OLTL Participant Directed Models of Service · Public Partnerships 4/15/2013 3 Common Law Employer...

Public Partnerships 4/15/2013

www.publicpartnerships.com 1

Commonwealth of PennsylvaniaVendor Fiscal/Employer Agent Financial Management Services

OLTL Participant Directed Models of Service

PPL/Service Coordinator Meetings

www.publicpartnerships.com

Agenda• Roles and Responsibilities

• Authorizations

• Pay Rate

• Program Policies

• Questions/Comments

.

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ROLES AND RESPONSIBILITIES

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Common Law Employer Roles and Responsibilities

• Recruit, hire, manage and dismiss DCWsRecruit, hire, manage and dismiss DCWs

• Verify DCW and vendor qualifications

• Ensure that DCWs complete the enrollment requirements

• Train DCWs in providing services described in the ISP

• Decide how much to pay DCW

• Develop and implement a backup plan

• Approve and submit all timesheets and invoices to PPL

• Report suspicions of Medicaid fraud or financial abuse related to the delivery of participant-directed services

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Common Law Employer Roles and Responsibilities

Employer Responsibilities Supporting Rolep y p pp g

Recruit, hire, manage and dismiss DCWs PPL/Service Coordinator

Verify DCW and vendor qualifications PPL/Service Coordinator

Ensure that DCWs complete the enrollment requirements

PPL/Service Coordinator

Train DCWs in providing services described in the ISP

Service Coordinator

Decide how much to pay DCW PPL

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Develop and implement a backup plan Service Coordinator

Approve and submit all timesheets and invoices to PPL

PPL

Report suspicions of Medicaid fraud or financial abuse

PPL (who reports suspicions to the SC)

PPL Roles and Responsibilities

General responsibilities:p• Provide pre-populated Common Law Employer tax forms and DCW

enrollment packets

• Provide assistance in completing CLE and DCW paperwork

• Process and review completed CLE and DCW paperwork including perform all necessary record checks on prospective DCW’s

• Issue payments to DCW’s bi-weekly with the receipt of properly submitted timesheetssubmitted timesheets

• Provide payments to vendors through Services May Way program

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General responsibilities cont.:p• Withhold appropriate taxes at the

local, state and federal level

• File monthly, quarterly, and annual forms and tax deposits with state and federal agencies

• Issue W-2 statements to each DCW in JanuaryJanuary

• Provide 24/7 on-line access to information via PPL Web Portal

• Provide training and user guides on how to use PPL Web Portal

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Customer Service Responsibilities:p• Provide toll-free customer service via

phone, fax and email

• Provide translation and interpreter service

• Provide assistance in completing CLE and DCW paperwork

• Notify participants of missing or incorrect paperworkpaperwork

• Notify participants of issues that may be pending payroll to DCWs

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Enrollment Manager Responsibilities:g p• Serve as main point of contact for service coordinators and service

coordination organizations

• Respond to day to day participant direction issues identified by SCs

• Support the training and education need of the SC’s and SCO’s

• The primary support system available to participants and DCWs is PPL customer service.

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Service Coordinator Roles and Responsibilities

• Facilitates transition into participant directed servicesp p• Helps the participant determine who will serve as the CLE

• Makes referrals to PPL using web portal• Handout provided giving instructions for online referral

• Develops and updates the ISP with the participant

• Initiates informal supports or agency services until the participant is ready to receive services and DCW is approved

• May assist participant in completing enrollment forms• May assist participant in completing enrollment forms

• Supports the consumer in:• Training DCWs in providing services described in the ISP

• Developing and implementing a backup plan

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Service Coordinator Roles and Responsibilities

• Monitors the delivery of services and supportsy pp

• Oversees any transition to and from participant direction• Reports temporary stops in services

• Keeps participant’s demographics

up to date in HCSIS/SAMS

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AUTHORIZATIONS

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Authorizations• PPL routinely receives timesheets for participants without

authorizations. The authorizations are missing because:• They were incorrectly entered

• They were not entered in a timely manner

• SCs can help by:• Asking for training if they are uncertain about the requirements for adding service

plans to HCSIS/SAMS

• Adding authorizations, particularly monthly authorizations, in a timely manner

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Authorizations• Process for adding service plan information into SAMS/HCSIS is

unchanged.

• The begin dates of service for FMS should be:

Service Begin Date of Service

FMS Start-Up Fee (W7341 U4) Date the SC made the referral

FMS Admin Fee (W7341/W7341 U2) First day of the month after the FMS Start Up-Fee

PAS (W1792

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PAS (W1792

30 days from the date the plan was submitted to OLTL and referral was

made to PPL

Respite (S5150)

Part. Directed Community Supports (W1900)

Part. Directed Goods and Services (W1901)



PAY RATE

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Pay Rates• PPL did not receive wage rates for all DCWs when the data was transferred

f i FEAfrom prior FEAs

• PPL temporarily defaulted those missing wage rates to the regional maximum wage rate

• We contacted all CLEs with missing rates asking them to submit wage rates

• SCs can help by:• Educating CLEs about their ability to set wage rates

• Encouraging CLEs to send in wage rate information

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Pay Rate Rules• For transitioning participants, the pay rate is not just the hourly

amount paid to the worker! It is

• The pay rate must be lower than or equal to the regional maximum wage rate

Hourly DCW Rate

State Unemploy-

mentInsurance experience

rating

Employer Taxes Pay Rate

wage rate

• A CLE who wants to increase or decrease a DCW’s rate of pay should submit a change on the Qualified DCW Rate Sheet

• Approval of the change will depend upon it being no greater than the regional maximum wage rate

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Qualified Direct Care Worker Rate Sheet

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PROGRAM POLICIES

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Enrollment – Transitioning Participants and DCWs• PPL provided all transitioning participants and DCWs with the

necessary paperwork to transfer services

• The paperwork requirements were limited because we got much of the paperwork from prior FEAs.• Existing DCW’s have background check status “grandfathered” as

PASSED.

• Some CLEs and DCWs did NOT submit this paperwork.

• PPL has been contacting them to obtain this paperwork

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Enrollment – Transitioning Participants and DCWsRequired documents for transitioning participants:q g p p

IRS Form 2678 Employer Payer Appointment of Agent

IRS Form 8821 Tax Information Authorization

IRS Form 8822-B Change of Address - Business

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Enrollment – Transitioning Participants and DCWsRequired documents for transitioning DCWs:q g

Direct Care Worker Agreement

Application for Tax Exemptions (if applicable)

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Enrollment – New Participants• After receiving a referral, PPL will send the CLE an enrollment packet

• CLE must sign and date the forms and send them back to PPL

• Some CLEs have not submitted this paperwork.

• PPL has been contacting them to obtain this paperwork

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Enrollment – New ParticipantsRequired documents for new participants:q p p

Authorized Representative Designation Form

Common Law Employer Agreement

CLE Information Form

IRS Form SS-4 Application for Employer Identification Number

IRS Form 2678 Employer Payer Appointment of Agent

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of Agent

IRS Form 8821 Tax Information Authorization

IRS Form 8822-B Change of Address -Business



Enrollment – New DCWsApplies both to transitioning CLEs with new DCWs and to pp gnew CLEs with new DCWs:• DCW enrollment packets are available on PPL’s website

• DCWs may NOT start to work until accurate enrollment paperwork has been received by PPL and all criminal background checks have been processed and we have notified the DCW to start in writing.

• ALL DCWs must have a state background check

• If someone lives in the home where services are provided is under the age of 18,

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p g ,then the DCW must also have a child abuse history check

• DCWs living in the state of PA for less than 2 years are also required to have an FBI criminal history check.

• DCWs may not work while their criminal background check is in an “In Process” status.

Enrollment – New DCWsApplies both to transitioning CLEs with new DCWs and to pp gnew CLEs with new DCWs:• PPL will notify the DCW that they are good to start providing services

by mailing them a letter. The mailing will also include:• DCW ID number

• Paper timesheets

• Paper and e-timesheet instructions

• Instructions for accessing PPL’s web portal

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• The DCW is not qualified to work before receiving this and will not be paid for any work prior to the date they are approved.

• Approval is based on the singular DCW/participant relationship. Approval to provide services to one participant is not approval to provide services to any other participant.



Enrollment – New DCWsRequired documents for new DCWs:q

USCIS Form I-9

IRS Form W-4

PA Residency Certification Form

Application for Tax Exemption

DCW Application

DCW Agreement

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DCW Qualification Form

Qualified DCW Rate Sheet

Enrollment – New DCWsCommon errors:• DCWs start working BEFORE their background checks are back and

BEFORE we notify them in writing that they are approved to work.

• DCWs complete paperwork for background checks that they do not need

• Participants schedule DCWs prior to the 1st authorized start date

• DCWs do not complete the I-9 correctly• Needs to be signed by both the DCW and the CLE

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• Needs to be signed by both the DCW and the CLE

• Section 2, which lists documentation showing that the worker is legal to work in the US, needs to be completed accurately



Form I-9

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Enrollment Packet Training ResourcesThe following resources are available to help CLEs and DCWs

l t th i kcomplete their paperwork:

• Customer Service

• Video Recorded Trainings https://www.publicpartnerships.com/programs/Pennsylvania/PADPWOLTL/program.asp

o Conference Call Q&A Sessions

o Informational Packets

PPL Web site:• PPL Web site: https://www.publicpartnerships.com//programs/pennsylvania/PADPWOLTL/index.asp

Username (PADPWOLTL) and Password (PPLDPW56) are required

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Program Policies• PPL cannot pay timesheets for services worked if we do not have an

authorization for those services.

• Whether a participant submits a paper or electronic timesheet, it must be approved by the CLE before PPL may process it.

• The approval of a paper timesheet is the CLE’s signature

• The approval of an electronic timesheet is an electronic CLE signature. If the CLE does not have internet access, the DCW can print out the e-timesheet for signature and then submit by mail or fax.

• Currently, participants are not consistently signing paper or electronic

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Currently, participants are not consistently signing paper or electronic timesheets

• PPL has been contacting them to have them sign those timesheets

How to approve and submit e-timesheets• Login to the PPL Web Portal. It defaults to the Timesheet List page. https://fms.publicpartnerships.com/PPLPortal/login.aspx

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How to approve and submit e-timesheetsOn the Timesheet List page, participants can search for submitted ti h ttimesheets

The submitted timesheets will come up and then you should select the

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Approve/Reject Button.

How to approve and submit e-timesheetsAfter selecting the “Approve/Reject” button, the screen below will appear. .

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To approve the timesheet select the “Approve” button.



Summary of changes• PPL will no longer be permitted to pay for services that do not have

authorizations.

• PPL will no longer be permitted to pay DCWs who do have not have a wage rate.

• PPL will no longer be permitted to pay DCWs who do not have complete paperwork or whose CLE does not have complete paperwork.

• PPL will no longer be permitted to pay DCWs whose timesheets are not signed.

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Questions / Comments

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OLTL Participant Directed Models of Service · Public Partnerships 4/15/2013 3 Common Law Employer...

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Transcript of OLTL Participant Directed Models of Service · Public Partnerships 4/15/2013 3 Common Law Employer...