Consumer Directed Services Proposal Packet
Consumer Directed Services (CDS) include:
- Personal Care Assistance which includes, but is not limited to
- Personal care – Bathing, grooming, dressing, personal hygiene
- Toileting – Ostomy or catheter hygiene; bowel and/or bladder routine, general toileting activities
- Health – Use of transfer devices/mobility issues/prostheses, passive range of motion, manual assistance with medications, treatments, cleaning and maintenance of equipment
- Housekeeping – Cleaning, dusting, bed linens, laundry, trash
- Meals – Meal preparation and/or assistance with eating, washing dishes
- Transportation – Essential shopping/errands, medical appointments, school or employment
- Independent Living Waiver Services which includes
- Case management
- Environmental Accessibility Adaptations – adaptations to a participant’s home to ensure the health and safety of the individual and/or enable the individual to function with greater independence in the home. Adaptations include, but are not limited to ramps, grab-bars, widening doorways, etc.
- Specialized Medical Equipment/Supplies – supplies used
Services are authorized by Department staff and are reimbursed to contracted entities using Medicaid (Title XIX of the Social Security Act) funds through MHD.
The reimbursement rate is subject to and determined by the State Legislature on an annual basis. The current rate is $3.62 per unit. A unit is defined as 15 minutes. The minimum hourly rate to be paid to a personal care attendant is $7.50 before taxes.
Policies/procedures and assurances must comply with requirements of the program including all state laws, rules and regulations affecting Vendors of Medicaid services. The requirements include:
- 208.900 – 208.930, RSMo Consumer Directed Services;
- 19 CSR 15-8.100 through 500 Consumer Directed Services;
- Program Requirements of Participation Agreement for Home and Community Based Care (contract); and
- Terms and Conditions of the Participation Agreement for Home and Community Based Care.
- 660.315, RSMo Employee Disqualification List;
- 660.317, RSMo Criminal Background Checks;
- 210.900 to 210.936, RSMo Family Care Safety Registry; and
- 19 CSR 30-82.060 Hiring Restrictions - Good Cause Waiver (paragraph 10 only).
Additionally, the Department periodically issues Vendor Memos to clarify program requirements, announce changes, etc. These memos are a valuable resource and can be found at Consumer Directed Services Vendor Memos.
State Fiscal Year (SFY) 2011 Proposal Outline
Proposals following this outline must be received by the Department between July 2, 2010 and March 31, 2011
A cover letter that is on the applicant’s letterhead and signed by an authorized representative of the entity. The cover letter must include statements indicating whether any persons, individuals or business entities identified within the proposal
- are currently contracted with the Division of Senior and Disability Services to provide any other service. If so, the type of service and the name of the company;
- have ever previously contracted with the Department, and, if so, the name of the company and the position held; and
- have ever been sanctioned, suspended, terminated from participation, or denied enrollment in Medicaid, Medicare, SSBG/GR or any other government public assistance program.
Section I – Vendor Profile
Document the following information on the Vendor Profile form:
Section I: Vendor Information
SSBG/GR No. Leave this field blank.
- Full legal name of the applying entity as filed with the Missouri Secretary of State, Internal Revenue Services (IRS) and Missouri Department of Revenue (DOR) and used throughout the proposal.
- Physical Address for Vendor main office
- Mailing Address for Vendor main office, if different
- Business Telephone Number
- Business FAX Number
- Emergency Telephone Number, pager, etc. for nights, weekends, holidays, etc.
- E-Mail Address
- Federal Employer Identification Number (FEIN)
- State (Missouri) Employer Identification Number (SEIN)
- Business days and hours of operation (when the office is open and staff are onsite)
- If a satellite office is listed in Section IV, indicate counties served by this main office (if there is no satellite office, leave this field blank)
Section II: Personnel Information
- Executive Director
- Telephone Number for Executive Director
- E-Mail Address for Executive Director
- CDS Coordinator
- Telephone Number for CDS Coordinator
- E-mail Address for CDS Coordinator
Section III: The month and day the potential Vendor’s fiscal year begins and ends
Section IV: Satellite Office Information
A satellite office is defined as an office that is regularly staffed. Offices used solely to drop off timesheets, pick up schedules, etc. do not need to be reported. List the following information for each satellite office the agency may have:
- CDS Coordinator
- City, State, Zip Code
- Telephone Number
- Fax Number
- Emergency Telephone Number (nights, weekends, etc.)
- E-Mail Address
- Days & Hours of Operation
- Counties Served by This Office (this office will be contacted regarding consumers residing in this county(ies)
Section II – Service Area Commitment
Service Area Commitment form indicating the geographic areas (counties) the applicant plans to serve.
Section III – Business Organization
The entity’s correct legal name must be the same on all of the following documents and must be used throughout the proposal.
- Business Organizational Structure form:
- fill in the entity’s correct legal name on the first page;
- complete only one section of the form;
- submit the required documents as indicated on the form according to the section of the form completed; and
- sign the bottom of page two of the form.
- Application for Employer Identification Number submitted to the IRS. If the application was submitted online, submit the application after the number has been assigned. If a paper application was submitted to the IRS, submit a copy of the application and the number notification received from the IRS.
- Notification from the Missouri Department of Revenue of the agency’s Missouri Employer Identification Number.
- Vendor registration verification e-mail. Register as a vendor with the State of Missouri through the Missouri Office of Administration at https://www.moolb.mo.gov/Glue/default.asp . The Standard Registration (no fee) is required. The Premium Registration ($50 annual fee) is not required. If the name and federal employer identification number is already registered, do not submit anything.
- A current Vendor No Tax Due certificate issued by the Missouri Department of Revenue. Information regarding this certificate is available at http://www.dor.mo.gov/tax/business/sales/hb600.htm, Obtaining a Vendor No Tax Due.
- An organization chart for the entity.
Section IV – Business Plan
Applicants must assure the Department that sufficient financial resources exist to provide continuous service to consumers of the Department. The use of a Business Plan will help entity’s manage their business and ensure financial stability.
The Business Plan, at a minimum, must include the following information:
- Company - Full legal name of entity as filed with the Missouri Secretary of State, IRS and Missouri DOR and used throughout the proposal. Description of the entity including if is new or existing, its history, purpose, etc.
- Office/Plant - Office address and description of area and building. State whether the office is rented, leased or owned. If the business is located in a home, describe the space that is dedicated exclusively for business. Describe how the building meets Americans With Disabilities Accessibility requirements and handicap accessibility.
- Personnel - Describe how personal care attendants will be recruited to provide direct care.
Describe how employees will be recruited for administrative and billing functions.
Describe the prior experience or education that qualifies management to run this type of business.
- Marketing - Describe the local market for this service.
Describe the methods to be used to obtain consumers in this market.
Describe what efforts, if any, will be used to expand beyond the local market.
Describe what kind of payments will be sought (Medicaid, Medicare, private pay, etc).
- Financial Management - State the name and qualifications of the person handling the financial matters of the entity.
Submit a financial management plan. The plan must include a budget for starting the business and operating costs for the first year of operation.
State the sources of revenue to be used to start the business.
State how the agency will be able to provide fiscal conduit services (continuously meet financial responsibilities prior to state reimbursement).
Section V – Consumer Training
A detailed training and orientation plan for consumers. The plan must include an agenda outlining each topic to be trained and a short description. Do not submit training materials to be used.
Section VI – Policies and Procedures
The following policies and procedures must be detailed, step-by-step instructions of how your company will comply with the requirements of the program. The policies and procedures must answer who, what, where, when and how.
- The philosophy for promoting the consumer’s ability to live independently in the most integrated setting or the maximum community inclusion of consumers with physical disabilities.
- The telephone system to be used.
- Utilization of the Change Request form (available on this web site).
- Notification to consumers of any changes in office location, business hours and/or telephone number.
- Maintaining service delivery during times of natural or man-made disasters.
- The quality assurance and supervision process that will ensure program compliance and accuracy of records.
- Abuse, neglect and exploitation.
- Misappropriation of consumer property or funds, including falsification of service delivery documents.
- Spouse as a personal care attendant.
- Personal care attendants serving members of the consumer’s household or performing household tasks.
- Suspending and closing services to consumers.
- Handling inquiries and problems.
- Maintaining a list of eligible personal care attendants.
- Consumer case records.
- CDS Service reports.
- CDS Financial reports.
- Audit of the agency.
- Filing claims for Medicaid reimbursement.
- Performing payroll functions for consumers.
- Drug free workplace.
- Personal care attendant employment application.
- Criminal background record checks.
- Employee Disqualification List (EDL) checks.
Section VII - Assurances
- Maintain internet access and an e-mail address at all times in order to retrieve information posted on the Department web site and to communicate with the Department.
- Maintain subscription to DSDS E-News.
- Operate in accordance with the proposal as submitted, amended and approved by the Department.
- Comply with all applicable federal and state laws/regulations including laws authorizing or governing the use of federal funds paid to the Vendor through the consumer directed services program.
- Comply with Fair Labor Standards Act as amended, Title VI of the Civil Rights Act of 1964, Title VII of the Civil Rights Act of 1991 as amended, Section 504 of the Rehabilitation Act of 1973, Title IX of the Education Amendments of 1972, the Age Discrimination Act of 1975, the Americans with Disabilities Act of 1990 and all other applicable federal and state laws, regulations and executive orders regarding employment practices.
- Comply with all applicable Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations and all amendments thereafter.
- Enroll and comply with all requirements of the E-Verify federal work authorization program. Information regarding E-Verify is available at http://www.dhs.gov/files/programs/gc_1185221678150.shtm.
- Verification of environmental accessibility adaptations reimbursed through the Consumer Directed Services program are performed by competent licensed contractors.
- Verification all environmental accessibility adaptations reimbursed through the Consumer Directed Services program comply with all applicable state and county code requirements.
Section VIII - Appendixes
- Employment application to be used.
- A copy of the HCS Provider Contracts Registration and Screening Request form completed and submitted to the Family Care Safety Registry (FCSR) for the executive director listed on the Vendor Profile and each individual listed on the Business Organizational Structure form. The original forms must be mailed directly to the Department’s FCSR at the address listed on the form. If the individual is not already registered with the FCSR, a copy of their social security card and the one time registration fee of $9.00 must be attached to the form.
The HCS Provider Contracts Registration and Screening Request is a special form used only during the proposal process so that the FCSR will forward the results of these screenings directly to the HCS Provider Contracts Unit (the FCSR notifies the registrant of the results also). For all other screening requests, the FCSR Employer Background Screening Request form must be used.
Screening results will not be accepted from the applicant. HCS Provider Contracts must receive the screening results directly from the FCSR.