Federally approved BI, CAC, CADI, DD and EW waiver plans, Minn. Stat. §256B.0913 (AC program)

The purpose of the CDCS enhanced budget is to help people with high needs attract and retain qualified workers.

A 7.5% CDCS enhanced budget is available for work that is both:

The eligibility for the enhanced budget changed from 12 hours of PCA/CFSS per day to 10 hours per day effective Jan. 1, 2022, for disability waivers and July 1, 2022, for Alternative Care (AC) and the Elderly Waiver (EW).

Note

Regardless of the number of workers who have completed the qualifying trainings, the person’s budget can be enhanced by 7.5% only once during the service plan year.

The results of the person’s MnCHOICES/legacy assessment will indicate whether they are eligible for 10 or more hours per day of state plan PCA/CFSS.

If the person did not receive a MnCHOICES/legacy assessment or CFSS Assessment, DHS-6893A, the case manager should complete an enhanced budget eligibility review by following the process on CountyLink – Enhanced budget eligibility review.

The case manager should keep copies of completed enhanced budget eligibility reviews, but they do not need to send copies to DHS.

This section provides an overview of the entire process for the CDCS budget enhancement. The sections below provide specific instructions for lead agencies, CDCS participants, financial management services (FMS) providers and workers.

1. The lead agency identifies CDCS participants eligible for the enhanced budget and tells them they meet eligibility requirements.

2. The eligible person’s worker completes qualifying training and submits documentation to the Minnesota direct support worker (DSW) training website for validation.

3. The DSW training administrator confirms the worker met requirements and emails a confirmation letter to the worker.

4. The worker gives the administrator’s confirmation letter to the person.

5. The person contacts the lead agency case manager/care coordinator and gives them the worker’s confirmation letter.

6. The lead agency does all of the following:

7. The person completes the bottom portion of DHS-6633B, signs it and submits it to the lead agency.

8. The lead agency reviews and approves DHS-6633B.

9. The lead agency gives the approved DHS-6633B to the FMS provider.

10. DHS processes the request to enhance the person’s CDCS budget. The enhanced budget is effective through the end of the person’s service plan year.

The lead agency is responsible to:

1. Identify and inform CDCS participants of their eligibility for the enhanced budget (see the eligibility section)

2. Verify the person has a qualifying worker by reviewing the DSW training administrator’s confirmation letter the person provided to the lead agency

3. Calculate the 7.5% enhancement to the person’s CDCS budget (see the how to calculate increase section)

4. Complete the top portion of CDCS Enhanced Budget Request & Community Support Plan Addendum, DHS-6633B (PDF) and submit it to DHS using the applicable instructions:

5. Wait for confirmation that DHS received the form

6. Give DHS-6633B to the person to inform them of the enhanced budget amount and ask them to complete the bottom portion of the form

7. Review and approve the person’s changes to DHS-6633B after the person submits it

8. Direct the person to revise their CDCS Community Support Plan, DHS-6532 to reflect the budget modification

9. Give the approved DHS-6633B and revised CDCS Community Support Plan to the FMS provider to implement the budget

10a. For people on BI, CAC, CADI and DD: Enter a corrected service agreement or service authorization into MMIS to reflect the budget change and enter a Y indicator in the PCA/CFSS complex field on the ASA2 screen in the service agreement

10b. For people on AC and EW (fee-for-service):

10c. For people on EW (enrolled in an MCO):

11. Keep the completed DHS-6633B in the person’s file.

The enhanced budget is effective through the end of the person’s service plan year. At the end of that year, the lead agency must follow the process and procedure in the reassessments section.

Confirmation

BI, CAC, CADI and DD

The lead agency does not receive formal approval or confirmation from DHS when DHS processes the enhanced budget request.

To confirm DHS processed the request, the lead agency should verify the person’s new budget generated in the Waiver Management System (WMS). This happens after the next WMS download.

The enhanced budget will be indicated by an E and double asterisks (E**) on the CDCS budget detail page.

AC and EW (fee-for-service)

DHS staff will approve the enhanced budget request and send an email confirmation or request further information from the case manager.

EW (MCO)

For people on EW enrolled in an MCO, contact the MCO for instructions on enhanced budget approval confirmation.

The CDCS participant (or their legal representative) should:

1. Ask their worker for a copy of the DSW training administrator’s confirmation letter that confirms the worker met training requirements

2. Give the worker’s confirmation letter to the lead agency

3. Receive CDCS Enhanced Budget Request & Community Support Plan Addendum, DHS-6633B (PDF) from the lead agency

4. Complete the bottom portion to indicate how they will apply the additional funds toward the wages and wage-related costs of personal care assistance of the qualified worker(s). Some wage-related costs include employer’s share of FICA taxes, Medicare taxes, state and federal unemployment taxes and workers’ compensation premiums. Wage-related costs do not include mileage reimbursement, health and dental insurance, life insurance, disability insurance, long-term care insurance, uniform allowance, contributions to employee retirement accounts or any other employee benefits.
(Note: The person can only apply the funds in the personal assistance service category for the qualified worker)

5. Revise their CDCS Community Support Plan, DHS-6532 to reflect the budget modification

6. Submit both of the following documents to the lead agency:

The FMS provider must:

1. Obtain the approved CDCS Enhanced Budget Request & Community Support Plan Addendum, DHS-6633B (PDF) from the lead agency

2. Apply the funds in the personal assistance service category on the FMS provider’s budget worksheet, as directed by the person.

The worker is responsible to:

1. Submit training documentation to the Minnesota DSW training website for validation (see DHS – Enhanced rate/budget for support workers)

2. Give the DSW training administrator’s confirmation letter to the eligible CDCS participant with whom they work.

At the time of the person’s annual reassessment, the lead agency must determine if the person continues be eligible for the enhanced budget by verifying both of the following criteria:

Then, the lead agency follows the applicable instructions:

If the person remains eligible

If the person remains eligible for the enhanced budget, the lead agency must:

1. Enter a Y indicator in the PCA/CFSS complex field on the ALT4 screen of the LTC screening documents (both fee-for-service and MCO)

2. Enter a Y indicator in the PCA/CFSS complex field on the ASA2 screen in the service agreement (fee-for-service only)

3. Inform DHS that the person remains eligible for the CDCS enhanced budget by:

When the person remains eligible, they do not have to complete the bottom portion of DHS-6633B. Their budget will continue to be enhanced, and there are no additional funds applied.

If the person is not eligible

If the person is not eligible for the enhanced budget, the lead agency must:

1. Enter an N indicator in the PCA/CFSS complex field on the ALT4 screen of the LTC screening document (both fee-for-service and MCO)

2. Enter an N indicator in the PCA/CFSS complex field on the ASA2 screen on the service agreement (fee-for-service only).

The lead agency should enhance the budget effective the first of the month both of the following criteria are met:

To calculate the total increase to the person’s CDCS budget, use the following example:

The person has a $60,000 budget for a service agreement/service authorization period that goes from May 1, 2021 to April 30, 2022 (i.e., $5,000 per month). The lead agency should calculate the budget increase for the time period starting at the beginning of the month the person met all requirements.

Prorating

The lead agency must prorate the person’s budget if eligibility is determined in the middle of the person’s plan year.

For example, if the worker completed the qualifying training on Sept. 15, 2021, the lead agency does not enhance the budget from May 1, 2021 – Aug. 31, 2021 (i.e., $20,000).

The remaining prorated budget (i.e., $ 40,000) for Sept. 1, 2021 – April 30, 2022 should have the 7.5% enhancement applied to it.

To apply the increase, multiply the Sept. 1, 2021 – April 30, 2022, budget amount ($40,000, in our example) by 1.075.

The result is $43,000, which is the new CDCS authorized budget amount for the Sept. 1, 2021 – April 30, 2022, period.

The lead agency then enters the additional amount (i.e., $3,000) in the “amount change” field on CDCS Enhanced Budget Request & Community Support Plan Addendum, DHS-6633B (PDF).