Legal authority

Federally approved BI, CAC, CADI and DD waiver plans, 42 C.F.R. 440.180, Minn. Stat. §256B.49, Minn. Stat. §256B.092

Applicability

This page applies to the following waivers only:

For information on adjusting CDCS budgets for Alternative Care (AC) and Elderly Waiver (EW), refer to CDCS Manual – Partial-year budgets for AC/EW.

Definition

Annual CDCS budget: Total dollar amount available to purchase services over one service agreement period (i.e., a year) for all services on the person’s disability waiver. For information on how the county/tribal nation obtains a person’s annual CDCS budget, refer to CDCS Manual – Budgets.

Overview

This page describes how the county/tribal nation calculates a partial-year budget for a person on BI, CAC, CADI or DD, if necessary. The county/tribal nation must adjust the person’s budget when they:

Initial service agreement for a person new to CDCS

If a person is new to CDCS and the waiver, the couny/tribal nation enters a service agreement that is shorter than a full year. The county/tribal nation must:

1. Follow the directions on CDCS Manual – Budgets to find the person’s annual CDCS budget.

2. Divide the result of step 1 by:

3. Multiply the result of step 2 by the number of days in the person’s service agreement.

Switching between CDCS and traditional waiver services

If the person switches between CDCS and traditional waiver services within a service plan year, the instructions vary based on the person’s circumstances.

Switching from CDCS to traditional waiver services

If the person switches from CDCS to traditional waiver services, the county/tribal nation must:

Switching from traditional waiver services to CDCS

If the person switches from traditional waiver services to CDCS, the county/tribal nation must prorate the person’s CDCS budget based on their yearly CDCS budget to reflect the number of days remaining in the person’s service plan year.

Switching between CDCS and traditional waiver services multiple times in one service plan year

If the person switched from CDCS to traditional waiver and then switches back to CDCS, the county/tribal nation authorizes the lesser of the following amounts:

Facility stays up to 121 days

If the person resides in a facility for 121 or fewer days, the county/tribal nation follows the process on CBSM – Temporary waiver exits and restarts: MMIS actions.

Resuming CDCS

Person returns to the community within 30 days

When the person returns to the community within 30 days, the county/tribal nation must:

1. Work with the person and their financial management services (FMS) provider to determine the amount the person spent before they entered the facility.

2. Adjust the total requested amount (TOT REQ) of the existing CDCS line to the total amount the person spent.

3. Subtract the amount entered in step 2 from the person’s annual CDCS budget.

4. Add a new CDCS line to the existing service agreement with:

Person returns to the community between 30 and 121 days

When the person returns to the community between 30 and 121 days, the county/tribal nation must enter a new service agreement with a CDCS line. The county/tribal nation must:

1. Work with the person and their FMS provider to determine the remaining balance of the person’s CDCS budget by deducting the amount the person spent before entering the facility from their annual CDCS budget.

2. Enter a CDCS line on the ASA3 screen of the new service agreement with:

Closing the waiver

If the person experiences an event that requires the country/tribal nation to close their waiver, the county/tribal nation must exit the person from the waiver and end the CDCS line item in MMIS.

The county/tribal nation must:

1. Work with the person and their FMS provider to determine the total cost of CDCS services delivered to the person up to waiver closure. The amount cannot exceed the person’s annual budget.

2. Adjust the amount entered in the REQ TOT AMT fields of the now-closed CDCS line item authorization with the amount provided by the FMS provider.

3. Close the service agreement.

Changing the CFR

If the person’s CFR changes, the current CFR must:

1. Work with the person and their FMS provider to adjust the CDCS line item to reflect the total cost of services delivered to the person before the CFR change, up to, but no more than, the annual approved CDCS budget.

2.Close the person’s service agreement, effective the last date the current county is the CFR.

The person’s new CFR must:

1. Work with the person, previous CFR and FMS provider to authorize the remaining balance of the person’s CDCS budget on the line item.

2. Enter a new service agreement that starts the day the new county is the CFR.