CALLER:
Hi, I am on ECF, and I have not had a PA (personal assistant) in a few years. My mother is doing everything, and I don’t even have a respite provider to give her a break. My mother and I met some people from the Consumer Direct Care Network. They had a table at a community meeting last fall. We have some ideas about finding a worker ourselves and using consumer direction. We are thinking about talking to one of my cousins about working with me. Still, I’m a little nervous about it, but I know we could not do worse than what it has been. How can we learn more?
CALL PATHFINDER:
Consumer Direction is a path that works great for some individuals and families. It gives you more independence over your own schedule and who works with you. It may be more of a natural fit for persons who don’t mind managing some details.
Basically, a member who chooses consumer direction does some of the tasks that an in-home assistance agency does. For example, the member decides who to hire, when to fire, how much to pay a worker, schedules the work, signs off on the worker’s time, and develops a good back up plan. The Consumer Direct Care Network Tennessee (CDTN) assists by being the financial employer agent, that is, they collect and maintain the schedule and time worked information. They cut the paychecks and withhold and deposit taxes. They collect and maintain needed forms for a worker like their I-9 form, a record of their required training, and needed forms from the member who becomes the employer of record or EOR. In other words, a personal assistant does not work for CDTN; the member or their representative is the personal assistant’s employer.
One thing people really like about consumer direction is that you can pay your worker a higher wage that what an agency pays. In fact, you (the member) decide on what that wage amount is within the allowable range. And as you probably know, a higher wage makes it more likely that a worker will stick with you longer.
The CDTN has set up a user-friendly website for learning more about how to self-direct your own services. Consumer direction is an option for someone enrolled in one of these Tennessee Medicaid waiver programs: the Katie Beckett Program, Choices, Employment and Community First Choices (ECF), or the TennCare 1915c Self Determination Waiver Program (SDWP). In ECF, a member can self-direct four services – personal assistance, supportive home care, respite, and transportation.
The website is where I recommend you take a deep dive into what self-direction could mean for you. You may want to start on the Training page and click on the member training video for the program in which you are enrolled. The transcript option is great on the right side, for persons who like to read along with the audio.
Another feature I like about this website is the portal, where members sign on to access the electronic visit verification system (EVV), which is how a worker clocks in and out of their shift. As the employer, you sign off on each shift worked. The EVV system and a related APP are also included in the worker and member training videos.
Worker training is posted on the website, by program. That would be another good video to view if you are considering consumer direction. It will help you know what to tell a potential worker about what is required. There is also information about the required CPR and First Aid training with in-person certification, and an onsite list of CPR and First Aid vendors where the appropriate training can be found.
If you switch to or choose consumer-direction, you will be assigned a CDTN supports broker to help you manage the program and its requirements. They meet with you by phone monthly and in person, annually. You can use our Pathfinder listing to find the supports broker number for your TennCare managed care organization – Wellpoint (which used to be Amerigroup), United Healthcare, or BlueCare.
If you are ready to try TNCD, talk with your ECF coordinator so they can change parts of your ECF person-centered support plan. And before you can hire someone, you will need to work with your supports broker to ensure you have completed all the necessary training and paperwork.
Hope this works well for you!