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Consumer directed community supports (CDCS) screening documents

Page posted: 8/3/26

The long-term care (LTC) screening document requires specific coding for the CDCS service option. This coding ensures MMIS applies the proper budgets within programs and allows you to authorize CDCS services on waiver and Alternative Care (AC) service agreements.

This page includes information about:

· Coding instructions.

· Exception codes.

· CDCS budget for Alternative Care (AC) and Elderly Waiver (EW).

· CDCS on Brain Injury (BI), Community Alternative Care (CAC) and Community Access for Disability Inclusion (CADI) waivers.

· Changing to or from CDCS during a service year.

· CDCS enhanced budget for AC and EW.

The information on this page does not include all instructions for completing a screening document or service agreement. It focuses on CDCS-specific information. For general instructions, refer to MMIS LTSS Manual – Work with LTC screening documents and MMIS LTSS Manual – Work with service agreements.

Coding instructions

The screening document identifies the person’s choice of the CDCS service option.

The ALT4 screen has the following fields related to CDCS:

· CDCS field that uses values Y for yes/elected to use CDCS or N for no/elected to not use CDCS. This is a required field for all waiver and AC program types.

· REASON FOR NF CONT STAY/CDCS ENDING field used when CDCS ends during a service year for people on AC or EW.

The ALT5 screen has a service summary that records two values related to CDCS:

· 40: CDCS.

· 41: Paid CDCS parent/spouse.

The ALT6 screen has a field called AC FEE WAIVER REASON. A person using the CDCS service option through AC does not have an AC fee. You must code the field with 09: Person is receiving CDCS.

Exception codes

MMIS may post the following CDCS-related exception codes on the LTC screening document.

Table 1: CDCS exception codes

Exception code

Title

Description

441

CDCS field missing or invalid

Status: 4 (suspend)

MMIS will post this exception code if the CDCS field is missing or invalid. If program type equals 01 through 12, the value must be Y or N.

If the person will receive CDCS services, enter Y. If the person will not receive CDCS services, enter N.

Note: The program types above do not include the Essential Community Supports (ECS) program type. CDCS is not an available service through the ECS program.

442

Procedure not allowed due to MRRP

Status: 4 (suspend)

MMIS will post this exception code if the CDCS field is Y and the span on the PCUR-RPCR screen within the recipient subsystem overlaps with the effective date field on the screening document. For more information, refer to MMIS LTSS Manual – Work with a person’s data and MMIS LTSS Manual – Recipient screen descriptions.

The person cannot use CDCS while on the Minnesota Restricted Recipient Program (MRRP).

CDCS budget for AC and EW

The monthly budget amount available for the person to purchase AC and EW services is based on:

· Effective date.

· Case mix classification.

· Program type.

MMIS automatically calculates the monthly CDCS budget cap on the LTC screening document. You can find the CDCS amount field on the ALT4 screen in MMIS.

MMIS populates the dollar amount in the CDCS amount field and identifies the person’s monthly CDCS budget cap as of the effective date listed on the LTC screening document. MMIS calculates the total amount allowed on the MMIS service agreement by multiplying the number of months in the support plan and/or the service agreement times the CDCS amount listed on the associated screening document(s) to calculate a total amount “not to exceed” the budget cap. If the support plan or service agreement header period changes (i.e., extends or shortens), the total amount available for service authorization will change as well.

The total amount is the total dollar amount available on the person’s support plan and/or fee-for-service (FFS) service agreement for all services except required case management, the cost of background checks, AC conversion case management and, for EW, any Moving Home Minnesota (MHM) services authorized.

Note: Before Jan. 1, 2024, the monthly case mix budget available for purchase of non-CDCS AC and EW services was different than the CDCS budget when the person selected the CDCS service option. For assessments and reassessments with an effective date on or after Jan. 1, 2024, the non-CDCS case mix budget dollar amounts and the CDCS budget dollar amounts are the same.

CDCS and EW conversions budgets

CBSM – EW hospital high-needs budget exception and nursing facility conversion budget includes information about eligibility, approval process and required forms for EW conversion budget requests.

For EW conversion screening documents (for program type 04), MMIS will post exception code 784 to route the screening document to DHS staff for approval if you manually increase the dollar amount in the CDCS amount field. This will happen regardless of whether the CDCS field is Y or N.

The exception code will not post and route to DHS if there is a managed care code in the long-term care consultation (LTCC) county field on the last approved screening document.

CDCS on BI, CAC and CADI waiver programs

For the BI, CAC and CADI waiver programs, the county/Tribal Nation authorizes a dollar amount to enter into the person’s service agreement based on the person’s support plan. This amount cannot exceed the state-established dollar amount.

The LTC screening document does not include information about budgets for these programs. CDCS budget information for BI, CAC and CADI is available in the Waiver Management System (WMS). For more information, refer to CBSM – WMS.

Changing to or from CDCS during a service year

A person on a waiver or AC can choose to use CDCS at any time during the service year. To record this change, use activity type 05 or 07 (administrative activity).

You must update the screening document when a person chooses to use or discontinue CDCS during a service year by changing the CDCS code from Y to N or N to Y.

MMIS does not extend the waiver or AC span when you change CDCS using activity type 05 or 07.

Additional steps for AC or EW

In addition to updating the CDCS code field on the MMIS screening document, you must use specific assessment results to select or discontinue CDCS on AC or EW during the service year:

· Assessment result 36 (elected elderly CDCS): Use this result when the person decides to use the CDCS service option during the service year.

· Assessment result 37 (elected elderly non-CDCS services from CDCS): Use this result when the person decides to discontinue using CDCS and change to non-CDCS services during the service year.
Note: When you use assessment result 37, you must add up to two reasons for continued or long-term institution stay (REASON FOR NF CONT STAY/CDCS ENDING field on the ALT4 screen) for why the person chose to end CDCS.

MMIS uses the effective date from the screening document to compare against the service agreement line item and header start dates. This effective date depends on the assessment result:

· Assessment result 36 (elected elderly CDCS): The effective date is the first day CDCS service can be authorized on a service agreement. The date before the effective is the date the lines for non-CDCS services that are not compatible with CDCS must end.

· Assessment result 37 (elected elderly non-CDCS services from CDCS): The effective date is the first day some non-CDCS service can be authorized on a service agreement. The date before the effective date is the date the CDCS service lines must end.

You cannot use assessment results 36 and 37 to close or exit a person from AC or EW.

Table 2: Screening document exception codes when changing CDCS election for AC and EW

Exception code	Title	Description
448	CDCS field equals N Status: 4 (suspend)	MMIS will post this exception code if the assessment result is 36 (elected elderly CDCS) and the CDCS field is not Y.
449	CDCS field equals Y Status: 4 (suspend)	MMIS will post this exception code if the assessment result is 37 (elected elderly non-CDCS services from CDCS) and the CDCS field is not N.
644	Reasons missing/invalid/duplicated Status: 4 (suspend)	MMIS will post this exception code if you do not have at least one unduplicated, valid code in the REASON FOR NF CONT STAY/CDCS ENDING field on the ALT4 screen. This field is mandatory when the assessment result is 37 (i.e., person is ending CDCS).

Additional steps for BI, CAC and CADI waiver programs

To change a person’s choice of CDCS on the BI, CAC and CADI waiver programs during the service year, use the activity type 05 or 07 and the assessment result 98 on the LTC screening document and update the CDCS “Y/N” field on the ALT4 screen.

CDCS enhanced budget for AC and EW

In MMIS, the enhanced budget is called “PCA/CFSS complex.” When a person on AC or EW is eligible for “PCA/CFSS complex,” you may need to increase the CDCS amount field to support higher costs for a qualified worker. For information about eligibility for PCA/CFSS complex and worker qualifications, refer to CDCS Manual – CDCS enhanced budget process.

Instructions to access additional CDCS funding when needed for AC and EW

To access additional AC/EW CDCS funding for PCA/CFSS complex:

1. Enter Y in the PCA COMPLEX field on the ALT4 screen of the screening document if the person needs PCA complex and has a case mix E, F, G, H, K or V.
Note: For case mix A, B, C or L, if you leave the PCA COMPLEX field blank or enter Y, MMIS will change the field to N when you press F9 after completing the screening document. For case mix V, if you leave the PCA COMPLEX field blank or enter N, MMIS will change the field to Y when you press F9 after completing the screening document.

2. Manually increase the dollar amount in the CDCS AMOUNT field on the on the ALT4 screen of the screening document.

3. If the screening document effective date is Jan. 1, 2024, or later, manually increase the CASE MIX AMT field on the ALT4 screen of the screening document to match the increased amount listed in the CDCS AMOUNT field.
Note: For AC and EW diversion program types, if the PCA COMPLEX field is N when you increase the amounts manually, MMIS will decrease the amounts in the CASE MIX AMT and/or the CDCS AMOUNT field to the state-established amount allowed for the person’s case mix classification. If the amounts manually entered are less than the amount allowed for the person’s case mix MMIS will change the amount back to the state-established amount allowed.

When you increase the amounts, exception code 784 will post to route the screening document to DHS staff for approval, unless there is a managed care code in the LTCC county field on the ALT1 screen. DHS does not approve CDCS budget increases for people in managed care.

After DHS approves the screening document, you must follow the applicable service agreement steps below, depending on whether the current agreement includes PCA/CFSS or new PCA/CFSS line items will be added to an existing agreement. For additional instructions, refer to MMIS LTSS Manual – Route the LTC screening document for additional approval.

Current service agreement includes approved PCA/CFSS lines

If the current service agreement includes approved PCA/CFSS lines and the PCA/CFSS COMPLEX field is N:

1. End the current service agreement. For instructions, refer to MMIS LTSS Manual – Close a service agreement.

2. Create a new service agreement for the remaining months of the current service year. For instructions, refer to MMIS LTSS Manual – Create a new service agreement. MMIS will populated a new total cap amount on the new service agreement based on the CDCS amount field on the most recently approved screening document.

3. On the new service agreement, code the PCA/CFSS COMPLEX field as Y on the ASA2 screen.

4. Take the appropriate action on the service agreement:

· For AC: Increase the CDCS line item T2028 on the service agreement to cover the additional cost of the PCA complex services.

· For EW: Enter T1019 TG for PCA/CFSS complex service authorization lines.

5. Enter line items for CDCS and other allowable services from the support plan.

6. Press F9 to display exception codes.

7. Resolve any exception codes.

8. Press F3 to save and exit the service agreement.

Current service agreement does not include PCA/CFSS or only includes denied line items

If the current service agreement does not include PCA/CFSS or only includes denied PCA/CFSS line items:

1. Add PCA/CFSS complex line items to the existing service agreement. For instructions to change an existing service agreement, refer to MMIS LTSS Manual – Change an existing service agreement.

2. Change the PCA/CFSS COMPLEX field to Y on the ASA2 screen. MMIS will populate the total cap amount on the current agreement based on the CDCS amount field on the most recently approved screening document.

3. Change the status of any existing PCA/CFSS line items with a pended or suspended status to D (deny).