PA DHS Office of Developmental Programs. VF/EA FMS Model Supports Coordinator Orientation & Training

Transcription

1 PA DHS Office of Developmental Programs VF/EA FMS Model Supports Coordinator Orientation & Training Vendor Fiscal/Employer Agent Financial Management Services SC/AE Professional Development

2 Agenda Introduction to Public Partnerships, LLC Role and Responsibilities of Public Partnerships Role and Responsibilities of the Common Law Employer (CLE) Enrollment Process for the Participant/CLE/SSP Frequently Asked Questions and Contact Information 2

3 Participant Directed Services Options There are two options for participants who want to self direct their services: Agency with Choice and Vendor Fiscal/Employer Agent. We will be discussing the Vendor Fiscal/Employer model. Characteristics of the Vendor Fiscal/Employer Agent (VF/EA) The participant or their surrogate is the legal employer All of the Individual Supports Plan budget goes towards services Other provider models set the hourly rate for their employees. What the worker is paid will most likely be lower than what a worker is paid in the Vendor Fiscal program. The VF/EA FMS model maximizes the control over services to recruit, hire, train, schedule and manage Support Service Professionals 3

4 PPL Background PCG Public Partnerships (PPL) will act as the Vendor Fiscal/Employer Agent (VF/EA) to assist Participants and their surrogates with the responsibilities of self direction such as enrollment, processing payroll and performing required tax functions. PPL maintains two offices in Pennsylvania Harrisburg Philadelphia PPL Resource Coordinator is available to assist with participant concerns, enrollment and educate Administrative Entities and Supports Coordinators on utilizing PPL s services, its processes, and program rules. PPL Enrollment Specialists, located throughout PA, provide in home and telephone visits to new participants to assist with the initial enrollment paperwork and provide orientation and training to the CLE. 4

5 PPL s Pennsylvania Team Regina Stewart Sr. Program Manager Customer Service primary contact for families PA ODP TEAM Terri Reeser Program Manager Michael Barlett Resource Coordinator 5

6 What s New Enrollment Specialists Time4Care Mobile Timesheet Application FLSA Overtime Rules Difficulty of Care Federal Income Tax Exclusion Provider Directory (coming soon) 6

7 The VF/EA FMS Model The Vendor Fiscal/Employer Agent (VF/EA) Financial Management Services (FMS) model is a self directed service delivery approach. The model is intended to give participants maximum choice and control over how their services are delivered. With increased control comes increased responsibility of the part of the CLE. 7

8 The VF/EA FMS Model A designated Common Law Employer (CLE), may hire a friend, a neighbor, certain family members or other trusted individual to be a qualified Support Service Professional (SSP). Participants, with assistance from their CLE, can manage their authorized services to receive a range of direct care services and goods to meet their needs and the goals of the Individual Supports Plan. Services are identified and authorized based on need the ability to reallocate service funds is dependent on team agreement and ISP approval/service authorization. 8

9 Which services can be used under VF/EA? Direct Services Homemaker/Chore Supports Broker Companion Services Supported Employment Home and Community Habilitation Respite (unlicensed) Vendor Services Transportation Respite Camp Home and Vehicle accessibility adaptations Assistive Technology Specialized Supplies Education Support All waiver Participants should be made aware of their service delivery options under their respective waiver. Both Direct Services and Vendor services are available to be self directed through the VF/EA FMS model. 9

10 Who is involved in the VF/EA model? The following entities/people, when opting for the VF/EA FMS Model, will assist the participant in the VF/EA model: Common Law Employer manages the day to day services and supports Supports Coordinator provides assistance in locating, coordinating and monitoring services and supports The Participant Public Partnerships provides enrollment, payment and other fiscal reporting duties Administrative Entity approves and authorizes needed services and tracks utilization 10

11 PPL s role as the Vendor Fiscal Agent Support the Common Law Employer during the enrollment process Process Common Law Employer and Support Service Professional enrollment forms Complete all criminal background checks for potential Support Service Professionals Verify the Support Service Professional meets all ODP required qualifications Notify the Common Law Employer when he/she and their Support Service Professionals are Good to Go Handle Fiscal Duties on the Common Law Employer s behalf Process timesheets and request for vendor payments Process payroll mail checks/make direct deposit transactions Withhold and file employer taxes Mail W 2 s to Support Service Professionals by January 31 of each year Obtain a Worker s Compensation Policy for the employer Address any employer related questions by taxing authorities 11

12 PPL s role as the Vendor Fiscal Agent Keep the Common Law Employer Informed Provide access to PPL s BetterOnline web portal that has real time access to participant and SSP enrollment information, timesheets, payroll and service utilization. Maintain a website that contains program information, forms, and helpful links Mail monthly spending reports to the Common Law Employer Conduct group or one on one Common Law Employer trainings The ability to issue broadcast announcements through our customer service on hold messages and web portal messages 12

13 Program Enrollment Forms & Materials Our website has up to date program forms, frequently asked questions and other useful links, such as to MyODP.org. Go to > click on Programs > Pennsylvania > ODP Program. Examples include: Program Enrollment Forms CLE Materials SSP Materials New Participant Enrollment Form VF/EA Informational Packet SSP Enrollment Packet Good To Serve Process Flow Designation Form Agreement Form SSP Termination Form Progress Notes Rate Sheet Transportation Log Request for Vendor Payments Participant Voluntary Termination Form SSP Agreement SSP Qualification Form Back Up Designation Form Direct Deposit Enrollment 13

14 PPL s PA ODP Program Website Program Documents 14

15 Key Points to Clarify PPL s Role PPL does not employ SSPs. All SSPs are legal employees of the Common Law Employer. PPL does not set rules and regulations they are determined by DHS/ODP and are implemented by PPL. PPL is NOT a provider in that we do not provide waiver services, we simply serve as a vendor fiscal agent for the Common Law Employer. PPL does not have the same access to HCSIS as the AE/SCO/SC. What we can view is very limited. We cannot advise on issues related to HCSIS such as adding/changing/deleting services. PPL communicates all pertinent information through your ODP Regional Lead/AE. If there is information or reports that you are not receiving, please contact your AE/Regional Lead. 15

16 Role of the Common Law Employer Complete Enrollment Process with PPL Complete all Common Law Employer Enrollment Forms and submit to PPL Develop a job description, recruit, hire and train all Support Service Professionals (SSP) Assist the Support Service Professional in completion of the SSP Enrollment Forms Packet and forward completed SSP rate sheet to SC for approval and submittal to PPL Negotiate wage rates for their qualified SSPs within ODP established wage ranges and in accordance with Federal and State labor laws Determine the SSP s responsibilities to ensure services are provided in accordance with ODP service definitions and as specified in the ISP Develop the SSPs work schedule and back up plan in that is reflected in the current authorized ISP Ensure the SSP does not provide services before being contacted by PPL with a start date Qualify the SSP for the services approved in the ISP 16

17 Role of the Common Law Employer Common Law Employer Duties Review, approve, sign and submit qualified SSP timesheets to the VF/EA FMS organization for processing Use monthly spending reports from PPL to manage service utilizations Contact PPL Customer Service as necessary on issues pertaining to enrollment and payments Actively supervise the SSP and discontinue employment if necessary Ensure Progress Notes are completed CLE should be managing employer duties on their own, using PPL and optionally, a Supports Broker for training and assistance Re qualify the SSP according to ODP requirements (current re qualification occurs every two years) See Common Law Employer Agreement form for complete list of CLE responsibilities 17

18 Support Broker When Supports Broker services are needed and the service is authorized in a participant s ISP the Supports Broker can assist the individual or their designated surrogate with employer related functions in order to be successful in self directing some or all of the individuals needed services. A Supports Broker can provide support to the Common Law Employer in: Completing paperwork Finding and hiring new employees Creating work schedules Providing or arranging SSP training Problem solving, decision making, and achieving desired personal and assessed outcomes related to the individual directed services More... See the ISP Manual for Individuals with an Intellectual Disability Note: Support Broker Services are no longer part of the participant s budget of services in the ISP. The participant can receive this valuable service without reducing their service funding. 18

19 Supports Coordinator role in VF/EA FMS Provide the participant or their surrogates information on participant directed services and assist with decisions related to self direction, including whether to self direct considering the benefits and responsibilities and which FMS option to select Have a basic knowledge/understanding of the Vendor Fiscal model and discuss it as an option at team/isp meeting Assist the participant with transitioning to the VF/EA model, if they chose the model Complete and return the New Participant Information (Referral) form to PPL Provide the Common Law Employer with PA ODP wage range for SSPs. Obtain completed SSP rate sheets from the CLE; review/obtain approval and forward to PPL unless your specific county requires AE to approve rate sheet Use a person centered planning process to develop ISPs for all individuals Correctly enter services and admin fee into HCSIS Advise family of frequency, duration of services and consequences of overtime usage Review progress notes at your in home monitoring. Serve as intermediary between families and PPL for escalated issues 19

20 Administrative Entity role in VF/EA FMS Ensure the Supports Coordinator provides information to all waiver participants on participant directed service options Ensure that individuals and their surrogates have the right to choose, direct, and control the support services in the approved ISP Approve services Review utilization and overtime reports sent by ODP Regional Lead and funnel down to SCO/SC Track, monitor and implement corrective action procedures for noncompliant CLEs Use PPL s BetterOnline web portal to research pended timesheets, enrollment issues, utilization/authorizations, etc. 20

21 Support for AEs and Supports Coordinators Michael Barlett is the primary point of contact for Supports Coordinators and Administrative Entities Respond to SC inquiring regarding enrollment or payment status Our customer service staff are also readily available to answer questions in regard to enrollment or payment status as well as spending plan utilization. We will be offering SC Orientations and Trainings throughout the year and can also coordinate additional trainings and work directly with SCOs and AE offices. PPL will notify the AE when the Participant is Good to Serve 21

22 Enrollment Process Summary SC discusses Participant Directed Service options with the participant during a Team Meeting and Participant selects VF/EA FMS model PPL receives a New Participant Enrollment Form from the SC PPL mails the CLE a Pre filled Enrollment Packet, and 2 blank SSP Enrollment packet CLE completes the CLE Enrollment Packet CLE completes the SSP enrollment packet with the SSP (s) CLE selects rate of pay for SSP, completes SSP Rate Sheet form and sends to their SC CLE returns both packets to PPL NOTE: PPL Enrollment Specialist is available to assist new participant with enrollment paperwork SC/AE reviews and authorizes rates of pay for approved services & sends rate sheet to PPL PPL notifies the employer that he or she, and their SSP(s), are Good to Serve 22

23 New Participant Enrollment Form The New Participant Enrollment Form is available on the PPL Website. The form simply collects baseline information on the Participant and a Common Law Employer or Primary Contact. It is used to prepopulate enrollment packets. 23

24 CLE Enrollment Forms All Employer Tax Forms come pre filled in the Enrollment Forms Packet so the Common Law Employer simply needs to sign and date! Form SS 4 Employer ID Form 2678 PPL as the Agent Form 8821 PPL can talk to the IRS In addition to the three tax forms there are three ODP forms: The Common Law Designation and Agreement Forms as well as the Designation for Back up Coverage form. 24

25 CLE Enrollment Forms The following ODP forms are required (signed and dated): Common Law Employer Designation: The Participant document that establishes another individual as their common law employer. Common Law Employer Agreement: Informs the common law employer of their job functions and duties. The common law employer signs indicating they agree to abide by the terms and conditions described in the agreement. A common law employer takes on additional responsibilities when they choose to use the VF/EA FMS model. Designation for Back up Coverage: The common law employer must submit a back up plan that identifies either a paid or natural support that can provide services in the event the regular SSP cannot. 25

26 Becoming Good to Serve The Good To Serve Status will only be communicated to the common law employer, Supports Coordinator and Administrative Entity when the enrollment process is complete. The common law employer should communicate the Good To Serve status to their Support Service Professionals. Generally, in order for a new Participant to become Good To Service, all common law employer forms are completed and at least one SSP has to have completed the SSP Enrollment Packet. Our Customer Service Representatives are there to support the CLE and answer questions. A complete Enrollment Process Flow procedure is available at: 26

27 Support Service Professional Enrollment The CLE is responsible for recruiting, interviewing, hiring and ensuring all SSP Enrollment Packet forms are completed and submitted. Generally the process to enroll a new SSP takes approximately 2 weeks, however, if an FBI and Child Abuse Clearance check are required it can extend the enrollment process up to 3+ weeks. Form I-9 PA Residency SSP Agreement SSP Qualification Form W-4 Tax Exemption 27

28 Who can be an SSP? Relatives* Friends Neighbors Any Trusted Individuals *Relatives and Legal Guardians may be paid to provide Waiver services when the following conditions are met: The service provided is not a function that the relative or legal guardian would normally provide for the participant without change in the usual relationship among members of a nuclear family; The service would otherwise need to be provided by a qualified provider of services funded under the Waiver. They are not the Common Law Employer They meet the qualifications *The services a relative or legal guardian may provide are: Habilitation, Supported Employment, Transportation Supports Broker Services, and Respite, if they are not the primary caregiver. See the waivers for more details 28

29 Difficulty of Care Federal Income Tax Exclusion Difficulty of Care Federal Income Tax Exclusion: If a SSP lives with the participant full time, the SSP may be eligible for a Difficulty of Care Income Tax Exclusion for the services, they provide. If the SSP lives in the home where they are providing your services, PPL encourages the SSP review important information on our Pennsylvania ODP Program web site at and seek tax advice to determine their eligibility for the exclusion. A Difficulty of Care Income Tax Exclusion Form must be completed and submitted to PPL if an SSP determines they are eligible. This form is also available on our website or can be obtained by calling customer service to have a form mailed. Please remember that PPL is unable to provide tax advice. 29

30 Fair Labor Standards Act (FLSA) FLSA Guidance from ODP: On January 1, 2016, new rules established by the United States Department of Labor s Fair Labor Standards Act (FLSA) relating to overtime eligibility for direct support professionals became effective. The FLSA requires that direct support professionals be paid overtime when they work more than 40 hours per week unless they reside in a home with both the participant and the employer. This is called the Live In Domestic Service Exemption. A Support Service Professional is considered to be a direct support professional. According to the FLSA, a Support Service Professional resides in a home when he or she: Stays at the home 7 days a week, AND has no other home, OR Works and sleeps at the home for at least 5 days (120 hours) per week, OR Works and sleeps at the home for 5 consecutive days regardless of the number of hours worked per week. Compliance with the Live In Domestic Service Exemption is mandatory for Support Service Professionals who meet the requirements for the exemption 30

31 Fair Labor Standards Act (FLSA) - continued What this means is that, when a Support Service Professional, Common Law Employer, and a participant all reside in the same place, the Support Service Professional cannot be paid overtime even if he or she works more than 40 hours per week. Common Law Employers must complete a form and submit it to PPL if the employee qualifies for the live in exemption from overtime pay. This form may also be used to revoke the exemption when the employee no longer qualifies for the exemption (e.g. because the living situation of the SSP has changed). For additional information, please visit the PPL s Program Website at 31

32 Criminal Background Checks Public Partnerships will complete, and make payment for, all required Criminal Background Checks per the following guidelines: State Criminal Background Check: Required on all potential SSPs. This is an online registry check that usually returns results within 24hrs. The authorization to complete this check is included in the SSP Enrollment Packet. Child Abuse Clearances Check: Required when the SSP will provide services to a Participant under the age of 18. The authorization to complete this check is included in the SSP Enrollment Packet. Federal Bureau of Investigation: Required when the SSP: Has not lived in Pennsylvania for the last two consecutive years. Will provide services to a Participant under the age of eighteen. 32

33 SSP Rate Sheet ODP sets an hourly wage range that Common Law Employers may pay their SSPs for each service code. The range varies by geographic region. The agreed upon hourly rate must fall within the wage range for the area in which the Administrative Entity for the participant is located. The SSP Rate Sheet must be completed and then faxed or mailed by the Common Law Employer to the Supports Coordinator (or A/E) who will validate the pay rate and procedure codes. See the VF/EA Wage Range Packet for more detail Upon approval the Support Coordinator, or AE, will fax (or ) the approved Rate Sheet to Public Partnerships:

34 VF/EA Calculation Tool ODP has developed a calculation tool to assist in determining the amount that needs to be entered on the budget screen. The tool can be found: PPL PA ODP Program website at OR MyODP.org 34

35 Voluntary Termination from VF/EA A participant may voluntarily discontinue services under the VF/EA FMS model at any time. A Voluntary Participant Termination Form must be completed by the participant and Supports Coordinator when the participant has expressed their decision to discontinue participant direction under the VF/EA FMS model. The AE and SC should retain a copy of the form. The SC must provide a copy of the form to the participant/surrogate and CLE (when applicable). The AE must provide a copy of the form to the VF/EA FMS organization to notify the VF/EA FMS of the date that the authorizations for all participant directed services under the VF/EA FMS model have/will be end dated in the ISP. 35

36 Updating the Individual Service Plan Once notified that the individual has enrolled, the SC will need to update the ISP. This will be completed by: Attaching Public Partnership, LLC as the State Vendor Fiscal FMS. Calculating the amount of units and dollars by service code to be attached to PPL. The VF/EA Calculation Tool is available to assist in the calculation Submitting the ISP to the AE for review, approval and authorization. It is important to note that all services added ISP should have the following MPI for PPL: PPL MPI: Please do not use PPL MPI:

37 VF/EA Start-up Service and Admin Service A one time start up service is to be attached for each participant for required activities related to the participant s enrollment with Public Partnerships. The start up service is attached to the ISP for each participant in the first month that PPL is authorized to provide VF/EA FMS. The startup service is an administrative service, is placed on the plan the same way as the monthly administrative fee and does not count toward the total plan budget amount. 37

38 PPL Tools PPL BetterOnline web portal Time4Care Mobile Timesheet Application Reports Customer Service Website resources CLE Orientation & Skills Training Handbook Program Management Staff, specifically, Resource Coordinator and Enrollment Specialists 38

39 PPL BetterOnline web portal Provides real-time access to participant information Information available on the portal Participant/CLE demographic information Associated Support Service Professionals and current/max pay rate Access to enrollment status and items needed for good to go Good to Go status for participant and SSP View Timesheets and message causing timesheet to pend Participant budget and utilization reports 39

40 Time4Care Mobile Timesheet Application Time4Care Mobile Timesheet Application PCG Public Partnerships new Time4Care mobile application will provide SSPs the flexibility and convenience of using a cell phone to enter and submit timesheets for CLE approval. It is now available for download on Apple, Android and Windows phones. Using the app is extremely simple. SSPs just download and log in using their current BetterOnline Web portal username and password. Any time claimed using the mobile app will also be visible in PPL s BetterOnline Web 40

41 PPL Customer Service Provide toll-free customer service via phone, fax and Provide translation and interpreter service Provide assistance in completing CLE and SSP paperwork Notify CLE of missing or incorrect paperwork Notify CLE of issues that may be pending payroll to SSPs Respond to participant calls within 1 business day 41

42 PPL Customer Service PPL Customer Service Staff will: Reflect principles of self-determination Demonstrate cultural sensitivity Customer Service Call Handling Features: Interactive Voice Response (IVR) Call Recording, a service feature announced when calling into Customer Service that records many calls for monitoring and training purposes. Blaze Calls to CLEs IMPORTANT: Only PPL, CLE, Designated Representative, AE, SC, and Supervisor will be able to speak with PPL Customer Service staff about a participant s services. 42

43 Frequently Asked Questions What are the Employer Tax Rates for ODP in 2017? Social Security: 6.2% Medicare: 1.45% Federal Unemployment: 0.6% State Unemployment Rate (New Employer Rate): %* Workers Compensation: 2.8% Total Employer Tax Rate: 14.73% * Each year the State Unemployment Rate is reviewed and may change. 43

44 Frequently Asked Questions Q: Can SSPs work overtime? A: While there is a legal requirement to pay all time worked including time and a half for hours for 40, no Support Service Professional should work more than 40 hours per week. The 40 hours per week limit includes ALL services (Companion, Hab, Respite, Supported Employment, etc). Any participant receiving more than 40 hours of services per week will need to hire multiple SSPs. Any participant approved for more than 40 hours per week of services will need to hire multiple SSPs to cover all hours. Q: What is a work week? A: A work week is the hours or days of work in a calendar week. The work week for ODP runs from 12:00AM Sunday 11:59PM Saturday. 44

45 Contact Information PPL Customer Service: (for CLE, SSP, SC) Hours: 8:30 am 8:00 pm (Monday Friday) 9:00 am 1:00 pm (Saturday) Closed: Federal Holidays Administrative Fax (Referral Forms): Terri Reeser: (SC or AE contact only) Michael Barlett: (SC or AE contact only) PPL Web Site: You can access program information, program forms, wage range bulletin and helpful links. Go to: Select: Program>Pennsylvania>ODP>Program Documents tab 45

46 Questions / Comments Please send questions to: padpw_odp@pcgus.com. Questions will be used to compile a FAQ document 46

47