Missouri Code of State Regulations › Title 9 - DEPARTMENT OF MENTAL HEALTH › Division 45 - Division of Developmental Disabilities › Chapter 3 - Services and Supports › Section 9 CSR 45-3.080 - Self-Directed Supports

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the scope of and
				  requirements for the use of Self-Directed Supports, a service delivery option
				  available under Home and Community Based waivers as created by section 1915(c)
				  of the Social Security Act.
(1) Definitions.
(A) Agency-based supports-supports provided
				by a public or private agency, including independent contractors, under
				contract with the Department of Mental Health and enrolled with the MO
				HealthNet Division to serve participants of any home and community-based
				waivers operated by the department.
(B) Back-up plan-an emergency plan developed
				to address situations when the employee providing essential supports is
				unavailable. The individual support plan for all individuals receiving self-
				and family-directed supports must provide information about the back-up
				plan.
(C) Budget authority-the
				right and responsibility of the employer to exercise control and management of
				a yearly budget allocation.
(D)
				Designated representative (DR) - a parent, relative, or other person designated
				by an adult individual or a guardian, who shall act in the best interest of the
				individual and serves at the discretion of the individual.
(E) Employer-individual receiving services
				through self-directed supports and/or person with the power to act on such
				individual's behalf, such as: a designated representative; guardian; or parent,
				if the individual is a minor. The employer maintains the Federal Employer
				Identification Number and employs persons to provide services to the
				individual.
(F) Employment
				authority-the right and responsibility of the employer to recruit, hire, train,
				manage, supervise, fire, and establish the wages for employees within the
				limits described in section (16) of this rule.
(G) Family member-a parent, stepparent,
				sibling, child, grandchild, or grandparent related by blood, adoption, or
				marriage, or a spouse.
(H) Fiscal
				management service (FMS) - a service to assist the employer with
				payroll-related functions. The FMS ensures the selfdirected supports program
				meets federal, state, and local employment tax, labor and workers' compensation
				insurance rules, and other requirements that apply when the individual or
				his/her designee functions as the employer of workers. The FMS makes financial
				transactions on behalf of the individual.
(I) Home and community-based waivers (HCB
				waivers)-a set of long term community-based supports and services authorized by
				the Centers for Medicare and Medicaid Services which are provided as an
				alternative to care in institutions such as nursing facilities and intermediate
				care facilities for individuals with intellectual disabilities. The specific
				services provided under a home and community-based waiver is referred to as
				home and community-based services.
(J) Improvement plan-a corrective action plan
				to address issues of non-compliance with program requirements. The goal of the
				improvement plan is to focus on needed supports to ensure the employer succeeds
				when using self-directed supports.
(K) Individual-person receiving supports
				through a home and community-based waiver.
(L) Individual Support Plan (ISP)-a document
				that results from the person-centered planning process, which identifies the
				strengths, capacities, preferences, needs, and personal outcomes of the
				individual. The ISP includes a personalized mix of paid and non-paid services
				and supports that will assist the person to achieve personally defined
				outcomes.
(M) Individual Support
				Plan team (ISP team)-the individual, the individual's designated
				representative(s), and the support coordinator. Providers of waiver-funded
				services may also participate in the support plan team if such participation is
				requested by the individual or guardian.
(N) Natural supports-unpaid support provided
				through relationships that occur in everyday life. Natural supports typically
				involve family members, friends, co-workers, neighbors, acquaintances, and
				community resources.
(O)
				Self-directed supports (SDS)-a service delivery option available under the home
				and community-based waivers for persons with intellectual and developmental
				disabilities and who wish to exercise more choice, control, and authority over
				their supports.