A fee is required for all alternative care eligible clients to help pay for the cost of participating in the program. The amount of the fee for the alternative care client shall be waived when a person has chosen to participate in a consumer-directed service (CDCS) plan for which the cost is no greater than the total cost of the person's alternative care service plan less the monthly fee amount that would otherwise be assessed.
Case
Managers- to determine if the fee can be waived do the
following:
1. Cost out a service plan that will meet the consumer's
needs under traditional services (non CDCS).
2. Calculate the AC premium on the service plan
3. Subtract the premium from the plan
4. The budget is the cost of the traditional plan
minus the premium
no fee will be assessed. (reason code field
#98 = 07)
Example of fee waiver:
AC
Funding: (Case Mix A) $730 mo.
Monthly fee amount: $34. mo
CDCS Plan Amount: $696. mo (or less)
Monthly Fee Waived
