Employer Guide to the CDS Option for Nursing and Professional Therapists — Community Living Assistance and Support Services

The CDS Option for Nursing in the CLASS program

Even if you choose nursing through the CDS option, the CLASS DSA nurse will continue to conduct the initial Level of Care assessment and the annual re-assessment.

Service Planning for CLASS Nursing and Professional Therapies

At your service planning meeting, you and your interdisciplinary team (IDT) will decide if you need nursing, physical therapy, occupational therapy or speech/hearing therapy. The service planning process is the same for those who use CDS option and those who do not.

If the IDT determines a need for Nursing

  • You will be authorized for 4 hours assessment and plan of care development.
  • You will hire your own registered nurse (RN) who will develop your nursing plan of care that will determine how many of hours of nursing you will need. Board of Nursing rules do not allow an Licensed vocational nurse to develop the plan of care. Your RN will advise you on how many of your nursing hours can be provided by an LVN).
  • Your RN must send your nursing plan of care to your case manager for service authorization and utilization review by state office staff. You, the employer, must also keep a copy of the nursing Plan of Care in your files.
  • You must not use any nursing beyond the four hours of RN services authorized until your nursing hours have been approved by HHSC.

If the IDT determines a need for physical therapy, occupational therapy or speech/hearing therapy….

  • You will be authorized for 4 hours of service for an assessment by a licensed therapist you hire
  • During the ASSESSMENT, the therapist hired by you will create a plan of care—which includes hours of therapy needed and what the therapy will accomplish.
  • The professional therapist must send the Plan of Care to your case manager for authorization and utilization review by HHSC. You, the employer, must also keep a copy of the therapy Plan of Care in your files.
  • You must not use any therapy beyond the four hours of authorized for professional therapy assessment until your therapy hours have been approved by HHSC

How to Look for a Nurse or Therapist

  • Ask someone you know
  • Call a local disability organization
  • Advertise in the newspaper or Craig's list
  • What to include:
    • Must provide a current license
    • Have experience with individuals with disabilities or particular condition
    • What days and times to deliver services
    • Contact phone number
  • What Not to Include:
    • Address or that you live alone

Supervision as Defined by Licensing Boards

The professional you hire must understand and practice the supervision requirements of his or her respective profession.

For example, it is important to remember that an LVN can not work without the supervision of an RN and there are certain tasks the only an RN can perform.

Documentation of Supervision

Your licensed vocational nurse (LVN) MUST complete HHSC Form 1747 before payment can be made.

Licensing Boards

The Recruitment and Hiring Process

  • The nurse or therapist you hire will be hired as your employee and will have unemployment taxes taken out of his/her paycheck.
  • Nurses must be hired as employees. If you want to hire your physical, occupational or speech therapist as a contractor, you will need to review and adhere to guidelines related to contractors vs. employees in ESPECIALLY FOR TEXAS EMPLOYERS on the Texas Workforce Commission (TWC) website. 

Remember...

Your CDSA must notify you that they have verified the License and that the applicant has passed all background checks BEFORE you sign the Employer-Employee Agreement.

Verifying Continued Eligibility

Provide documentation to the CDSA within 30 calendar days after the renewal date of the service provider's license, certification, or other permission

Documenting Service Delivery

  • You must use Form 1745, Service Delivery Log
  • This serves as a timesheet and gives you documentation of what occurred.
  • Your nurse or therapist records the time of the visit
  • Your nurse of therapist records what occurred during the visit.
  • Activities must match the plan of care.Send the 1745 to your CDSA for payment to your nurse or therapist.

Service Delivery Notes

  • Ask your nurse or therapist to give you a copy of their detailed service notes for you to keep
  • Each profession is required to write these in a certain way
  • Your CLASS case manager may ask to review these notes or your Plan of Care when they visit to ensure that you are receiving your CLASS services according to program rules.