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Office of Mental Health

Home and Community Based Services Waiver
Guidance Document
Division of Children and Families

400.6 Flex Funds

Policy

Flex Funds 

Flex dollars are provided as part of the Individualized Care Coordination (ICC) rate to each agency for each of their allocated slots in the amount of $1,250 per slot. (One twelfth of $1,250 is to be billed using the “HCBS Waiver flex fund” rate code). Total annual flex expenditure cannot exceed this figure multiplied by the total number of approved slots per agency. Flex funds can be used either to meet emergency needs or to meet on-going needs of the child and family. ICC Agencies need to have a dedicated process for monitoring, recording and accounting for flex dollars. Flex funds must be linked in writing to the child's goals and objectives in the methods section of the Service Plan. Expenditures must be documented in the Progress Notes. A Flex Fund Spending Log must be used, and made available during site visit reviews. Here is a sample Flex Fund Spending Log.PDF Document  

Individual consumer dollar proposed expenditures of $250 to $ 499 must be pre-approved by the Agency Waiver Program Manager and the Local Governmental Unit (LGU). Proposed expenditures of $500 to $1,249 must be pre-approved by the Agency Waiver Program Manager, the LGU of that child's county, and the Office of Mental Health (OMH) Regional Field Coordinator. Proposed flex dollar expenditures of $1,250 and above (for a single use or in aggregate for ongoing needs) must be pre-approved by all of the above as well as the OMH Central Office Waiver Program Administrators. The Flex Funds Approval Form PDF Document is to be used and maintained in the child's case record.

The expenditure of flex funds must be closely and continuously monitored in detail by the Waiver Program Manager and Waiver supervisors. Receipts, sales slips, etc. must be maintained by the ICC Agency. Unspent flex dollars must be maintained by the ICC agency and will be collected by OMH. Flex funds may only be used while a child is enrolled in the Home and Community-Based Services (HCBS) waiver. Flex funds may not be used for post discharge services.

A tax exempt form can be used by the ICC Agency when spending flexible service funds; however, this cannot be used if family members, themselves, make the purchases. Flex funds cannot be used to pay for a child/family’s rent under any circumstances or to purchase a car. Flex funds may not be used for capital improvements for the enhancement of the value of home and property unless such enhancements relate to the safety of the Waiver child. Examples of this include but are not limited to: replacing broken windows or doors; repairing (or replacing if indicated) furnaces, plumbing, electric wiring, septic tanks, roofs, etc. Flex funds cannot be used to pay for staff/workers meals, entrance fees, etc. when accompanying a child or family member.

Examples of appropriate use of flex funds include activities that clearly support the child’s goals and objectives such as: clothing, utilities (not on a routine basis throughout Waiver enrollment), crisis and other specialists, medical, dental and optical care and supplies, transportation, and security deposits not covered under Medicaid or readily available and accessible through other means (e.g. social services).  In addition, flex funds can be used to further youth development goals, such as memberships, music lessons, art supplies, summer camps, and other activities to further the youth’s interests or skill sets.  ICCs must make every effort to see if scholarships or other financial assistance is available to the child for any youth development activities before using flex funds.

Emergencies:

Emergency purchases generally meet unanticipated needs. Funding to meet many of these needs may be available through the Department of Social Services or other community agencies; all efforts should be made to utilize these alternate resources first. For emergency uses, the plan must be developed within 10 days of the emergency. It must clearly state the situation precipitating the use of flex dollars, the types and quantities of goods and services to be purchased with estimated costs, and the anticipated duration of the need. Emergency needs are generally understood as lasting less than one week. If the need goes much beyond this, then a plan for meeting on-going needs must be developed.

On-Going Needs:

On-going service needs are more long term than emergency needs. Approval of the use of flexible service funds for on-going needs must be given only after a careful review of the circumstances by the Agency ICC Program Director and, as appropriate, the family and child. Any anticipated ongoing expense that exceeds $1,250 per child must also be pre-approved by the Agency Waiver Program Manager, the LGU of that child's county.

Flex funds provide temporary assistance to the child and family. A plan must be developed for how the family will ultimately manage without flex funds if the need is on-going. This plan must be documented in the service plan.

For additional information regarding rules for using flex funds, go to Spending Plan Guidelines: General Provisions. Scroll to the bottom of the page and click on "Direct Contract". Follow menu prompts - select for Provider: "Complete Guidelines"; for Contract Number: select "all"; for Year: select the current year. In the next drop-down, select "Aid to Localities Fiscal Contracting Guidelines."

Letter to Participating Family:

Each family must be given the OMH approved Family Flex Funds Letter within 30 days of enrollment into the Waiver. The ICC is expected to review the letter with the family and respond to their questions. Please note that if it is an ICC agency's policy to utilize gift cards and/or purchase orders, the sections pertaining to those options may be added to the letter.

Worker Desk Guide:

The Flex Fund Worker Desk Guide is designed to assist Waiver workers in determining appropriateness of requests to use flex dollars as well as a quick review of procedures and required approvals.

Comments or questions about the information on this page can be directed to the Home and Community Based Waiver Program.