j0318792[1]                                 

Self Determination:

 

Self-determination is not a new program, rather an evolving process and set of principles that supports people with disabilities in having control of their lives.  It supports people’s rights as citizens to control their resources so they can make their own choices, be part of their community, and have meaningful relationships.  Self-determination is another way of saying freedom.  It is a basic human right.  Self-determination provides people who receive developmental disability and mental health services control for the resources needed for support, freedom of choice and the responsibility for their decisions and actions.  SCCMHA is actively incorporating the principles and process of self-determination into all programs and services.

 

 

return

 

Questions and Answers

 

1.     Does staff receive pay for training?

 

Training expectations should be arranged between the staff and the employer (i.e., consumer/guardian).   CMH is paying an all inclusive rate of $12.00 per hour or $3.00 per 15 minute unit of CLS services provided. 

 

  1. How does CMH establish a billable rate?

 

The billable rate is established taking into account providers’ costs related to services provision and staff’s pay. 

 

3.    What is a billable service?

 

Community Living Supports is a main component of a self determination budget for an individual.  Community Living Supports is defined as:  face-to-face time with a consumer.  Within the context of this face-to-face time, staff may actively train, assist, and / or observe a consumer across a wide range of activities. The Medicaid Manual outlines the specifics related to such activity, and is attached for easy reference.

 

4.    What is a non-billable service?

 

As a function of self determination, the employer (i.e. consumer /guardian) may choose to pay staff for time spent in training, vacation time, holiday time, overtime, mileage and the like.   Although these may be part of the employment agreement between the staff and employer, these activities are not individually billable to CMH.  The understanding is that these expenditures are rolled into and part of the billable rate.

 

5.    Contingency Fund?

 

According to Medicaid, there is no contingency fund.   Items which would come from a “contingency fund” are essentially rolled into billable services.  Most billable services have some form of non-billable activity that is associated with them.  The billable rate takes into consideration all non billable time.

 

6.    How much can the employer pay his / her staff?

 

This is arranged between the employer and his / her staff .  The fiscal intermediary typically assists with this process.  Remember CMH’s rate for CLS is $12.00 per hour.  This  includes staff hour wage, employer payroll taxes (7.65%), Workers Compensation insurance, Unemployment, and any benefits paid to staff (i.e. training time, vacation time, holiday pay, mileage, etc.).

 

For example:  If an individual has a budget of 100 hours a month @ $12.00 per hour = $1,200 per month.  $1,200 month x 12 months = $14,400 annual budget for CLS services.

 

Budget            CLS - Staffing                                                                                                $ 14,400.00

Staff Wages   ($9.00 per hour x 100 hrs x12 months)                                              10,800.00

Payroll Taxes    ($10,800 x7.65 %)                                                                       826.20

Unemployment ($10,800 x2 %)                                                                                              216.00

Workers Compensation (600 for full time employee)                                                       600.00

 

Sub Total                                                                                                                1,957.80

 

In this example there is $1,957.80 remaining to cover the non-billable staff time or at $9.00 per hour, the staff can receive pay for approximately 175 - 200 hours of non billable time, which may include such activities as:  training, vacation, holiday time, mileage and the like. Consequently, when determining the hourly wage for staff, the entire employment package offered to staff will need to be considered.

 

7.    Can the employer pay one staff more than another?

 

Yes, so long as the average staffing costs do not exceed $12.00 per hour.

 

8.    Does the employer have to pay for training?

 

This is at the employer’s discretion.  Training can be paid out of funds as outlined above, or securing the necessary training can be made as a condition of employment.  This will need to be clearly addressed within the employment agreement.

 

9.    How does Home Help/Chore Services affect a self determination budget?

 

Home Help/Chore Services hours are a direct reduction in the hours CMH will provide.

 

10. Can CMH funds be used to increase the DHS home help chore services rate?

 

NO

return