Why is this change being made?

This change helps align the Consumer Directed Community Supports (CDCS) and Consumer Support Grant (CSG) programs with current Minnesota law (Minn. Stat., §256B.0711). Currently, “agency with choice” is offered by fiscal support entities and is a co-employment model. In the future, participants will use financial management services (FMS) providers and the participant will be the employer.

What are the benefits for the participant?

In many ways, the benefits of CDCS and CSG will not change. The participant will continue to:

• Self-direct their services and supports
• Retain budget authority
• Receive assistance from the financial management services provider for employer-related tasks.

Is the change a Centers for Medicare & Medicaid requirement?

No, this is not a CMS requirement.

What is the difference between the agency with choice model and the payroll model?

Agency with choice is a co-employment model. The agency is the common-law employer and the participant is the managing employer.

In the payroll model, the participant is the employer. He/she will need to obtain an Employer Identification Number (EIN) to employ support workers. Under the payroll model going forward, the financial management service (FMS) provider’s role will be to assist the participant with employer-related and other financial responsibilities.

Participant is the employer

What is the estimated timeline for this change to be put into effect?

There are several steps that need to happen before these changes can be made:. DHS first needs to:

1. Review the responses from the request for proposal and select financial management service providers
2. Amend the waiver plans by adding information about the financial management service provider
3. Conduct a formal 30-day public comment period for proposed waiver plan revisions
4. Submit waiver amendments to the Centers for Medicare & Medicaid Services
5. Notify participants and lead agencies of information and instructions on an ongoing basis during the process

We will keep everyone informed of the progress of these steps as we can. There is not a definite timeline for these steps.

Will CDCS and CSG participants need to change from a fiscal support entity (FSE) to an financial management service (FMS) provider in the middle of their plan or at their renewal?

Depending on when the change is implemented, we anticipate that some participants will change at the time of their renewal and some will change in the middle of their plan year.

What if a participant does not want to employ his/her workers but still wants to use CDCS?

A CDCS participant may continue to purchase traditional waiver or state plan services through an agency (i.e. 245D licensed provider, personal care assistance), for his or her workers.

What if a participant cannot find his/her own workers?

Can a participant’s CDCS community support plan include a combination of traditional agency services and the CDCS option to purchase goods?

Yes. A participant can use CDCS for the purchase of goods, along with using workers through an agency (i.e. 245D-licensed provider, PCA, etc.).

What is the expected number of FMS providers available to participants on CSG or CDCS?

That depends on how many people apply to the DHS request for proposal (issued May 2, 2016). Any qualified and willing provider can respond to the request for proposal. DHS will not limit the number of financial management service providers.

Will the process of contracting with FMS providers deter agencies from responding to the RFP?

DHS does not anticipate that the requirement to have a contractual relationship with DHS will deter qualified providers from responding to the RFP, and therefore to become an FMS provider.

Was the RFP published in the State Register?

Yes, the financial management service provider request for proposal was published in the State Register on May, 2, 2016. DHS also sent out an eList to announce its availability.

Given the FMS will be a contracted entity, what is the fee structure?

FMS providers will establish their own rates on a fee-for-service basis. Participants will purchase fiscal services from the FMS provider using their individual budget. DHS may establish maximum FMS provider fees. FMS fees and employment taxes will vary depending on which FMS the participant selects and the services in the participant’s plan.

Will the CDCS budget methodology change?

No. The change from an FSE to FMS model will not affect the current CDCS budget methodology.

Will this model cost less?

Can CDCS funds be used for transportation service?

Yes. Transportation will continue to be an allowable expense within CDCS and there are no policy changes planned. As always, transportation must be a part of the approved plan and follow expenditure guidelines for CDCS.

I’m a participant using the agency with choice model. I will be changing to the payroll model. What do I need to know about being my own employer?

The financial management service (FMS) provider will guide you as you make the change. It will provide information about and assistance with employer-related tasks, billing and other financial responsibilities.

What tax considerations do paid parents and paid spouses need to consider when they become an employee of the participant?

The paid worker still will need to pay federal and state taxes. Whether the taxes are withheld from their check depends on the relationship between the employer and their employee(s). The FSE or FMS can give participants information about their employer-related options as it relates to payroll tax withholdings.

What kind of support can participants, or their representative, expect from the FMS related to state labor laws, workers’ compensation, unemployment, and so on?

The FMS provider will ensure participants comply with all federal and state labor, tax and workers’ compensation insurance rules, timelines, and regulations for household employers. The FMS also will prepare payroll and related tasks for the participant’s individual workers.

Will participants or their representative become financial management services (FMS) providers?

No. The FMS provider has to meet certain (Vendor Fiscal Employer Agent) qualifications and contract and enroll with the state. Unless participants themselves, or their representatives, meet these qualifications, they cannot be an FMS provider.

If a participant doesn't choose the payroll model and still wants to self-direct, do they have to move to the personal care assistance (PCA) service? Are there other alternatives?

If a person selects CDCS, the person must use the payroll model. But, he or she does have the option to use his or her CDCS budget to purchase traditional waiver (245D licensed provider) or state plan services (such as PCA) through an agency.

Why would a CDCS participant choose to purchase traditional services within their CDCS budget, rather than have the full budget amount and use traditional services only?

Under the payroll model, are there increased liabilities to participants/families?

The change from the three-model to the one-model option does not change the participant’s risks or responsibilities, nor does it change fiscal support entity (FSE) or financial management service (FMS) provider responsibilities.

Will these changes impact traditional services purchased through CDCS, such as employment services?

This change does not affect providers of traditional waiver services. A CDCS participant can continue to purchase traditional waiver or state plan services through an agency (i.e. 245D licensed provider, PCA, employment services).

What do you mean by "purchase of goods?"

Under CDCS and CSG, participants can purchase goods as part of their support plan. Those goods could include supplies, equipment, adaptive clothing, assistive technology, or items in the support plan that are not services.

Can you give examples of the language changes you plan to propose to CMS?

No, not at this time. When we draft the waiver amendments, we will make the language available for a 30-day public comment period. That is when you can submit your feedback on the language and the changes.

Will there still be certified support planners to assist people and their families with writing their CDCS or CSG plans?

Will this change to the payroll model impact the assessment process or budget amounts?

No, this change does not impact assessments or the amount of the waiver or individual budgets. This only affects the type of fiscal provider available for CDCS and CSG participants.

Will the change affect lead agency authority to review and approve a participant’s plan?

How will this affect lead-agency case management?

This change does not affect lead-agency case management.

Who will provide the training to the selected FMS providers and participants about the new responsibilities and tasks?

DHS will contract with and train financial management service (FMS) providers.

FMS providers are responsible to provide training and support to the participant-employer in regard to all aspects of their duties when using payroll model.