Federally approved BI, CAC, CADI, DD and EW waiver plans, Minn. Stat. §256B.0659, subd. 17a, Minn. Stat. §256.476, subd. 11, Minn. Stat. §256B.0913

This page applies to workers who provide the following programs/services:

For information and instructions on the enhanced budget for CDCS participants, see CDCS – Enhanced budget process.

Some PCA and CSG workers are eligible for enhanced wages or benefits if they complete qualifying trainings.

Details

For workers in PCA traditional, PCA Choice, extended PCA and CSG, a 7.5% enhanced rate or budget is available for work that is both:

Note

Extended PCA hours do not count toward eligibility for the enhanced rate. However, if a person is eligible for 10 or more hours of state plan PCA and has a qualifying worker, the enhanced rate also applies to their extended PCA rate.

To qualify for the wage/benefit increase resulting from the enhanced rate or budget, workers need to complete qualifying trainings. The worker must submit documentation of completion of qualifying trainings on the Minnesota Direct Support Worker Training website.

Tracking qualifying training

PCA provider agencies and financial management services (FMS) providers should encourage workers to review DHS – Qualifying for the enhanced rate. It has information about how to register for qualifying trainings and submit documentation of completed trainings.

If the worker qualifies for the wage/benefit increase using a license or certification, their eligibility expires when that license or certificate expires. The worker is responsible to submit proof of continuing eligibility (i.e., an updated certificate or license or proof they completed another qualifying training) on the Minnesota Direct Support Worker Training website before their eligibility expires in order to remain qualified. If the worker fails to remain qualified, the provider agency will no longer receive the enhanced reimbursement.

The process to update the individual provider enrollment file can take up to 30 days after the DHS contractor verifies recertification. Workers should start the recertification process before their license or certification expiration date to avoid a lapse in enhanced reimbursement to the provider agency.

PCA traditional, PCA Choice and extended PCA

Starting on the date the worker qualifies, the PCA provider agency must pass on the 7.5% enhanced rate in wages and/or benefits to the specific worker who both:

CSG

FMS providers work with the person to add the additional information to the CSG plan to give the qualified worker(s) a 7.5% wage or benefit increase (see CSG process for FMS providers).

This section includes instructions for:

Instructions for eligible people with qualified workers

At initial assessment or reassessment, if the person meets eligibility requirements:

1. The assessor confirms the person's eligibility for the enhanced rate and enters the eligibility on the service agreement

2. The assessor authorizes the enhanced rate on the service agreement

3. The DHS contractor sends the worker a confirmation letter that they completed the qualifying training

4. The DHS contractor notifies DHS that the worker has completed the qualifying training, and DHS updates the worker’s provider file

5. The worker shows the confirmation letter, including the expiration date, if applicable, to the provider agency

6. The provider agency bills at the enhanced rate

7. DHS pays the claim at the enhanced rate when the worker listed on the claim is a qualified worker

8. Effective the date on the worker’s notification letter, the provider agency passes on the increase to the worker in wages and/or benefits.

Instructions for eligible people without qualifying workers

At initial assessment or reassessment, if the person meets eligibility requirements:

1. The assessor confirms the person's eligibility for the enhanced rate and enters the eligibility on the service agreement

2. The assessor authorizes the enhanced rate on the service agreement

3. The provider agency bills at the enhanced rate

4. DHS adjusts the claim to the non-enhanced rate.

People who receive CSG always have the option of working with their FMS provider to change a worker’s wage (within program rules).

At initial assessment or reassessment for CSG, if the person meets eligibility requirements:

1. The assessor confirms the person's eligibility for the enhanced budget

2. The assessor indicates the person is eligible in the service agreement and either:

If the FMS provider needs to modify an existing service agreement to include enhanced budget information, the provider must follow instructions in the modifying service agreements section.

Lead agencies, PCA provider agencies and FMS providers can request changes to a service agreement to authorize the enhanced rate/budget when the person both:

In this situation, the person’s current service agreement must end and a new one must be entered without completing a reassessment.

PCA not on a waiver

The PCA provider agency uses PCA Technical Change Request form, DHS-4074A (PDF) to request the enhanced rate from DHS. On DHS-4074A, the provider agency should:

DHS will verify the person's eligibility and take the following steps:

The service agreement span from the original assessment will remain the same.

The PCA provider agency can begin billing at the enhanced rate once all steps are completed.

PCA on a waiver or AC

The PCA provider agency and/or the person notifies the case manager of a qualified worker. The case manager will verify the person’s eligibility and take the following steps:

The service agreement and waiver/AC span from the original assessment will remain the same.

The PCA provider agency can begin billing at the enhanced rate once all steps are completed.

CSG

If the a qualifying worker is identified after the assessor enters the service agreement:

1. The DHS contractor notifies the worker that they completed the qualifying training

2. The worker shows the notification to the person who receives CSG

3. The person who receives CSG gives the notification to their FMS provider

4. The FMS provider uses PCA Technical Change Request form, DHS-4074A (PDF) to request the enhanced budget from DHS. On DHS-4074A, the FMS provider should:

5. Once DHS receives DHS-4074A, DHS will check to see if the person who receives CSG is eligible, update the eligible person’s budget and generate a service agreement letter through MMIS

6. The person and FMS provider will add the additional information to the plan to give the qualified worker(s) a 7.5% wage or benefit increase.