INFO ON CONSUMER-DIRECTED SERVICES

Under the Medicaid Waiver, Consumer-Directed Service is just as it sounds. You, the Consumer, will be in charge of your own care. You can pick who you would like to take care of you and make decisions regarding your care. A Service Facilitator is required in order to get your authorizations for Personal Attendant Care, Respite, or Companion Care. A Service Facilitator will come to your home, do an assessment of your current medical conditions, see where you fall on the Medicaid scale, and submit all paperwork to Medicaid or your Medicaid authorized company, such as Anthem, Optima, Virginia Premier, Magellan, Aetna or United Healthcare. The Medicaid authorized company makes the decision on authorizations and sends the approvals to the Service Facilitator and you.  The Service Facilitator will then conduct monthly in-home visits to make sure you are in good health and note any changes that might have taken place. 


The Service Facilitator also sets you or your designated individual up as Employer of Record (EOR) with the designated payee contractor for the Medicaid authorized company. Aetna, Anthem, Optima and United Healthcare use Public Partnerships (PPL); straight Medicaid and Virginia Premier use Consumer Direct Care Network (CDCN); and Magellan uses ACES$ under MyCIL. You are required to go online and submit additional information regarding yourself as the EOR, or the individual you appoint must go online, and you can also add any attendants you wish to hire online.  You are the employer, and as such, must handle all aspects of payroll and hiring of attendants.  You and your attendants will receive packets of forms to fill out and send back.    Once your authorization is in place, the Medicaid authorized company will send your authorization to the designated payee contractor (PPL, etc.) in order for your Personal Attendants to start receiving paychecks for caring for you.