FMS Services: Current vs. Self Determination

Transcription

1 FMS Services: Current vs. Self Determination A special presentation by: Stephanie Medina Regional Director, Operations Ryan Iwamoto Owner & Co-Founder

2 What Three Letters are Missing? J, F, M, A, _, J, _, A, S, O, N, _ WWW. 24HRCARES.COM /REGIONAL CENTER - INLAND@24HRCARES.COM

3 24Hr HomeCare Company Background Founded in 2008 in Torrance, California by 3 Owners: David Allerby CEO Ryan Iwamoto CMO Tyner Brenneman-Slay COO 15 company owned locations in California, Texas and Arizona corporate office in El Segundo, CA

4 Active Regional Center Partners 24Hr HomeCare is actively vendored with the following Regional Centers: Harbor Regional Center San Andreas Regional Center Regional Center of the East Bay Westside Regional Center Tri-Counties Regional Center Regional Center of Orange County South Central Los Angeles Regional Center San Diego Regional Center Frank D. Lanterman Regional Center North Los Angeles Regional Center Inland Regional Center Eastern Los Angeles Regional Center Golden Gate Regional Center

5 Current FMS Services Partnered with 9 Regional Centers for FMS Services FMS Transportation (470): SCLARC, Harbor, Lanterman, SDRC, SARC, RCOC FMS Day Care (455): SCLARC, Lanterman, TCRC, SARC, RCOC FMS Family Respite (465): TCRC, NLACRC, SARC, WRC FMS Vouchered (475): TCRC Service Specific FMS Authorizations Combined with Management Fee

6 Why FMS? Why do we need FMS? DDS has mandated that all parent-vouchered services must be reimbursed by a FMS vendor The federal and state government want to keep track of money being spent and taxes being paid Client accountability Documentation of services Streamline your Parent-Vouchered reimbursement process, improve productivity and simplify administration for Regional Center staff. Regional Center no longer pays families directly

7 What is FMS? FINANCIAL MANAGEMENT SERVICES may provide the following: Assist client or family with general payroll and billing functions Verify worker s eligibility status Complete background check for worker(s) Handle all employment documents Workers compensation/liability/ui through company policy Pay all employment taxes Ensure all labor laws are followed Collect, verify, and process timesheets from worker Cut payroll checks Monthly budget statement sent to client and regional center

8 Current FMS Models Employer Agent (E/A) Service Code 490 Client/Family is sole employer 24Hr HomeCare provides non-wage reimbursement to family No liability or workers compensation insurance by 24Hr HomeCare Family is responsible for any payroll taxes if applicable Taxes not withheld from check, but worker is responsible for reporting and paying taxes if applicable Co-Employer Service Code Hr HomeCare and the family are employers for worker 24Hr HomeCare provides wage reimbursement Covered by liability and workers compensation insurance by 24Hr HomeCare 24Hr HomeCare handles payroll taxes Taxes withheld from worker s check and W2 provided at end of year

9 490/Employer Agent Intake Process Client only fills out two forms and sends back to 24Hr HomeCare: Certification Statement Reimbursement Enrollment Form Client can , mail, fax or hand deliver the forms for enrollment Once forms are received, 24Hr HomeCare will contact the family and counselor the same business day to let them know that they are enrolled and ready to start accepting reimbursement logs

10 491/Co-Employer Intake Process Family selected worker must go through hiring process with 24Hr HomeCare Worker fills out employment application and must submit necessary IDs proving legally eligible to work in the US Nationwide background check conducted prior to hire W4 form for state/federal taxes mandatory Worker is notified of hire and can start working only after application is complete and background is back clear (usually 2-4 business days)

11 FMS Role in Self Determination WIC (F)(1) Financial Management Services definition/role summary Help clients manage their individual budgets to ensure their funds will last throughout the year Ensure participant has the financial resources to implement his/her IPP throughout the year Bill pay services Activities that facilitate employment of service and support workers by the participant including: fiscal accounting tax withholding compliance with relevant state and federal employment laws verifying provider qualifications criminal background checks expenditure reports

12 FMS Role in Self Determination continued Provide participant and regional center service coordinator with monthly statement showing Total fund allocations to each category Amount spent in previous 30 days Amount of funding remaining Facilitate or Verify Criminal Background Checks Direct Personal Care Service Providers Any non-vendored provider criminal background is requested by participant or FMS provider Cost of background check must be paid by provider or employing agency

13 Rules for FMS to Make Payment Service and Support must be eligible for federal financial participation Cannot pay for services if a generic service or support is available Only make payments for purchase of services necessary to implement IPP Only make payments for purchase of services within Individual Budget Individual budget will be line itemed into budget categories developed by the department (DDS) Participant may transfer up to 10% of the funds originally distributed to any budget category to another category Transfers in excess to 10% of the original amount must be approved by regional center or the IPP team Payments from the FMS must not exceed both the total budget and category amount (within the 10% allowable transfer)

14 FMS Approval Limitation Examples CAN Participant submits invoice for rent to FMS Deny due to not being an eligible service Participant submits invoice for new supported living provider and did not notify FMS of change Deny payment due to no verification of mandatory background check Participant submits invoice for approved supported living provider for amount of $1,000 when remaining budget is $800 Deny payment of $200 over budget due to not being allowed in the budget CANNOT Participant submits new supported living provider who lives in Irvine with background check completed Deny provider due to not being HRC catchment area Participant in the South Bay contracts with supported living company for 35/hr because they can guarantee staffing at this rate Deny payment due to agreed rate being higher than average for services Participant wants to split supported living services between 2 companies to provide more consistent care Deny using 2 companies because they don t want to write 2 checks for the same services

15 FMS Models Applied to Self Determination EMPLOYER AGENT (SIMILAR TO 490) Client/Family is sole employer Participant creates job description FMS provides non-wage reimbursement to family No liability or workers compensation insurance by FMS Workers Compensation Insurance must be attained by participant Participant is responsible for any payroll taxes if applicable Taxes not withheld from check, but worker is responsible for reporting and paying taxes if applicable ANTICIPATED COSTS FOR RESPITE FOR 30HRS/MONTH Worker s Pay $10/hr CPR/First Aid ($110 at Red Cross distributed over a year)- $0.31 Workers Comp Insurance(8-12%, calculated at 10%) $1/hr Payroll Taxes 12.5% $1.25 Sick Leave - $0.66 FMS Management fee (based on DDS current rate of 40/month) 1.33/hr Total Cost: $14.55/hr This does not account for time spent for participant/family acquiring workers comp insurance, calculating sick leave, verifying employment eligibility, creating job description, managing employees, etc Background check fee (Employee must pay) - $32 FBI + $17 DOJ + $10-25 rolling fee = $59-74 (LIVESCAN Required and cannot be deducted from budget)

16 CO-EMPLOYER/EOR (SIMILAR TO 491/EOR) Service Code 491/ Co-Employer/EOR Co-Employer Model 24Hr HomeCare and the family are employers or worker 24Hr HomeCare provides wage reimbursement Covered by liability and workers compensation insurance by 24Hr HomeCare 24Hr HomeCare handles payroll taxes Taxes withheld from worker s check and W2 provided at end of year FMS Models Applied to Self Determination ANTICIPATED COSTS Current EOR Rate: $15.32/hr covers: Or apply burden rate: 26% of pay rate CPR/First Aid Certification cost Workers Compensation Insurance Payroll Taxes Sick Leave Management of Employee Certifications/Issues/Questions Verification of Employment Eligibility Taxes Withheld from Check and W2 sent yearly General and Professional Liability Bonding Handles Conflict Resolution Termination of Employees when necessary Background Check Fees 401k option Affordable Care Act insurance to eligible employees Continual Management of Changes in Labor/Employment Laws Takes on liability of following all labor laws correctly (OT, Split Shift Premiums, Driving if Authorized, protecting families from lawsuits in relation to fair wages) Corporate Perks for employee (discounts on Verizon, AT&T, travel and more 24/7 Assistance from office staff for emergencies Handles Regional Center Mandated Incident Reporting

17 24Hr HomeCare One Sheet 24Hr HomeCare Torrance Office: (310) Michelle Haenel General Manager Randy Shiozaki Assistant General Manager Danielle Urrutia Account Manager/FMS Coordinator Tatiana Orozco Account Manager/FMS Coordinator Corporate: (310) Ryan Iwamoto Owner & Co-Founder Stephanie Medina Regional Director, Operations Active in the Self Determination Advisory Boards for Regional Center of Orange County, Inland Regional Center, North LA, Westside Regional Center, Lanterman Regional Center, and South Central LA Regional Center

18 Questions?