1. For MRDD system Case Managers Presented by: Kansas Department of SRS June 2011

2.  FMS is a new waiver service for the administrative and information & assistance functions for self-directing individuals  Replaces current payroll agent process  Kansas has elected to operate FMS as an Agency with Choice (AWC) employer model  FMS is only available for services that are self- directed

3.  Centers for Medicare and Medicaid Services (CMS) new requirement  Separates administrative functions from direct service payment rates

4.  I&A is a service within FMS that is available to provide information, including independent resources, and assist in the development of options to ensure that individuals understand the responsibilities involved with directing their services.  Practical skills training is offered to enable self-directing individuals, their families and/or representative to independently direct and manage waiver services.  The extent of the assistance furnished to the self- directing individual will be determined by the self- directing individual or individual’s representative.  I&A services may include the performance of activities that nominally overlap the provision of targeted case management services. However, such overlap does not constitute duplicate provision of services.

5.  Meet all applicable requirements to be and maintain status as FMS provider  Develop and implement policies that ensure the delivery of FMS services, and subsequent reimbursement, meeting applicable requirements  Provide I&A as requested  Develop and maintain all applicable agreements

6.  Choose from qualified and available FMS providers  Participate in the development of all plans including planning, startup, delivery and administration of direct support worker services  Work collaboratively with their FMS provider to meet shared objectives  Recruit, hire, train, dismiss and schedule direct support workers  Inform the FMS provider and Targeted Case Manager of any changes in the status of the individual or individual’s representative, within 3 working days  Verify time worked by Direct Support Worker(s) was delivered according to the POC; approve and sign timesheets

7.  Ensure the person is aware of the new FMS service  Revise plan of care timely and appropriately within local procedures.  Refer the person to resources so they can educate themselves about FMS service and providers such as the self-direct website http://selfdirect.ks.gov and the self-direction / KPASS tool kit. http://selfdirect.ks.gov  Monitor service provision and plan implementation

8.  For a self-directed individual the plan of care has to include both FMS and at least one of the self- directed services.  Revising the plan of care should follow the same CDDO procedures for any other revision to services on the plan of care.  The plan of care must be signed by the person or their representative.  FMS Rate = $115 / month  Personal assistant services = $2.64/15 minutes built on an avg. attendant care wage of $8.98/hr.  Procedure codes: PAS=T1019 FMS=T2040U2

10.  Choosing a FMS provider shall follow the same process the CDDO utilizes for choosing any other provider type.

11.  Why are we making the change to Fiscal Management Services? The change has been brought about by the Centers for Medicare and Medicaid Services (CMS) requiring the State to separate administrative costs from direct service costs.  Will I have to change my attendant care providers? No, you will be able to keep your current attendant care providers.  Will I have to change to a different payroll agent? Maybe. There may be some current payroll agents that choose not to become a provider of Fiscal Management Services.  What will the FMS provider do for me? There will be an agreement between the consumer and the FMS provider which will outline both the responsibilities of the FMS and the consumer of services. Some of examples are processing timesheets, paycheck creation, and filing of taxes, unemployment and liability insurance.  Will this change the amount of services that I receive? No.

12.  What is I & A? Information and Assistance (I&A) is a service that is incorporated into the definition and requirements of the FMS provider. This service is available to provide information, including independent resources, and assist in the development of options to ensure that individuals understand the responsibilities involved with directing their services. A complete detailed definition is available on the SRS website at (place web address here), or, if you don’t have access to the internet, ask your case manager for a copy of the document.  Will I have to pay the FMS or how is the FMS paid for its work? No. The FMS will bill the State directly for the FMS it provides.  Can I have I & A and Case Management? Who will do what for me? Yes, although the services cannot be duplicative. FMS providers have specific I & A responsibilities which are different than the responsibilities of case managers.  Who should I contact if I have questions? Your Case Manager is required to attend training on this change of service. They should be your primary contact for information. You may also go to our website at….