Administrative Code

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Virginia Administrative Code
Title 12. Health
Agency 30. Department of Medical Assistance Services
Chapter 122. Community Waiver Services for Individuals with Developmental Disabilities

12VAC30-122-150. Requirements for consumer-directed model of service delivery.

A. Criteria for consumer-directed model of service delivery.

1. The FIS and CL Waivers have three services that may be provided through a consumer-directed (CD) model: companion services, personal assistance services, and respite services.

2. Requirements for individual.

a. The individual or a person designated by the individual shall serve as the employer of record (EOR). If an individual is unable to direct his own care or is younger than 18 years of age, he shall designate another person older than 18 years of age to serve as the EOR on his behalf. If the individual is younger than 18 years of age, a legally responsible individual shall serve as the EOR.

b. The EOR shall be the employer in this service and shall be responsible for recruiting, interviewing, hiring, training, supervising, and firing CD assistants. Specific EOR duties include checking references of assistants, determining that assistants meet basic qualifications, training assistants, supervising the assistant's performance, and submitting and approving the assistant's timesheets to the DMAS designated fiscal employer agent on a consistent and timely basis.

c. The individual, the family/caregiver, or EOR, as appropriate, shall have a back-up plan in case the assistant does not show up for work.

d. Individuals choosing consumer-directed services may receive support from a CD services facilitator. Services facilitators shall assist the individual or his EOR, as appropriate, in accessing and receiving consumer-directed services. This function shall include providing the individual or EOR, as appropriate, with employer of record management training including a review and explanation of the employee management manual and routine and reassessment visits to monitor the CD services.

e. If an individual choosing consumer-directed services chooses not to receive support from a CD services facilitator, then another family member or caregiver other than the EOR shall perform all of the duties and meet all of the requirements of a CD services facilitator, including documentation requirements identified for services facilitation. However, the family member or caregiver serving as the services facilitator shall not be reimbursed by DMAS for performing these duties or meeting these requirements.

f. The individual's support coordinator/case manager may also function as the paid services facilitator.

Statutory Authority

§ 32.1-325 of the Code of Virginia; 42 USC § 1396 et seq.

Historical Notes

Derived from Virginia Register Volume 37, Issue 14, eff. March 31, 2021.

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