Benefits, Rights and Responsibilities

Consumer Directed Attendant Support CDAS Program

Workshop Goals

• Benefits of Consumer Direction• Rights as a CDAS Participant• Responsibilities of CDAS

Participants

Medicaid Long Term Care Options

• Nursing facility• Agency care

– Home and Community Based Services– Home Health care

• Consumer directed care

Benefits ofConsumer Direction

Benefits of Consumer Direction

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Benefits of Consumer Direction

• Control your own schedule, based on your health needs and lifestyle

• Choose whom to hire, based on your own criteria

• Find better attendants who stay longer• Decide which tasks each attendant

provides, and train your attendants to perform to your standards

Benefits (cont’d)

• Set the wages your attendants receive, based on skill, training required, scheduling, etc.

• Attendants are accountable to you, not to an agency

• Decide when it is time to dismiss an attendant

• Provide your own dependable emergency backup system

CDAS Participant Rights

CDAS Participant Rights

If you are eligible for CDAS and enroll in the program, you have various rights. This section covers the following:

• Manage your own attendant support• Appeal and fair hearing• Authorized Representative• Accessing appropriate information• Support for financial management• Maintaining eligibility• Withdrawing from the program

Managing Your OwnAttendant Support

• Choose the attendants you want to hire• Decide what special knowledge and

skills your attendants should have• Train attendants to meet your needs• Replace attendants as necessary• Request a new assessment if you need

a change in services• Change your Attendant Support

Management Plan, with approval

Appeal and Fair Hearing

• You have all the rights other Medicaid clients have, including:– The right to appeal decisions– The right to have a fair hearing on

those decisions

Authorized Representative• You may designate an Authorized

Representative who has the judgment and ability to direct care on your behalf

• An Authorized Representative must:– Accept responsibility for directing care on the client’s

behalf and handling the financial aspects of the client’s care.

– Show a strong personal commitment to the client. – Show knowledge about the client’s preferences.– Follow the client’s wishes and respect the client’s

preferences.– Use sound judgment to act on the client’s behalf.– Be at least 18 years old.– Have known the client for at least two years.

• An Authorized Representative may not be paid for directing care

Accessing Appropriate Information

• Information in a format that best fits your needs

• Training materials and formats that best suit your needs– Small group– Individualized– Self-paced

Support forFinancial Management

• You can get help to handle finances related to your attendant support management

• The person who helps you cannot: – Receive pay from your allocation– Direct your attendant support (unless

the person is your Authorized Representative)

Maintaining Eligibility

• Participating in a consumer direction program does not cause your Medicaid eligibility to change. Other changes in your life, such as income, health, etc. could affect your eligibility.

• Leaving a consumer direction program will not cause your Medicaid eligibility to change

Withdrawing From the Program

• CDAS is voluntary• You may withdraw from the program at

any time• If you leave a consumer direction

program, you have the right to return to your earlier services, provided you still need those services and meet eligibility requirements

CDAS Participant Responsibilities

CDAS Participant Responsibilities

• Demonstrate the required skills and abilities

• Manage your own health• Manage your attendant support• Manage emergencies• Oversee quality assurance• Follow relevant employment laws

Demonstrate the RequiredSkills and Abilities

• You must show that you can direct your own attendant support, by:– Completing CDAS training– Passing the Post-Training Assessment– Developing an Attendant Support

Management Plan

Manage Your Own Health

• Maintain your health and monitor your medical condition

• Be open and frank about your needs

• If you need medical help, it is up to you to get it

Manage Your Attendant Support

• Budget for attendant support within your allocation, including a budget for emergencies

• Decide on wages, schedules and benefits (if any) for your attendants

• Recruit and interview people to be attendants

• Do reference checks• Review criminal background checks• Hire attendants, set wages and complete

hiring/provider agreements

Manage Your Attendant Support (cont’d)

• Schedule, train and supervise attendants

• Follow all laws and rules on employing attendants

• Complete paperwork and timesheets

• Fire attendants and replace them as needed

Manage Your Attendant Support (cont’d)

• Explain the role of the Intermediary Service Organization (ISO) to attendants– Employer of record– Conducts CBI checks– Processes timesheets– Handles payroll and taxes– Sends checks to attendants– Handles benefits and worker’s compensation

(as appropriate)

Manage Your Attendant Support (cont’d)

• Practice employee safety– Provide a clean and safe work

environment – Use universal precautions, when

necessary– Train attendants to use proper body

mechanics if lifting is involved– If an attendant is injured while working,

see that they receive medical attention, if necessary, and report injuries as appropriate

Manage Emergencies

• Budget and include plans for backup care in your Attendant Support Management Plan

• In the event you are unable to direct your care, have information ready for attendants and emergency personnel

• Plan for communitywide disasters, such as fires, floods, blizzards, power outages, etc.

• Understand how to prevent and address critical incidents, such as abuse (physical, mental or verbal), threats, theft, etc.

Oversee Quality Assurance

• You must make sure you receive quality attendant support– Follow your approved Attendant

Support Management plan– Inform your case manager about the

quality of your care– Complete a survey and self-

assessment every six months on your progress, concerns, health, satisfaction, etc.

Follow RelevantEmployment Laws

• As the “supervising employer” in CDAS, you must abide by applicable federal, state and local laws governing employment– Title VII of the Civil Rights Act of 1964– Age Discrimination in Employment Act– The Americans with Disabilities Act– The Family and Medical Leave Act– The Fair Labor Standards Act

It May be Discriminatory to Ask Applicants About…

• Arrests• U.S. citizenship• Children (how many, names, ages, child

care arrangements, etc.)• Disabilities or physical conditions that do

not relate to performing the job• Marriage status • Pregnancy, birth control, or child bearing

plans• Ancestry, national origin, race or color• Religious affiliation, holidays observed, etc.• Age

Why Choose Consumer Direction?

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For More Information

• CDAS application packets• CDAS Training Reference Manual

for enrolled participants• Single Entry Point case manager• http://www.hcpf.state.co.us

– Click on “Medical Assistance Programs,” and then click on “Consumer Directed Attendant Support”

Questions?