COMMUNITY FIRST SERVICES & SUPPORTS OVERVIEW M inne s o t a Home Care A s s o c iat ion Fall Co nfe r e nce M inne s o t a D e p ar t m ent o f Human S e r vices Presenters Cara Benson, Disabilities Services Division Jane Vujovich, Aging & Adult Services N o ve m b er 1 4, 2 01 3 Community First Services and Supports (CFSS) means the assistance and support program under Medical Assistance State Plan for accomplishing activities of daily living, instrumental activities of daily living, and health-related tasks through hands-on assistance to accomplish the task or constant supervision and cueing to accomplish the task, or the purchase of goods that replace the need for human assistance. 2 WHY SUPPORTS? 2020 REFORM STRATEGY -- Redesign and improve services. PCA, CSG CFSS Better and different support to those living in community. Expand self-directed services under HCBS Improved individual outcomes Opportunities Under the 2010 Patient Protection & Affordable Care Act for Medicaid State Plan Option K and I and 1115 Broader service scope skills development, goods & technology to replace human assistance, transition etc. 6% enhanced Federal Financial Participation(FFP) 2013 Legislation established authority MN Statutes 256B.85 3 1
HIGHLIGHTS OF CFSS Minnesota s vision: to establish a self -directed state plan option with flexibility, responsibility, control, and accountability over services and supports as determined by the participant 27,000 PCA participants convert to CFSS by 10-1-14 Medical Assistance State Plan Option for FFS and Managed Care enrollees Assistance with and skills acquisition to complete ADLS, IADLS and health related tasks and back-up systems May include transition costs from institutional services that increase independence Access through MnCHOICES assessment Service amount based upon assessed needs Implementation Council 4 OPPORTUNITIES UNDER CFSS PCA Agency control Activities of Daily Living Instrumental Activities of Daily Living Heath related tasks Complex health needs CFSS Provides two service models Traditional Agency Budget Participants can use funds to purchase goods that increase independence or substitutes for human assistance Stronger self-directed focus Skill acquisition and Education 5 STRONGER PERSON CENTERED FOCUS Self-directed guiding principles Freedom to plan and live life as participant chooses Support to arrange and receive the help the participant needs Authority to control the allocation to participant within the established parameters Responsibility to accept the benefits and risk for choices made and to be accountable for the allocation spent Person-centered planning process Driven by the participant Includes people chosen by the participant Provides information and support so the participant is able to make informed choices Reflects cultural considerations of the participant Offers choice 6 2
THE FRAMEWORK MNCHOICES Assessment Agency Worker Training & Consultatio n Service FM S Budget Worker Training & 7 CONSULTATION SERVICE PROVIDER Consultatio n Service Required and available under both models of service Provides all participants with Information, instruction, and guidance for enhancing personal success with CFSS. Adds support and enhances quality of service Required services include Annual CFSS orientation, CFSS service delivery plan development and review and review/update orientation with any assessment or change in home care rating, and program integrity activities 8 AGENCY MODEL One of two options of service delivery for CFSS Agency A qualified agency provides services and supports through the agency's own employees and policies Allows participant to have a significant role in selecting and dismissing the support worker Provides or arranges Worker Training and (we will go over this later in the presentation) Works with the participant and Consultation Service contractor to finalize the plan Completes background checks for support workers, maintains personnel records, and reporting hours used 9 3
BUDGET MODEL Budget One of two options of service delivery for CFSS Adds a higher level of self-direction Participant is the employer and is responsible to recruit, select, train, manage, evaluate, supervise, and discharge support workers and may choose to have assistance from the Consultation Service provider Plans and defines services using CFSS service delivery plan and budget worksheet 10 FINANCIAL MANAGEMENT SERVICES FMS Contracted with DHS Is financial management support to the participant in the budget model Bills DHS for services and goods Pays support workers Provides Employer Agent Functions Completes the background check Files payroll taxes Obtains workers compensation policy Assists participant to maintain compliance with State and Federal laws and regulations Responsible for record keeping and reports participant spending related to support workers Is the support for compliance and program integrity by monitoring spending 11 WORKER TRAINING AND DEVELOPMENT Worker Training and QP like function in the current PCA program Available in both models Includes a variety of services for developing support worker skills as needed by the individual participant Services are listed and budgeted in the service delivery plan Arranged by the employer of the Support Worker and can include: Training Education Direct observation and supervision Evaluation or consultation pertaining to job skills, tasks and performance 12 4
QUESTIONS? 13 Contact us: DHS.CFSS@STATE.MN.US 14 5