Consumer Directed Community Supports

CDCS is a service available to individuals with Medical Assistance (MA) and a waiver.

CSG is available to qualifying individuals with only Medical Assistance.

If you choose to use self-directed services, you receive a personal budget allocation from the state to fund the services and supports you need. Your budget allocation is based on a PCA or MNChoices assessment, and can change if your condition changes.

Summit Fiscal Agency is a Fiscal Support Entity (FSE). We provide a menu of employment and reimbursement services to you and act as a billing liaison between you and the state. There are three models of support that describe the balance of consumer responsibility and Summit supports:

Agency with Choice, Vendor Fiscal/Employer Agent and Fiscal Conduit.

The Agency with Choice model offers the most support to you or your representative if you want to direct your own services. Under this model, Summit is the Common Law Employer and you or your representative are the Managing Employer (ME). This is a dual employer arrangement that allows you to recruit, screen, hire, train, supervise and evaluate employees, and set employee wages and mileage reimbursement rates based on your budget. You obtain and verify all of your employees’ paperwork, timecards and expense reimbursement requests. While you are free to decide you no longer want to have an employee work in your home, Summit retains the authority to discharge the employee in its role as the Common Law Employer.

As the Common Law Employer, Summit requires background and motor vehicle checks, carries liability insurance, a worker’s compensation policy, and pays all wages and taxes. Under the Agency with Choice model, Summit provides all the tools and materials that you need to manage both your employees and your state allocation.

With the Vendor Fiscal/Employer Agent model, you or your representative are the Common Law Employer. This means that you obtain an Employer Identification Number (EIN) and are the lawful employer of those who provide you with direct support. This model allows you to have autonomy and self-direction in managing your support services. You will hire employees, train, supervise, evaluate and discharge them at your own discretion. You must also take responsibility for following all applicable federal and state employment laws. You must complete all employer paperwork and obtain proper insurance and workers compensation policies.

In the Vendor Fiscal/Employer Agent model, Summit is NOT the employer. Summit is your agent that provides administrative support, such as paychecks to employees, payment of payroll taxes, processing of employment related information and record keeping. Summit will pay the workers’ compensation premiums on your behalf. Summit will also provide you or your representative with the forms and information needed to become an employer and to manage employees. You and your representative have both the responsibility and liability for properly executing employer obligations and for following all applicable laws.

The Fiscal Conduit model allows you the most flexibility and self-direction. You become the Common Law Employer and are responsible for managing all aspects of your household business including: paying support workers and other vendors for goods and services directly, and managing or outsourcing the management of payroll related tasks. In this scenario, Summit will reimburse you for payments made after the services are rendered. You may also request that Summit pay vendors directly after you have approved the expense.

Summit will require that you file documentation prior to billing and cash disbursement. This will include payroll documentation that indicates individual wages paid and taxes withheld and paid. All expenses that have been paid require receipts.

Across all models, Summit will perform billing as the Medical Assistance-enrolled provider, verify documentation of allowable expenditures, and report use of the allocation to you, your County and the Department of Human Services. Summit’s responsibility under the fiscal conduit model is limited to these actions.

Can we help you or someone you love to live a more independent life? Summit Fiscal Agency and Pinnacle Services work side-by-side to provide comprehensive, customer-friendly service to individuals using CDCS, CSG and waiver programs. For more information about the CDCS and CSG programs or the associated models of service, please feel free to contact Chris Smith at 612.977.3952 or chris.smith@pinnacleservices.org.

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Not all agencies require the extensive training that Pinnacle does.

According to Karin Malkowski Stende, trainer/human resources associate, Pinnacle requires “very intensive, 30-plus hours of classroom and on-site training that new staff are expected to complete during their initial two weeks of employment.”

“The state requires 30 hours of training within the first 60 days of employment,” says Stende. “We believe that our two-week training model exceeds that requirement and allows us to better equip our new staff with the knowledge and expertise they will need in order to be of maximum service to the consumer.”

The Pinnacle curriculum includes training on:

• The Vulnerable Adult/Maltreatment of Minors Act (which mandates reporting of actual or suspected abuse/maltreatment of vulnerable adults and/or minors)
• Rule 40 (which regulates the use of controlled procedures)
• Medication administration
• Home health aide competency
• Basic dementia training (which includes communication skills and working with challenging behaviors)
• CPR and first aid from American Red Cross-certified instructors
• Boundaries
• Vehicle safety
• Funding and waivers
• HIPAA
• Alternative intervention, and
• Pinnacle Services company history, mission, and core values.

New staff also gets intensive on-site orientation that includes medical equipment training, as well as completing risk management post-tests.

“All of our trainings are designed to give our new staff the confidence and competence they need so they can provide consumers with services of the highest quality — one of our company’s core values,” says Stende.

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***  PHYSICAL OBSERVATION:  increased fragility; unkempt person or home; increase sensory impairment; acute illness or injury.

***  PSYCHOSOCIAL OBSERVATIONS:  increased confusion/forgetfulness; anxiety or depression; change in mood or personality; increased isolation; new or increased paranoia; deteriorating relationships.

***  SUPPORT SYSTEMS:  inadequate support systems; change in support systems; loss of significant other or relationships.

The post Pinnacle Services Home Care for the elderly anticipates early warning signs indicating possible problems for your loved one appeared first on Pinnacle Services.

The full article can be found at:  http://www.nytimes.com/2009/06/07/us/07squeeze.html?scp=1&sq=Chokehold&st=cse

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