About Family Support: What is Flexible Funding?

This is a funding resource made available to families to assist in their caregiving role, which can be used to purchase allowable services and goods.

Individual Flexible Funding Allocations

What is Flexible Funding?

DDS recognizes that having a family member with a disability often means extra expenses. Flexible funding helps families with some of these expenses, based on the individual family’s needs and the funding that is available. This funding is provided to families through our family-support centers and many of our family-support programs, working with DDS Area Offices. Sometimes, flexible funding is given for one-time expenses, and sometimes it is given on an annual basis to address ongoing needs. At times, DDS can cover an expense in full, and other times we can contribute only partially toward an expense.

Below is an overview of how flexible funding is managed.

1. Family discusses their need for Flexible Funding with their Family Support program staff or DDS Service Coordinator. Together, family and staff consider other resources for meeting that need. If a flexible funding request will be made, they will also need to determine if the request is on the allowable list, and how much it will cost.
2. DDS Service Coordinator and Family Support staff discuss the level and urgency of need, and determine if funds are available to support that need, either in full or in part.
3. Family is told if the requested funds are available. If approved, a Flexible Expenditure Plan is completed by the Family Support Center staff and signed by the family.
4. Flexible Funding checks may be made directly to a vendor, or given to family as a reimbursement or before a purchase is made. Receipts for purchases must be provided to your Family Support staff.

Ways That Flexible Funding Can Be Used: Categories of Allowable Spending

The categories below describe many different ways that families can use flexible funding. Please note that we have included a full listing of categories, but only short explanations of what may be included in each category. For complete explanations, contact your DDS service coordinator or family-support center, or download the Family Support Program Manual and Guidelines from the DDS website.

Whenever possible, families should use other sources of funding and support first. Some of these sources are health insurance, schools, and other community resources. This helps us to serve the greatest number of families possible, and allows families to use their flexible funding for other priority needs. DDS service coordinators and family-support staff can help families try to get other funding sources before requesting flexible funding through DDS.

1. Respite Support
   This provides families a break in caregiving responsibilities, either on a regular or occasional basis. Services are generally provided by a caregiver that the family picks, and can be provided in the individual’s home, in the community, or in different out-of-home settings.
2. Recreational & Social Inclusion Activities
   These are social activities or supports that increase an individual’s participation and membership their community. Examples include camps, fees for community recreational activities, specialized supports for someone to participate in a family vacation, etc.
3. Child Care
   Families may choose to use their funding to cover a portion of the cost for services like after-school programs and day- care costs for their child with a disability. Other resources should be used first.
4. Home Management Support Services
   These services help with general household tasks (like housecleaning, snow removal, meal preparation, etc.) when the caregiver needs help so that they can provide for their family member with a disability.
5. Short-Term Emergency Needs
   Short-term assistance may be provided on a one-time basis, which can’t last longer than three months in a fiscal year. Emergencies may include food, rental assistance, clothing, car rental, etc.
6. Specialized Evaluations &Therapeutic Services & Supports
   Before using DDS funds, families must first use other sources of funding (MassHealth/CBHI, private insurance, schools, etc.). Can be used for evidenced-based services, like occupational, physical, speech, and behavioral therapies by licensed professionals, for an individual with disability. Other approved uses include costs for dental or medical care not covered by insurance (including co-payments for medical appointments), and medication. Private health insurance premiums are not allowable, and families can’t use the funds to add to what MassHealth pays for medically necessary services.
7. Adaptive Equipment & Supplies
   Before using DDS funds, families must use other sources of funding (MassHealth, private insurance, schools, etc.). This category includes personal adaptive equipment not covered by insurance for an individual with a disability. Examples include positioning boards, special chairs, water or hospital beds, air conditioners or purifiers, generators, safety equipment, etc. Can be used for computers, tablets and other assistive technology, and personal safety-monitoring devices to benefit an individual with disability. We can give you more information about this.
8. Specialized Nutrition & Clothing
   Families must first use other sources of funding (MassHealth, private insurance, etc.) before using DDS funds. Includes special vitamins, specialized foods, and dietary supplements that are recommended by a health professional or are FDA-approved. The funding can also be used for adaptive clothing or footwear, as well as for replacement clothing due to excessive wear and tear related to the individual’s disability.
9. Specialized Utility Cost
   This includes extra heating or air conditioning costs specifically related to individual’s disability, including extra costs when using generators in emergency situations.
10. Transportation
    Includes gas or mileage and other travel-related expenses when unusual out-of-pocket expenses occur due to hospitalizations and/or medical appointments that are related to the individual’s special health care needs. Note: Mileage reimbursement is paid at the Commonwealth of Massachusetts rate (currently $.45/mile).
11. Personal Growth & Enrichment
    These are services or activities designed to assist individuals in learning and/or improving skills in their home or community, such as using public transportation, preparing meals, taking computer or art classes, taking part in well- ness and fitness groups, etc. May also be put toward the expense of developing a formal person-centered plan.
12. Family Training
    Includes payment of registration costs and fees for family members to attend local trainings and conferences that provide knowledge, skills, and support to more effectively care for their family member with a disability. Does not include lodging and travel.
13. Educations Consultation & Support
    Funding can be used by families to get consultation and support for their child/young adult who is entitled to receive special education services. This may include helping to prepare families for Individual Education Plan (IEP) meetings, as well as attending IEP meeting with families. Funding for this service is limited to $750.00 per year. This funding can’t be used to pay for a lawyer or other legal costs related to educational appeals.

14. Vehicle Modification

    Family-support funding may be used for modifying vehicles. The vehicle being modified must be the primary means of transportation for the individual and be specifically related to how the individual’s disability limits them. This can include money for adapting a new van or vehicle that a family bought or leased. The money can be available at the time of purchase or lease. Examples include van lifts, tie-downs, ramps, and specialized seating equipment. Families can’t use the money to buy or lease a vehicle, or pay for auto insurance or excise taxes.

    There is a prior-approval (PA) process for any vehicle modifications that cost more than $1000. As a part of this process, family-support staff should help the family to look for different funding sources, such as insurance, civic organizations, fundraising, and other general resources before asking to use a family-support allocation for a vehicle modification.

15. Home Modification

    Family-support funding may be used only to contribute toward the cost of family home adaptations. These adaptations must directly benefit the individual with a disability and relate to their health and safety. Family-support funding can be used only for renovations that will support the individual in their primary residence, and must specifically relate to how the individual’s disability limits their functions.

    There is a PA process for any home modifications that cost more than $1000. As a part of this process, family-support staff should help the family to look for other funding sources. These sources include insurance, civic organizations, fundraising, and other general resources. Families should use these resources before asking to use a family-support allocation to modify their home. Family-support staff must also explore using portable modifications to accommodate changes in residence, the person’s size, and changes in equipment and needs.

16. Other Approved Use
    Families may request unique or individualized items or options that would meet their needs but aren’t on the disallowable list.

Ways That Flexible Funding Can’t Be Used: Categories of Disallowable Spending

General

1. Items or activities that have limited benefit to the individual with a disability. An example is a home modification that has no direct impact on limiting the function of the person with a disability; or luxury items.
2. Any purpose that may directly or indirectly jeopardize the integrity of the program—for example, fraudulent use of funds, support for criminal conduct, or any activity that places the individual at physical or medical risk.
3. Any purpose that may overly invade an individual’s privacy or that may violate their human rights.
4. Buying items or services that aren’t allowed by state regulation, including the regulations of the Operational Services Division about lobbying for litigation against the Commonwealth.
5. Providing or buying services that are normally covered by other contracted DDS service codes. These service codes include, but aren’t limited to, residential supports outside of the family home; employment; and day program services. Generally, transportation costs associated with other DDS contracts, like day services and employment, aren’t allowable except in certain circumstances, which you can find in Allowable Category 10 (transportation).

Medical

1. Payment for therapies, treatments, or medications that are not evidence-based, including experimental and/or non- approved FDA (Federal Drug Administration) treatments or medications, unless they’re part of an approved clinical trial.
2. Costs associated with CommonHealth and other private health insurance premiums. Funds also can’t be used to add to MassHealth or private insurance rates for medically necessary services.

Personal Expenses

1. Long-term (more than three months) financial assistance to pay for basic needs, like groceries, rent, mortgage, payment of utility bills, etc.
2. Payment for housing supports, like the principal on a mortgage, the down payment on a residence, or tax or other municipal bills on property.
3. Payments for buying or leasing a vehicle, including insurance costs and related taxes.
4. Share of the cost of family vacation or housing rental.
5. College-credit classes, and related registration, fees, books, meals, and education-based residential housing. Funding can’t be used for out-of-state programs. See DDS Post High School Educational and Training Institutions- Interim Guidance (Fall of 2018).

Legal

1. Paying for a lawyer or legal fees. Examples include fees related to trusts, immigration petitions or appeals (citizenship), educational appeals, and guardianship. Family Support Provider Agencies and DDS staff will help families look for alternative resources if a family asks for help with expenses related to guardianship.

If a family-support provider is unsure about whether a request is an allowable expense, that provider should ask the service coordinator. If there continue to be questions, the service coordinator may confer with the Area Direc-tor/Designee or the Regional Family Support Director.

Flexible Funding: Frequently Asked Questions

1. How can I get flexible funding? 
   Talk with your family-support staff or DDS service coordinator about your family’s needs. They will help you determine if there are other ways to meet your needs, and if flexible funding might be available to help you.
2. How do Area Offices decide who gets flexible funding allocations? 
   When a family needs financial support, DDS service coordinators and family-support staff first try to help them find other funding options and ways to meet their needs. If other options aren’t available, then a flexible funding request is made. All flexible funding is based on many factors, including whether the need can be met through other resources; the availability of funding; the level and urgency of the need, etc. Due to budget constraints, we are not able to provide flexible funding for every family who would benefit from it, although we really wish we could!
3. How can I get my flexible funding? 
   You can get flexible funding in one of three ways: you can have your family- support agency pay a vendor for goods or services for you; you can be reimbursed for expenses for which you have receipts; or you can get a stipend to pay for goods and services (after which you will need to provide receipts to your family-support agency).
4. What are my responsibilities when my family gets flexible funding? 
   If your family gets flexible funding, you’ll need to work with your family-support center staff to plan how to use the funding according to the list of “allowable expenses.” Your family will then sign an expenditure plan. If at a later time you want to change how you use your flexible funding, it’s important to let your family-support staff know so they can update your expenditure plan. Finally, you will have to give receipts to your family-support staff for the items or services you buy with flexible funding.
5. What are my options if I disagree with a decision about my flexible funding (for example, how I spend it, how much my family has received, or whether I got the funding in time? 
   If you have an issue or concern about flexible funding, you should discuss it first with your family-support staff. You can do this by using the agency’s complaint- resolution process, if you choose. If this does not resolve your concern, then contact your DDS service coordinator or their supervisor in the Area Office. After trying these steps, you may talk with the regional family-support director about issues that are unresolved or that need clarification.
6. Can my family receive flexible funding even if we are enrolled in adult/family foster care (AFC) through MassHealth? 
   Flexible funding for families providing AFC in the family home is allowed only for specific purposes that directly benefit the individual. These purposes include an adult education course, travel training, wellness or fitness groups, assistive technology, or adaptive footwear not covered by insurance. Some of the items not allowed include respite, or payment of utility bills. If you get AFC through MassHealth and flexible funding through DDS, talk to your family-support staff or DDS service coordinator about how you can use your funding.