Broker Base

You are considered an Agency Support Broker if you are hired through an Agency and are fingerprinted by the Agency you work for. If you are fingerprinted through RCIL, you are considered an Independent Support Broker and that is how it should be listed in your Support Broker Agreement.

If you have a business name, such as a LLC, you can use your business email address on the Support Broker Agreement, however, you should indicate “Independent” on the Agreement in the Name of Agency field. If you request payment directly to your business name, you should list your business name on your W-9.

Must be a wet signature or a verified electronic signature showing the date/time stamp.
Font changes are not acceptable.

Budgets can be submitted in eVero, however, they must also be submitted to sdpreapprovals@rcil.com.

All supporting documents should be sent to sdpreapprovals@rcil.com.

• Notice of Decision
• LCED
• Information Session Certificate/Letter of Eligibility
• Current approved Life Plan with justification of Self-Direction in the Narrative as well as listing RCIL for Support Broker and Fiscal Intermediary (Effective date: Upon approval of SD Budget)
• To expedite the pre-review process please be sure all items are sent in one email.

• IDGS/OTPS/Staffing Worksheet (Excel Version)
• Weblink or Flyer for requested Classes, Camps, Memberships, Transitions Programs or Interpretation services
• SD-15 if Agency Supported, Direct Provider Purchased or Contracted Services in the budget
• If Paid Neighbor or Staffing Support being added, need written verification from participant/designee that they are not related by blood or marriage
• Clinical Script if Clinician Direct is being added
• Approved current Life Plan listing RCIL for all SD services in budget
• Approved current RCIL Staff Action Plan
• Participant Approval
• To expedite the pre-review process please be sure all items are sent in one email.

For Individuals with Housing:

• Current non month to month lease.
• To obtain Preliminary Approval, Attachment C OPWDD Housing and Transition Stipend Application must be completed.
• Housing Participant Agreement, and Housing Quality Assurance Checklist if housing is being added for the first time or the individual has moved to a new home.
  
• Participants who are eligible for Section 8/HUD are not eligible for new housing subsidies. (Individuals are grandfathered prior to 3/10/2022)
• Current proof of Income, Utility Bills, Insurance Policy, HEAP & SNAP Award/Denial letters.
• To expedite the pre-review process please be sure all items are sent in one email.

• IDGS/OTPS/Staffing Worksheet (Excel Version)
• Weblink or Flyer for requested Classes, Camps, Memberships, Transitions Programs or Interpretation services
• Worker Change Form if Self-hired staff wages/hours are being changed
• LS55 Form (hard copy) if staff wages are being reduced or services being added/removed
• SD-15 if Agency Supported, Direct Provider Purchased or Contracted Services in the budget
• If Paid Neighbor or Staffing Support being added, need written verification from participant/designee that they are not related by blood or marriage
• Clinical Script if Clinician Direct is being added
• Approved current Life Plan listing RCIL for all SD services in budget
• Approved current RCIL Staff Action Plan
• Participant Approval
• For FI Transfers only: Most recent Budget Expenditure report, CR4 and Termination Form from former FI. **

For Individuals with Housing:

• Current non month to month lease.
• Housing Participant Agreement, and Housing Quality Assurance Checklist if housing is being added for the first time or the individual has moved to a new home.
• Participants who are eligible for Section 8/HUD are not eligible for new housing subsidies. (Individuals are grandfathered prior to 3/10/2022)
• Current proof of Income, Utility Bills, Insurance Policy, HEAP & SNAP Award/Denial letters.
• To expedite the pre-review process please be sure all items are sent in one email.

• Yes, all budget submission must include verification that a CAS/CANS assessment is current and completed within the required timeframe.
  *A current CAS/CANS assessment means: CAS (age 18 and over) within the past 2 years. CANS (age 17 and under) within the past year.

Worker Change Forms are required if staff whose hourly rate(s) and/or hours are being changed.

LS-55 Forms are required when self-hired hourly rate(s) are being reduced, or services are being added/removed.
The original hard copy must be returned to the RCIL HR Department at the following address: 131 Genesee St. Utica, NY 13503

A pre-approval of classes is required prior to RCIL being able to reimburse for any classes out of IDGS.

You must submit a current website or flyer to sdpreapprovals@rcil.com for pre-review.

• Classes that are recreational in nature.
• Classes not open to the general public.
• Classes where there are not published rates.
• Classes that are credit bearing.
• Classes that do not relate to a habilitative goal in the Life Plan.
• Classes that duplicate another HCBS Waiver service.
• Classes that are provided at an entity that provides HCBS Waiver services.

A Transition Stipend is a one-time payment that covers the basic and necessary expenses associated with moving or establishing a household for the individual.

A CTS is for individuals who are enrolled in Home and Community Based Services (HCBS) waiver by the date of payment. These services are intended to help the individual transition from specific provider or state-operated facilities to independent, community living.
An ISS Transition Stipend is for individuals who are moving out on their own, not from a specific provider or state-operated facilities.

• CTS – Maximum $5,000.00
  The individual must be moving from a(n):
• OPWDD operated Individualized Residential Alternative (IRA), Community
• Residence (CR) or other OPWDD operated residential setting;
• OPWDD certified IRA, CR or other OPWDD certified residential setting;
• Family Care home;
• New York State funded private residential school;
• State operated residential school; or
• ICF/DD, developmental center, nursing facility or any other Medicaid funded
• institutional placement.
  
  Additionally, the individual must be moving to a non-certified community living arrangement within New York State where they will be responsible for their own living expenses. Individuals moving to certified community residential settings (such as a group home or supported apartment) are not eligible for community transition services.
• ISS – Maximum $3,000.00
• Be eligible to receive an OPWDD Housing Subsidy
• Not qualify for a CTS
• Not have received an OPWDD Transition Stipend before.

Initiating a Transition Stipend typically begins with the Individual's Care Manager.
However, a Care Manager is not required for an individual to be eligible for an OPWDD Housing Subsidy.

If an individual does not have a Care Manager, the individual can initiate the Transition Stipend
Application process by working with a Housing Subsidy Provider Agency or the DDRO.
The Care Manager must help the individual to apply for other available benefits and housing
assistance before applying for an OPWDD Housing Subsidy. Once all other benefits and housing
assistance has been exhausted; the Care Manager must complete the OPWDD Housing
Subsidy application packet and other related paperwork.

Allowable expenses include:

• Moving expenses
• Set-up fees
• Utility deposits (e.g., telephone, electricity, heating, water, etc.)
• Services provided before the individual moves in, that are necessary for their health and safety (e.g., pest eradication, cleaning)
• Furniture
• Window coverings
• Rugs and floor coverings
• Lamps and light bulbs
• Food preparation items
• Linens
• Other items with prior approval from OPWDD

Unallowable expenses include, but are not limited to:

• Monthly rental or mortgage expenses
• Food
• Regular utility charges
• Cable, streaming, internet access
• Additional warranties or protection plans
• Diversion or recreational expenses (e.g., televisions, computers, video games, stereos,
• DVD players)
• Other items as determined by the DDRO

They must buy start up items 90 days prior to moving and 90 days after they move. If items are purchased outside of these time frames they will not be reimbursed.
Participants will need to save all their receipts until the monies allocated for the Transition Stipend have been spent. All receipts will need to be provided to RCIL and once received RCIL will submit your transition stipend in one installment.

Qualifying expenses are those specific to the establishment of a residence including, but not limited to:

• furniture;
• window coverings;
• rugs and floor coverings;
• lamps and light bulbs;
• food preparation items;
• linens;
• utility deposits (e.g., telephone, electricity, heating, water);
• services provided before the individual moves in that are necessary for their health and safety (e.g., pest eradication, cleaning);
• security deposits; and
• moving expenses.

Items not allowed under CTS include, but are not limited to:

• monthly rental or mortgage expenses;
• food;
• regular utility charges;
• cable/internet access charges; and
• diversion or recreational expenses (e.g., televisions, computers, video games, stereos, DVD players).

The following elements must be included in the Life Plan:

• Identification of CTS under the category of waiver service (i.e., Community Transition Services);
• Identification of the agency providing CTS (i.e., the FI provider);
• Specification of an effective date that is on or before the date of service for which the FI provider bills CTS for the individual;
• Specification of the frequency for CTS as “One Time Expenditure;” and
• Specification of the duration for CTS as “One Time Expenditure.”

They must buy start up items 90 days prior to moving and 90 days after they move. If items are purchased outside of these time frames they will not be reimbursed.

Participants will need to save all their receipts until the monies allocated for the Transition Stipend have been spent. All receipts will need to be provided to RCIL and once received RCIL will submit your transition stipend in one installment.

Initiating a Housing Subsidy typically begins with the Individual's Care Manager.
However, a Care Manager is not required for an individual to be eligible for an OPWDD Housing Subsidy.

If an individual does not have a Care Manager, the individual can initiate the Housing Subsidy
Application process by working with a Housing Subsidy Provider Agency or the DDRO.
The Care Manager must help the individual to apply for other available benefits and housing
assistance before applying for an OPWDD Housing Subsidy. Once all other benefits and housing
assistance has been exhausted; the Care Manager must complete the OPWDD Housing
Subsidy application packet and other related paperwork.

Care Managers must also find and connect individuals with OPWDD Housing Subsidy Providers
and/or Financial Intermediaries (Fl). The selected Housing Subsidy Provider Agency must work
with the Care Manager to provide any additional information required to finalize the application.
The preliminary application packet must include:

• OPWDD Housing Subsidy and/or Transition Stipend Application (Attachment C);
• Subsidy Calculation Template and Instructions (Attachment D);
• Self-Direction budget, if applicable;
• Life Plan with appropriate Safeguards and Staff Action Plans (if applicable); and
• Other documentation as requested by the DDRO

The Care Manager or Housing Subsidy Provider/Fl must submit the individual's complete
application for an OPWDD Housing Subsidy. Applications must be sent to the DDRO for review
a preliminary approval. The DDRO will review the application and determine whether the
individual is preliminarily approved for an OPWDD Housing Subsidy, and if so, for how much.

****Preliminary approval does not mean you are approved for the housing subsidy.********
If the individual has been given preliminary
approval by the DDRO, they can begin looking for a housing unit that meets OPWDD's allowable
housing criteria.
Housing units must:

• Be a separate legal dwelling unit with a Certificate of Occupancy (COO), or other official approval document, as determined by the applicable jurisdiction, locality, and/or New York State;
• Not be certified or operated by OPWDD or any other state agency;
• Be generally available for any member of the public (including those without intellectual or developmental disabilities) to rent or own;
• Be fully integrated in the broader community and not be institutional in nature and/or isolating the individual from the broader community; and
• Have no more than the lesser of four (4) unrelated adults or the maximum number of unrelated adults allowed by local ordinance living together in the housing unit;
• Meet OPWDD's Housing Subsidy Housing Quality Assurance Expectations

• If the housing unit is located in an apartment (or apartment style) building or
  complex in which five (5) or more OPWDD Housing Subsidy recipients will reside and where such building or complex is developed or controlled by a provider of services, a family member of the individual or group of families, the funding for the Housing Subsidy for the eligible recipients in the apartment building or complex must have received prior approval from OPWDD through OPWDD's Request For Housing Subsidy Support Letters process.

Preliminary approvals are effective for ninety (90) days. If the individual has not found appropriate housing within ninety (90) days, they may ask the DDRO for an extension of the preliminary approval before their ninety (90) day preliminary
approval period ends.
Requests for preliminary approval extensions are allowed at the discretion of the DDRO. If the extension is not approved, or the individual does not ask for an extension, they must re-apply for preliminary approval of the OPWDD Housing Subsidy.

Once an appropriate housing unit has been found, the Care Manager and/or OPWDD Housing Subsidy Provider Agency must submit additional Housing Subsidy paperwork to the DDRO for final approval. Final approval documents must include:

• Any updates to the information provided in the preliminary packet;
• An OPWDD Housing Subsidy Participation Agreement;
• A Lease or deed;
• A passing OPWDD Housing Subsidy Housing Quality Expectations Checklist (completed no later than seven (7) days after the individual moves into the housing unit);
• Additional funding sources if the housing unit does not appear to be affordable to
  the individual, as determined by the DORO based upon available income after a
  person contributes 30% of their countable income; and
• Any other documents requested by the DDRO.

Annual recertifications are due by the 365th day of the last annual recertification.
The following documents must be completed within the last 12 months and are required for OPWDD's annual renewal of the OPWDD Housing Subsidy:

• A Housing Quality Assurance Standards Checklist completed in person within the last twelve (12) months by paid staff of an OPWDD approved provider (e.g. Housing Subsidy Agency staff, Fl staff, Support Brokers, Care Managers, or
• Community Habilitation staff);
• A Participation Agreement completed within the last twelve (12) months;
• A copy of the lease meeting OPWDD's criteria;
• Most recent Life Plan and Safeguards and Staff Action Plans as applicable;
• Review of the individual's budget template, which must include either:
• Evidence that the individual's budget template was reviewed if there were no changes to the budget; or
• A Budget Template completed within the last twelve (12) months and all documents supporting the information in the Budget Template; and
• Other documents requested by the DDRO staff.

Your service documentation needs to be completed no later than the 10th of the month the dates of service to ensure timely processing and billing.

You cannot submit any service documentation that is over 90 days as RCIL is unable to bill for this.

Required Billable Support Brokerage services must be provided to the individual, as needed. Required Billable Support Brokerage services include:

• Assisting the individual in developing and maintaining a Circle of Support/Planning Team and assisting in planning and directing meetings (this includes: assisting the individual in scheduling and facilitating meetings; identifying new members; identifying and assigning roles and tasks for Circle of Support/Planning Team members; assisting with the overall functioning of the Circle of Support/Planning Team; ensuring members are freely chosen by the individual; and the team is operating in the individual’s best interests and within the principles of Self-Determination);
• Meeting with the individual’s Circle of Support/Planning Team, at least twice a year as detailed in the Circle of Support/Planning Team Meetings section below;
• Ensuring completion of and updates to Staff Action Plans for self-hired Community Habilitation and Supported Employment (SEMP) staff for individuals who receive such services;
• Assisting the individual to develop a comprehensive Self-Directed Budget that is consistent with his/her Life Plan; and
• Working with the individual and his/her Circle of Support/Planning Team to ensure that all necessary safeguards are included and addressed in the Life Plan.
  Person centered Support Broker services must be clearly identified and detailed in the Support Broker Agreement. Allowable services may include:
• Assisting the individual with developing a comprehensive Life Plan;
• Providing education, training, and technical assistance to the individual and his/her Circle of Support/Planning Team in implementing the Self-Directed Budget according to applicable federal and state standards;
• Working with the individual, his/her Circle of Support/Planning Team, and the Care Manager to identify and develop initial connections in the community, as identified in the individual’s Life Plan;
• Monitoring Self-Direction expenditures to ensure that spending does not exceed the Self-Directed Budget by assisting the individual and the Circle of Support/Planning Team to review the expenditure report provided by the Fiscal Intermediary (FI);
• Working with the individual and Circle of Support/Planning Team to review and update the Self-Direction Budget, as needed, so that it meets the needs of the individual and remains current and eligible for Medicaid funding;
• Attending the individual’s Life Plan reviews and assisting the individual with reviewing and updating his/her Life Plan as requested;
• Ensuring that at least two face-to-face Circle of Support/Planning Team meetings occur each year;
• Assisting the individual with properly documenting services according to applicable federal and state regulations and policy (including assisting the individual with reviewing and submitting documentation to the FI, such as employee time sheets; monthly summary note; mileage and expense reimbursement forms; and all other required documentation); and
• Assisting the individual with hiring and retaining appropriate support staff (including assisting the individual in recruiting, interviewing, hiring, scheduling, and supervising self-hired staff, and assisting the individual with identifying and retaining adequate back-up staffing to ensure availability as needed)

Support Brokers must have at least two face-to-face PTM/COS meetings with the individual during a one-year period.

This one-year period begins on the date that the Broker signs the Support Broker signature line on the initial Support Broker Agreement between the individual and the Support Broker. The one-year period repeats on the anniversary date of the Support Broker signature.

Community Habilitation:

• Workers can be paid at a maximum of $37.50/hour. Overtime is available at a maximum of $26.13/hour. Please indicate the workers’ name and their weekly hours.
  2:1 Community Habilitation:
• When 2 staff are working with 1 participant at the same time; must be noted in individual's plan. Each worker can be paid at a maximum of $18.75/hour. NO overtime available
  1:2 Community Habilitation
• When 1 staff is working with 2 Participants at the same time; must be included in the individual's plan. Workers can be paid up to a maximum of $18.75/hour per participant, NO overtime available
  Respite: 
• Workers can be paid at a maximum rate of $22.00/hour. Overtime available at applicable minimum wage.

The overall maximum for IDGS is $32,000.00 per year.
The following categories have maximum amounts you can allocate to them:

• Camp - $4,000.00/yr
• Coaching/Education for Parents - $500.00/yr
• Memberships - $1,500.00/yr
• Household Related Items - $1,500.00/yr
• Paid Neighbor - $800/month
• Staffing Support - $20.00/hour
• Transition Stipend - $350.00/course or $800.00/month

The overall maximum for OTPS is $3,000.00

The following categories have maximum amounts you can allocate to them:

• Clothing - $250.00/yr

The overall maximum for FRR is $3,000.00 per year.

In general, landline, internet, clothing, utilities, and board stipend expenses are not reimbursable in OTPS for children under 18 years old where parents are responsible for these costs. Exceptions may be granted by the Developmental Disability Regional Office (DDRO) in cases where justification for a specific need in relation to their disability is established (e.g., the family would not otherwise have internet in the home, but it is necessary to support a technology system utilized by the FI and self-hired staff).

Justification for the good/service must be sent to sdpreapprovals@rcil.com for review and approval.

Excluded items include, but are not limited to:

• Medical visit co-pays
• Any expenses related to hospitalization or nursing home stays (including staff or respite supports or family expenses)
• Any illegal item or activity
• Cable television
• Common household supplies (e.g., paper towels, wipes, soap)
• Treatments that are experimental in nature
• Repairs, like a broken step or railing, as they should be covered under the lease or are the responsibility of the homeowner
• A self-directing person’s activity fees or related supplies for an activity or community class, even if funded through Individual Directed Goods and Services
• Rental cars (this OTPS exclusion does not apply to vehicles leased in the participant’s name)
• Vehicle purchases, payments towards a purchased vehicle
• Legal fees
• OTPS cannot be used to apply against housing costs in excess of housing subsidies. If a person’s rent is in excess of allowable housing subsidies, this will have to be reimbursed with the person’s or the family’s own resources.

Excluded items include, but are not limited to:

• Academic Tutoring
• Automatic pill dispenser/medication system
• Cell Phones/Telephones
• Computer Hardware
• Computer Programs/Software
• Leased and Purchased Vehicles
• Health-Related Services, Equipment and Supplies
• Items and services from a vendor that present a conflict
• Parents’ Activity Fees, Expenses and Meals
• Participants’ Activity Fees, Expenses and Meals
• Personal Monitoring Systems
• Direct Clinician service delivery and Therapies: Physical Therapy, Occupational Therapy, Speech Therapy, Psychology (Medicaid state funded)
• Experimental Therapies.

Self-hired staffing:

• Deducted from budget based on the date of service.

Support Broker:

• Deducted from the budget based on the date of service.

IDGS and OTPS:

• Deducted from the budget based on the date of payment.