4200, Enrolling the Individual in the Consumer Directed Services Option

Revision 17-1; Effective November 1, 2017

To enroll an individual in the CDS option, the case manager sends the following documents to the FMSA:

  • a completed Form 1584, Consumer Participation Choice, within five business days after the individual or LAR selects the CDS option;
  • a copy of the completed PAS/Habilitation Plan - CLASS/DBMD/CFC schedule; and
  • a copy of the completed proposed IPC when it is sent to HHSC for authorization.

The FMSA needs the proposed IPC in order to conduct the required CDS orientation with the individual or LAR before services delivered via the CDS option can begin.

During the CDS orientation, several key activities must occur before services starts. The FMSA will:

  • explain the hiring process to the employer, including the required criminal history, registry and Medicaid exclusion checks;
  • ensure the employer understands who can and cannot be hired to provide CLASS services under the CDS option (e.g., CFC PAS/HAB or CLASS habilitation, respite, nursing, physical therapy, occupational therapy or speech/language pathology);
  • work with the employer to develop the draft CDS budget, which includes the hours direct service providers will work, wage rate and benefits for each employee hired and project expenditures for employer services and supports, including support consultation if included on the IPC (the draft CDS budget is based on the proposed IPC); and
  • explain service delivery documentation must relate back to the individual's plan of care and justification for each CLASS service.

The FMSA will need to know the number of hours of CFC PAS/HAB or CLASS habilitation, respite, nursing, physical therapy, occupational therapy, speech/language pathology or support consultation on the proposed IPC in order to assist the employer with development of the CDS budget. The FMSA conducts the CDS orientation while the proposed IPC is under review by HHSC.

The FMSA is required to notify the case manager via HHSC Form 2067, Case Information when the orientation has been completed. The case manager files the form in the individual's record.

Services delivered through the CDS option may not begin until:

  • the in-person CDS orientation has been completed;
  • direct service provider eligibility has been determined and verified by the FMSA;
  • the service provider agreement(s) has been signed;
  • the CDS budget has been approved by the FMSA; and
  • the IPC has been authorized by HHSC.

HHSC notifies the CMA in writing of whether the proposed IPC is authorized. The case manager must then provide the FMSA with a copy of the HHSC authorized IPC. In the event the number of hours authorized for a CDS service changes as a result of HHSC review, the case manager will notify the FMSA of the change by sending Form 2067 to the FMSA so that adjustments can be made to the individual's CDS budget as necessary.

Financial Management Services (FMS)

For individuals who use the CDS option, the IPC must include FMS. FMS is authorized as a monthly service. For example, for a 12-month period, 12 units of FMS must be included on the IPC.

Support Consultation

If the individual or LAR requests support consultation or the individual's SPT determines support consultation would be beneficial to provide employer coaching, hours for support consultation must also be included on the IPC.

Support consultation is to be used, as needed. On average, an individual may be authorized for six to nine hours of support consultation per year. It is generally not the type of service to be used on a weekly basis.

Note: A CLASS DSA is not responsible for delivering or billing for a service delivered through the CDS option.

If the individual or LAR decides to receive nursing through the CDS option, the DSA is not responsible for supervising or verifying the credentials of the nurse hired by the CDS employer.