Manage Spending. Fully understand what is included in your plan and the budget limits imposed on each category and item X X Provide monthly or real-time online access to spending utilization X Monitor spending utilization monthly, at a minimum X X X Responsibility to stay within budget limits without going over X X Consumer Directed Community Supports (CDCS) / Consumer Support Grant (CSG) Goods & Services Only F/EA or Payroll Model Consumer Directions FMS Responsible to pay back any expenses incurred over the budget limits X X Other Self-Direction Responsibilities Responsibility to complete, get approved and make any required revisions to your plan and spending budget in a timely manner X X Responsibility to pay any co-pays, spenddowns or waiver obligations assessed by the State of Minnesota X X Responsibility to check with your insurance agent regarding any additional liability, property or umbrella insurance that may be recommended in role as a common-law employer of domestic/household employees. Additional costs incurred for adding this insurance, for this purpose, may qualify for reimbursement under your plan. X X Responsible for care, supervision, health and safety of child or adult using Self-Directed Services X X Receive service authorization and approved plan, xxxx the payer(s) source for program expenditures, track accounts receivable and manage/secure adequate cash flow X Initial Here EXHIBIT B Your Grievance Procedure What is a Grievance? A grievance is a complaint about something that you do not like about the customer service or processes involving the services within the scope of CDI’s services that has been communicated but has not been resolved. You should feel free to bring any complaints to CDI without being afraid of losing any services or having anything bad happen to you. If you have a complaint or problem, you should follow these steps: • Step One: Gather and document the facts of the issue at hand.
Manage Spending. Fully understand what is included in your plan and the budget limits imposed on each category and item X X Provide monthly or real-time online access to spending utilization X Monitor spending utilization monthly, at a minimum X X X Responsibility to stay within budget limits without going over X X Responsible to pay back any expenses incurred over the budget limits X X Other Self-Direction Responsibilities Responsibility to complete, get approved and make any required revisions to your plan and spending budget in a timely manner X X Responsibility to pay any co-pays, spenddowns or waiver obligations assessed by the State of Minnesota X X Responsibility to check with your insurance agent regarding any additional liability, property or umbrella insurance that may be recommended in role as a common-law employer of domestic/household employees. Additional costs incurred for adding this insurance, for this purpose, may qualify for reimbursement under your plan. X X Responsible for care, supervision, health and safety of child or adult using Self Directed Services X X Obtain service authorization and approved plan, xxxx the payer(s) source for program expenditures, track accounts receivable and manage/secure adequate cash flow X EXHIBIT B Minnesota Home Care Xxxx of Rights PER MINNESOTA STATUTE, SECTION 144A.44. THESE RIGHTS PERTAIN TO CONSUMERS RECEIVING HOME CARE SERVICES FROM LICENSED ONLY HOME CARE PROVIDERS. Statement of Rights A person who receives home care services has these rights:
Manage Spending. Fully understand what is included in your plan and the budget limits imposed on each category and item X Provide monthly spending utilization X Monitor spending utilization monthly, at a minimum X X Responsibility to stay within budget limits without going over X Responsible to pay back any expenses incurred over the budget limits X Other Self-Direction Responsibilities Responsibility to complete, get approved and make any required revisions to your plan and spending budget in a timely manner X Responsibility to pay any participant responsibility X Responsibility to check with your insurance agent regarding any additional liability, property or umbrella insurance that may be recommended in role as a common-law employer of domestic/ household employees. Additional costs incurred for adding this insurance, for this purpose, may qualify for reimbursement under your plan. X Responsible for care, supervision, health and safety of child or adult using Self Directed Services X Obtain service authorization and approved plan, bill the payer(s) source for program expenditures, track accounts receivable and manage/secure adequate cash flow X Initial Here EXHIBIT B
