Consumer Directed Services Guide

How Consumer Directed Services works.

Use this guide to understand the people, programs, paperwork and systems involved in Consumer Directed Services.

Consumer Directed Services

Understanding the parts of Consumer Directed Services.

Look up a CDS term to see what it means, what it covers, and how it fits into your services.

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CDS Consumer Directed Services

Overview: a Texas service-delivery option where the person/family takes more control over hiring and managing the people who provide certain authorized services.

What it coversCDS gives you more control over who provides certain authorized services, while an FMSA supports the payroll, tax and administrative side. See the CDS roadmap for the overall process.

FMSA Financial Management Services Agency

Overview: the company that supports the financial and administrative side of CDS—things like required employee verification, payroll/tax functions, budget reporting and employer support. The FMSA is not the caregiver’s employer.

What it coversAn FMSA handles required employee verification, payroll and tax functions, budget reporting, forms and ongoing administrative support. Your FMSA does not choose or supervise your caregiver for you.

CDS Employer

Overview: the person who recruits, chooses, schedules, trains, supervises and can terminate the CDS employee. Depending on the situation, this may be the person receiving services, their legally authorized representative, or an approved representative.

What it coversThe CDS employer chooses, schedules, trains and supervises the employee, approves accurate time and services, and works with the FMSA on required employment paperwork.

Designated Representative (DR)

Overview: an eligible adult appointed to help perform CDS employer responsibilities when allowed.

What it coversA Designated Representative may help carry out employer responsibilities when allowed. Eligibility and appointment requirements depend on the program and situation.

Service Coordinator / Case Manager

Overview: the person who helps coordinate the Medicaid program/service plan and remains involved even after you choose CDS.

What it coversThe service coordinator or case manager helps with program eligibility, service planning, authorizations, changes in needs and coordination of Medicaid services.

Service Budget

Overview: the authorized amount available for certain CDS services and employer-related costs. It is not a blank check.

What it coversThe service budget sets the available amount for authorized CDS services and employer-related costs. Wages, hours, overtime and allowable expenses must fit within the approved budget.

EVV Electronic Visit Verification

Overview: the electronic system used for certain Medicaid services to verify that a visit/service occurred, including required visit information.

What it coversEVV records required visit information for certain Medicaid services. The exact system, clock-in/clock-out method and correction process depend on the program and FMSA setup. See Payroll & EVV.

Service Backup Plan

Overview: your plan for what happens if a critical service cannot be delivered as scheduled.

What it coversA service backup plan explains what will happen if an important scheduled service cannot be delivered as planned.

HCS Home and Community-based Services

Overview: a Texas Medicaid waiver program for eligible people with intellectual disabilities or related conditions. Certain HCS services can be delivered through CDS.

What it coversHCS is a Texas Medicaid waiver program for eligible people with intellectual disabilities or related conditions. Certain HCS services may be delivered through the CDS option.

TxHmL Texas Home Living

Overview: a Texas Medicaid waiver program that provides selected services/supports to eligible people with intellectual disabilities or related conditions living in their own/family home.

What it coversTxHmL provides selected Medicaid services and supports to eligible people with intellectual disabilities or related conditions who live in their own or family home. Certain services may be available through CDS.

CLASS Community Living Assistance and Support Services

Overview: a Texas waiver program for eligible people with related conditions who need community-based supports. Some services may use CDS.

What it coversCLASS is a Texas Medicaid waiver program for eligible people with related conditions who need community-based services and supports. Some authorized services may be available through CDS.

DBMD Deaf Blind with Multiple Disabilities

Overview: a Texas waiver program for eligible people who are deaf-blind and have another disability that significantly limits independent functioning.

What it coversDBMD is a Texas Medicaid waiver program for eligible people who are deaf-blind and have another disability that significantly limits independent functioning. CDS requirements can vary by authorized service.

STAR+PLUS

Overview: Texas Medicaid managed care for many adults with disabilities and older adults who need long-term services and supports. Some members may use CDS for eligible services.

What it coversSTAR+PLUS is Texas Medicaid managed care for many adults with disabilities and older adults who receive long-term services and supports. Eligible services may be delivered through CDS.

STAR Kids

Overview: Texas Medicaid managed care for children and young adults with disabilities. Certain long-term services may be available through CDS.

What it coversSTAR Kids is Texas Medicaid managed care for children and young adults with disabilities. Certain long-term services may be available through CDS.