Live Independent Consumer Direct LLC

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					                          Live Independent Consumer Direct LLC

                              Consumer Directed
                                Services (CDS)

       Home Office‐Hazelwood, MO
                                                      Phone: (314) 680-1976
                                                      Fax:   (314) 551-9881

Maury O. Clay       
Accounting:            Phone: (314) 551-9881

        M Clay

Page 1 of 12 Last Revised: Oct 26, 2010
                        TABLE OF CONTENTS
Page 3         Introductory Information
               A Description of Consumer Directed Services (CDS)
               A Description of a Personal Care Attendant
               A Description of Independent Living
               A Description of a Spend down

Page 4,5,6,7   Attendants
               Hiring an Attendant
               Qualifications of Employment
               Attendant Training
               Attendant Registry
               Attendant Wages
               Attendant Background Screening & Employee Disqualification List (EDL)
               Back-Up Attendants
               Do I need more than one Attendant?
               How can I find Personal Care Attendants?
               Training a Personal Care Attendant
               Information Live Independent Consumer Direct (LICD) has disclosed to your Attendant
               Attendant and Consumer Relationships

Page 8         Payroll and Timesheets
               Medicaid Fraud
               Timesheet Reminders

Page 9         Needs and Tasks
               In-Patient Hospital Stay
               Day Care and Pet Care
               Additional Family Member Care
               Pet Care
               Doctor Visits
               Unmet Needs
               Undue Hardships
               Department of Health and Senior Services (DHSS) Rights and Responsibilities

Page 10        Communication with LICD
               Notify LICD about……
               Monthly Phone Visits
               Quarterly Home Visits

Page 11,12     Appeals and Policies
               Grievance Policy
               Abuse, Neglect, and Exploitation
               DHSS Adverse Action/Appeal Rights
               DHSS Privacy and Disclosure Policy

Page 2 of 12 Last Revised: Oct 26, 2010
                        Introductory Information
A Description of Consumer Directed Services (CDS)
Some persons with disabilities require assistance with activities of daily living to enable them to live
independently within their communities. The CDS Program can provide Personal Attendant Services to
individuals with physical disabilities. Hiring an individual(s) to perform routine tasks of daily living and
other tasks the individual(s) are unable to perform alone, allows this person to live independently. Daily
living activities can include dressing, undressing, bathing, grooming, housekeeping, meal preparation,
shopping, transportation, etc. The CDS program is a program that allows the individual(s) to direct his or
her own care which means the individual(s) choose, recruit, hire, train, and manage their own attendant.
The individual is the employer. Live Independent Consumer Direct provides case management services
to the consumer and assists the consumer with achieving independence!

A Description of a Personal Care Attendant
A Personal Attendant is an individual who is hired, trained, and supervised by a person with a disability
(the consumer) to help with routines of daily living and other tasks they are unable to perform alone. A
Personal Attendant can enable a person with a disability to reach a level of independence based on
personal choices. Without the help of a personal attendant, many people with disabilities would be forced
to live in a nursing home or other institution and would not be able to live in their own home.

A Description of Independent Living
Independent living is basically living just like everyone else. Having opportunities to make decisions that
affect one's life and the ability to pursue activities of one's choosing, limited only in the same ways that
others who do not have disabilities are limited. Most Americans take for granted the opportunities,
transportation, social and recreational activities, etc. These are just a few of the decisions that the
disabled community is denied. The disabled also face many physical barriers: access to public buildings
and restrooms, curbs without cuts, lack of adaptive communication materials, and many others. Often the
most difficult obstacles to overcome are the prejudices found within the nondisabled community. These
last barriers are the hardest to overcome, causing many disabled persons to live less independently, due
to prevalent ideas of institutionalization and hiding people with disabilities away from mainstream life.

A Description of Spenddown
Spenddown refers to the amount of medical expenses that are a person's financial responsibility, similar
to an insurance deductible. The spenddown amount is the amount by which an individual's or couple's net
income exceeds the non-spenddown income limit. A person's spenddown obligation can be met by either:
1) submitting incurred medical expenses to their eligibility specialist on a monthly basis; or 2) paying the
monthly spenddown amount to the Missouri (MO) HealthNet Division, much like an insurance premium

If a person chooses to meet their spenddown with incurred medical expenses, medical coverage for that
month begins the date on which the spenddown is met and ends on the last day of that month. MO
HealthNet will not pay expenses used to meet the spenddown.

If a person chooses to pay the monthly spenddown, pay-in prior to the first day of the month payment is
due will ensure continuous coverage. Pay-in can be by check, money order, or automatic withdrawal
from a bank account.

Attendants cannot be paid for hours worked on dates that the consumer has not met their spenddown
(usually the beginning of each month). Make sure you ask your employer if he/she has a spenddown and
how they meet it every month.

Page 3 of 12 Last Revised: Oct 26, 2010
Hiring an Attendant
Here are a few pointers to remember when hiring an attendant/employee:
1. Each consumer may employ up to 4 attendants/employees
2. Each attendant/employee must meet the qualifications for employment
3. You must notify Live Independent Consumer Direct when you are planning on hiring/firing a new
4. Prior to a new attendant/employee starting their employment, we must have a completed attendant
application along with a copy of their social security card and driver's license and the background
screening results.
5. Upon hiring of all attendants/employees a background screening will be performed. The
attendant/employee must be able to successfully pass the background screening in order to be
employed. If he/she doesn't pass the screening, they may not begin employment until they have
submitted a Good Cause Waiver and been approved to start working.
6. If you need assistance in hiring a new attendant/employee, notify Live Independent Consumer Direct.
We can assist you with the search for a new attendant/employee by checking our attendant registry.
7. We strongly recommend that you do have a back-up attendant/employee hired for emergencies or
when your regular attendant employee cannot work for you.
8. Please remember that the attendant is an employee of you, the consumer, not LICD
9. The consumer/employer may terminate the attendant/employee at any time.

Qualifications of Employment
1. Must be at least 18 years of age
2. Must be able to meet the physical and mental demands required to perform specific tasks required by a
particular consumer
3. Must agree to maintain confidentiality
4. Must be emotionally mature and dependable
5. Must be able to handle emergency situations
6. Can be a friend or relative of the consumer, other than a spouse
7. Must have reliable transportation
8. Must be able to successfully pass the Family Care Safety Registry Background screening and
Employee Disqualification List

Live Independent Consumer Direct LLC provides Personal Attendant Training FREE of charge to any and
all applicants of the Consumer Directed Services Program.

Attendant Registry
Applications are accepted at any time for any city/county in Live Independent Consumer Direct LLC
service area.

Attendant Wages
Wages are $7.75 per hour and attendants are paid every two weeks.

Attendants are eligible for wage increases under the following conditions:
1. The attendant MUST be employed by you for a minimum of full-year prior to the request of a wage
2. Once an attendant has been approved for a wage increase, you may only submit a wage increase
request once per year.
3. The consumer shall complete the Attendant Wage Increase Request form 30 days prior to the desired
effective date of the wage increase to a Live Independent Consumer representative.
4. The request form shall contain information for determining approval for the wage increase.

Page 4 of 12 Last Revised: Oct 26, 2010
                                     Attendants continued
5. The consumer shall provide a reasonable explanation for request (examples: efficiency, good work
habits, comparative job wage scale high in area, potential loss of attendant without increase, needs
require certain skills which attendant has ascertained.)
6. The consumer shall complete, sign, and date the wage increase form.
7. The consumer shall include information from case notes regarding increase and verify reason for
8. The Executive Director shall respond in writing within 30 days upon receipt of the request with the
decision regarding the wage increase.
9. The Live Independent Consumer representative shall submit recommendations regarding the increase
to the Director for approval/denial.
10. If you disagree with the final decision, you may appeal within 30 days in writing to LICD Executive
11. LICD Executive Director shall issue a final appeal decision within 30 days of the receipt of the written
appeal notice from the consumer.
12. All wage increase shall be in increments of twenty five cents per hour.
13. The wage increase will take effect on the first day of the next pay cycle.
14. Mail Wage Increase Forms to:
         Attn: CDS Coordinator
         320 Brooks Dr., Suite 203
         Hazelwood, MO 63042
15. Mail appeal letters documentation including why you are appealing the Directors decision to:
         Attn: Directors
         320 Brooks Dr., Suite 203
         Hazelwood, MO 63042
16. The attendant may, at no time, sign and submit a Wage Increase Request for approval.
17. If the attendant works for more than one consumer and he/she has been approved for one consumer,
he/she is not eligible for a raise for each of the consumers. Each consumer must submit a Wage Increase
Form in order for that attendant to get a wage increase.
18. The Wage Increase Request form MUST be filled out COMPLETELY in order to be submitted for
approval. If the information is not filled out completely, the form will be returned to you for completion.
19. If your attendant voluntarily or involuntarily terminates employment, and is later re-instated, he/she
will be re-instated at the current starting wage of $7.75 per hour.
20. If you appeal to our Board of Directors and your appeal is denied, you may only reapply for an
attendant wage increase 6 months from the date on the denial letter from the appeal.

Background Screening & EDL Information
All Personal Care Attendant are required to have the FCSR background screening completed PRIOR to
employment. Attendant/Employees will be required to inform the consumer/employer as well as the CDS
staff of any discrepancy on their background screening. The cost the background screening is $9.00 and
can be paid by check or money order only. The check should be made payable to the Missouri
Department of Health.

Any attendant with a Class A or Class B felony or with any other criminal history or charges filed with the
Family Support Division will not be allowed to work for a consumer/employer of the CDS program without
having an approved "Good Cause Waiver" issued from the State of Missouri. "Good Cause Waiver" forms
are available from you Live Independent Consumer representative.

Attendants/Employees listed on the Employee Disqualification List will have to request in writing an
application to be removed from the list through Division of Senior and Disability Services. Information on
where to make your written request is available through Live Independent Consumer Direct LLC. All
attendant/employees backgrounds will be rechecked quarterly to verify their continued employment.

Page 5 of 12 Last Revised: Oct 26, 2010
E-Verify is a web-based system that Live Independent Consumer Direct LLC will use to verify your
eligibility for employment in the United States. E-Verify is a partnership between the Department of
Homeland Security (DHS) and the Social Security Administration (SSA). U.S. Citizenship and Immigration
Services (USCIS) oversee the program. E-Verify will query your Social Security number and other
information provided on the I-9 Form to confirm your legal working status.
Emergency/Back‐Up Attendant
Even the best Personal Care Attendants may have unexpected emergencies or illnesses which may
cause them to cancel. It is important to have a back-up attendant for these times. You may have friends
or relatives who can help out as your emergency or back-up attendant. During the interview process you
may find applicants who are willing to assist on short notice also. Keep in mind that we will also need to
have an attendant application on file for your back-up attendant also. This way when the attendant work,
they will be able to turn in a timesheet showing the days and hours they worked for you.

Explain any technical works you may use--be as descriptive as possible. Speak as clearly as possible.
When giving instructions involving a procedure, such as transferring, include each step as you go. State
the importance of doing something a certain way. Do not assume your Personal Care Attendant knows
what you mean. Ask the Attendant to explain the procedure in their own words.

Do I need more than one personal care attendant?
If you require a personal care attendant for different times throughout the day, it may be helpful to employ
more than one person. You can have a total of 4 attendants/employees. This eliminates the problem of
one person working too many hours or perhaps performing too many tasks. This is also useful in an
emergency situation. When one personal care attendant is unable to work, you might be able to call on

How can I find Personal Care Attendants?
You may place an ad in the local newspaper; hang up a flyer at your church or restaurant, by word of
mouth, etc. LICD also keeps an attendant registry. Our attendant registry is compiled of many applicants
who are looking to begin work as a Personal Care Attendant. You may request applications from your
Live Independent Consumer Direct representative. Your Live Independent Consumer Direct
representative will not, however, call and do the interview and/or hire an attendant for you. You must do
the interview and hiring since you will be the employer.

Training a Personal Care Attendant
After interviewing and selecting a Personal Care Attendant to work for you, you will need to contact your
Live Independent Consumer Direct to inform us of your decision. Your Live Independent Consumer Direct
will need to verify all of the necessary Attendant Application paperwork has been completely filled out.
Your Live Independent Consumer Direct representative will also need to schedule Attendant Training for
both you and your new Personal Care Attendant prior to your new Attendant's start date.

On the scheduled date of Attendant Training your Live Independent Consumer Direct representative will
provide timesheet training for both you and the attendant. They will also cover several topics relating to
the CDS Program and the certain rights and responsibilities of both of you, the consumer/employer and
the attendant/employee. You may also need to provide your attendant with some additional training
specific to your needs. Training someone on your individual needs may reduce confusion and prevent
crisis situation.

       Begin by explaining your disability in as much detail as you feel necessary.
       Emphasize anything relating to safety or emergencies.
       Be patient. Your attendant may not get everything right on the first or second time.
       Be aware of your attendant's feelings as you train. Put yourself in his/her place.
       Use others to assist in training your attendant, such as former personal care attendants, family
        members, or your Live Independent Consumer Direct representative.

Page 6 of 12 Last Revised: Oct 26, 2010
Information LICD has disclosed to your Attendant
       LICD must have a current copy of a VALID photo ID including a driver's license, non-drivers
        license, etc.

       LICD must re-submit background checks and requests periodically, as required in our agreement
        with DHSS. If you fail any of these background screenings, you must immediately suspend
        working and submit a Good Cause Waiver. Upon approval, you may begin working again.

       LICD is a mandated reporter for Medicaid Fraud, Abuse, Neglect, and Exploitation. We must
        report any suspicions to Department of Health and Senior Services (DHSS) immediately and an
        investigation will occur promptly.

       If the attendant chooses to work for more than one consumer, he/she must submit all new
        paperwork for each consumer he/she works for.

       LICD must have a contact number for the attendant.

       The consumer/employer is responsible for training the attendant/employee of tasks he/she
        requires assistance with.

Attendant and Consumer Relationships
Your Personal Care Attendant relationship with the consumer is a very unique one. This relationship
requires maintenance and constant attention to make it work effectively. The foundation for any Personal
Care Assistance relationship is based on good communication. This manual provides some information to
help you. It may not cover every situation you may encounter.

Treat your attendant with respect. Remember your attendant is an adult so treat him/her that way. Do
not address your attendant in a negative or condescending manner. You hired an attendant to help you
and that is what they are there to do. Do not abuse your attendant in any way and do not accept any
form of abuse from your attendant.

Often the best attendant is the one that is a relative or someone you know very well.

Page 7 of 12 Last Revised: Oct 26, 2010
Payroll and Timesheets
                                                                         th       st
All paychecks will be mailed to the attendant/employee on paydays (6 and 21 of each month). The
paycheck can also be picked up at Live Independent Consumer Direct LLC at 320 Brookes Drive Suite
203 in Hazelwood, MO 63042 between the hours of 9:00 a.m. and 3:00 p.m. payday. The attendant is
the only person who can pick up their check and they must present valid photo ID. It is the attendant's
responsibility to bring in their ID. We offer direct deposit to all attendants. Any payroll discrepancy must
be reported immediately.

Medicaid Fraud
If an incorrect timesheet is purposely submitted, you could be referred to legal authorities for falsifying
records, which could result in Medicaid Fraud. Any falsification or other misrepresentation on a timesheet
constitutes Medicaid Fraud. All payments made as a result of inaccurate timesheet information will be
recouped from the consumer/employer and the attendant/employee. Any apparent Fraud will be reported
to the proper authorities.
         *If it wasn't done….DON'T SIGN IT!*---IT'S MEDICAID FRAUD
         *If the times worked are not correct….DON'T SIGN IT!*---IT'S MEDICAID FRAUD
         *Make sure to follow your Plan of Care--HAVING YOU ATTENDANT/EMPLOYEE PERFORM

Timesheet reminders
The timesheet is the record that supports the daily tasks performed by the attendant/employee. All
information on the timesheet should be done in black or blue ink. Please do not use pencil or colored gel
pens. It is the consumer/employer's responsibility to ensure the accuracy and timely arrival of the
timesheet to our office. Timesheets are due to LICD by 3:00 p.m. on the Monday following the end of the
pay period.

Timesheets must be completed and signed on a daily basis by consumer/employer and all
attendants/employees. All time in/time out must state if the hours worked are am or pm. The activities
performed daily must coincide with the DHSS Consumer Directed Services Care Plan. The
consumer/employer may have a total of 4 attendants/employees. If more than one attendant is working,
make sure they do not have overlapping hours. They must be working different hours. Use a separate
timesheet for each attendant/employee. Timesheets must be accurate.

Timesheets may be returned due to the following circumstances below. If returned, the attendants check
will be delayed for 2 weeks, until the next pay cycle. It is your responsibility and the responsibility of the
attendant to ensure that all information is complete and accurate. LICD will not be held responsible for
any mistakes made on the timesheet by either/both the consumer and/or attendant. If you want to be
paid, make sure the timesheet is filled out correctly.

1. Timesheet was turned in before hours were worked.
2. Timesheet was faxed. (LICD needs the original)
3. Timesheet is not signed on the back-side by attendant and/or employer.
4. Timesheet has incorrect dates of service.
5. Time In/Out listed is incomplete or missing.
6. More than one attendant is listed on this timesheet.
7. No initials on sections scratched out and corrected by consumer ONLY.
8. White-out has been used on this timesheet.
9. Signature of attendant and/or employer is missing on the front of the timesheet.
10. Tasks checked on the backside are not authorized by DHSS' Care Plan
11. Attendant is not authorized to begin working in our computer system.
12. Any other reason LICD feels that the timesheet is not accurate.

Page 8 of 12 Last Revised: Oct 26, 2010
Needs and Tasks
The attendant/employee at times may be asked by the consumer/employer to provide transportation for
tasks such as shopping or doctor visits. It is the responsibility of both of you to reach an agreement on the
transportation arrangements. For example: The consumer may want to provide the vehicle along with gas
for transportation. If meals will be eaten while out, an agreement will also need to be made between the
attendant and consumer on who will be financially responsible for the meals. Please keep in mind that if
the consumer's vehicle is being used, the attendant/employee should be respectful of their property and
rules. For instance, you may not allow smoking, drinking, or food consumption in your vehicle. The
attendant/employee must abide by those rules.

In‐Patient Hospital Stays
Live Independent Consumer Direct LLC is to be notified immediately if the consumer has or will be going
into the hospital. While the consumer is in the hospital, their consumer-directed services are put on hold.
This means the attendant will NOT BE PAID for hours while the consumer is in the hospital. Upon release
form the hospital, the consumer and/or attendant should notify Live Independent Consumer Direct LLC to
resume services. Please remember that attendants may get paid for their hours worked up to the time the
consumer entered the hospital. The attendant may get paid for their hours worked after the
consumer/employer returns home from the hospital.

Day Care & Pet Care
The attendant is not allowed and shall not provide any childcare for the consumer. If the attendant
provides childcare, the consumer must make payment separately to the attendant and you cannot clock
that time on your timesheet. Additionally, the attendant is not allowed to provide any pet care for the
consumer. This includes any and all animals.

Additional Family Member Care
The attendant is not allowed and shall not provide any care to additional family members or visitors of the
consumer. If the attendant provides any additional care for persons other than the consumer, it is the
responsibility of the consumer to be financially responsible for the attendant’s wages for that time and it
cannot be clocked on the timesheet. This includes meal preparation, meal clean-up, household cleaning,
laundry, transportation, etc.

Doctor Visits
The attendant is not allowed to be paid for time spent WAITING in a doctors office while the consumer is
at his/her medical appointment unless time is specified on the DHSS Care Plan.

Vacations The consumer is to notify Live Independent Consumer Direct LLC prior to vacationing. If
attendant care is needed while on vacation, this needs to be discussed with your CDS Caseworker.

Unmet needs are those routine tasks and activities of daily living as allowable by Medicaid that are not
adequately met by current support systems without causing undue hardships to the consumer and/or

Undue hardships are the result of a significantly difficult circumstance experienced by a caregiver who is
currently meeting the needs of the person with a disability that creates a situation of burden, risk, or harm
to the caregiver or consumer. Undue hardship includes but is not limited to" Loss of income, overall
disintegration of the family, abuse or neglect, misuse of child labor, inadequacy of training, or physically

Page 9 of 12 Last Revised: Oct 26, 2010
Communication with LICD
Important Things to Notify LICD of:
*You have a new address or phone number
*The consumer/employer has been admitted to the hospital
*The consumer/employer has been released from the hospital
*You feel there are any problems that require LICD’s assistance in solving
*You feel additional timesheet or other training is needed
*You feel that fraudulent activity is going on in the consumer/employer's home
*You feel that abuse or neglect is occurring to the consumer
*You are planning on going on vacation or being away from home for a period of time
*You feel that your Consumer Directed Services (CDS) needs have changed
*You plan on hiring or firing an attendant/employee
*You need assistance finding a new attendant/employee
*You have received a call from DHSS to schedule your re-evaluation.
*Your attendant/employee has an address or phone number change

Monthly Phone Visits
Live Independent Consumer Direct is required to contact you, the CDS consumer by phone or mail on a
monthly basis, every 30 days. During this monthly contact Live Independent Consumer Direct will need to
speak with you, the consumer, not your attendant(s) or family member(s), unless there are other
extenuating circumstances.

Quarterly Home Visits (Is this required by Missouri?????)
A home visit shall be conducted in your home every 3 months by Live Independent Consumer Direct.
During the visit, you will be required to answer a series of questions regarding timesheets, your
attendant/employee, the condition of your home, your health, safety and welfare issues, etc. These
reports will be completed by a Consumer Directed Services (CDS) Specialist and placed in your file.

Page 10 of 12 Last Revised: Oct 26, 2010
Appeals and Policies
Grievance Policy
It is LICD policy to allow Consumers to issue grievances to LICD in the event that the consumer is
dissatisfied with any action or inaction by Live Independent Consumer Direct LLC, in connection with the
provision of its services to the consumer.

Under this procedure:
1) If the consumer is dissatisfied with his/her services, he/she should discuss concerns with the LICD
Executive Director.

2) If the consumer is dissatisfied with his/her services, the consumer may submit a written grievance to
Live Independent Consumer Direct LLC Executive Director. The grievance is to be submitted within 10
working days after that action or inaction of the complaint. The results shall be mailed by letter within 30
working days from the date of the grievance.

3) If the consumer is dissatisfied with his/her services, the Independent Living Specialist and/or CDS, and
the Executive Director, the consumer may submit a written grievance to the Board of Directors for Live
Independent Consumer Direct LLC within 30 working days after that action or inaction of the complaint.
The written decision of the President of the Board of Directors is the final decision through the center. The
results shall be mailed by letter within 30 working days from the date of the grievance.

4) If the consumer is dissatisfied with all decision of Live Independent Consumer Direct LLC, the
consumer may make a grievance to the Missouri Protection & Advocacy Services. (Please refer to the
blue brochure given at initiation of services titled Client Assistance Program MO P&A.)

Written Grievances to the Executive Director should be mailed to:
        Attn: CDS Coordinator
        320 Brooks Dr., Suite 203
        Hazelwood, MO 63042

Missouri Protection & Advocacy Services may be contacted at:
         925 South Country Club Dr.                          phone: 573-893-3333
         Jefferson City, MO 65109                            fax: 573-893-4231
         e-mail:                       toll free: 800-392-8667

Abuse, Neglect, and Exploitation
Abuse, Neglect, and Exploitation are against the law in Missouri, and so is failure to report abuse,
neglect, and exploitation. Attendants and LIVE INDEPENDANT CONSUMER DIRECT case managers
are mandated reporters for abuse or neglect as a result of the delivery of or failure to deliver CDS
Services. If you suspect a person has been abused or mistreated, you are required to report it to the
Abuse Hotline at 1-800-392-0210. You are required to make a report with 48 hours of the time you
suspected the person has been or may be abused or neglected. Abuse is mental, emotional, physical or
sexual injury to a person or failure to prevent such injury to a person.

What is Abuse? "Abuse" means an intentional, knowing, or reckless act or omission by an individual that
causes or may cause emotional harm or physical injury to, or the death of a person.

Page 11 of 12 Last Revised: Oct 26, 2010
What is Neglect?
"Neglect" means a negligent act or omission by an individual, including failure to comply with an individual
treatment plan, plan of care, that causes or may cause substantial emotional harm or physical injury to, or
the death of a person. (Example: lying in bed for periods of time without turning or transferring.)

What is Exploitation?
"Exploitation" means the illegal or improper use of a person or of the resources of a person for monetary
or personal benefit, profit, or gain by an employee, volunteer, or other individual. Some examples would
be misappropriation of funds or property of in-home services clients or residents of long-term care
facilities; falsification of documentation which verifies service delivery to in-home services clients; or
financial exploitation, a person in a position of trust and confidence knowingly and by deception or
intimidation abstains control of property for use by someone other than the owner.

What should you do if you feel that you or someone you know are being abused, neglected, or exploited?
You are to notify LICD immediately. You are also required to contact the Abuse Hotline at:

DHSS Adverse Action/Appeal Rights
If at any time you receive and Adverse Action Notice from the Department of Health and Senior Services
(DHSS) to advise you that a decision has been made concerning your services through the Missouri
Division of Senior and Disability Services you need to be aware of your Appeal Rights. You may also
want to Live Independent Consumer Direct immediately for any assistance they can provide you with
during this process.

You have the right to appeal the decision for ninety (90) days from the date of the notice pursuant to
Sections 208.921 and 208.930, RSMo Supp. 2005.

To appeal you must submit a written request to the worker listed on the Adverse Action Notice.
If you request a hearing within ten (10) days of the date of mailing the notice, your services will continue
unchanged while your hearing is pending.

However, if the decision of the agency is determined to have been correct, the state has the ability to hold
you responsible for re‐paying the cost of services you received while your hearing was pending.

If your request for an appeal is not received within ten (1) days of the date of mailing the notice, your
services will be reduced, modified or discontinued by the date indicated on the Adverse Action Notice.

However, you will have the right to appeal the decision within ninety (90) days of the notice.

Page 12 of 12 Last Revised: Oct 26, 2010