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					                              SCOTT COUNTY

    CONSUMER SUPPORT GRANT EXPENDITURE
                  GUIDE



                        Effective: March 1st, 2010
                (replaces March 1, 2009 CSG Expenditure Guide)




             GENERAL APPROVAL CRITERIA FOR CSG EXPENDITURES:

       Support the outcomes or goals in an approved Individual Service Plan, Care Plan or
        Individual Social Service Plan
       Reasonably assure the health, safety and well-being of the consumer
       Represent a cost effective strategy for providing support
       Fall within a customary cost range for similar supports, goods and/or services
       Cannot be paid for through private insurance, Medical Assistance (MA)/state plan
        services
       Be over and above the normal costs of caring for the consumer if the consumer did
        not have a functional limitation
       Be directly attributable to the consumer’s functional limitations
       Support the consumer’s ability to remain living in his/her home and to participate in
        the community

1                                 CSG Expenditure Guidelines 2010                        2/9/10
                                FUNDING GUIDELINES FOR PARENTS OF MINOR CHILDREN

       The guidelines below represent an attempt to differentiate the fiscal responsibilities of parents for their
       minor children from the costs which are over and above what is normal due to caring for a child with a
       disability. Only those expenditures which fall into the “Allowable Expenditures” category can be
       considered for approval as an expenditure under the Consumer Support Grant.
       In addition to these guidelines, each approved expenditure must also meet the following criteria:
       1. Be related to a need, support or service identified in an approved Consumer-Directed Plan.
       2. Support the recipient’s health, safety, independence and/or general well being.
       3. Contribute to the prevention of out-of-home placement.
       4. Represent a cost-effective strategy for meeting the need.
       5. Fall within a customary cost range for similar supports, goods and/or services.
       6. Does not duplicate any other service.
             PARENTAL RESPONSIBILITIES                                                     ALLOWABLE EXPENDITURES
1. Rent/Mortgage/Utilities-electric, gas/oil, water                      None
2. Appropriate clothing for all occasions and seasons                    Adapted items of clothing or the cost to have a regular clothing
                                                                          item adapted.
                                                                         Articles of clothing that are not normally purchased and which are
                                                                          necessary due to recipient’s disability.
3. Food                                                                  Extra cost of an MHCP physician prescribed and state authorized
                                                                          special diet
4. Age appropriate supervision to assure health and safety of            Cost of supervision strategies above and beyond those required
   recipient.                                                             for a child of similar age without a disability and which are directly
                                                                          related to the recipient’s disability.
5. Age appropriate level of assistance with activities of daily          Cost of assistance with activities of daily living which is over and
   living                                                                 above that required by a child of similar age without a disability
6. Child care cost for children 11 years of age and under.               Child care costs for persons 12 years of age and over
                                                                         Additional cost for a child 11 years and under for necessary
                                                                          supports to maintain them in appropriate child care setting.
7. Transportation to day care, after school activities, community        Modifications to vehicle which allow for safe transport of recipient
   recreation activities, medical/dental appointments and any             and which are directly related to recipient’s disability.
   other activity typical for a child of similar age without a
   disability. Cost of transportation for a recipient 17 years of
   age or younger.
8. Babysitting expenses for children 11 years of age or under            Respite or child care costs for children 11 years and over
                                                                         Additional cost associated with utilizing a person with specific skills
                                                                          which are necessary to provide adequate care to recipient.
                                                                         Additional cost associated with the need for more frequent respite
                                                                          due to recipient’s disability.
                                                                         Additional cost associated with need to hire additional person to
                                                                          provide adequate supervision to recipient.
9. Fees/costs for recreational activities and for any equipment             Cost of a support person necessary for recipient to participate in activity.
    normally required for activity.                                         Special adaptive equipment needed for recipient to participate in activity.
10. Toys, games, DVD’s, and any other play equipment which               Specialized therapeutic play equipment recommended in writing
    is typical and age appropriate for a child of similar age             by an appropriate professional and would not normally be utilized
    without a disability                                                  by a child of similar age without a disability
11. Other items which will be utilized and/or will benefit the entire    None
    family.
12. Normal upkeep and maintenance of the home and other                  Modifications to home which are of sole benefit to the recipient,
    modifications to the home that ensure the health and safety           directly related to recipient’s disability and necessary for the health
    of the entire family                                                  and safety of the recipient.



       2                                                   CSG Expenditure Guidelines 2010                                                     2/9/10
                                  CSG EXPENDITURE CATEGORIES


    1. PERSONAL CARE- (Personal care services include assistance with eating, bathing, dressing,
       personal hygiene, and activities of daily living. which are essential to the health and welfare of
       the consumer).

          Typically, this assistance does not require a high level of clinical knowledge or skill.
          The maximum gross pay rate, including payroll and benefit expenses, is not to exceed the
           state set maximum Personal Care Attendant rate per hour. The actual wage may vary
           across FI/ER agencies due to varying fee structures. Check with the FI/ER agency for the
           current wage maximum.
          Support staff may be paid for up to 40 hours per week for providing care to the consumer.
           Any hours over 40 hours per week may be paid only if part of an approved CSG Community
           Support and Expenditure plan (excluding parents of minor child and spouses of adult
           consumers).
          Support staff must be able to pass a criminal background check. The cost for this
           background check is included in the FI/ER agency’s administrative fees.
          A peer companion/mentor for children up to age 18 may be paid a nominal fee (less than
           minimum wage) for work up to a maximum of five hours per week. Check with the FI/ER
           agency for their policy.
          If a support staff is under the age of 18, this must be identified in the consumer’s Community
           Support and Expenditure Plan.

       Support Staff – Parent of a Minor Child

       Certain requirements must be met to approve payment to a parent(s) of a minor or payment to a
       spouse of an adult consumer. For this purpose, “parents” are defined as biological parents,
       adoptive parents and stepparents. To receive payment for performing Personal Assistance, all
       of the following criteria must be met:

          The type of assistance or support provided falls within the description and allowable costs of
           the Personal Assistance service.
          The care for which a parent(s) of a minor or spouse of an adult consumer is paid for
           providing is directly related to an assessed and documented functional limitation of the
           consumer.
          The number of hours for which a parent or spouse is to receive payment is addressed in the
           consumer’s Community Support and Expenditure Plan, which documents the assessed
           support need (such as help with dressing), the frequency of service delivery, the payment
           rate, and number of units provided per week.
          The assistance being providing and paid for must be over and above what a parent of a
           minor child would be responsible to perform. Examples of responsibilities include but are
           not limited to: supervision or transportation of children under the age of 17, typical household
           maintenance tasks, such as cleaning, meal preparation and laundry. For examples, please
           see page 2 of these guidelines.




3                                        CSG Expenditure Guidelines 2010                       DD/CSG Folder
       The following are the guidelines used by Scott County when considering approval for payment
       to a parent of a minor or a spouse of an adult consumer:

          Hours of care provided are over and above care provided to a similar age child without
           disabilities and that a family would not normally provide or be responsible for providing.
          May be paid for up to 40 hours per week of care. If two parents are providing care, the
           maximum for both cannot exceed a total of 40 hours per week, regardless of the number of
           children receiving services through the CSG program or CDCS option of the home and
           community based waivers.
          A parent(s) of a minor is not eligible to receive unemployment or worker’s compensation.
          A parent(s) or spouse must meet the minimum qualification or training standards necessary
           to perform the service or support as described in the consumer’s Community Support and
           Expenditure Plan.

       Support Staff – Parent/Guardian of an Adult Consumer

          There must be a job description and work schedule for each parent/guardian of an adult
           consumer which must accompany the Consumer Support Grant (CSG) Community Support
           and Expenditure Plan.
          If the paid caregiver is also the legal guardian of the consumer, only the direct care activities
           and responsibilities that do not conflict with responsibilities of being a guardian, may be
           submitted as time worked.
          The tasks associated with being a legal guardian of an adult consumer are separate and not
           able to be submitted as time worked. Examples of guardianship tasks include: going to
           court, attending IEP meetings, attending interdisciplinary team meetings with service
           providers, giving consent for medical and other legal procedures, completing documentation
           required of a guardian, applying for financial resources, etc.
          Must meet the minimum qualification or training standards necessary to perform the service
           or support as described in the consumer’s Community Support and Expenditure Plan.

    2. COMPANION SERVICES- (for Adults only-Defined as: Non-medical care, supervision and
       socialization provided to an adult with functional limitations).
        Refer to #1 PERSONAL CARE for additional informal staffing criteria guidelines.

    3. INDEPENDENT LIVING SKILLS- (Costs for services to develop and maintain community living
       skills and community integration may be funded. These services may include supervision,
       training or assistance to the consumer with self-care, communication skills and socialization,
       sensory/motor development, reduction/elimination of maladaptive behavior, community living
       and mobility).
        Refer to #1 PERSONAL CARE for additional informal staffing guidelines.
        CSG funds may be used to purchase services from licensed ILS agencies.

    4. RESPITE SERVICES- (in-home or out-of- home care for the consumer in order to give
       temporary relief to the consumer’s primary caregiver(s).
        Customary cost guidelines for hourly respite should fall between minimum wage and $12 per
          hour.
        Respite care can be purchased by the hour or by the day. Respite care beyond 16 hours in
          any given day requires the development of a daily rate. Consult with FI/ER agency to
          determine if you will need to develop an hourly or daily respite rate.
        Camps related to the disability may only be funded when used as respite


4                                        CSG Expenditure Guidelines 2010                               2/9/10
    5. ADULT DAYCARE -(Services available to persons who are 18 years of age or older, and
       encompasses both health and social services which are needed to ensure his/her optimal
       functioning in a licensed adult daycare center or by a qualified individual who provides care in
       his/her own home or in the consumer’s home).

          If adult daycare is provided in the consumer’s home, refer to #1 PERSONAL CARE


    6. DAYCARE- (Daycare expenses for consumers with disabilities over the age of 11 may be
       funded. An allowable expense is limited to the portion of daycare fees that is in excess of that
       charged for similar-aged children without disabilities. After school or weekend daycare
       expenses for recipients who, because of their disabilities, are not able to remain at home
       unsupervised).

          For children 11 years of age and under: funds may be used to fund an additional one-to-one
           caregiver specifically for the child with the disability, if justified based on the needs of the
           child.


    7. CHORE SERVICES- (services needed to maintain the home in a clean, sanitary and safe
       environment. This includes heavy household chores such as washing floors, windows, and
       walls, tacking down loose rugs and tiles, moving heavy items of furniture in order to provide safe
       access inside the home, and shoveling snow to provide access and egress).

          The primary caregiver must be unable to perform housekeeping tasks, be temporarily unable
           to perform the tasks, or require such support in order to meet the needs of the consumer.
          Lawn mowing, snow removal and general household maintenance tasks may be considered
           for approval only if all household members are physically unable to perform the task, as
           documented by a physician.
          Housekeeping for families of children living in their family homes may be funded when the
           caregiver or caregivers living in the home are unable to perform the tasks, are temporarily
           unable to perform the tasks, or the caregiver requires such support in order to meet the
           needs of the consumer. Written justification in CSG expenditure plan must be provided by
           parent or primary caregiver prior to approval.
          Housekeeping service may be approved up to a maximum of 8 hours per month or $200 per
           month, whichever is less.


    8. HOMEMAKER SERVICES- (costs for meal preparation, routine household care, shopping and
       errands)

          For adult consumers, funds may also be used for assisting with daily activities, arranging
           transportation, providing emotional support and social stimulation, and monitoring health,
           safety and well-being.
          For housekeeping services, please refer to #7- CHORE SERVICES

    9. HOME DELIVERED MEALS- (costs for home-delivered meals for adult consumers who are
       unable to prepare nutritionally balanced meals for themselves and for whom there are no other
       persons available to do so, or where the provision of a home delivered meal is the most cost-
       effective method of delivering a nutritionally adequate meal.)



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    10. NUTRITION SERVICES- (costs for individual or group education provided by a licensed
        dietician or registered nurse related to the consumer’s diet-related health problems.

          Examples include: planning diabetic meal patterns, therapeutic diet suggestions for
           underweight consumers, weight reduction diets, etc).

    11. SPECIALIZED DIETS- (costs for specialized diet foods and nutritional supplements that are
        over and above the cost of a typical diet and/or in an amount which exceeds the USDA
        recommendations for a person of similar age without a disability).

          Must be prescribed by an MHCP physician who is operating within his/her scope of practice.
          Must directly relate to an assessed need associated with the consumer’s disability.
          Extra food costs associated with a specialized diet may be approved up to a maximum of
           $100 per month. This amount is based on the cost difference between typical foods and
           special diet foods and is in addition to the parental responsibility to provide for a consumer’s
           basic needs. Approval for additional funding will be given consideration with documentation
           of actual expenditures over a 3 month period that identifies an increased need.
          It is expected that food would be purchased at a local grocery store when possible.
          Authorized specialized diet foods purchased with CSG funds must be purchased separately
           and specifically for the consumer. A receipt reflecting only special diet items must be
           submitted to FI/ER agency.
          Foods that are naturally gluten free such as fruits and vegetables are not allowable CSG
           purchases.
          Extra food costs due to consumer preferences will not be funded.

       The following diets are allowable for payment if the above criteria have been met:
                Anti-dumping diet
                Controlled Protein Diet (40-60 grams and requires special products)
                Controlled Protein Diet (less than 40 grams and requires special products)
                Gluten free diet
                Casein free diet
                High protein diet
                High residue diet
                Hypoglycemic diet
                Ketogenic diet
                Lactose free diet
                Low cholesterol diet
                Pregnancy and Lactation diet

       Note: The extra costs of special diets may be covered by an MSA special needs payment, food
       support, cash assistance or an MFIP special needs payment. In these instances, CSG funds
       cannot pay for special diet items.

    12. CAREGIVER TRAINING AND EDUCATION (training and education that provides a paid or
        unpaid caregiver with increased knowledge and skills in order to deliver quality care to a
        consumer may be funded).

          Fees for training in the form of workshops and conferences in MN or in the consumer’s Local
           Trade Area for unlicensed caregivers may be funded.


6                                        CSG Expenditure Guidelines 2010                              2/9/10
          Any travel costs, meals, or lodging associated with the training cannot be reimbursed.
           Meals, if part of the conference fee, may be funded.
          Training for licensed vendors cannot be funded as a separate expense. Costs for staff
           training must be incorporated into the vendor’s established rate for service.
          Books, videos, DVDs and magazine/journal subscriptions that relate to an assessed need
           associated with the consumer’s disability and that are for caregiver training purposes may be
           funded.
          CSG funds cannot pay for classes or ongoing trainings which lead to a certification or
           degree.

    13. EDUCATIONAL- (cost of educational programs and services for which the local education
        agency is not responsible for providing or are necessary above and beyond what is provided by
        other sources).

          Items which a parent would be responsible for providing or have the option of providing if
           their child did not have a disability are not allowable.
          Costs for educational/therapeutic books, computer software, videos, cassettes, CDs or
           DVDs may be funded if they are specifically designed for the child’s disability, address the
           child’s functional limitations and are not age-appropriate.
          The total cost of books, videos, cassettes, CDs and DVDs may not exceed $250 in any given
           budget year.
          The total cost for computer software may not exceed $500 in any given budget year.
           Consideration may be given for larger computer software packages that are needed due to a
           consumer’s communication or assistive technology needs.
          Items in this category must be specifically recommended in writing by an appropriate
           professional.
          Academic tutoring which does not replace educational services that are available through
           the school district is allowable with a recommendation from an educational professional from
           the school district. The recommendation must document the child’s need for tutoring as it
           directly relates to the child’s disability.

    14. FAMILY COUNSELING AND TRAINING- (costs for counseling to assist the consumer and/or
        his/her family members in crisis, coping strategies, stress reduction, etc).

          Only services not available through an MA vendor and/or reimbursed through private
           insurance may be funded through CSG funds.
          The service must be provided by an appropriate licensed professional.
          If seeking reimbursement for any medical expenditures through your flexible spending
           accounts, the consumer or parent/guardian may not also use CSG funds to be reimbursed
           and vice versa.
          CSG funds cannot be used to pay for insurance co-pays or deductibles.

    15. MEDICAL- (costs for medical expenses which are not reimbursable through private insurance,
        MA or other private social services funds).

          Expenses which are in excess of those covered by the consumer’s private insurance when
           those expenses have been determined to be ineligible for MA reimbursement are allowable
           CSG fund expenditures.




7                                       CSG Expenditure Guidelines 2010                            2/9/10
          The use of flexible spending accounts to reimburse the consumer or parent/guardian for
           medical expenditures purchased through CSG is not allowed.
          CSG funds cannot be used to pay for insurance co-pays or deductibles.

    16. MEDICATION- (costs for prescription and non-prescription medications which are needed due
        to the consumer’s functional limitations and are not reimbursable through other funding sources,
        such as MA or private insurance).

          Over-the-counter medications must be prescribed by a physician, operating within his/her
           scope of practice. Since MA typically pays for medications that can be purchased over the
           counter, consumers must see if physician will write a prescription before seeking
           reimbursement from CSG funds.
          If seeking reimbursement for any medical expenditures through your flexible spending
           accounts, the consumer or parent/guardian may not also use CSG funds to be reimbursed
           and vice versa.
          CSG funds cannot be used to pay for insurance co-pays or deductibles.

    17. SUPPLIES AND EQUIPMENT- (costs for durable and non-durable medical items which are
        necessary due to the consumer’s functional limitations).

          This category may also include devices, controls or appliances which enable the consumer
           to increase his/her ability to perform activities of daily living, as well as ancillary supplies
           necessary for proper functioning of items.
          Medical equipment must be prescribed by a physician and must be for the sole benefit of the
           consumer due to a diagnosed medical condition that is directly related to the consumer’s
           disability.
          CSG cannot fund items which private insurance or MA will pay for.

    18. SPECIAL CLOTHING- (costs for extra clothing and bed linens for a consumer with incontinence
        and/or an excess of bodily secretions).

          Funds may be used to purchase clothing/linens for a consumer whose clothing/linens wear
           out quickly due to abnormal wear and tear resulting from a disability or from behaviors
           associated with the disability.
          Funds may be used for the purchase of necessary clothing items that must be specially
           designed or adapted due to the consumer’s disability and for articles for which there is no
           other funding available (e.g. orthopedic shoes, helmets for head protection during seizures,
           etc.).

    19. MODIFICATIONS AND ADAPTATIONS TO HOME AND VEHICLE- (costs for adaptations to the
        consumer’s home and vehicle which are necessary to reasonably ensure the health, well-being
        and safety of the consumer AND which enable the consumer to function with greater
        independence in the home and in the community).

          Such adaptations may include ramps, grab bars, door widening, installation of visual and/or
           tactile signaling devices, adapted bathroom devices, wheelchair lifts, adapted seating, door
           handle replacements, wheelchair securing devices, adaptive furniture and utensils, etc.
          Adaptations or improvements to the home must be of direct or remedial benefit to the
           consumer.




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    Other requirements for modifications include the following:
     Funds cannot be used for a modification that results in any additional (including finished)
       square footage to the home.
     The modification needs to be directly related to the consumer’s functional limitations as
       documented by an appropriate professional.
     Case managers must review the area to be modified before and after the modification is
       completed.
     Only modifications to the consumer’s primary residence and/or vehicle can be funded.
       Exceptions can be made in cases of dual households for minor children.
     At least two itemized estimates must be submitted for prior approval.
     Non-portable/removable home and vehicle modifications will not be considered for rented
       properties or leased vehicles.
     Costs associated with aesthetic portions of a home modification or upgrades to a van
       modification package will not be approved.
     Modifications or adaptations that do not meet building codes and are not inspected by the
       appropriate building authority, and which are done by unlicensed or non-certified person(s)
       become the home owner’s financial responsibility to correct.

    Other requests and guidelines in this category include:

    Fences

       Funds may be utilized to enclose an outdoor area that will provide adequate freedom of
        movement for the consumer, while ensuring his/her safety.
       Funds for or toward the enclosure may be approved up to a maximum cost of $5,000.
       At least two detailed estimates are required and need to be submitted to the County for prior
        approval.
       Estimates should only include the most cost effective materials and height required to meet
        the identified need.
       Only one fence per property may be purchased with CSG funds, so safety requirements for
        growing children need to be considered in the planning process.
       The homeowner or consumer maintains all financial responsibility for any decorative posts or
        post tops and for upgrading the building materials, design, etc. to comply with neighborhood
        covenants, zoning ordinances, or personal preferences.
       Funding for fences will not be authorized on rental property

    Emergency Egress

       Requests for an outdoor platform with or without railings, raised or ground-level, will only be
        considered for a consumer who requires a barrier-free environment and a second accessible
        exit to ensure safety in evacuating the home in an emergency. The age of the consumer will
        be taken into account when evaluating the request.
       At least two detailed estimates with proposed layout for most cost effective materials are
        required for all platform requests. Platform may not exceed four feet by four feet.
       The homeowner or consumer is responsible for any additional costs incurred for increasing
        platform size, decorative railings, upgraded building materials, etc.,
       Funding for an emergency egress will not be authorized on rental property.




9                                     CSG Expenditure Guidelines 2010                             2/9/10
        Security System

           Requests for security system components will be considered for approval on a case-by-case
            basis with at least two detailed estimates; components must be directly related to the
            consumer’s assessed needs for safety.
           The safety of the consumer must be dependent on having a security system within his/her
            home. Other less costly residential safety measures must have been considered, or tried
            and documented, and a security system has been proven to be the most cost effective
            strategy.
           Funds may be used to purchase and install a basic/standard security system.
           The homeowner or consumer maintains responsibility for paying any ongoing monthly
            monitoring costs.

        Home Repairs

           Routine maintenance of the consumer’s home cannot be funded.
           Repair of damages caused by the consumer with the disability may be funded if the health,
            safety and well-being of the consumer is dependent on the repair being made.
           Repairs must be done in a manner as to prevent further or reoccurring damage by the
            consumer.
           If damage is a result of behavioral outbursts, CSG may fund cost of repair if there is a
            behavioral plan in place, available for review and developed in conjunction with an
            appropriate professional.
           The case manager must view area to be repaired prior to seeking approval for CSG funding.

     20. CONSUMER SUPPORT GRANT EXPENSES- (costs that are incurred for administering CSG
         funds such as liability insurance, unemployment compensation, fiscal intermediary/employer of
         record fees, and check order fees).

           CSG funds may not be used to directly pay for MA parental fees.
           CSG funds may not be used to pay for office furniture, office equipment and/or office
            supplies.

     21. SPECIAL EQUIPMENT- (equipment required by a consumer, which is directly related to the
         consumer’s functional limitations and for which no other funding is available).

           Examples of these types of expenses include adapted toilet seats, adapted car seats, etc.

        Requests and guidelines in this category include:

        Cell Phones and Service

               Cell phone service may be funded only for extreme need, such as medical or behavioral
                emergencies and must be documented in the consumer’s service plan.
               Cell phone service plan is limited to pre-paid wireless programs which cost up to a
                maximum of $100.00 per year. The cost of the phone can be reimbursed up to $20.00.
                Parent and primary caregiver cell phone plans cannot be supplemented with CSG funds.




10                                       CSG Expenditure Guidelines 2010                            2/9/10
           The cell phone may only be purchased for use by a paid caregiver when accompanying
            the consumer in the community in the event that caregiver needs assistance with or
            information about the consumer.

     Assistive Technology

     Requests for Assistive Technology must meet the following definition: any tool or piece of
     equipment used by a person with a disability to increase, maintain, or improve his or her
     functional capabilities and allows him/her to live more independently. This technology allows
     individuals with disabilities to perform functions that might otherwise be difficult or impossible.

     Items in this category must meet one or more of the following criteria:

            1. Improves consumer’s ability to perform activities of daily living, such as dressing,
               personal hygiene, bathing, home maintenance, cooking, eating, money
               management, household management, medication administration, etc. Examples
               may include: adapted furniture; tools or utensils; seating and positioning aids; vision
               and reading aids; switches; reachers; adaptive clothing; dressing aids; adapted
               personal hygiene aids; eating and cooking aids; toileting and bathroom aids; home
               maintenance aids, etc.
            2. Improves consumer’s ability to control or access his/her environment within their
               home or workplace. Examples may include: mobility devices; pencil grips; adapted
               keyboards; communications device/software; adapted seat for bath/shower; visual
               supports such as PECS (Picture Exchange Communication System); vision and
               reading aids; speech and augmentative communication aids; writing and typing aids;
               accessible software; switches.
            3. Improves consumer’s ability to control or access his/her community such as
               arranging and/or using transportation, participating in community activities, using
               community resources, shopping. Examples may include: mobility devices; adapted
               car seat; adapted recreational equipment; visual supports such as PECS; vision and
               reading aids; speech and augmentative communication aids; switches.

     Additional items in this category may be considered for funding but requests must be for the
     most cost effective option to meet the needs of the consumer. The cost of the item may be
     prorated based on the number of people in the household and only the consumer’s portion of the
     item may be funded. Items typically used by the general public may be pro-rated based on the
     customary versus the adapted cost.

     Digital Cameras/Camcorders and Accessories

           Requests for these items must be accompanied by documentation from an appropriate
            professional stating the need for and sole benefit to the consumer.
           The cost for a digital camera may not exceed $100.
           The cost for a camcorder may not exceed $200.
           Requests for each item in this category may only be made once every five years.
           Requests for extended warranties will not be approved.

     Additional items in this category may be considered for funding but requests must be for the
     most cost effective option to meet the needs of the consumer. The cost of the item may be
     prorated based on the number of people in the household and only the consumer’s portion of the
     item may be funded.


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     22. Transportation- (expenses for transportation that are incurred as a result of the consumer’s
         functional limitations).

            Medical transportation that can be reimbursed through MA or other funding sources may not
             be reimbursed through CSG funds
            Transportation to and from daycare, after school programs, extracurricular activities, and
             community recreational activities for children are a parental responsibility and will not be
             funded.
            Medical mileage may be funded through Medical Assistance. Requests are made through
             Scott County Transit at 952-496-8341.
            Mileage reimbursement cannot exceed the current Federal mileage rate.
            Non-medical mileage may be reimbursed for paid staff, excluding parents of minor children,
             when transporting the consumer to and from locations and places that have been authorized
             for funding in the CSG expenditure plan and which are not considered by the county to be
             the responsibility of a parent to provide.

     23. Other- (items that do not fit into one of the above categories but which may be needed for a
         consumer due to the consumer’s disability. These items must meet the general criteria for a
         CSG allowable expenditure and will be considered individually for authorization as requested).

         Common requests and guidelines in this category include:

         Behavioral Incentives

        Behavioral incentives must be recommended by a mental health professional for the
         implementation of a therapeutic intervention that is part of a larger therapeutic program.
        Behavior/treatment plans must be written by and include monitoring from a mental health
         professional, therapist or Behavior Analyst. A copy of this plan must be submitted when
         requesting items in this category.
        Behavioral incentives that are not allowable include but are not limited to: tickets and related
         costs to attend sporting or other recreational events; dining out; community outings/activities;
         family memberships for children to clubs; recreation centers; museums; cash.
        The maximum amount that can be paid for behavioral incentives is $50 per month.

         Additional household expenses

            The extra costs incurred in the consumer’s household due to increased laundering of
             clothing, use of electricity or other household expenses will not be approved for funding.

         Adaptive Bicycles

            Requests for adaptive bicycles, if approved, will be reduced by the customary cost for this
             item for a child of a similar age. The reduction amount from the actual cost will be $50 for
             children ages 7 and under and $100 for children ages 8 and over.




12                                         CSG Expenditure Guidelines 2010                                2/9/10
         Office supplies or equipment

           If you are the employee, you are responsible for any costs incurred for employee related
            activities.
          Office supplies or office equipment of any kind are not allowable, including those for
            employee related activities.
         Therapies (PT, OT, RDI, ABA, music therapy, art therapy, therapeutic horseback riding, etc.)

        Must be prescribed by a MHCP physician who is operating within his/her scope of practice.
         Prescriptions/orders from a MHCP physician must clearly state the necessity of the therapy as it
         relates to an assessed need associated with the consumer’s disability and the outcomes the
         therapy is to achieve (use Alternative Treatment forms).
        CSG cannot be used to pay insurance co-pays or deductibles, and any therapy or service
         offered through Private Insurance or MA.
        Therapies must be provided by individuals or agencies that meet certification and/or State
         licensing standards.
        There needs to be a copy of the related treatment plan/therapy plan in the consumer’s file.

Therapeutic Play Equipment/Materials/Supplies

        Items must be recommended by an appropriate professional for the implementation of a
         therapeutic intervention that is part of a larger therapeutic program. The recommendation must
         include evidence that the requested item has been tested with the consumer and found to be a
         successful intervention
        Items may include sensory equipment, specialized toys, organizational supplies and other items.
        A copy of the therapy plan needs to be included when requests for specific items are submitted
         for approval from the County.
        Funding may be approved for the rental of a specific item for a trial period prior to purchase.
        Age-appropriate items and items that are the responsibility of the parent or spouse to provide
         are not allowable.
        The purchase of multiple items that address the same need will not be approved.

Health Club Memberships/Fitness Programs (for adult consumers only)

        Some MA managed care plans currently pay for health club memberships. If you are on a plan,
         please consult with your care coordinator to see if your plan currently covers this.
        Must be determined to be necessary and appropriate to treat a physical condition identified in
         the consumer’s plan of care or to improve or maintain the adult consumer’s physical condition;
         there must be an agreed upon outcome in the consumer’s plan of care. Documentation to verify
         usage, based on goals, will be monitored by the case manager on at least an annual basis and
         must be available to the county at any time upon request.
        Must be prescribed and monitored by a Minnesota Health Care Provider (MHCP) enrolled
         physician operating within his/her scope of practice.
        Payment structure must be based on the most cost effective payment option (e.g., daily rates,
         monthly memberships, and annual memberships) depending on the consumer’s actual and
         projected use of the health club or fitness center.




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24. Examples of additional items that may be funded include but are not limited to:

        Costs for community activities for adults with disabilities and their paid staff, which are part of a
         habilitation program identified in the Individual Service Plan or Individual Social Services Plan.

        Reimbursement for community activity costs for paid caregivers of minor children (excludes
         parents of minors) which are part of a habilitation program identified in the Individual Service
         Plan or Individual Social Services Plan.

        Memberships to disability related organizations (e.g. ARC, PACER, Autism Society of MN and
         other similar disability organizations)

25. UNALLOWABLE EXPENDITURES- CSG funding CANNOT be used for any services that:

        are for comfort or convenience,
        are items or supports normally furnished by the consumer’s parents, family or spouse,
        do not meet an identified need,
        are not preapproved in the Community Support and Expenditure Plan.

     In addition to the items already listed in the content of these guidelines, Scott County, in most
     instances, will not approve CSG funding for the following:

        Family or individual memberships for children to clubs, recreation centers, museums, etc.
        Bonuses to support staff
        Extended warranties
        Home-based schooling
        Office supplies or office equipment of any kind, including those for employee related activities.
        Mileage reimbursement for parents of minor children or spouses
        The extra costs incurred in the consumer’s household due to increased laundering of clothing,
         use of electricity or other household expenses
        The cost of age appropriate community activities/classes for children, regardless of therapeutic
         benefit to the consumer, will not be funded. Examples of such activities include, but are not
         limited to: gymnastics, Tae Kwan Do, soccer, motor sports, dance, swimming lessons, etc.

     While the list above notes specific exclusions, any goods, services or items approved in a
     COMMUNITY SUPPORT AND EXPENDITURE PLAN support plan must meet all criteria listed on
     the cover sheet, page 1. In other words, the absence of a good or service from this excluded list
     does not mean it will be automatically approved in any plan. Each plan must be reviewed to ensure
     that all goods and services meet criteria for approval.




14                                         CSG Expenditure Guidelines 2010                               2/9/10
                                SCOTT COUNTY
                     Consumer Support Grant
                        Expenditure Guide
                               (CSG)
                     Effective March 01, 2010

                         (Replaces March 01, 2009 Guide)

         Name of Consumer: _________________________________________________


            By signing this, I am indicating that I received a copy of the March 01, 2010

                                     CSG Expenditure Guide.




     _________________________________________                         ___________________
     Guardian/Authorizing Representative Signature                      Date




     Social Work Case Manager/Public Health Nurse Signature             Date




15                                   CSG Expenditure Guidelines 2010                         2/9/10

				
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