NEW CONSULTANT TRAINING
February 5 & 6, 2013
Rick Scott
Governor
Barbara Palmer
Director
Welcome and Introductions
Ivonne Gonzalez
Training and Outreach Coordinator
Submit questions throughout this presentation to:
Liesl_Ramos@apd.state.fl.us
2
Training Objectives
•Identify the Five Principles of Self Determination
•Describe the roles and responsibilities of Participant,
Representative, Consultant, Area and State Office
•Describe different provider types
•Demonstrate how to write a Purchasing Plan
•Describe how to properly manage your CDC+ Budget
•Demonstrate how to Reconcile the account
3
CDC+ Tools
• The Developmental Disabilities Medicaid Waivers
Consumer-Directed Care Plus Program
Coverage, Limitations and Reimbursement
Handbook (CDC+ Rule Handbook)
• Participant Notebook
• Appendix to Handbook & Participant Notebook
4
CDC+ History
•In 2000- Consumer-Directed Care(CDC)- Pilot Program
•Demonstration phase January 2004 (CDC+)
•Permanent Program March 2008, authorized by Medicaid
through the 1915j State Plan Amendment
•Expansion Fall 2009
•2500 new participants
•Training and enrollment
•CDC+ Rule
•Adopted as of 11/12/12 -Any changes that occur will be
shared
5
5
What is CDC+
•Long-term care program alternative
•Based on principles of Self-Determination and
Person-Centered Planning
•Provides opportunities to improve quality of life
6
Self-Determination and
Person Centered Planning
Person-Centered Planning
Principles of Self-Determination
Freedom
Authority
Support
Control
Responsibility
7
CDC+ Eligibility and Enrollment
Requirements
•Enrolled in the DD/HCBS waiver
•Able to direct own care
•Live in family or own home
8
iBudget Transition
• Tier Waiver to iBudget by (July 1, 2013)
• Authorized iBudget funds determine CDC+ Monthly Budget
• CDC+ participants will still manage their iBudget funds in
accordance with the CDC+ Rule Handbook
More information regarding iBudget on iBudgetFlorida.org
9
Roles and Responsibilities
•Participant
•CDC+ Representative
•Consultant
•Area Liaison
•State Office
10
Role of Participant
(when representative not selected)
•Authorized signer
•Decision maker
•Employer
•Develops Purchasing Plan
11
Role of Participant, continued
•Maintains accurate and complete records
•Spends CDC+ budget responsibly
•Complies with training and monitoring requirements
•Develops Emergency Backup Plan (CDC+ Rule Handbook pg
3-3)
12
Role of CDC+ Representative,
•Same role as Participant
•Unpaid Advocate; at least 18 years of age
•Readily available to Participant and Consultant
•Responsible for appropriate use of public
money
13
Consultant Requirements
•Be a Waiver Support Coordinator in good standing
•Complete CDC+ New Consultant Training
•Pass Readiness Review
•Enroll as a Medicaid provider for consultant services
•Complete CDC+ registration forms
•Sign Memorandum of Agreement
14
Role of Consultant
•Waiver Support Coordinator
•Complies with training and monitoring requirements
•Sign a participant/consultant agreement
•Provides on-going technical assistance
15
Role of Consultant, continued
•Reviews and signs off on CDC+ documents
•Responsible for appropriate use of public money
16
Role of Consultant,
continued
•Develops and updates support plan
•Ensures cost plan is updated
•Monitors and reviews participant account activity
•Ensures Medicaid eligibility
17
Role of Consultant,
continued
•Keeps active contact with Participant
Monthly – by phone or in person
Annually – two face-to-face per year
•Completes monthly review documentation
•Communicates effectively with Area Liaison
18
Role of Area Liason
•Authorizes CDC+ Budget
•Reviews Purchasing Plans
•Facilitates employee background screening
•Liaison between participant, consultant, and
State office
19
Role of State Office
•Administers CDC+ Program
•Develops policies
•Approves CDC+ Monthly Budget
•Develops and provides training
•Provides Customer service
20
Role of State Office, continued
•Provides Quality assurance
•Assigns Provider ID Numbers
•Pays service claims and employer taxes
•Sends monthly statements
•Monitors consumer spending
21
Quality Assurance Requirement
•Consultant
•Participant
Person Centered Review
Provider Discovery Review
22
Steps for CDC+ Participant
Enrollment
•Expresses interest
•Completes training
•Passes Readiness Review
23
Steps for CDC+ Participant
Enrollment, continued
•Application Packet
•2 page application document
•Cost plan service authorization summaries
•Budget calculation worksheet
•Enrollment Packet
•8821 – IRS
•2678 – IRS
•Fiscal Informed Consent
24
Steps for CDC+ Participant
Enrollment, continued
•Area calculates monthly budget
•Participant chooses supports and services
•Participant interviews potential providers
•Providers complete background screening
requirements
25
Steps for CDC+ Participant
Enrollment, continued
•Participant develops and submits purchasing plan;
CDC+ approves plan
•Participant completes and submits employee and
vendor packets; CDC+ issues provider ID’s
•Participant begins self directing supports and
services
26
Calculating the Monthly Budget
•Budget calculation worksheet – Participant Notebook Appendix
D(3)
•Current approved DD/HCBS Waiver Cost Plan
•Discount rate- 8%
•Administrative fee- 4% or max amount of $160.00
27
Calculating the Monthly Budget,
continued
•PCA for children under 21 (use different Budget
Calculation Worksheet) paid through Medicaid State
Plan-(procedure code S9122TJ)
•STE-Short Term Expenditure & OTE-One Time
Expenditure
•Consultant fee is not part of monthly budget (billed
directly through FMMIS)
28
Total Cost
Plan Amt
Service
Number
of
Monthly Cost
months
Plan
PCA
$
7,200.00
12 $
600.00
Respite
$
8,870.40
12 $
739.20
PT
$
5,340.80
12 $
445.07
Trans
$
8,049.60
12 $
670.80
ST
$
3,204.98
12 $
267.08
CMS
$
372.40
12 $
31.03
Total
$ 33,038.18
$
2,753.18
Take the percentages of Col D Total
0.92
$
This is the CDC+ Monthly Budget
2,532.93
$
(160.00)
$
$
2,372.90
2,753.18
0.92
2,532.93
(110.13)
$
$
This is the CDC+ Monthly Budget
$
$
2,753.18
0.04
$
If more than $4,000.00, use $160 for fees
If less than $4,000, use 4% calculation for fees
110.13
Consultant services or funds for either OTEs or STEs are not
included in the calculation of the monthly budget
2,422.80
29
Participant Controls
What, when, who, where and how support & services
will be provided that best meet their needs & goals
•Setting Priorities
•CDC+ Program Services (CDC+ Rule Handbook Chapter 4)
•Restricted or Unrestricted (CDC+ Rule Handbook pgs. 4-3, 4-4)
•Allowable purchases (CDC+ Rule Handbook pgs.1-5, 3-8)
•Unallowable purchases (CDC+ Rule Handbook pgs.1-19, 3-9)
30
CDC+ Program Services
•Every service contains a definition to include:
Descriptions, limitations, special conditions,
provider qualifications and service type.
(CDC+ Rule Handbook Chapter 4)
•Service codes and abbreviations can be found in
the Service Code Chart
31
CDC+ SERVICE CODE CHART
RESTRICTED SERVICES
Service Name
Adult dental services
Behavior Analysis Services
Behavior Analysis Assessment
Behavioral Assistant Services
Dietitian Services
Occupational Therapy
Occupational Therapy Assessment
Physical therapy
Physical Therapy Assessment
Private Duty Nursing/LPN
Private Duty Nursing/RN
Respiratory Therapy
Respiratory Therapy Assessment
Skilled Nurse/LPN
Skilled Nurse/RN
Specialized Mental Health Services/ Therapy and Assessment
Speech Therapy
Speech Therapy Assessment
Environmental Modification Assessment
Durable Medical Equipment and Supplies
Environmental Modifications
Vehicle Modification
Abbreviation
DENT
BT
BTA
BTS
DIET
OT
OTA
PT
PTA
PDL
PDR
RT
RTA
SNL
SNR
Service Code
03
06
06A
08
12
29
29A
38
38A
49
50
45
45A
47
48
MHT
51
ST
STA
ENVA
EQUIP
ENV
VMOD
53
53A
14A
83
14
80
Abbreviation
ADT
ADV
CAMP
COMP
CMS
EMP
GYM
IHS
OTC
PCA
PERS
PERSI
PARTS
RHAB
RSPD
RSPH
SLC
TRNG
TRAN
XTHER
Service Code
02
89
85
11
63
55
88
22
65
32
33
33A
82
43
58
46
56
61
60
39
UNRESTRICTED SERVICES
Service Name
Adult Day Training
Advertizing
Seasonal Camp
Companion Services
Consumable Medical Supplies
Supported Employment
Gym Membership
In-Home Supports
Over-The-Counter Medications
Personal Care Assistance
Personal Emergency Response System (PERS)
PERS Installation
Parts and Repairs Therapeutic or Adaptive Equipment
Residential Habilitation Services
Respite Care- Day
Respite Care- Hour
Supported Living Coaching
Specialized Training
Transportation
Other Therapies
FOR CONSUMERS PARTICIPATING IN THE FLORIDA FREEDOM INITIATIVE (FFI) ONLY
Service Name
Microenterprise
Vehicle
Abbreviation
MICRO
VEH
Service Code
75F
70F
32
Provider Types
•Directly Hired Employee (DHE)
•Agency/Vendor (A/V)
•Independent Contractor (IC)
33
How to Find, Hire and Manage
Providers?
•Identify service/support being purchased
•Type of provider needed
•Provider requirements
•Hiring packet – (Appendix E of the Notebook)
34
How to Find, Hire and Manage
Providers, continued
Employee Packets- (Appendix G Notebook)
Vendor Packets- (Appendix H Notebook)
Background Screenings
Level 2 for all providers listed on a Purchasing Plan
Valid for 5 years- provided there is not a break in
service of 90 days or more.
35
Directly Hired Employee
Services
•The Participant decides
what will be done and create job description
how services will be performed
the hours per week/month worked
hourly rate of pay (negotiable)
Companion- only service exempt from minimum wage
requirements
•The Participant must
review, approve, & submit timesheet
budget for applicable employer taxes
36
Agency/Vendor and
Independent Contractor
•A person or business that provides
services/supports
•Participant controls/directs only the result
of work performed, and not the means
and methods of accomplishing the result
•Participant pays from submitted invoice
•No Taxes withheld or paid
37
Hiring an A/V, IC or DHE
Agency/Vendor (A/V) or
Independent Contractor (IC)
Directly Hired Employee
• Vendor/Independent
• Employee Information
Form
• Internal Revenue Service
(IRS) Form W-4
• Department of Homeland
Security (DHS) Form I-9
• Background Screening
Clearance Letter
Contractor Information
Form
• Internal Revenue Service
(IRS) Form W-9
• Background Screening
Letter
• Optional- Direct Deposit Form (EFT)- include a copy of a pre-printed voided check
38
Purchasing Plan –
Appendix E
•Describes how CDC+ monthly budget will be
spent to meet needs and goals
 Authorizes services/supports
 Authorizes providers
•Developed by Participant or Representative
Consultant may provide technical assistance
and guidance (CDC+ Rule Handbook Appendix E)
39
Purchasing Plan – Timelines
Person
Responsible
Activity
Due Date
Participant
(Representative)
Complete Purchase Plan;
submit to Consultant
By the 5th of the month
Consultant
Review and sign; submit
to Area Liaison
By the 10th of the month
Area Liaison
Review and sign; submit
to State Office
By the 20th of the month
40
Purchasing Plan Types
•New Purchasing Plan
•Purchasing Plan Change
•Purchasing Plan Update
•Quick Update
41
OTE/STE Expenditure
• One Time Expenditure- 100% of authorized
amount - only 3 services:
• Equipment/Devices DME
• Environmental Modifications
• Vehicle Modifications
• Short Term Expenditure-Services authorized in
waiver cost plan that are approved for 6 months or
less, or are periodic in nature – ex. Dental,
Assessments
42
Restricted/Unrestricted Services
• Restricted Services-requires a licensed
provider, 92% of the units of measure that are
approved in the Cost Plan must be utilized
• Unrestricted services-services and supports
that a CDC+ Participant may purchase provided
the service meets needs and goals as identified in
the support plan.
43
Critical Services
• Critical Services- require two emergency backup
providers who are ready and able to drop
everything and come to work as an emergency
backup, ex. PCA
44
Purchasing Plan Sections
The CDC+ purchasing plan consists of:
Page 1 – Section A – Basic Information
Page 2 – Section B – Needs and Goals
Page 3 – Section C.1 and C.2 – Services and Supplies
Page 4 – Section D – Cash (no longer available)
Page 5 – Sections E and F – Savings Plan and
OTEs/STEs
Page 6 – Budget Summary and Signatures
45
Purchasing Plan Instructions
• Open blank purchasing plan
• Follow along slide by slide
• Reference tools
46
The CDC+ Purchasing Plan
To move from page to page on the
purchasing plan, click on a page tab in the
blue bar on the bottom of the Excel page
frame. Each page contains a section of the
purchasing plan
Extra pages in Section C.1 and C.2
are provided in the Excel file for
participants who need additional
space to enter services and
supports
47
CDC+ Purchasing Plan
Page 1 - Top
Provide the required information
Enter the day the
Purchasing Plan will be
effective
Enter the participant’s
approved CDC+ Monthly
Budget amount
Enter the number of the
APD area in which the
participant lives
Participants on the
Florida Freedom
Initiative (FFI) check
“Yes”, otherwise
check “No”.
48
Purchasing Plan - Page 1
Section A – Participant Information
Enter the participant’s
legal first name, middle
initial and last name as
found on birth
certificate
Enter the
participant’s ID
number
Enter the participant’s
age as of the effective
date of the Purchasing
Plan
49
Purchasing Plan - Page 1
Section A – Participant Information (continued)
Enter the
representative’s legal
first name, middle initial
and last name
Enter a valid phone
number for the
participant or
representative
Enter a valid cell phone
number for the
participant or
representative
50
Purchasing Plan - Page 1
Section A – Reason for Submitting Purchasing Plan
Enter the page numbers
that are revised
Enter the number of
Employee or Vendor/IC
packets submitted
Enter the legal name
for all providers
appearing on the
Purchasing Plan for
the first time
51
Purchasing Plan - Page 1
Section A – Reason for Submitting Purchasing Plan (continued)
Enter the names of all the
providers who appeared on
previous Purchasing Plans but
do not appear on this
Purchasing Plan
Enter the total number
of Purchasing Plan
pages. The minimum
number of pages is six
(6)
Manually number each page
of the Purchasing Plan
including the total number
of pages
52
Purchasing Plan - Page 1
Section A – Reason for Submitting Purchasing Plan (continued)
This option is no
longer available
This area is to be completed
by the consultant and area
liaison
53
Purchasing Plan - Page 2
Section B – Needs
The participant’s name will
automatically fill in from the
information provided on the first
page
The plan’s effective date will
automatically fill in from the
information provided on the first
page
54
Purchasing Plan - Page 2
Section B – Needs – Column 1
Enter the date of the current
Waiver Support Plan
Enter all needs and goals
identified on the participant’s
current Waiver Support Plan
55
Purchasing Plan - Page 2
Section B – Needs – Column 2
Enter all services and
supports approved on the
current Waiver Cost Plan
Enter the current
Waiver Cost Plan
date
Enter the number of
months for each
support or service
56
Purchasing Plan - Page 2
Section B – Needs – Column 2 (continued)
The average number of units per
month is automatically calculated
and inserted in this box
Enter the total number of units
for each support or service
Click on the box to open a dropdown
box then select the type of unit in
Cost Plan for each service or support
57
Purchasing Plan - Page 2
Section B – Needs – Column 3
Enter each service or support
the participant will be
purchasing to meet long term
needs and goals
Enter the total number of units per
month for each service or support
58
Purchasing Plan - Page 2
Section B – Needs – Column 3
Enter note if service or support is an
OTE, STE, savings item or unpaid
natural support
Click on the box to open a
dropdown box and select type of
unit in Purchasing Plan
59
Purchasing Plan - Page 3
Section C.1 – Budget Details – Services
If the service listed is critical, enter Y
(yes), if not critical enter N (No). If yes is
entered there must be a minimum of (2)
emergency back-up providers listed. EBU
providers can only be listed for critical
services
The service code box will
automatically fill in the code
when the service is selected
from the dropdown box
Click on the box to open a
dropdown box then select a
service
60
Purchasing Plan - Page 3
Section C.1 – Budget Details – Services (continued)
•
Direct Hire Employee (DHE) provider relationship numbers:
1 = Parent or step-parent
2 = Participant’s child or stepchild under age 21
4 = Person under 18 currently in high school (not participant’s child or stepchild)
3 = Spouse
5 = All others
Click on the box to open a
dropdown box then select a
provider type
Enter the provider
relationship number by
opening the dropdown box
and selecting the number
that applies
Enter the legal name of all providers.
If the provider is critical, list at least
two (2) back-up providers on the lines
directly underneath on the same page
61
Purchasing Plan - Page 3
Section C.1 – Budget Details – Services (continued)
Enter the number of
units for each service
Enter the cost per
unit for each service
Click on the box to
open a dropdown box
then select the unit
type
62
Purchasing Plan - Page 3
Section C.1 – Budget Details - # of Units:
• 22 weekdays in a month
• Monday - Friday workweek
• 9 weekend days in a month
• Saturday and Sunday workweek
• 31 calendar days in a month
• Always plan for the maximum number of days in a month
63
Purchasing Plan - Page 3
Section C.1 – Budget Details – Services (continued)
Provider total cost
automatically calculates
The sub-total
automatically calculates
and the amount will
appear in this box
Employer taxes
automatically calculate and
the amount will appear in
this box
64
Purchasing Plan - Page 3
Section C.1 – Budget Details – Services – EBU Added Cost
Click here to calculate additional
emergency back-up cost
Total monthly cost will
automatically calculate and
appear in this box for
primary providers
If emergency back-up cost is
calculated the amount will appear in
this box
65
Purchasing Plan - Page 3
Section C.1 – Budget Details – Services – Totals
The total amount of EBU added
cost will appear here and also
appear in box for total
estimated cost for EBU in
Section E
Total monthly costs for
services will
automatically calculate
and appear in this box
66
Purchasing Plan - Page 3
Section C.2 – Budget Details – Supplies
•
Only one (1) supply type can be listed:
CMS – Consumable Medical Supplies (63)
Select the supply type from the
dropdown box. Only one (1) type
can be entered - CMS
When the service is selected, the
service code will automatically
populate
67
Purchasing Plan - Page 3
Section C.2 – Budget Details – Supplies (continued)
•
List all supply providers and detailed descriptions for each supply including quantity
Examples:
Adult Large Diapers (96)
Adult Large Diapers (96), 1 case Wipes (6), 2 boxes Bed Pads (24) = 1 unit
Enter the number of
units to be purchased
Enter the legal name of
the provider where
supplies will be
purchased
Enter a detailed description for
each supply including quantity
68
Purchasing Plan - Page 3
Section C.2 – Budget Details – Supplies (continued)
Enter the rate for each
supply listed
The total cost
will
automatically
calculate
Enter the unit
type
69
Purchasing Plan - Page 3
Section C.2 – Budget Details – Supplies (continued)
The total will calculate and insert in the
box at the bottom of the total cost
column
Check box to indicate if additional
page 3A is used to complete this
section
70
Purchasing Plan - Page 4
Section D – Budget Details – Cash Purchases - Discontinued
This option is no
longer available
Option 1. Section E - Savings
Option 2. Section C.1 & C.2 – Services/Supplies
71
Purchasing Plan - Page 4
Section D – Budget Details – Cash Purchases – Total
In this area, enter an explanation on how purchases requested
in Section E will meet the needs and goals or increase
independence. Also, enter any additional information that
would assist APD staff in approving the participant’s
Purchasing Plan
72
Purchasing Plan - Page 5
Section E – Savings Plan – Authorizations for Use of Accumulated,
Unrestricted Funds
Enter the most
current statement
date (mm/yyyy)
Enter the ending
balance on the
current statement
Enter the total
amount of
unrestricted funds
available
73
Purchasing Plan - Page 5
Section E – Savings Plan – Authorizations for use of Accumulated,
Unrestricted Funds (continued)
Unrestricted funds
made available for
savings plan
purchases each month
The accumulated unrestricted
funds must always be
reserved and available for use
by emergency back-ups
The total estimated
cost amount is
forwarded from the
Budget Detail
Services section EBU
Added Cost total
74
Purchasing Plan - Page 5
Section E – Savings Plan – Authorizations for use of Accumulated,
Unrestricted Funds (continued)
Enter the legal provider name
for each item or service
Enter each item or
service description
Click on box to open the dropdown
box containing service code
numbers. Select the correct service
code for the item or service listed
75
Purchasing Plan - Page 5
Section E – Savings Plan – Authorizations for use of Accumulated,
Unrestricted Funds (continued)
Enter the number of units to be
purchased for each item or
service
Click on the box to
open a dropdown box.
Select the provider
type for the item or
service
If provider is a DHE, click on the box to
open a dropdown box. Select the
number that describes the relationship
of the participant to the DHE named
Enter the unit type for the
item or service to be
purchased
76
Purchasing Plan - Page 5
Section E – Savings Plan – Authorizations for use of Accumulated,
Unrestricted Funds (continued)
Enter the rate per unit
for each item or
service
Sub-total will automatically
calculate and appear in this
box
If applicable, employer taxes will
calculate. The amount will
appear in the employer taxes
box
77
Purchasing Plan - Page 5
Section E – Savings Plan – Authorizations for use of Accumulated,
Unrestricted Funds (continued)
The total estimated
cost amount for each
item or service will
calculate and insert
here
Enter the estimated date
the item will be
purchased. This will
always be the last day of
the month (mm/dd/yyyy)
Enter the actual date
the item was
purchased.
(mm/dd/yyyy)
78
Purchasing Plan - Page 5
Section F – Budget Detail – One Time and Short Term Expenditures
Click on box to open a dropdown box listing
items and services available for either OTE or
STE. Select the item or service to be purchased
Click on box to open a
dropdown box. Select type
of expenditure – OTE or
STE
When item or service is
selected the assigned
service code will appear
in the service code box
79
Purchasing Plan - Page 5
Section F – Budget Detail – OTEs and STEs (continued)
Enter the legal
provider name for
each item or service
Click on the box to
open a dropdown
box. Select the
provider type for item
of services
If the provider is a DHE, click on the
box to open a dropdown box. Select
the number that describes the
relationship of the participant to the
DHE named
80
Purchasing Plan - Page 5
Section F – Budget Detail – OTEs and STEs (continued)
Enter the number of units to be
purchased for each item or
service
Click on box to open
dropdown box. Select
the unit for each item
or service
Enter rate in dollar
amount for item or
service to be purchased
81
Purchasing Plan - Page 5
Section F – Budget Detail – OTEs and STEs (continued)
Sub-total will automatically
calculate and appear in this
box
If DHE employer tax is
calculated, the amount
will appear here
The total budget for each
item or service will
calculate and appear here
82
Purchasing Plan - Page 5
Section F – Budget Detail – OTEs and STEs (continued)
Enter the start date for
each item or service
(mm/dd/yyyy)
Enter the end date
(mm/dd/yyyy). This is the
same date as the end date of
the item funding
Slide 48
Purchasing Plan - Page 6
Budget Summary
The service and supplies
amount is automatically
populated. It is the sum of
Sections C.1 total and C.2
total of the Purchasing Plan
The authorized budget amount is
automatically populated. It is the
amount that was entered as the
monthly budget on the top of Page
1
84
Purchasing Plan - Page 6
Budget Summary (continued)
This section no longer
applies and should not
contain any numbers
The total monthly
expenditures is the total
authorized budget
amount
The Savings Plan amount
will automatically
populate. The amount is
unrestricted funds made
available each month in
Section E
85
Purchasing Plan - Page 6
Signatures – Participant or CDC+ Representative
The participant or representative
must print name then sign and
enter date signed on hard copy of
form
86
Purchasing Plan - Page 6
Signatures – Consultant
The consultant must print name
then sign and enter date signed
on hard copy of form
87
Purchasing Plan - Page 6
Signatures – APD Staff
APD staff will review the
purchasing plan. If the plan meets
the participant’s needs and goals
and is written correctly then APD
staff will sign and date indicating
approval
88
Purchasing Plan - Page 6
Signatures – APD Staff (continued)
Any exceptions will be indicated in
the approval exception box. Followup by participant or representative is
required
89
Purchasing Plan
Submission Process
Participant Responsibilities:
•
•
•
•
•
Double-check all information
Minimum six (6) completed pages
Submit all required paperwork
Retain copies
Submit by 5th of the month
90
Purchasing Plan
Submission Process
Consultant Responsibilities:
• Review for accuracy
• Signs the Purchasing Plan
• Submit by 10th of the month
91
Purchasing Plan
Submission Process
Area Office Responsibilities:
• Review for accuracy and signatures
• Ensures all documents enclosed
• Submit by 20th of the month
92
Purchasing Plan
Approval Process
CDC+ Central Office:
•
•
•
•
•
•
Reviews submitted documents
Returns if revisions are needed
Approves and processes documents
Assigns provider identification (ID) numbers
Contacts new participant with ID numbers and start date
Provides approved Budget Summary copy
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Developing a Purchasing Plan
GROUP ACTIVITY
• Developing a Purchasing Plan using a
Training Scenario
• Developing a Quick Update
• Signing off on both
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Getting Claims Paid
•Directly
Hired Employees
•Time Sheets –(CDC+ Rule Handbook Appendix G-2)
•Vendors (AV, IC)
•Invoice
•Must be tracked – (Participant Notebook Appendix K (3,4)
•Rep Reimbursements (Savings, OTE/STE)
•Receipt
•Must be tracked – (Participant Notebook Appendix K (6)
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Getting Claims Paid, continued
•Bi-weekly payroll
•Pay Schedule – (CDC+ Participant Notebook Appendix O
(4))
•CDC+ work week (12:00am midnight Monday - 11:59pm Sunday)
•Payroll submission
•Secure Payroll System – Web based
•Interactive Voice Response – IVR
•Call in – Customer Service
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Managing Monthly Budget
•Spend within CDC+ Monthly Budget
Use Calendar – Participant Notebook Appendix O (2)
Spend consistent with Purchasing Plan
•Overtime
Not good use of funds
•Reconcile Monthly Statements
•Participant Notebook Appendix M (2)
•Track current account balance between statements
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Budget Mismanagement
•Budget mismanagement will lead to either
Corrective Action Plan (CAP) or
Not “entitled” to a CAP before other sanctions can occur
Disenrollment and return to the Waiver
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Overspending
•Purchasing supports or services greater than
the amount that is authorized
•Insufficient funds in a consumer’s account
result in claims being held until additional funds
become available.
•Once held, claims will be reviewed in the
following order: timesheets, invoices,
reimbursements.
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Corrective Action Plan (CAP)
Appendix N,
•A tool to assist participants or representatives to correct
problems with mismanagement of the program as required by
the 1915j State Plan Amendment.
•Developed and signed by participant and consultant
•To be developed immediately when participant/representative:
•
•
•
•
Purchases inconsistently with the approved Purchasing Plan
Overspends
Does not produce receipts upon request
Puts health and safety at risk
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Corrective Action Plan (CAP),
continued
The CAP plan addresses
WHAT has happened/caused the problem
HOW the participant/representative plan
to correct the problem
WHEN the problem will be corrected
WHO is responsible for each step
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Disenrollment from CDC+
•Voluntarily or involuntarily
•CDC+ Participant Information Update
Form – (Participant Notebook Appendix D(XV11)
•CDC+ Account Close-Out Procedure- (Participant
Notebook Appendix M(3)
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Thank you
Ivonne Gonzalez
Ivonne_m_gonzalez@apd.state.fl.us
850-417-8270
CDC+ Customer Service
1-866-761-7043
CDC+ Website http://apdcares.org/cdcplus/
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Terms to Review
Roles and Responsibilities
Critical Service,
Restricted Service,
STE- Short Term Expenditure
Pended claims,
Rep Reimbursement
CAP- Corrective Action Plan
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Closing Activities
Final Q and A’s
Readiness Review
http://apd.myflorida.com/cdc-plus/refreshform1.php
Evaluations
http://www.surveymonkey.com/s/2LGVKFV
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