CDCS and CSG fiscal changes frequently asked questions

This change helps align the Consumer Directed Community Supports (CDCS) and Consumer Support Grant (CSG) programs with current Minnesota law (Minn. Stat., §256B.0711). Currently, “agency with choice” is offered by fiscal support entities and is a co-employment model. In the future, participants will use financial management services (FMS) providers and the participant will be the employer.

In many ways, the benefits of CDCS and CSG will not change. The participant will continue to:

• Self-direct their services and supports
• Retain budget authority
• Receive assistance from the financial management services provider for employer-related tasks.

No, this is not a CMS requirement.

Agency with choice is a co-employment model. The agency is the common-law employer and the participant is the managing employer.

In the payroll model, the participant is the employer. He/she will need to obtain an Employer Identification Number (EIN) to employ support workers. Under the payroll model going forward, the financial management service (FMS) provider’s role will be to assist the participant with employer-related and other financial responsibilities.

There are several steps that need to happen before these changes can be made:. DHS first needs to:

1. Review the responses from the request for proposal and select financial management service providers
2. Amend the waiver plans by adding information about the financial management service provider
3. Conduct a formal 30-day public comment period for proposed waiver plan revisions
4. Submit waiver amendments to the Centers for Medicare & Medicaid Services
5. Notify participants and lead agencies of information and instructions on an ongoing basis during the process

We will keep everyone informed of the progress of these steps as we can. There is not a definite timeline for these steps.

Depending on when the change is implemented, we anticipate that some participants will change at the time of their renewal and some will change in the middle of their plan year.

A CDCS participant may continue to purchase traditional waiver or state plan services through an agency (i.e. 245D licensed provider, personal care assistance), for his or her workers.

A CDCS participant may continue to purchase traditional waiver or state plan services through an agency (i.e. 245D licensed provider, personal care assistance) for his or her workers.

Yes. A participant can use CDCS for the purchase of goods, along with using workers through an agency (i.e. 245D-licensed provider, PCA, etc.).

That depends on how many people apply to the DHS request for proposal (issued May 2, 2016). Any qualified and willing provider can respond to the request for proposal. DHS will not limit the number of financial management service providers.

DHS does not anticipate that the requirement to have a contractual relationship with DHS will deter qualified providers from responding to the RFP, and therefore to become an FMS provider.

Yes, the financial management service provider request for proposal was published in the State Register on May, 2, 2016. DHS also sent out an eList to announce its availability.

FMS providers will establish their own rates on a fee-for-service basis. Participants will purchase fiscal services from the FMS provider using their individual budget. DHS may establish maximum FMS provider fees. FMS fees and employment taxes will vary depending on which FMS the participant selects and the services in the participant’s plan.

No. The change from an FSE to FMS model will not affect the current CDCS budget methodology.

Maybe. FMS fees and employment taxes will vary depending on which financial management service (FMS) the participant selects and the services in the participant’s plan.

A CDCS participant can develop a plan that contains goods only. If a participant is only purchasing goods, there is no need for an Employer Identification Number (EIN). The financial management service (FMS) provider will assist the participant with the purchase of goods.

Yes. DHS is not changing the policy that relates to paying parents of minor and adult participants or a participant’s spouse.

Yes. Transportation will continue to be an allowable expense within CDCS and there are no policy changes planned. As always, transportation must be a part of the approved plan and follow expenditure guidelines for CDCS.

The financial management service (FMS) provider will guide you as you make the change. It will provide information about and assistance with employer-related tasks, billing and other financial responsibilities.

The paid worker still will need to pay federal and state taxes. Whether the taxes are withheld from their check depends on the relationship between the employer and their employee(s). The FSE or FMS can give participants information about their employer-related options as it relates to payroll tax withholdings.

The FMS provider will ensure participants comply with all federal and state labor, tax and workers’ compensation insurance rules, timelines, and regulations for household employers. The FMS also will prepare payroll and related tasks for the participant’s individual workers.

The participant still gets to choose who his or her support workers are. The change does not affect the participant’s responsibility to select and hire.

DHS still is working on the details of affiliation. We do know that participants no longer will use fiscal support entities (FSE), but instead, will need to select a financial management services (FMS) provider. A participant’s current FSE may or may not be an FMS provider.

No. The FMS provider has to meet certain (Vendor Fiscal Employer Agent) qualifications and contract and enroll with the state. Unless participants themselves, or their representatives, meet these qualifications, they cannot be an FMS provider.

If a person selects CDCS, the person must use the payroll model. But, he or she does have the option to use his or her CDCS budget to purchase traditional waiver (245D licensed provider) or state plan services (such as PCA) through an agency.

When a participant becomes waiver eligible, he or she has an option to self-direct his or her services through CDCS or to use traditional waiver services. The lead agency case manager or care coordinator informs the participant of their CDCS budget and their traditional waiver budget. This allows the person to make a choice about how services are delivered. CDCS allows participants to purchase traditional waiver services.

The change from the three-model to the one-model option does not change the participant’s risks or responsibilities, nor does it change fiscal support entity (FSE) or financial management service (FMS) provider responsibilities.

This change does not affect providers of traditional waiver services. A CDCS participant can continue to purchase traditional waiver or state plan services through an agency (i.e. 245D licensed provider, PCA, employment services).

Under CDCS and CSG, participants can purchase goods as part of their support plan. Those goods could include supplies, equipment, adaptive clothing, assistive technology, or items in the support plan that are not services.

No, not at this time. When we draft the waiver amendments, we will make the language available for a 30-day public comment period. That is when you can submit your feedback on the language and the changes.

This change does not affect lead-agency case management.

DHS will contract with and train financial management service (FMS) providers.

FMS providers are responsible to provide training and support to the participant-employer in regard to all aspects of their duties when using payroll model.

Yes, support planners still will provide support to participants. This change does not affect CDCS support planning services.

No, this change does not impact assessments or the amount of the waiver or individual budgets. This only affects the type of fiscal provider available for CDCS and CSG participants.

No. This change affects fiscal services to CDCS and CSG participants. It does not change lead agency oversight as it does not change other CDCS and CSG policies.