CONSUMER DIRECTED OPTIONS

Consumer directed options are meant to give you flexibility and a range of control and responsibility over the services that support your life. They put you or your family member in the role of managing your supports. Think of it as the "Do It Yourself" plan.

In a Consumer Directed Option program, you hire your caregivers, set the work hours specific to your needs, and identify, hire, and supervise them. Caregivers may include neighbors, friends, and family members.

Consumer Directed Options are available to people who are elderly; who have an acquired brain injury; who have mental health concerns; with cognitive/intellectual disabilities; sensory impairments; or who are medically fragile.

Mains'l Services offers a full range of Consumer Directed Options, including Consumer Directed Community Supports (CDCS), Consumer Support Grant (CSG) and Personal Support. We would be honored to be your partner in maximizing your options. Our level of involvement will be determined by you and the option you choose.

Personal Support is a traditional service option available to individuals who are on a DD waiver. This service provides unlicensed staffing support. This simply means your employees are not mandated to be trained as in licensed services. Supports are offered in your home or in the community to achieve increased independence and inclusion in the community, as desired.

Consumer Directed Community Supports (CDCS) is a state-funded or private paid program that allows you to purchase goods and services including staffing within your assigned budget allowance based upon your personal needs.

Consumer Support Grant (CSG) is a state-funded alternative to Medicaid reimbursed home care. Eligible participants receive monthly cash grants to replace fee-for-service Home Care payments and, with county assistance, manage and pay for a variety of Home and Community Based Services.

CDCS and CSG Program Options:

• Fiscal Support Entity, also called Fiscal Intermediary (we help you manage your budget)
  Individuals in the CDCS and CSG programs choose a Fiscal Support Entity to assist with the monitoring the supports and goods you plan to purchase and are approved by the county or lead agency. Mains'l Services, Inc. provides you monthly spending reports, much like a bank statement, showing you how much you have spent and how much you have left in your "account."

Once you choose your Fiscal Support Entity you would then choose one of the following three options to be provided by your Fiscal Support Entity or another provider:

• Fiscal Conduit (we pay your bills)
  If you do not have the need for an FEA or AWC provider you can choose the Fiscal Conduit option. We simply pay the bills for the goods and services you have used in your approved plan.
• Fiscal Employer Agent ("payroll model" - we help you be the employer)
  Do you want to be an employer, who hires and trains employees to work with you or your loved one? If so, Mains'l Services, Inc. can act as your Fiscal Employer Agent (FEA). As your FEA, we walk with you through every step of the enrollment process with the state and federal governments, setting you up as a household employer. Don't be afraid-it's not as hard as it seems. It's cost effective, yet gives you lots of control over your consumer directed funds. We simply pay your employees and file necessary employer-related taxes on your behalf. And, if you are the spouse, parent or child of the service recipient, you are "exempt" employees, and not required to pay payroll taxes or carry insurances.
• Agency with Choice (we help you with it all)
  If you don't want to be the "employer," you can let Mains'l Services, Inc. take care of this responsibility, through the Agency with Choice option (AWC). We form a joint or dual employer relationship. You hire the people you want, train them, schedule their time, and supervise them. However, unlike the Fiscal Employer Agent model, employees are covered under Mains'l Services, Inc.'s liability insurances, including Worker's Compensation and Unemployment. In addition, you will receive enhanced support from Mains'l Services, Inc. around all supervisory functions.

Mains'l Services has proven systems that support hiring and managing direct support workers, reimbursing expenses promptly, as well as reporting information in a timely manner. These systems, along with our knowledgeable, experienced management staff, allow us to uphold our commitment to excellent customer service.

Mains'l Services has proven systems that support hiring and managing direct support workers, reimbursing expenses promptly, as well as reporting information in a timely manner. These systems, along with our knowledgeable, experienced management staff, allow us to uphold our commitment to excellent customer service.

Mains'l Services has proven systems that support hiring and managing direct support workers, reimbursing expenses promptly, as well as reporting information in a timely manner. These systems, along with our knowledgeable, experienced management staff, allow us to uphold our commitment to excellent customer service.

Funding Options
Consumer Directed Options are available through several funding streams, specific to your state. Our management staff is knowledgeable about funding sources and how to best maximize the resources available to you.

In Minnesota, funding sources include:

• Community Alternatives for Disabled Individuals (CADI) Waiver
• Community Alternative Care (CAC) Waiver
• Elderly Waiver (EW)
• Developmental Disabilities and related conditions (DD) Waiver
• Traumatic Brain Injury (TBI) Waiver
• Alternative Care Program (AC)
• Consumer Support Grant (CSG)
• Private pay

In addition, Mains'l Services, Inc. is also experienced in working with managed care organizations.

For more information, contact Stacy Roe at 763-416-9146 or sroe@mainsl.com, or Haley Tschida at 763-416-9135 or hmtschida@mainsl.com.