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Instructions to apply temporary 8.4 percent COVID-19 rate increase for PCA participants

NOTE: DHS updated this on Dec. 17, 2020, to reflect federal approval, completion of MMIS updates for the temporary increase and a new FAQ resource

The following includes detailed instructions for providers and lead agencies (counties, tribal nations and managed care organizations) to implement a COVID-19-related increase for personal care assistance (PCA) services to cover costs for direct support.

Background

Recent legislation (Minnesota Session Laws, 2020, 5th Special Session, Chapter 3, Article 10, Section 4) allows for a temporary rate increase for direct support workers to respond to COVID-19. Therefore, DHS will temporarily increase rates/enhanced rates for direct support services provided to PCA participants by 8.4 percent. (The increase does not apply to qualified professional (QP) supervision services (T1019 UA) but applies to T1019 with any other modifier.)This document includes instructions to distribute this increase.

There is a parallel increase for people who access consumer directed community supports (CDCS) and the Consumer Support Grant (CSG), as well.

Effective date

DHS received federal approval for this temporary rate increase. The effective dates will be Dec. 1, 2020 through Feb. 7, 2021.

Implementation

To implement the temporary change, DHS will apply the increase through claims for personal care services provided during the effective dates. MMIS changes have been completed and any claims that were processed before MMIS changes will be automatically reprocessed to add the temporary increased rate.

Fee-for-service participants

When a provider submits a claim for a fee-for-service participant, the provider will receive the 8.4 percent add-on for any service dates between Dec. 1, 2020, and Feb. 7, 2021.

EW participants enrolled in managed care

For EW participant who use managed care, the provider will submit claims to the managed care organization (MCO) as usual. The MCO will pay an additional 8.4 percent to the provider for each claim submitted with service dates of Dec. 1, 2020, through Feb. 7, 2021.

Requirements

When using the additional funds, the PCA agency must:

  • Use at least 80 percent of the additional revenue to increase wages, salaries and benefits for direct support workers and any corresponding increase in the employer's share of FICA taxes, Medicare taxes, state/federal unemployment taxes and workers' compensation premiums
  • Use the remainder of the additional revenue, if any, for activities and items necessary to support compliance with Centers for Disease Control and Prevention (CDC) guidance on sanitation and personal protective equipment.

For each participant, the provider must document and retain records showing both:

  • The additional funds received (as a result of the add-on) for all services with a date of service between Dec. 1, 2020, and Feb. 7, 2021
  • The additional funds paid out for wages/salaries/benefits to direct support workers and/or personal protective equipment/supplies.

Distribution plans

PCA agencies must develop a distribution plan that includes an estimate of the amount of money to be used for employee increases and details distribution of the funds. Providers must post the distribution plan by Dec. 20, 2020. It must be in an accessible location for employees for at least six weeks. The plan also needs to be available for review by the DHS upon request.

The distribution plan needs to include information for employees who believe they did not receive the compensation-related requirement. The plan must include the following information to reflect the mailing address, email address and telephone number of DHS contacts:

DHS contact info

Mail

Minnesota Department of Human Services
Community Supports and Continuing Care for Older Adults
PCA Temporary Rate Increase
P.O. Box 64967
St. Paul, MN 55164-0967

Email

Email questions to dhs.ccarates@state.mn.us. DHS will direct the questions to the person who can best provide an answer.

Phone

If you have questions, you can call the DSD Response Center at 651-431-4300. DHS will direct the questions to the person who can best provide an answer.

Note: The telephone number listed is a voice number. TDD users may call the Minnesota Relay at 711 or 800-627-3529. For the speech-to-speech relay, call 877-627-3848.

Information for lead agencies

Important information for counties, tribal nations and MCOs:

  • PCA claims for dates of service Dec. 1, 2020, through Feb. 7, 2021, will pay an additional 8.4 percent. This temporary increase does not apply to QP supervision (T1019 UA).
  • For waiver service agreements, lead agencies should not adjust the participant’s service plan or budget due to the temporary increase. Do not include the increase when calculating the person’s service plan cost.

Questions

Review the frequently asked questions about the 8.4 percent increase frequently asked questions about the 8.4 percent increase that DHS posted Dec. 17, 2020. If you have questions about this increase or how to implement it, contact dhs.ccarates@state.mn.us.

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