PA DHS Office of Developmental Programs VF/EA FMS Model ... · of the presentation. Please keep your phone on mute during the presentation to minimize any background noise. Any questions

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

www.publicpartnerships.com | Example PCG Public Partnerships Presentation 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/SSW

Frequently Asked Questions and Contact Information

Questions

Attendees have not been muted and will be able to ask questions after each of the agenda segments and at the end of the presentation. Please keep your phone on mute during the presentation to minimize any background noise. Any questions not answered during the webinar, will be answered using a FAQ document to be distributed following the training session.

PPL will be recording this training session to make it available for future reference and viewing.

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Participant Directed Services Options


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• The VF/EA FMS model maximizes the control over services to recruit, hire, train, schedule and manage Support Service Workers

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.

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.

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PPL’s Pennsylvania Team

PA ODP TEAM

Regina Stewart

Sr. Program Manager

Terri Reeser Asst.

Program Manager

Michael Barlett Resource

Coordinator

Customer Service –primary

contact for families

What’s New

• Enrollment Specialists• Time4Care™ Mobile Timesheet Application• FLSA Overtime Rules• Difficulty of Care Federal Income Tax Exclusion• Provider Directory (coming soon)


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.

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 Worker (SSW).

• 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 re‐allocate service funds is dependent on team agreement and ISP approval/service authorization.

Which services can be used under VF/EA?


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.

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

Who is involved in the VF/EA model?


The Participant

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

Public Partnerships ‐provides enrollment, payment and other fiscal reporting duties

Supports Coordinator –provides assistance in locating, coordinating and monitoring services and supports

Administrative Entity –approves and authorizes needed services and tracks utilization


PPL’s role as the Vendor Fiscal Agent

Support the Common Law Employer during the enrollment process• Process Common Law Employer and Support Service Worker enrollment forms

• Complete all criminal background checks for potential Support Service Workers

• Verify the Support Service Worker meets all ODP required qualifications• Notify the Common Law Employer when he/she and their Support Service Workers 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 Workers by January 31 of each year• Obtain a Worker’s Compensation Policy for the employer• Address any employer related questions by taxing authorities


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 SSW 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

Program Enrollment Forms & Materials


Program Enrollment Forms

• New Participant Enrollment Form

• VF/EA Informational Packet

• SSW Enrollment Packet• “Good To Serve” Process Flow

CLE Materials

• Designation Form• Agreement Form• SSW Termination Form• Progress Notes• Rate Sheet• Transportation Log• Request for Vendor Payments

• Participant Voluntary Termination Form

SSW Materials

• SSW Agreement• SSW Qualification Form• Back Up Designation Form

• Direct Deposit Enrollment

Our website has up‐to date program forms, frequently asked questions and other useful links, such as to MyODP.org. Go to www.publicpartnerships.com‐> click on Programs ‐> Pennsylvania ‐> ODP Program. Examples include:

PPL’s PA ODP Program Website Program Documents



Key Points to Clarify PPL’s Role

• PPL does not employ SSWs. All SSWs 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.


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 Workers (SSW)

• Assist the Support Service Worker in completion of the SSW Enrollment Forms Packet and forward completed SSW rate sheet to SC for approval and submittal to PPL

• Negotiate wage rates for their qualified SSWs within ODP established wage ranges and in accordance with Federal and State labor laws

• Determine the SSW’s responsibilities to ensure services are provided in accordance with ODP service definitions and as specified in the ISP

• Develop the SSWs’ work schedule and back‐up plan in that is reflected in the current authorized ISP

• Ensure the SSW does not provide services before being contacted by PPL with a start date


Role of the Common Law Employer

Common Law Employer Duties

• Review, approve, sign and submit qualified SSW 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 SSW 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

See Common Law Employer Agreement form for complete list of CLE responsibilities

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 SSW 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

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 SSWs.• Obtain completed SSW 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

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 non‐compliant CLEs

• Use PPL’s BetterOnline™ web portal to research pended timesheets, enrollment issues, utilization/authorizations, etc.

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

Enrollment Process Summary

1•SC discusses Participant Directed Service options with the participant during a Team Meeting and Participant selects VF/EA FMS model

2•PPL receives a New Participant Enrollment Form from the SC•PPL mails the CLE a Pre‐filled Enrollment Packet, and 2 blank SSW Enrollment packet

3•CLE completes the CLE Enrollment Packet•CLE completes the SSW enrollment packet with the SSW (s)•CLE selects rate of pay for SSW, completes SSW 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

4•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 SSW(s), are “Good to Serve”

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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.

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!

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.

Employer ID

Form SS‐4

PPL as the Agent

Form 2678

PPL can talk to

the IRS

Form 8821

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 SSW cannot.

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 Workers.

• Generally, in order for a new Participant to become Good To Service, all common law employer forms are completed and at least one SSW has to have completed the SSW Enrollment Packet.

Our Customer Service Representatives are there to support the CLE and answer questions. A complete Enrollment Process Flow procedure is available at:

www.publicpartnerships.com

Support Service Worker Enrollment


SSW Agreement

Form W-4

Tax Exemption

SSW Qualification

PA Residency

Form I-9

The CLE is responsible for recruiting, interviewing, hiring and ensuring all SSW Enrollment Packet forms are completed and submitted. Generally the process to enroll a new SSW 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.

Who can be an SSW?


*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…

Relatives*

Friends

Neighbors

Any Trusted Individuals

Difficulty of Care Federal Income Tax Exclusion


Difficulty of Care Federal Income Tax Exclusion:

If a SSW lives with the participant full time, the SSW may be eligible for a Difficulty of Care Income Tax Exclusion for the services, they provide. If the SSW lives in the home where they are providing your services, PPL encourages the SSW review important information on our Pennsylvania ODP Program web site at http://www.publicpartnerships.com 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 SSW 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.

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 Worker is considered to be a direct support professional.

According to the FLSA, a Support Service Worker “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 Workers who meet the requirements for the exemption

Fair Labor Standards Act (FLSA) - continued


What this means is that, when a Support Service Worker, Common‐Law Employer, and a participant all reside in the same place, the Support Service Worker 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 SSW has changed).

For additional information, please visit the PPL’s Program Website at www.publicpartnerships.com.


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 SSWs. This is an online registry check that usually returns results within 24hrs. The authorization to complete this check is included in the SSW Enrollment Packet.

• Child Abuse Clearances Check: Required when the SSW will provide services to a Participant under the age of 18. The authorization to complete this check is included in the SSW Enrollment Packet.

• Federal Bureau of Investigation: Required when the SSW:• Has not lived in Pennsylvania for the last two consecutive years. • Will provide services to a Participant under the age of eighteen.

SSW Rate Sheet


• ODP sets an hourly wage range that Common Law Employers may pay their SSWs 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 SSW 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 047‐16 for more detail

Upon approval the Support Coordinator , or AE, will fax (or email) the approved Rate Sheet to Public Partnerships: 1.855‐405‐7037 [email protected]

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 www.publicpartnerships.comOR

• MyODP.org

Voluntary Termination from VF/EA


• A participantmay 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.

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: 102718892

Start up and administrative fee use PPL MPI: 100833877

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 start‐up 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.

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

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PPL BetterOnline™ web portal

• Provides real-time access to participant information

• Information available on the portal• Participant/CLE demographic information• Associated Support Service Workers and current/max pay

rate• Access to enrollment status and items needed for good to go• Good to Go status for participant and SSW• View Timesheets and message causing timesheet to pend• Participant budget and utilization reports

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Time4Care™ Mobile Timesheet Application


Time4Care™ Mobile Timesheet ApplicationPCG Public Partnerships’ new Time4Care mobile application will provide SSWs 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. SSWs 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

PPL Customer Service

• Provide toll-free customer service via phone, fax and email

• Provide translation and interpreter service• Provide assistance in completing CLE and SSW

paperwork• Notify CLE of missing or incorrect paperwork• Notify CLE of issues that may be pending

payroll to SSWs• Respond to participant calls within 1 business

day

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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.

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Frequently Asked Questions


What are the Employer Tax Rates for ODP in 2016?Social Security: 6.2%Medicare: 1.45%Federal Unemployment: 0.6%State Unemployment Rate (New Employer Rate): 3.6785%*Workers’ Compensation: 2.8%

Total Employer Tax Rate: 14.73%* Each year the State Unemployment Rate is reviewed and may change.


Frequently Asked Questions

Q: Can SSWs 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 Worker 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 SSWs. Any participant approved for more than 40 hours per week of services will need to hire multiple SSWs 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.


Contact Information

PPL Customer Service: 1.877.634.6805 (for CLE, SSW, SC)Hours: 8:30 am ‐ 8:00 pm (Monday‐Friday)

9:00 am ‐ 1:00 pm (Saturday)Closed: Federal Holidays

Email: [email protected]

Administrative Fax (Referral Forms): 1.855.405.7037

Terri Reeser: [email protected] (SC or AE contact only)Michael Barlett: [email protected] (SC or AE contact only)

PPL Web Site: You can access program information, program forms, wage range bulletin and helpful links. Go to: www.publicpartnerships.comSelect: Program>Pennsylvania>ODP>Program Documents tab

Questions / Comments

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Please send questions to: [email protected].

Questions will be used to compile a FAQ document

www.publicconsultinggroup.com