Service Delivery Options

Many programs have 2 Service Delivery options:

Agency-directed Services (Who is my “agency”?) Consumer-directed Services (CDS)
This is the traditional model where a Provider Agency does all the employer jobs, including:

  • Advertising the job.
  • Checking the qualifications of the employee candidates.
  • Set the pay rate.
  • Hire and train the employee.
  • Provide backup when the employee isn’t available.
  • Pay the employee.
  • Bill HHSC.
  • Be audited by HHSC to keep their license.
 This is the alternative model where the family or individual acts as the Employer, with the assistance of a Payroll company (FMSA).

Family FMSA
  • Advertising the job.
  • Checking the qualifications of the employee candidates.
  • Set the pay rate.
  • Hire and train the employee.
  • Provide backup when the employee isn’t available.
  • Pay the employee.
  • Bill HHSC.
  • Be audited by the Waiver program and other agencies (if licensed Home Health agency).
  • Pay the employee.
  • Bill HHSC.
Funds from HHSC are used to cover:

  • Payrate of employee
  • Employer taxes
  • Company overhead + profit
 Funds from HHSC are used to cover:

  • Payrate of employee
  • Employer taxes
HHSC pays a lower hourly rate for Consumer-Directed Services, since there is no Provider Agency overhead/profit to account for.
Therefore, the CDS Option saves funds while providing more control to the individual/family.

Now let’s look at Personal Factors that effect your Service Delivery Options…