Consumer Directed Care Plus

Transcription

1 Consumer Directed Care Plus Module: CDC+ 101 for Consultants 1 REVISED 9/2012..

2 INTRODUCTION This module is an introductory training for all consultants working with CDC+ consumers in the following programs: Aged and Disabled Adult Waiver (Department of Elder Affairs and Department of Children and Families); Traumatic Brain and Spinal Cord Injury Waiver (Department of Health); and Aging Out Program (Agency for Health Care Administration). 2

3 PART I OVERVIEW SUPPORT SYSTEM WAIVER REQUIREMENTS CONSULTANT ROLE CONSULTANT TOOLS 3

4 BRIEF OVERVIEW OF CDC+ CDC+ is an option for participants enrolled in the Aged and Disabled Adult Waiver (DCF & DOEA), the Traumatic Brain and Spinal Cord Injury Waiver (DOH), and the Aging Out Program (AHCA). CDC+ empowers the consumer to make choices regarding the provider of services and how the services will be delivered. CDC+ consumers are responsible for hiring, training, supervising, and terminating employees. 4

5 5 Waiver Case Manager SHIFT IN SUPPORT SYSTEM Medical Model Determines needs and service plan Oversees provision of services May seek participant input Establishes goals and outcomes Program parameters and standards limit flexibility Solves problems Assesses quality of services and supports CDC+ Consultant Social Model Works with participant to determine needs and service plan Assists participant with overseeing provision of services Participant involvement is critical Participant is responsible for goals and outcomes High flexibility of services and supports Advises participant on problemsolving strategies Participant assesses quality of services and supports

6 WAIVER REQUIREMENTS ADA Waiver Requirements Additional CDC+ Requirements Medicaid eligibility Level of care determination 701B Assessment Care plan reviews CDC+ Consent Form Agreements Consumer/Representative and Consumer/Consultant Personal Goal Setting Tool (PGS) CDC+ Budget Plan Monthly contact Report fraud, abuse, neglect, and exploitation Emergency back-up plan Monthly Consumer Review Form 6 Incident reporting

7 When CONTACT REQUIREMENTS Type of Contact Activity/Program Upon consultant knowledge Telephone or face-to-face Change Form (CDC+) Employer/Employee Agreement (CDC+) Incident reporting (ADA/CDC+) Fraud, abuse, neglect, exploitation reporting (ADA/CDC+) Monthly Telephone or face-to-face Assess client status (ADA) Monthly Consumer Review Form (CDC+) Quarterly Face-to-face Care plan review (ADA) Budget plan review (CDC+) Annually Face-to-face Level of care re-determination (ADA) 701B re-assessment (ADA) Care plan review (ADA) Budget plan review (CDC+) Emergency back-up plan (CDC+) Personal Goal Setting Tool (CDC+) 7

8 CDC+ Monthly Consumer Review Form The CDC+ Monthly Consumer Review Form ensures review of: services and supports; account statements; receipts and purpose for cash purchases; and vendor invoices. 8

9 Monthly Consumer Review Form 9 8/29/12

10 CONSULTANT ROLE: 10 What does a consultant do? INFORMS the consumer about options available for needed medical, social, educational, and other services regardless of funding source. COUNSELSthe consumer on choices available from CDC+, based on the ADA care plan and monthly allocation. TRAINSthe consumer on responsibilities as a household employer and CDC+ Program requirements. ASSISTSthe consumer in setting goals, and in understanding and submitting accurate/complete paperwork for continued CDC+ enrollment.

11 Consumer/Consultant Agreement A CDC+ consultant should: Provide training to the consumer/representative; Review the CDC+ Budget Plan to ensure it meets the consumer s needs; and Be available to answer questions. 11

12 Consumer/Consultant Agreement 12 8/29/12

13 CONSULTANT TOOLS Waiver Care Plan The Personal Goal Setting Tool (PGS) CDC+ Guidelines Account Statement Corrective Action Plan 13 CDC+ Program Office

14 Personal Goal Setting Tool (PGS) Required by the waiver; Required during the CDC+ enrollment process; Must be reviewed and revised annually or when there is a significant change on the care plan. 14

15 Account Statement Mailed to consumers or representatives monthly. Made available to consultants online for monthly review. Consultants need a user name and password to access the statements and information for their consumers. The CDC+ Program Office provides the user name and passwords for consultants. 15

16 Corrective Action Plan (CAP) Corrective action plans are developed by the consultant and the consumer/representative to correct a problem. Examples of circumstances where a CAP is appropriate: Overspending the budget (e.g., not having adequate funds to meet payroll or other obligations); Paying employees with cash to avoid taxes; Mismanagement of employees; Inability to self direct; Failure to comply with CDC+ Program guidelines. 16

17 Corrective Action Plan 17 8/29/12

18 PART II Additional Roles in CDC+ Consumer Representative Family Members Employees Vendors DOEA as Fiscal/Employer Agent (F/EA) 18

19 Consumer Consumeris the term used to identify the person currently enrolled on the traditional waiver who enrolls in CDC+. A consumer is considered a household employer by the IRS. Consumers must use their monthly allocation responsibly. 19

20 Representative Must pass a Level II Background Screening; Assists a consumer in managing the requirements of the CDC+ Program; Are not paid for this assistance; and Receives cash checks and other correspondence from the CDC+ Program Office. 20

21 Family Members/ Employees/Vendors Employees may include family members, friends, and neighbors. These directly hired employees often provide services, such as personal care, homemaker, chore, and respite. Vendors are often used to provide emergency back-up services when the regular workers are not available. 21

22 DOEA as Fiscal/Employer Agent Federal Requirements: Internal Revenue Service Federal Regulations/Law Center for Medicare and Medicaid Services State Requirements: Florida Department of Revenue Agency for Workforce Innovation State Regulations/Law Contractual Requirements: Subagents for information technology and financial services 22

23 CDC+ Program Office Customer Service Customer Service: address: 23

24 PART III Savings Change Forms CDC+ Website 24

25 Savings Consumers can allocate a monthly amount to save for items that increase the consumer s independence. The development of savings must be tied to needs identified on the waiver Care Plan and on the Personal Goal Setting Tool. An appropriate savings code must be on the consumer s CDC+ Budget Plan before purchasing the item. Consumers must always have an emergency back-up plan for critical services. 25

26 26 Purchase Request Form Instructions

27 27 Purchase Request Form

28 Change Form The Change Form is the most important form the consultants will use to keep the CDC+ Program Office informed of consumer changes. It is crucial that the consultant submit a Change Form to the CDC+ Program Office as soon as the consultant becomes aware of a change of address, hospitalization, or death of a consumer. 28

29 29 Change Form

30 Home page CDC+ Members Only Training Information Available for Download 30

31 31 Thank you.