Community Pathways Waiver Amendment #1 - Proposal

Personal Support Changes

Purpose:

Enhance self-directed service model by removing 82 hour service preauthorization requirement and update personal support services by removing support staff hour requirements and restrictions including preauthorization requirement for more than 40 hour work week, 8 consecutive hours, time off between shifts, and time spent sleeping.

Overview:

The federal Department of Labor (DOL) published the Home Care Final Rule requiring employers to pay minimum wage and ensure overtime pay protections under the Fair Labor Standards Act (FLSA) for most home care workers.
The DDA fully supports self-determination and waiver participants’ rights to self-direct their services. Individuals self-directing their services, as the employer of their services, have the right to hire, set pay rates, train, and fire personal support staff. They determine the number of hours they need and work schedules based on their approved budget.
To further enhance the employer authority of participants self-directing services, the following two requirements for participants self-directing personal support services will be removed:
(1) Personal Supports is limited to 82 hours per week unless otherwise preauthorized by DDA.
(2) Direct service workers providing personal support services (a) shall work no more than 40 hours per week unless preauthorized by the DDA; (b) may work no more than 8 consecutive hours unless preauthorized by the DDA; (c) must be off duty for 8 hours or more before starting another shift; and (d) shall not be paid for time spent sleeping.

Agencies providing personal support services establish staffing schedules based on business models and the needs of the participant. The following requirement will also be removed for agencies providing personal support services: (1) Direct service workers providing personal support services (a) shall work no more than 40 hours per week unless preauthorized by the DDA; (b) may work no more than 8 consecutive hours unless preauthorized by the DDA; (c) must be off duty for 8 hours or more before starting another shift; and (d) shall not be paid for time spent sleeping.

Current language page 69:
D. Personal Support is limited to 82 hours per week unless otherwise preauthorized by DDA. To be approved, a service must be either the most "cost effective," which is the service that is available from any source, is least costly to the State, and reasonably meets the identified need, or short- term, which means that the services are provided for up to but no more than three months in order to meet identified medical and behavioral needs.
Revision:
D. For individuals not self-directing their services, Personal Support is limited to 82 hours per week unless otherwise preauthorized by DDA. To be approved, a service must be either the most "cost effective," which is the service that is available from any source, is least costly to the State, and reasonably meets the identified need, or short- term, which means that the services are provided for up to but no more than three months in order to meet identified medical and behavioral needs.

Current language page 69:
K. Direct service workers providing personal support services (a) shall work no more than 40 hours per week unless preauthorized by the DDA; (b) may work no more than 8 consecutive hours unless preauthorized by the DDA; (c) must be off duty for 8 hours or more before starting another shift; and (d) shall not be paid for time spent sleeping.
Revision:
The language was removed/deleted
K. Direct service workers providing personal support services (a) shall work no more than 40 hours per week unless preauthorized by the DDA; (b) may work no more than 8 consecutive hours unless preauthorized by the DDA; (c) must be off duty for 8 hours or more before starting another shift; and (d) shall not be paid for time spent sleeping.