Welcome. Department of Human Services March 25, 2016
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- Michael Patterson
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1 Welcome Department of Human Services March 25,
2 Financial Management Services (FMS) Changes to Consumer Directed Community Supports (CDCS) & Consumer Support Grant (CSG) 2
3 Acronyms & Definitions Community Directed Community Supports Consumer Support Grant Fiscal Support Entity Financial Management Services Request for Proposal Centers for Medicare and Medicaid CDCS CSG FSE FMS RFP CMS 3
4 Meeting Objectives Describe the role of current Fiscal Support Entities (FSE) vs the future Financial Management Services (FMS)providers Describe the proposed changes and who will be impacted Discuss our next steps 4
5 Currently. Overview Participants that are self-directing their waiver services (through Consumer Directed Community Supports (CDCS)) or self-directing their Consumer Support Grant (CSG)funds use Fiscal Support Entities (FSE) to help them with employer-related responsibilities and other financial services. FSE s provide a range of services that allow people to select how much independence they want in employing, managing and paying for services, supports and goods. FSE s offer 3 employment models: Fiscal Conduit Payroll Model Agency with Choice 5
6 CDCS Data In State Fiscal Year 2015, the overall annual count of people who used CDCS was 4,542 Agency with Choice Breakdown of employment model usage (as reported by FSE s 3/16) Payroll Model Fiscal Conduit #2,817 61% #1,701 37% #110 2% 6
7 CSG Data In State Fiscal Year 2015, the overall annual count of people who used CSG was 2,607 Agency with Choice Breakdown of employment model usage (as reported by FSE s 3/16) Payroll Model Fiscal Conduit #1,332 57% #891 38% #129 5% 7
8 Overview Future. Participants that are self-directing their waiver services through CDCS or self-directing their CSG funds will use FMS providers to help them with employer-related responsibilities and other financial responsibilities. FMS providers will offer only one employment model: Payroll Model In this model, CDCS and CSG participants are the employers of their support workers. 8
9 What s changing? Agency with Choice and Fiscal Conduit will no longer be options for CDCS and CSG participants. All CDCS and CSG participants will employ their support workers through the Payroll Model. Financial Management Services (FMS) providers will be enrolled providers and also have a contract with the state. 9 CDCS and CSG participants will no longer use FSE s.
10 Why is this changing? DHS has planned two Phases of implementation for the FMS providers. Phase I is the implementation of FMS providers for CDCS and CSG. We are selecting the FMS providers and starting this service with participants that are familiar with and have been using a similar type of service. Phase II will include participants using Community First Services and Supports (CFSS) When we transition to CFSS, participants who choose the budget model will use an FMS provider. Why will there be only one employment model offered? Our intent is to create one type of financial management services provider who will support all participants who choose a participant employer model of service. 10
11 Who will be affected by this change? All CDCS and CSG participants will be affected by this change. CDCS and CSG participants will need to select an FMS provider. A participant s current FSE may or may not be an FMS provider. 11
12 Scenarios What if a participant does not want to employ their own workers but still wants to select CDCS? A CDCS participant can continue to purchase traditional waiver or state plan services through an agency (i.e. 245D licensed provider, PCA) for their workers. What if a participant does not have any workers as part of their CDCS community support plan? (goods only) A participant can continue use CDCS. The FMS provider will assist them with the purchase of goods. 12 Can a participant s CDCS community support plan include a combination of traditional agency services and the purchase of goods? Yes, a participant can use CDCS for the purchase of goods, along with getting their workers through an agency (i.e. 245D licensed provider, PCA).
13 How will this change occur? Communication with participants and family members, lead agencies, FSE s, and interested stakeholders Prior to making any changes, DHS will provide notification to participants and lead agencies. Specific guidance, timelines, and instruction will be included in the notification Our intent is to transition participants to the FMS providers with the least amount of disruption to their services. 13
14 How will DHS obtain FMS providers? (FMS Process) DHS will: Publish a Request for Proposal (RFP) Review responders submissions to determine eligibility Enroll FMS providers (through Provider Enrollment) Contract with FMS providers Train providers Participants will: Select an FMS provider Lead Agencies will: Update participant s service agreements to reflect choice of provider 14
15 Now.. Then Current (FSE s) Future (FMS providers) Serves CDCS participants Required for CDCS participants Will serve CDCS participants Required for all CDCS participants Serves CSG participants Offers a range of employment models (Fiscal Conduit, Payroll model, and Agency with Choice) Will serve CSG participants until CFSS is implemented. At that time, CSG will go away. Will offer only one employment model Payroll Model Agency with Choice and Fiscal Conduit will no longer be an option 15
16 Now.Then Current (FSE s) Assist participants in obtaining their Federal Employer Identification Number (FEIN) for payroll model only Future (FMS providers) Assist participants in obtaining their Federal Employer Identification Number (FEIN) for payroll model (Participant Employers) Verify employment eligibility(background studies, I-9, W-4.) for support workers Verify employment eligibility(background studies, I-9, W-4.) for support workers Submit claims to the state for services/supports/goods Participants pay FSE fee from their budget Submitting claims to the state for services/supports/goods Participants pay FMS fee from their budget 16
17 Now....Then Current (FSE s) Pay workers Pay and file taxes on participants behalf Pay worker s comp if necessary Certified by the state MHCP enrolled provider Ongoing performance monitoring by the state Future (FMS providers) Pay workers Pay and file taxes on participants behalf Pay worker s comp if necessary Contracted with the state MHCP enrolled provider Ongoing performance monitoring by the state 17
18 Next Steps 1. Publish RFP and select FMS providers 2. Amend the disability waiver plans by adding information about the FMS providers 3. Conduct a formal 30-day Public Comment period 4. Submit waiver amendment to CMS for approval 5. Notify participants and lead agencies of timelines and instructions 19
19 Stakeholders Input Next Steps Prior to making changes to our waiver plans, and prior to our Public Comment period, DHS will obtain stakeholder input via a survey. 18
20 20 Closing
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