse hours, any personal assistance activities including supervision would typically be approvable.
• Implications For Paid Parents of Adults (PPOA):  As long as the participant requires support over 40 hours/week, the participant/managing party can choose the PPOA to provide that support, even if it results in overtime.  Each case will be looked at individually. 
• Overtime for other personal assistance staff:  Occasional overtime is allowed if planned for and approved in the CDCS Plan.  Regular or excessive overtime is not typically the least costly and most effective way to meet a person’s needs. It is often more cost effective to hire additional staff to meet staffing needs. Documentation is needed to justify the need for overtime.   Sometimes additional staffing can be difficult to obtain due to the staff shortage, high medical needs, high behavioral needs, etc. Each situation will be assessed individually.

For other 2023-24 Legislative Changes See our 2023 CDCS Newsletter - Winter Edition.