 If you have questions or comments about this newsletter or its contents, please contact your case manager.
 1/1/25 CDCS Budget Increases:
There will be a 4.53% increase to CDCS budgets on 1/1/25 for all waivers (DD, BI, CAC, CADI, EW) and AC. Refer to the eList announcement for more information about this increase, as well as other service rate increases that could apply, should you have licensed waiver services or MA Homecare Services on your plan. An update will be sent regarding the process for increasing your service agreement and allocating additional funds. Reminder, minimum wage also increases to $20/hour. This can be written into plans to avoid revisions later.
 1/1/25 Increase to Staff Minimum Wage
As of January 1, 2025, the minimum wage for all Individual Providers in the SEIU Healthcare Minnesota & Iowa union will be $20/hour. This is part of an agreement between the union and the state. Please ensure your staff are at this new minimum wage when writing plans for 1/1/25 and beyond. FMS providers will be automatically increasing wages for staff with hourly wages less than $20 after Jan 1st. Plans may need to be revised if the 1/1/25 budget increase is not enough to cover this change. More information will be provided soon.
CFSS and CDCS
Overview of CFSS: CFSS is a new service that replaces PCA and CSG. CFSS can be used as an MA/State Planned service OR can be used on a waiver. If on a waiver, CFSS is an OPTION under the waiver, and can be used with other licensed waiver services. Other licensed waiver services do NOT come out of the CFSS budget.
CFSS or CDCS?: Eligibility for CFSS will be determined at your MnCHOICES assessment, along with eligibility for HCBS waivers. Your case manager can help you determine what the best option is for you, based on your assessment. You will need to consider the differences between CFSS and CDCS:
- Differences in the budget amounts
- PPOM/Spouse CANNOT be the participant’s representative on CFSS, like they can be managing party on CDCS.
- Staff wages are capped at the PCA rate for CFSS.
- Consultation services are required for CFSS. Support planner services are optional for CDCS.
- Only goods and services that replace human assistance are allowable under CFSS. CFSS does NOT cover the following goods and services commonly found in CDCS:
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Examples include bonuses, nursing, monitoring technology, transportation, environmental supports, special diets, home-delivered meals, therapies, caregiver relief and companionship. (Note: CFSS may still be an option if on a waiver, as depending on the goods/services needed, you may be able to meet some of these needs by accessing licensed waiver supports in addition to CFSS. These other services would not be self-directed and would not have the "flexibility" that they might have under CDCS.)
- CFSS- If on a waiver, other licensed services can be authorized, but they can be authorized in addition to the CFSS service.
- CDCS- Other licensed waiver services can be authorized with CDCS, but they must fit within the budget amount.
CFSS and CDCS: We do not anticipate many people needing or wanting to use CFSS and CDCS simultaneously, unless they are having trouble finding staff. In this case, they can utilize CFSS agency model within the CDCS support plan to help employ and train staff. (Similar to how PCA has been used within CDCS.) If you currently have PCA services on your CDCS plan, 3 additional months of PCA will be authorized at renewal, while CFSS is set up to replace it. If you want to start CFSS within your CDCS plan, contact your case manager for more details. You will be connected with a consultation services provider who will help you write the plan and get the services approved. Important note: When using CDCS and CFSS, all services/supports must fit within the CDCS budget.
CDCS Plan Renewals and Electronic Visit Verification (EVV)
On 9/1/24, DHS began enforcing the compliance with EVV, meaning late plans could create a gap in services. For this reason, we must strive to approve CDCS renewal plans before the start date! To help make sure we can approve plans timely. Please follow these “best practices” to ensure services are not interrupted:
Participants/Managing Parties
- Schedule your MnCHOICES assessment as soon as you can when contacted by the assessor.
- 60 days before the renewal date, begin the process of writing your CDCS plan using previous year’s budget.
- Contact your case manager if you don’t get the CDCS budget by the 12th of the month prior to renewal.
- Update the plan with the budget from the case manager, tweak goals as needed after reviewing the MnCHOICES assessment and submit your plan by the 15th of the month prior.
- Submit the plan even if waiting on additional documentation, as these items can likely be pended until the information is received.
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Participant Guide to CDCS is a helpful guide for all things CDCS.
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Participant Guide for Completing a CDCS Plan is a checklist you can use if writing your own plan.
Case managers/Supervisors
Follow guidance in the Ramsey County CDCS Processes and Procedures document.
Policy Clarifications and Best Practices
Staffing Agencies and CDCS
If requesting staffing through an agency/provider other than the FMS, they MUST be a licensed 245D provider or properly enrolled with DHS. Enrollment will depend on the services the staff will provide. Participants should consult with their case manager before setting up services with a staffing agency. Case managers need to consult with the coordinator to determine if the staffing agency can be approved.
Replacement Mattresses are not allowable under CDCS
In the past, we have approved replacement mattresses for incontinence, bodily fluids, or property destruction based on the disability. CDCS manual states that “Items or support normally provided by the person, or their parents, family or spouse” are not allowable. Please apply this guidance moving forward.
Overtime when there are multiple CDCS participants in a household
The current recommended practice is to budget overtime on each plan. This is because the OT may have to be averaged out among all plans, depending on the payroll system being used by the FMS. In other words, it is not always possible to schedule the OT to come out of one person’s plan, by scheduling their hours at the end of the week. FMS systems vary, so questions can be directed to the FMS.
 MnCHOICES 2.0 and CDCS Budgets
As a result of the mandated MnCHOICES 2.0 Revisions Tool, some budgets are increasing and some are decreasing.
- All participants will switch to the new assessment tool within the next year.
- DHS has not changed any formulas however did make intentional and clarifying changes regarding scoring.
- If your CDCS budget decreases:
- Work with your case manager and assessor to determine what changed from last year to this year’s assessment.
- You may appeal the lower budget however in order to get this overturned you will need to prove the assessor did not correctly score an area of need.
- For more information on how CDCS budgets are determined, you can view the following budget methodologies:
PPOM Job Descriptions and Schedules
PPOM job descriptions should NOT include the following activities:
- Activities that are considered typical parental responsibility based on age. For example, a small child should not have transportation, meal prep, assistance with finances, etc. Since many of the activities a parent engages in with young children are considered “parental responsibility”, schedules should not include long shifts that would not account for activities that are parental responsibility.
- Nursing duties or Medication Administration.
Tips for determining hours and developing schedules:
- The appropriate number of hours should be based on the person’s assessed needs and when they are performed.
- To determine the appropriate number of hours each day, start with the number of extra hours needed to help with activities or daily living (ADL’s)/PCA assessment. Then, add instrumental activities of daily living (IADLs), behavioral redirection, and additional supervision.
- Spread your hours out over the week when you are performing personal assistance activities that are above and beyond usual parental responsibilities.
- If the child is the only person in the household on CDCS or CSG, and no overtime is being requested, you can include a more “general” schedule, to allow for intermittent work. For example, “3 hours- AM, 3 hours-PM” is acceptable.
- Detailed, family/household schedules outlining times are required in situations where there is more than 1 person in the household on a self-directed program (CDCS or CSG), if there is shared care, or if overtime is being requested.
- With electronic visit verification (EVV) time reporting, you must record the time you actually worked on a daily basis.
NOTE: A new PPOM Job Description form has been developed to assist participants/managing parties/support planners to develop the job description and determine the number of hours needed for support!
Addendums/Revisions
When making a change to a CDCS plan, please remember that an addendum form/revised plan is not always necessary. An EMAIL can be accepted instead of a form in the following situations:
- Moving funds between items/services that have already been approved. NOTE: For changes in staff hours, need a new staff schedule.
- Allocation of unallocated funds, to increase amount of a service/item that has already been approved.
- Correction of fiscal fees on initial plan/renewal
- COLA: Use of COLA increase for approved items
An addendum form OR revised plan is needed for all other changes. Ramsey County does not require both.
Stipends Available
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Training Stipend: Available only for workers in PCA Choice, CSG and CDCS who complete qualifying training before June 30, 2025. A worker may receive a $500 stipend starting July 1, 2023, until the $2 million of stipend funding is exhausted or June 30, 2025, whichever comes sooner. Stipends are available on a first-come, first-served basis. Learn more.
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Home Care Recruitment & Retention Stipend: $1,000 - All workers in Union programs (PCA Choice, CSG, CDCS, and CFSS Budget Model) now qualify for a one-time $1,000 retention stipend after 6 months of employment! This includes PCAs, Family Caregivers, and Paid Parents. Eligible workers who apply will receive a check in the mail, as well as a 1099 tax form. Stipend ends May 30, 2025, or when funds are exhausted. Apply now.
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Electronic Visit Verification (EVV) Stipend - $200: All workers in PCA Choice, CSG, CDCS and CFSS Budget Model qualify for a one-time $200 to offset potential costs related to using individual devices to access electronic visit verification. Stipend ends May 31, 2025, or when funds are exhausted. Apply now.
 CDCS Participant Training
New participants need to watch both the DHS and Ramsey County orientation trainings prior to starting CDCS. It is recommended that current participants watch annually as a refresher. CDCS participants who are NEW to Ramsey County should watch as well!
English: DHS Training Video
Ramsey County Participant Training
Spanish: Passcode +Ng54LlA
Hmong: Passcode U926$!PB
Somali: Passcode a8RM1FR&
Karen: No passcode needed
Case Manager/Supervisor
Training
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“Intro to CDCS” is a 3-part training that is mandatory for new case managers and new supervisors. In addition, there are several “topical” trainings available. All trainings are recorded and available in the shared drive for operated case managers, and in SharePoint for contracted case managers.
CDCS Consults (Case managers and supervisors)
2nd and 4th Tuesdays @ 11 am
 CDCS Unbundling
Effective Feb. 1, 2025, DHS will start the rolling implementation of the CDCS unbundling project. People who currently receive CDCS services will:
- Continue their approved CDCS community support plan (CSP), DHS-6532, or alternative format.
- Transition to the new unbundled CDCS service categories after their annual reassessment, occurring on or after Feb. 1, 2025.
DHS has provided some training for lead agencies and CDCS support planners. A new CDCS plan document is being created and CDCS policy pages are in the final stages of development. There will be some changes as to what is allowable and unallowable under CDCS, and once the policy pages are finalized, Ramsey County will disperse that information to participants and managing parties For more information, see the eList announcement. Note: CDCS unbundling will not change people's CDCS budgets.
 Helpful CDCS Documents
Participant Guide to CDCS
Participant Guide for Completing a CDCS Plan
General Information About CDCS
MN Department of Human Services (DHS)
Ramsey County Human Services
CDCS Policy Manual
MHCP Provider Manual (Does MA cover?)
Community Based Services Manual (CBSM)
EAA (Home and Vehicle Modifications) Q&A
Nursing Q&A
Translated Ramsey County CDCS Policy Guidelines
RC Policy Guidelines- English
RC Policy Guidelines- Spanish
RC Policy Guidelines-Hmong
RC Policy Guidelines-Somali
RC Policy Guidelines-Karen
 Need More Staff?
All staff need to be hired through the FMS once secured.
College Tuition Resource for Direct Care Staff
The Minnesota Future Together Grants-College tuition for direct support workers that meet income guidelines.
Person Centered Planning
A person centered planner, helps a person develop/create a life plan to help them reach their goals and achieve their dreams in life. Contact The ARC Minnesota
Cell Phone Programs
Autism Resource
DHS Culture Specific Autism videos and Resources Portal:
Other Helpful Resources
Multilingual Support Planner Group - Abdirahman Ahmed w/6 SP's speaking: English, Somali, Arabic, French, Oromo, and Spanish. maverickhealthcaremn.com, abdirahman@maverickhealthcaremn.com 612-707-3308
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