10 Colo. Code Regs. § 2505-10-8.7510

Current through Register Vol. 47, No. 24, December 25, 2024

Section 10 CCR 2505-10-8.7510 - Benefits Planning Service

8.7510.ABenefits Planning Service Eligibility

1. Benefits Planning Service is available to Members enrolled in one of the following HCBS waivers:

a. Developmental Disabilities Waiver

b. Supported Living Services Waiver

8.7510.BBenefits Planning Service Definition

1. Benefits Planning means analysis and guidance provided to a Member and their family/support network to improve their understanding of the potential impact of employment-related income on the Member's public benefits. Public benefits include, but are not limited to Social Security, Medicaid, Medicare, food/nutrition programs, housing assistance, and other federal, state, and local benefits. Benefits Planning gives the Member an opportunity to make an informed choice regarding employment opportunities or career advancement.

8.7510.CBenefits Planning Service Inclusion

1. Benefits Planning is available regardless of employment history or lack thereof and may be accessed throughout the phases of a Member's career such as: when considering employment, changing jobs, or for career advancement/exploration.

2. Certified Benefits Planners support Members by providing any of these core activities:

a. Intensive individualized benefits counseling;

b. Benefits verification;

c. Benefit summary & analysis;

d. Identifying applicable work incentives, and if needed, developing a work incentive plan for the Member and team;

3. In addition to the core activities, Benefits Planning may also be utilized to:

a. Conduct an informational meeting with the Member, alone or with their support network.

b. Assist with evaluating job offers, promotional opportunities (increase in hours/wage), or other job changes that the Member is considering which change income levels; and outlining the impact that change may have on public benefits.

c. Provide information on Waiver Benefits (including Buy-In options), federal/state/localprograms, and other resources that may support the Member in maintaining benefits while pursuing employment.

d. Assist with referrals and connecting the Member with identified resources, as needed, and coordinating with the Member, Case Manager, family, and other team Members to promote accessing services/resources that will advance the Member's desired employment goals.

e. Navigate complicated benefit scenarios and offer problem-solving strategies, so the Member may begin or continue working while maintaining eligibility for needed services.

f. Offer suggestions to the Member and their family/support network regarding how to create and maintain a recordkeeping structure and reporting strategy related to benefit eligibility and requirements.

1) If the Member needs assistance with the collection and submission of income statements and/or documentation related to the Social Security Administration (SSA), or other benefits managing organizations, and the Member does not have other supports to do so, the Benefits Planner may assist on a temporary basis.

g. Assist in accessing federal/state/local resources, evaluating the potential impact on benefits due to changes in income, and if there is a negative impact identified, explore alternatives to meet existing needs, all in collaboration with the Member's Case Manager and support team.

8.75010.DBenefits Planning Service Exclusions and Limitations

1. Benefits Planning shall not take the place of, nor shall it duplicate services received through the Division of Vocational Rehabilitation.

2. Benefits Planning services are limited to 40 units per support plan year. One unit is equal to 15 minutes of service.

8.75010.EBenefits Planning Service Provider Agency Requirements

1. Benefits Planning may be provided only by Certified Benefits Planners. A Certified Benefits Planner holds at least one of the following credentials:

a. Community Work Incentives Coordinator (CWIC);

b. Community Partner Work Incentives Counselor (CPWIC);

c. Credentialed Work Incentives Practitioner (WIP-CTM).

2. Documentation of the Benefits Planner's Certification and additional trainings shall be maintained and provided upon request by a surveyor or the Department.

3. Certified Benefits Planners must obtain and sustain a working knowledge of Colorado's Medicaid Waiver system as well as federal, state, and local benefits.

4. The Benefits Planning provider must maintain records which reflect the Benefits Planning activities that were completed for the Member, including copies of any reports provided to the Member.

5. If the Certified Benefits Planner encounters a benefit situation that is beyond their expertise, consultation with technical assistance liaisons is expected.

10 CCR 2505-10-8.7510

47 CR 03, February 10, 2024, effective 3/16/2024

47 CR 21, November 10, 2024, effective 11/30/2024