One Cabot rd. STE 102 Medford, MA 02155 Fax (877) 563‐6438 ... · One Cabot rd. STE 102 Medford, MA 02155 Phone (888) 866‐0869 Fax (877) 563‐6438 4 To begin with, a participant

One Cabot rd. STE 102Medford, MA 02155Phone (888) 866‐0869 Fax (877) 563‐6438

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Frequently Asked Questions MA Participant Directed Program

Topics in the Frequently Asked Questions I. General Participant Directed Program Information…………………………………………pg 3

a. What is Public Partnerships, LLC?b. How does PPL work with DDS?c. What is the purpose of the Participant Directed Program?d. What is the difference between the Participant Directed Program through PPL and the ISO

program through PPL?e. How do I know if the Participant Directed Program is the right fit for me?

II. Enrollment into the Participant Directed Program …………………………………………pg 4a. How does a participant get started with the Participant Directed Program?b. How do service providers get paid?c. When are payments sent out?d. Can participants use a Non‐DDS Agency to provide services?e. How do participants, families, providers and or DDS staff get the appropriate paperwork?

III. Providers…………………………….…………………………………………………………………………pg 6a. How do providers get started working with a participant in this program?b. How is it determined if Individual staff should be an independent contractor or a payroll

employee?c. Is there a resource participants, and or families and others can use to find providers for the

Participant Directed Program?d. How will PPL know who to set up as the Employer of Record if the participant decides to hire

employees?e. How much can providers be paid for services?f. Can Shared Living providers be paid through the Participant Directed Program?

IV. Provider Paperwork…………………………………………………………………………………………pg 8a. Do providers have to complete paperwork too?b. What is type of paperwork is in the employment packets?c. Which provider packet do providers fill out?d. Who is responsible for sending the provider packet to a new provider?e. Does a provider need to complete a new provider packet for each participant that he or she

works with?f. What are the Terms and Conditions of Employment?g. When does someone use Marion Edwards Associates (MEA?)h. What taxes are withheld for each employee?i. Who is responsible for paying Employment taxes for individual employees? How are Employer

taxes calculated?j. Can family members be hired as providers

V. CORI………………………………………………………………………………………………………………pg 11

One Cabot rd. STE 102Medford, MA 02155Phone (888) 866‐0869 Fax (877) 563‐6438

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a. Has worker been CORI approved?b. How long will it take for worker to be CORI approved?c. We need a worker to start sooner, can you make an exception/ prioritize our request?d. Can worker start working before CORI is approved?e. Worker was CORI approved through another agency, can they begin working?

VI. Grandfathering In Existing ISO Providers into PDP………………………………………..pg 12a. What does it mean that ISO Providers are ‘grandfathered in’ to the new PDP program?b. Does a provider who worked in the ISO program have to do a CORI for the new PDP program?

VII. Services…………………………………………………………………………………………………………pg 13a. What services are available in the Participant Directed Program?b. Will a participant be required to pay for services out of pocket?c. If a participant is using employee services and will be set up as the Employer of Record, is

Worker’s Compensation required?d. How much does a Worker’s Compensation insurance policy cost?

VIII. Payments and Budgeting………………………………………………………………………….……pg 14a. How do I, as a participant, provider, or DDS staff , know if a timesheet was received or a check

went out?b. How can either a participant or provider purchase other things like goods/items, memberships,

etc.?c. Can reoccurring payments, such as rent, be paid for in the PDP program? How can this be

done?d. How can a participant keep track of his or her spending?

Frequently Asked Questions

One Cabot rd. STE 102Medford, MA 02155 Phone (888) 866‐0869 Fax (877) 563‐6438

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I. General Participant Directed Program Information

a. What is Public Partnerships, LLC?

Public Partnerships, LLC (PPL) is a national organization dedicated to assisting state, county, and local public agencies implement a participant‐directed service model. We are currently in 17 states, serving more than 25,000 participants with a wide range of disabilities.

b. How does PPL work with DDS?

PPL and DDS work together to ensure that you receive the services you are authorized for. DDS provides PPL with information about which services you are authorized for through this program and PPL provides the financial management. PPL provides fiscal accountability by ensuring payments are consistent with what DDS has authorized and abides by state and federal requirements.

c. What is the purpose of the Participant Directed Program?

The Participant‐Directed Program is a statewide program, open to adults who receive services from DDS. Individuals who are enrolled in the Participant Directed Program can decide what suits their particular assessed needs. You may want to utilize this program to do many different things, or you may only want a few things. Through the Participant Directed Program, PPL is used as a tool to help individuals directly select and arrange for supports and services with community providers.

d. What is the difference between the Participant Directed Program through PPL andthe ISO program through PPL?

The ISO program through PPL was for adults who elected to self‐direct their services at a time when DDS participated in a single waiver program. On July 1, 2010, DDS will have the ability to enroll eligible adults into one of three new Waiver Programs. Now, all adults who would like to self‐direct their services will go through the new, Participant Directed Program through PPL.

e. How do I know if the Participant Directed Program is the right fit for me?

Meet with your DDS service coordinator and/or other DDS Area Office staff to talk about your individual needs and goals and determine whether this is the correct program for you.

II. Enrollment into the Participant Directed Program

a. How does a participant get started with the Participant Directed Program?


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To begin with, a participant should meet with his or her DDS service coordinator and/or other DDS Area Office staff to determine whether this is the correct program to meet his or her services and needs. As the Participant Directed Program is a statewide program, if a service coordinator is unfamiliar with the Participant Direction Program, we recommend finding out with whom to speak with in the Area to get more information.

DDS will assess all individuals to determine their needs for services. Based on this assessment, DDS will provide participants with the comprehensive list of service categories that are currently available through the Participant Directed Program. A participant’s Support Broker will work with him or her to develop a budget to cover needed services.

The participant’s name, information, and funding allocation will be provided to PPL by the DDS system (Meditech) which handles program enrollment. All enrollment information, including demographics and services, will be sent directly into PPL’s Web Portal by DDS.

The next step is to choose who will be providing your services and supports. Participants and/or their families can begin by interviewing individuals or agencies. If a participant decides to select an individual to provide services, it is required that the potential provider completes the CORI process and are approved before they can begin. This is to protect participants and to assure that the person who will be working with them can safely meet their needs.

All new providers are required to self‐register for the PPL Portal and identify the services they wish to provide. Please see the Self‐Registration Process for more details. The provider will fill out a Criminal Background Check Form (CORI) as the final part of the self registration process. Once PPL receives the results of the CORI, the provider, if approved, will receive e‐mail notification that they are able to begin work. Support Brokers will also have the ability to monitor the provider’s status on the PPL Web Portal.

Once individual providers and or agency provider have been identified, they must complete a PPL Provider Packet. A completed Provider Packet must be submitted to PPL prior to any paychecks being issued.

b. How do service providers get paid?

Providers will fill out a PPL timesheet with the dates and hours worked. There are several options available for submitting timesheets:

A. An individual provider may fill out a paper timesheet and have the participant sign and approve it. This can be returned to PPL either by mail (6 Admirals Way Chelsea, MA 02150) or fax (877‐779‐4188).


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B. The participant and the provider can submit and approve time online using the PPL Web Portal. This option will provide users with real‐time feedback if the timesheet can be processed.

C. Providers may submit time online through the PPL Web Portal, print out the timesheet, and have the participant sign and approve the paper copy. Users will still receive the same real time feedback on whether or not the timesheet can be processed.

Please note: All Agencies must submit their timesheets online through the PPL Web Portal.

A comprehensive user manual on E‐Timesheets is available atwww.publicpartnerships.comΦ

A provider may sign up for direct deposit. In order to do so, he/she must complete and send in the EFT application and a copy of a voided check or a letter that provides PPL with their account number and routing number.

c. When are payments sent out?

PPL produces checks on a bi‐weekly check run basis. The check run is from Sunday to Saturday, with all timesheets and requests submitted by noon on the Monday prior to the check run. A copy of our check run schedule can be found at our website, www.publicpartnerships.com.

d. Can participants use a Non‐DDS Agency to provide services?

Yes, participants can use a non‐DDS agency to provide services. All new providers to the PDP program must self register, and be qualified through the PPL Web Portal and identify the services for which they wish to be credentialed. The participant will need to negotiate a rate for each service provided and supply that information to the DDS Participant Directed Program.

e. How do participants, families, providers and or DDS staff get the appropriate paperwork?

Users can access all necessary forms on PPL’s website, www.publicpartnerships.com. Select “Massachusetts Participant Directed Program” from the drop down menu.- Select 'Program Documents' under the 'Resources' section to access all required forms. If you do not have access to a computer, we can fax or mail copies of necessary forms. You can call PPL Customer Service at (888) 866‐0869 to request copies of forms.

III. Providersa. How do providers get started working with a participant in this program?


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All new providers, whether individual or agency, are required to self‐register for the PPL Portal and identify the services they wish to provide. Please see the Self‐Registration Process for more details. If the provider is an individual, he or she will fill out a Criminal Background Check Form (CORI) as the final part of the self registration process.

If the provider is an agency, the CORI is conducted by the agency.

Once the credentialing process has been completed, the provider must complete the relevant employment packet (either independent contractor, agency, or employee). The completion of the employment packet provides crucial information to PPL such as:

Tax Status Services Provided Employment agreement specific between each participant and provider Negotiated pay rate(s)

After PPL has received the completed employment packet, providers can begin billing for services rendered. Note! If providers do not submit the necessary packet, payment cannot be issued.

b. How is it determined if Individual staff should be an independent contractor or a payrollemployee?

An Independent Contractor must exercise independent judgment, define assignments, and set priorities and schedules. The IRS states, “A general rule is that you, the payer, have the right to control or direct only the result of the work done by an independent contractor, and not the means and methods of accomplishing the result.”

In the Participant Directed Program, individuals providing services are set up as either employees (payroll employees) or independent contractors based on the service he or she is providing, the provider’s employment status has already been determined based on the nature of the service being delivered. Use the ‘Provider Paperwork Matrix’ as a guide to help determine if a provider will be and independent contractor or employee.

Individuals providing Professional Services and Supports will always be independent contractors. Since taxes will not be withheld from these providers’ paychecks, PPL will issue a 1099 year end statement to all Independent Contractors indicating the amount of income paid out by PPL in a given calendar year.

Note: Neither Employer of Record paperwork nor a Federal Tax Identification Number will need to be established if only independent contractors will be hired.

c. Is there a resource participants, and or families and others can use to find providers forthe Participant Directed Program?

Public Partnerships has created a Provider Directory exclusively for the Participant Directed Program. This is a common list of all providers who have elected to appear on


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our Provider Directory, and are willing to provide services to participants enrolled in the Participant Directed program. The Provider Directory allows for users to search for a range of service providers who work around the Commonwealth of Massachusetts.

The Provider Directory can be accessed directly on the PDP Web Portal at:

https://fms.publicpartnerships.com/pplportal/MAPDP

d. How will PPL know who to set up as the Employer of Record if the participant decides tohire employees?

Support Brokers will enter Employer of Record demographic information into the participant profile on the PPL Web Portal. Once this information has been populated, Support Brokers will print all of the necessary Employer of Record forms with pre‐populated information directly from the Web Portal and send or bring them to the participant to sign. The original forms must be returned to PPL at 6 Admirals Way Chelsea, MA 02150. These cannot be returned via fax or e‐mail because we need to have the original signature on file.

e. How much can providers be paid for services?

The Participant Direct Program allows participants to determine negotiated rates for services rendered. This allows for participants to flexibly determine how much to pay providers for hourly, daily, or monthly services. Note! There are ‘rate ceilings’, meaning negotiated rates cannot exceed a certain dollar amount. Please contact the DDS Waiver Management Unit for more information regarding these rate ceilings.

IV. Provider Paperwork

a. Do providers have to complete paperwork too?

Yes, providers will have to complete a provider packet. PPL will not be able to issue payments to providers until we receive the completed paperwork. There is more than one type of provider packet and each provider must each fill out the appropriate packet, depending on the type of service that they will provide. Please refer to the Individual Provider Paperwork Matrix (available at www.publicpartnerships.com), which contains a listing of the required paperwork by service code/ service type.

Providers, participants, representatives and DDS staff may download provider packets at any time. Upon request, PPL will mail a provider packet directly to a new provider. Please specify which provider packet should be mailed.

b. What type of paperwork is in the employment packets?


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All three provider employment packets (independent contractor, employee, and agency) each require the following documents:

Employment Agreement Part A Employment/Service Agreement Part B Provider Information Form Direct Deposit Form (Optional)

The tax paperwork for each packet is slightly different. For independent contractors and agencies, only a W‐9 form is required to verify the tax identification number (TIN). The employee tax forms are slightly more complex to verify an employee’s individual filing status. These forms include:

1‐9 Employment Verification (ensures an employee is eligible to work in the United States)

W‐4 (states an individual’s Federal tax filing status) M‐4 (states an individual’s state tax filing status)

c. Which provider packet do providers fill out?

This depends on the type of service that a provider is providing. Please refer to the Individual Provider Paperwork Matrix available at www.publicpartnerships.com which contains a listing of the required paperwork by service code/ service type.

d. Who is responsible for sending the provider packet to a new provider?

Providers, participants, representatives and DDS staff may download provider packets at any time. Upon request, PPL will mail a provider packet directly to a new provider. Please specify which provider packet should be mailed.

e. Does a provider need to complete a new provider packet for each participant that he orshe works with?

Yes, providers need to complete a separate provider packet for each participant that he or she works with. PPL associates providers to participants in the Web Portal based on the receipt of a signed Employment Agreement A & B between the provider and the consumer and related tax paperwork.

f. What are the Terms and Conditions of Employment?

Any provider (individual or agency) providing services in the Participant Directed Program must complete an Employment Agreement (Parts A and B) and submit them to PPL.

These documents need to be signed and dated by the provider and responsible party before PPL can issue a paycheck for services rendered. These Agreements will establish


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a hire date, wage rate, for each service being provided, as well as provide important information to the provider about employment policies and rules. The Terms and Conditions Agreement is included the all provider packets.

g. When does someone use Marion Edwards Associates (MEA?)

If a participant is going to hire an employee directly rather than through a provider agency, different tax laws apply and the participant must decide to be set up as the Employer of Record or designate a responsible party as the Employer of Record. However, if no person can act as Employer of Record, then the participant can hire employees through Marion Edward Associates.

If a participant cannot be set up as the Employer of Record (for instance, if you are receiving PCA services) then Marion Edwards Associated (MEA) can be set up as the employer agent for the participant’s employees. We recommend this option only if a participant cannot be set up as the Employer of Record and there is no one else (family member, legal guardian, etc.) that could set up as the Employer of Record.

MEA is a temporary staffing agency. PPL has contracted with MEA as an alternative option for individuals who are already set up as Employers of Record receiving PCA services and the option of setting up a family member or guardian as an EOR does not exist. This allows these individuals to self direct services and to hire employees, while still receiving PCA services.

MEA will pay all Employer taxes, hold a Worker’s Compensation policy, and charge an administrative fee. The employer taxes and the Worker’s Compensation policy are the same as if you were set up as an Employer of Record.

Timesheets will be faxed directly to MEA at 617‐426‐4632, who will produce and send checks directly to your staff. MEA will withhold Social Security, Medicaid (FICA), and state and federal income taxes from each employee’s paycheck. A summary of all employee tax withholdings will appear on their paycheck stub. Furthermore, MEA will also prepare and mail a W‐2 Wage Statement to each employee in January.

h. Which packet do employees paid through MEA have to fill out?

Employees paid through MEA must complete the ‘MEA employment packet’ and submit it directly to MEA. All employees, including those paid through MEA must complete the self registration and credentialing process.

i. What Taxes are withheld for each employee?

All payroll employees must pay taxes. Social Security, Medicaid (FICA), and state and federal income taxes are withheld from each employee’s paycheck. PPL will prepare and mail a W‐2 Wage Statement to each employee in January.


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For participants, PPL will act as the Agent of the Employer of Record and will insure that Social Security, Medicaid (FICA), and all state and federal income taxes are withheld from each employee’s pay check.

Please note, individuals paid as Independent Contractors will not have taxes withheld from their paychecks. Furthermore, PPL will issue 1099’s to these workers at the end of the calendar year.

j. Who is responsible for paying Employment taxes for individual employees? How areEmployer taxes calculated?

Employment taxes come out of the participant budget. But NOTE! PPL will calculate the Employment taxes for individual employees and issue the payments on behalf of participants. To help with budgeting for taxes to be paid, Support Brokers and Service Coordinator can utilize the DDS Excel Budgeting Tool that calculates the Employer taxes based on the amount participants wish to pay all of their employees.

Support Brokers and or Service Coordinators can enter the wage a participant wishes to pay staff and the total number of hours for the year into the DDS Excel Budgeting Tool which will do the math.

k. Can family members be hired?

Participants may not hire their spouse, or their legal guardian for any services. Parents and other family members may be hired.

V. CORI (Criminal History Background Check)

a. Has worker been CORI approved?Support Brokers can view the status of a provider’s CORI by searching for the provider on the PPL Web Portal. The Web Portal will communicate if the CORI is approved and the date they were approved, or if it is in process and the date it was submitted to the Criminal History Board.

The provider will receive an email from PPL once they are approved, notifying them they are now eligible to begin providing services in this program.

b. How long will it take for worker to be CORI approved?

It takes between оπп ōǳƛǎƴŜǎǎ Řŀȅǎ for PPL to receivŜ CORI results. UnfortunatelȅΣ PPL has no control over how long it takes to receive the results.

c. We need a worker to start sooner, can you make an exception/ prioritize our request?Unfortunately, this is not possible. PPL submits all CORI requests to the Criminal History Systems Board and we must wait until we receive the results from them. The provider will receive email notification as soon as they are approved.


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d. Can worker start working before CORI is approved?

Employees cannot begin work prior to CORI approval, and PPL will not issue payments for time submitted prior to CORI approval. This rule is in place to protect you and your family from hiring someone who may not meet the state standards to provide services available in this program.

e. Worker was CORI approved through another agency, can they begin working?

PPL cannot accept CORIs that were conducted by outside sources or third parties. In order for the provider to begin work, the CORI must be conducted through PPL. Workers provided through an Agency will have had a CORI review through their agency and not PPL.

VI. Grandfathering In Existing ISO Providers into PDP

a. What does it mean that ISO Providers are ‘grandfathered in’ to the new PDP program?

Existing ISO Providers will be ‘grandfathered in’ to the PDP program. To be ‘grandfathered’ allows existing ISO providers to enroll in the PDP program without undergoing the new PDP credentialing process. PPL will apply existing CORI information for grandfathered providers. Grandfathered providers who wish to provide services to additional individuals or to provide new services will, however, be required to go through the PDP credentialing process before being permitted to provide those new services or to serve new individuals.

b. Does a provider who worked in the ISO program have to do a CORI for the new PDPprogram?

No, if a provider was already working in the ISO, he or she will be ‘grandfathered’ to the new PDP program and does not need to do a CORI again.

VII. Services

a. What services are available in the Participant Directed Program?

The Participant Directed Program provides the self‐directed services which are offeredthrough three different HCBS Waivers, each having different services available. The threewaivers are the Adult Supports Waiver, Community Living Waiver and Residential SupportsWaiver. Please refer to the Service Overview Matrix posted on publicpartnerhips.com for acomplete list of all services available to program participants. Also contact DDS for fulldescriptions of available services within each Waiver Program.


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b. If a participant is using employee services and will be set up as the Employer of Record, is

Worker’s Compensation required?

Yes, in compliance with the Commonwealth of Massachusetts Department of Workforce Development, a Worker’s Compensation insurance policy is required for any Employer in the Commonwealth. A Worker’s Compensation policy will be obtained and maintained by PPL and the designated insurance agency, however, the cost of the policy will come directly out of the participant’s budget.

c. How much does a Worker’s Compensation insurance policy cost?

The cost of a Worker’s Compensation policy will vary depending on the total payroll an employer plans to pay across the entire fiscal year. To help budget and determine an exact dollar estimate for the cost of a Worker’s Compensation insurance policy, support brokers should refer to the DDS Excel budgeting tool which can calculate the policy cost based on the total payroll input into the worksheet.

VIII. Payments and Budgeting

a. How do I, as a participant, provider, or DDS staff, know if a timesheet was received or acheck went out?

Program participants and DDS staff involved in the PDP program can register to have accessto the PPL Web Portal. Participants will be able to view their current budget, details of whatwas paid, to whom and on what date. DDS staff will be able to view participants’ budgets,and details on what was paid, to whom and on what date, in their case loads. You can alsocall PPL Customer Service directly at (888) 866‐0869.

b. How can either a participant or provider purchase other things like goods/items,memberships, etc.?

Request for payment of items and goods and request for reimbursement will only be paidon PPL invoices. All invoices must include the vendor’s name, address where the item will beshipped, and a receipt or price quote as backup documentation that supports the requestfrom the vendor. Additionally, a W‐9 form is required of all vendors except for commonlyknown national vendors. We will not be able to process the request without the vendor’sTax Identification number.

c. Can reoccurring payments, such as for a monthly transportation pass, be paid for in thePDP program? How can this be done?

Yes, the Participant Directed Program allows for certain services to be paid on a reoccurring monthly basis, without any timesheets or invoices. Automatic reoccurring payments can be set up directly through the Web Portal. The participant will need to work with his or her support broker to determine services which should be paid on a reoccurring basis. The support broker will then authorize the payment directly in PPL’s


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Web Portal. The support broker will need to identify the service, participant, the provider, rate, number of units and recurrent time (monthly). Please Note: only those services listed with ‘Auto’ in the service name can be paid out on this reoccurring schedule. The Support Broker will authorize the ‘Auto’ service code directly in the PPL Web Portal.

d. How can a participant keep track of his or her spending?

PPL will send monthly reports to each participant for any month in which there is spendingactivity. Users may elect to view this report electronically through the PPL Web Portal or inhard copy. The electronic reports provide users with accurate, real‐time data.

The following information is included in the Family Friendly Spending Report:

What is documented as the budget for the year; What has been spent so far (by service); and What funding is available.

e. Who can be contacted for questions, concerns or comments?

Contact Public Partnerships, LLC (PPL) Customer Service at (888) 866‐0869.