Questions & Answers - Consumer Directed Care Plus (CDC+)
Q: Concerning CDC+ - how can you be sure that the family will not use the funds for themselves instead of for the consumer?
There are protections in place and monitoring that occurs in the program to evaluate this. The consultant is responsible for some of the oversight and the APD also conducts monitoring.
Q: When and how will families be signed up for the new CDC+ if they are interested?
A letter has been mailed to all individuals enrolled on one of the four DD/HCBS waivers who live in their own home or family home. If the individual is interested, then the letter of interest should be returned to APD by November 13 so that the agency can track the indivduals that are interested. Depending on how many people are interested in the program, the agency will proceed to enroll and train those indivdiuals who are interested.
Q: If the consumer is on CDC+, do the providers still have to abide by the handbook?
There are some services in CDC+ that are restricted services and have some of the same requirements as the DD Handbook. The service codes chart that can be found on the APD website includes these requirements. The CDC+ rule that is being promulgated will also include these requirements.
Q: How can providers know what qualifications are needed for CDC+?
The service code chart on the APD website includes this information and the information will be included in the CDC+ rule that is in the process of being promulgated
Q: Can CDC+ hire outside the system and can waiver providers have the flexibility to serve them?
CDC+ program allows the consumer to hire outside the waiver service system and providers must meet the requirements of the CDC+ program.
Q: Why are waiver support coordinators not automatically enrolled in the CDC+ program?
There is additional training and requirements that must be met for a WSC to be enrolled as a CDC+ consultant.
Q: If consumers on CDC+ are in the driver's seat why are my in home support services being cut to 6 hours?
First, the service needs of the individual are approved on the person's regular cost plan based on medical necessity. Once the cost plan is approved, the CDC+ budget is calculated based on that cost plan, and the consumer then has the flexibility under CDC+ to select the amount of services within CDC+ requirements.
Q: Why are consumers having difficulty with phone in timesheets on the automatic system that was set up?
As with any new system, people are getting used to reporting time via an automated phone system.
Q: Will there be a cost plan reduction of eight percent with CDC+?
Yes. There is an 8% discount off the cost plan and there is a 4% administrative fee (calculated from the amount of the monthly budget not to exceed $160)
Q: Will CDC+ be abolished once iBudgets are implemented?
No, the agency is focusing on ways to provide flexibility in all waiver programs.
Q: For CDC+ I was told that the computer selection would be random.
It may be that if the agency receives letters from more than 2,500 people who are interested there will be a random selection.
Q: Do you need a waiver support coordinator for CDC+?
There is a requireqment for a consultant, which is a WSC that has received special training for the CDC+ program.
Q: What guidelines are in place for family members that wish to become providers in the CDC+ program?
A family member cannot be the representative if he or she is going to provide services. Family members have to meet the requirements identified in the service codes chart that can be found on the APD website.
Q: If we choose to stay in the traditional program, will our funding be reduced as a result?
The CDC+ program is entirely voluntary. However, for the past two years, the traditional waiver program has by law been subject to rebasing of cost plans annually.
Q: Will CDC+/iBudget affect initial eligibility criteria (ex. Autism diagnosis no longer automatically eligible?)
No.
Q: Can we combine CDC+/iBudget + pay out of pocket to providers?
Consumers in CDC+ will have their budgets determined through iBudget but then be able to select services and providers according to CDC+ program rules.
Q: Will CDC+/iBudget move more people off the pre-enrollment list? Will they only be offered this option?
The CDC+ program is an option that people enrolled on a DD/HCBS waiver can choose. The Legislature has authorized APD to use the funds from the 8% discount to serve individuals on the pre-enrollment. We are hopeful that iBudgets would bring increased sustainability to the waiver program, which might create more opportunities in the future for serving the pre-enrollment.
Q: Will the PowerPoint slides be available online perhaps?
Yes.
Q:How will new CDC+ slots be offered to current consumers, first come first served? Is it a voluntary program?
The CDC+ program is a voluntary program for people who live in their own home or a family home. The agency has sent out letters to all eligible people who are currently enrolled on one of the four DD/HCBS waivers.
Q:Who can act as a representative for a consumer that elects the CDC+ option?
The representative can be a family member, a friend, etc. They will be trained and expected to function according to the requirments identified in the representative consent form.
Q:All waiver support coordinators should be trained for CDC+ as consultants for more family/consumer options.
Many waiver support coordinators have been trained over the last 6 months.
Q:Can my daughters hire me (mother) for companion services under the CDC+ plan we have? Do we need the Flexible Benefit Service to do this?
Yes, a parent can provide companion services under the CDC+ program but not under the flexible benefit service.
Q:When will the CDC+ open enrollment letters be mailed out? When will the open enrollment process begin?
The letters were mailed October 16, 2009.
Q:Who is liable to pay for injuries and lost wages when a CDC+ consumer's employee is injured on the job?
liability, if any, depends on several factors and is covered in more depth in the CDC+ materials.
Q:Why are support coordinators not automatically enrolled in the CDC+ program?
They must be trained in the CDC+ program requirements.
Q:If consumers can hire whoever they want - do providers need to adhere to "provider eligibility requirements" or "service definitions" spelled out for a particular service in the MedWaiver Handbook?
Yes, for some services they are required to do so. There are requirements specificed in the service codes chart that is on the APD website. The consumer also provides a job description to the provider.
Q:How can providers be informed of CDC+ consumer requirements to ensure that they get (1) paid, and (2) are meeting any requirements set for providers paid with these funds?
These topics will be covered in the training for the consumers. Program materials are also available on the CDC+ website.
Q:When will there be another CDC+ training in Jacksonville?
CDC+ training will be provided to all potential CDC+ enrollees within the next several months. Training for CDC+ consultant services are scheduled periodically around the state based on need.
Q:If a consumer hires a person, do those people have to be certified and monitored by the waiver support coordinator?
The person hired does not have to be a Medicaid-enrolled provider. Monitoring is done by the consumer, the consultant and the state.
Q:What is the cost basis for a consumer using CDC+? I know a case where a consumer had to quit CDC+ because he was too physically needy & his budget was lowered too low to cover necessary services.
The services approved on the person's cost plan are discounted by 8% to arrive at the CDC+ budget.
Q:How can you insist that caregivers & agencies adhere to strict rules & regulations & yet allow caregivers thru the CDC+ to adhere to almost none?
Caregivers through the CDC+ program do have to meet certain requirements such as background screening, must perform the job description, and must provide proper care for the person. Some services also have additional specific requirements. There are monitoring systems in place.
Q:Do you have a target date for the start of the CDC+ program?
The letters werer mailed on Octobe 16, 2009 to all eligible individuals with a due date of November 13 to return the letter of interest.
Q:What does rebasing mean?
The person's use of services over a fiscal year are compared to the person's approved cost plan amount. If the services used are less than the approved cost plan amount then the person's approved cost plan for the next year is limited to the amount the person spent in the previous year plus 5%. There are some exceptions allowed in law.
Q:Under CDC+ is a lump sum given to the consumer to pay each provider directly? Is a prior service authorization required for each service?
The consumer determines how to spend the CDC+ budget. The consumer does not receive the funds; the funds are held and paid by a fiscal employer agent at the consumer's direction. Prior service authorization is used to approved the cost plan services and then the CDC+ budget is determined from that. There is no prior service authorization in the CDC+ program once the budget is calculated and the person starts managing the funds.
Q:CDC+ training needs to be repeated this fall. Is computer cost + access for WSC's being taken into account for the electronic system planning? Training CDs would be nice but it would be cheaper to make the training available on your website for download. Even require a sign in. Training through Tallahassee Community College is great but fees get out of control fast for us - we providers are also taxpayers, homeowners with insurance, and income loss issues too. We need some kind of simple break.
Additional training will be offerred in the near future and regularly throughout the year.
Q:I was locked out of CDC+ training due to the fact that it was full. I do not think it's fair that no other training has been offered, and I will potentially lose my cases through no fault of my own. I think APD failed in their duty to offer training to all interested providers. This would not be tolerated if a consumer were excluded with no opportunity for inclusion into a program.
Additional training will be offerred in the near future and regularly throughout the year.
Q:Will there be a new assessment for the children in Tier 4 at a later date?
The agency intends to reassess individuals with the Questionnaire for Situational Information every three years.
Q:Will a list of services be provided in the letter for registration for CDC+ so we can decide if it would be equitable to switch to CDC+?
Yes, information regarding the services available in the CDC+ program will be included.
Q:If you don’t use all the money in CDC+ in a given year, do the funds rollover?
The funds roll over into the next fiscal year provided certain conditions are met.
Q:Do families get training as record keepers as well as consultants?
Yes.
Q:Are CDC+ family members or other people hired by CDC+ consumers:
(a) going to have to be background screened,
(b) have to take all classes that Medicaid providers take,
(c)do all the paperwork that Medicaid providers do, and
(d) be audited by Delmarva?
Yes, background screening is required and there is also training required, but it is not the same training as under the waiver program. Quality assurance will be conducted by a contracted provider.