Consumer Directed Community Supports (CDCS)

Consumer Directed Community Supports (CDCS)

Consumer directed community supports (CDCS) is a unique service option under the home and community-based waivers that gives persons more flexibility and responsibility for directing their services and supports, including hiring and managing direct care staff. CDCS may include services, support and/or items currently available through the Medical Assistance waivers, as well as additional allowable services that provide needed support to persons.

All persons using CDCS must have a Fiscal Support Entity (FSE) like Orion ISO and choose one of three service models depending on the level of control and responsibilities one wants to assume. Under all models, the FSE is the responsible for billing Medical Assistance on the Consumer’s behalf, verifying documentation of allowable expenses and providing spending reports to the Consumer, the County and the Department of Human Services.

Under all models, the Consumer (or Consumer’s Representative) assumes the role of the Managing Employer.

See details below.

Fiscal Conduit

The Consumer is the sole Employer and responsible for all aspects of managing this household business. Consumer handles all payroll responsibilities, including paying employees directly, withholding and depositing of taxes and obtaining worker’s compensation insurance for applicable employees. Payroll and other reimbursable expenses are submitted to Orion ISO for reimbursement after services are rendered.
*This model is often chosen by people who own an existing business and can integrate the payroll responsibilities into that structure.
*This model is also used for people who do not utilize any staffing services, and only purchase non payroll related goods and services.
Consumer = Common Law Employer and Managing Employer
Orion ISO = Fiscal Conduit

Payroll Agent

The Consumer is the Employer but purchases payroll services from Orion ISO. As the Payroll Agent, Orion ISO handles all payroll responsibilities including employee paychecks, tax withholding and employment taxes. Orion ISO can facilitate purchase of Worker’s Compensation insurance for applicable employees. Orion ISO will handle set up process for establishing Consumer as the Common Law Employer.
*This model is often chosen by Consumer’s or representatives hiring family members as there are substantial tax savings for certain family employees. (See “Family Employees Sheet” for more details)
Consumer = Common Law Employer and Managing Employer
Orion ISO = Payroll Agent

Agency with Choice

Under this model, the Consumer is the Managing Employer, while Orion ISO is the Common Law Employer. This is a dual employment arrangement which allows you to choose and manage your staff but Orion ISO has final discretion over hiring decisions and sole authority to terminate staff. Orion ISO handles all payroll responsibilities, including employee paychecks, tax withholding, employment taxes and providing workers compensation for all employees. Orion ISO provides you with administrative support and tools to manage your employees.
*This model is often chosen by people who want more support and involvement from the FSE and/or are not hiring family members that are eligible for tax savings.
Consumer = Managing Employer
Orion ISO = Common Law Employer