Agency Option or Consumer Directed Services?

 

 

 

 

Applying for services from Medicaid for individuals with Intellectual and Developmental Disabilities can sometimes be complex and confusing. The two main criteria used by the State in determining eligibility are personal income and level of need for the individual. The local authority in Fort Bend County can help you through the application process. If you are approved for Medicaid and offered services through one of several Medicaid waiver programs, your case manager or service coordinator will give you the choice of receiving the services through an Agency option or Consumer Direct Services option.

Choosing the Agency option places the responsibility for your program services with a provider agency. That agency will:

Select, schedule and manage attendants and substitutes.

Set wages and benefits for the attendants.

Manage time sheets, payroll and employment records.

Choosing the Consumer Directed Services (CDS) option allows you more control over your program services and service providers. If you choose CDS, you or your designated representative will:

Select and hire your own service providers and backup employees (including family, friends or neighbors).

Set wages and benefits for your employees based on a service budget.

Select a state contracted Financial Management Services Agency (FMSA) to:

train you to hire and manage employees,

process your timesheets and payroll,

process receipts and invoices, and

act as your agent to pay federal and state employment taxes.

Submit timesheets for your employees to your FMSA.

In most cases, the CDS option allows you to pay higher wages and attract a wider range of qualified service providers/employees. Additionally, the dollar amount of hourly units charged against your allocated funds from Medicaid is usually less in the CDS option. This can allow you more funds available for more units of service.

The CDS option is available in the following programs:

Texas Home Living(TxHmL)

Home and Community-based Services(HCS)

Community Attendant Services(CAS)

Medically Dependent Children Program(MDCP)

Community Living Assistance and Support Services(CLASS)

Deaf Blind and Multiple Disabilities(DBMD)

Primary Home Care(PHC)

Family Care(FC)

Community Attendant Services(CAS)

Community Based Alternatives(CBA)

Personal Care Services(PCS)

　

Neither option is designed to be a "one size fits all" program. You should explore both options and see what works best for you or the individual you are responsible for. While your service coordinator or case manager can help you understand the benefits for both, I would suggest speaking with individuals who have selected both options and see what their experience has been from a consumer’s perspective. You can also contact a state contracted Financial Management Services Agency (FMSA) who can explain in more detail the process of the Consumer Directed Services option.

A big thank you to Craig Coward from BWC Healthcare Services for being our guest blogger this week.