Self-Direction Frequently Asked Questions
Agency with Choice
Q: Someone becoming an employee of a participant was filling out the background screening information she had received from PPL. She said she was confused about how much money she should send for the background check because of information on the back of the card. Who pays for this?
A: PPL is responsible for the costs of the processing, not the provider or employer. There may be a charge for doing the fingerprints, which is not covered and is usually around $10.
Q: Has there been much interest in Self-Direction?
A: Yes, we have had over a hundred people attend informational sessions on self-direction, and we have many July plans that have been submitted with self-direction on them.
Q: Could you explain a little more about how to fill out the pre-approval page for self-directing?
A: In the self-direction section, you list the services that the participant plans on self-directing and then in the box under the subtotal, type in the amount they want to self-direct so it can be deducted from the IBA. The number of units for self-directed services are not necessary, since those are negotiable depending on the wage and ways that it may change. Also, if they end up choosing a different service to self-direct then what was listed, that is still okay. We want to make sure when we are approving the plan of care that services are being planned to meet the person’s needs. As a reminder, goods and services and unpaid caregiver training must be prior authorized by the Division before being self-directed.
Q: What would the area look like, do you put respite and the number of proposed units for example just like on the traditional waiver?
A: Just list “respite” and the total amount planned to self-direct. You as the case manager will then put this amount into the PPL web portal to “authorize” those funds for services.
Q: If we change some funds in the IBA to equipment from respite, do we do modifications like we do now?
A: The modifications to self-directed funds are done in the PPL web portal, not to the Division… unless more money from the person’s traditional services will be switched to self-direction then a mod is needed to lower units and allow you to authorize more of the IBA to be self-directed.
Q: A participant I know would like to receive self-directed services. What are the steps to get started with PPL?
A: The participant or legal representative would do the following:
Tell your case manager know that you would like to self-direct services!
Select a support broker from the provider list. (Your case manager can provide you with a copy of this list.)
Decide the amount of money from your budget that you and your team wants to self-direct and the case manager will modify your plan of care to include a self-directed service budget and let PPL know that you wish to enroll as an employer through the PPL.
The Division will review the modification to the plan of care for approval. Then the Division will enter the amount that is budgeted for self-directed services into PPL’s system.
After the Division adds your budget into PPL’s system, your case manager will refine the budget to reflect the specific services you are going to self-direct.
Complete the Employer Welcome Packet sent to you by PPL and send back to PPL. (Your support broker can help you fill this out.)
Your employees must fill out their Employee Packets and send back to PPL. Fingerprint cards and the DFS registry form are sent directly to Juanita Gordon at the Wyoming Life Resources Center.
Check on your Employer packet by calling PPL five (5) days after you send in your packet and make sure that they have all the information needed for you to be good to go as an employer. (Sometimes the mail and processing takes longer.)
Check to make sure your employees have sent in all the information they need to start being an official “employee” of yours by calling PPL within five (5) days of the employees mailing in their completed packet. Please note that in addition to sending in paperwork, your employee must pass the DFS Registry Check and send in proof of up-to-date First Aid and CPR Certification.
Double-check your start date for services with your case manager and support broker.
Begin self-directed services!
Q: What would the area look like on the preapproval form? Do you put respite and the number of proposed units for example just like on the traditional waiver?
A: Just list “respite” and the total amount planned to self-direct. The case manager will then put this amount into the PPL web portal to “authorize” those funds for services.
Q: Since there are no schedules involved with PPL do we need the objective pages?
A: There will be time sheets to fill out with a summary of services delivered, but schedules and other documentation required will be up to the “employer” which is the participant/legal representative.
Q: What if I missed the informational sessions on self-direction or the PPL enrollment sessions?
A: Information is available on the Division’s website on a Self-direction web page, which includes a self-direction handbook that will help explain all of the opportunities and options available through self-direction.
If a participant or guardian wants to enroll with PPL to self-direct through the Fiscal/Employer Agent Financial Management Service, which is an entity who will do the employer paperwork on their behalf, they can contact the PPL Customer Service number at 866-896-0040.
Q: Can we hire a person to provide respite for over 40 hours a week when we go out of town or do we need to hire to employees?
A: The Division worked with the Fiscal Employer Agent, PPL, to implement a Daily Respite unit that can be provided to up to two participants. When a provider works over four (4) hours, s/he can submit to be paid at a daily respite wage. This means that the provider will be paid at a flat wage regardless of how many hours have been worked (as long as it is at least four). The wage is set by the employer. This service unit is newly announced and was not a decision that was communicated during the PPL enrollment sessions. We recognized this was a need based upon stakeholder input at those sessions and have implemented this daily unit to help meet the needs of parents and caregivers. The wage does not need to be adjusted for minimum wage per hour because federal and state laws provide exemptions for household employees caring for the people who are elderly or with disabilities.
Q: Can the Fiscal/Employer Agent (PPL) and an Agency with Choice be on the same plan for self-direction?
A: Yes, there is nothing to prevent this from occurring. However, there is very little benefit from this combination and it could lead to much confusion as a participant is the employer of record for the Fiscal employer agent, and therefore the “boss”, and a co-employer through agency with choice and must work with the agency to be the “boss” of their employee.
Q: If there are several Respite providers on a plan, can some be self-directed while others are not?
A: Yes, you can choose to self-direct one or all of the services, except for case management. This means you may keep some services traditional, as long as the provider is not considered a “home-based worker.”
Q: If I provide several services to a participant and the participant/family only wants to self-direct one service I provide, do I still need to fill out the PPL paperwork or go to the Agency with Choice?
A: Yes, if the participant/family wants to self-direct any service, they have to enroll with PPL or use an Agency with Choice provider to self-direct and hire a support broker.
Q: How do you determine wages and the child habilitation fee paid by parents if a person is self-directing this service?
A: There is a wage range established with a minimum and maximum wage for this service. The parent portion to the provider of the service is determined between the employee (provider) and the parent and the Division recommends that the two parties have a contract on the amount to be paid, but the Division may need to verify a payment is being made.
Q: Who is ultimately liable in a legal sense for actions of Providers? Do I need to buy liability insurance that would cover me as the employer against any legal actions a provider might bring against me as employer or to protect against anything they might do while in my employ that resulted in a legal action taken by a third party? Am I (or a client) covered as an employer for EEOC type actions if I’m not a party to the FMS contract specifically?
A: Participants are liable as household employers for the action of providers. If a participant would like to formally insure against liability, this can be easily added to any homeowner or renter insurance policy. You should know that is has been PPL’s experience (we work in 16 states and manage services for 25,000 individuals who are consumer directing) that there are only rarely liability issues raised. Only one national study has been done on this issue but it identified the same results as PPL; only one worker compensation case was reported in the three states that were studied.
PPL and WY DDD are working out business rules to ensure that you comply with the Equal Pay Act (EPA), i.e., that you may not pay different wages to people of different sexes on the sole basis of sex difference. (All other EEOC regulations do not apply to household employers, who have fewer than 15 employees.)
Q: If the State (rather than the “employer”) has contracted with a Financial Management Service to certify that minimum training and background checks of providers are completed and that employment actions, legal work status, taxes, etc. have been done properly, am I protected as the “employer” from any action or inaction by the FMS? Also, if false information is given to the FMS by a Provider is the State as the contracting Agency ultimately liable for false reporting or does that fall on me as employer?
A: If PPL fails to properly complete contract requirements such as certifying minimum training, and meeting background check requirements, then that is a violation of PPL’s contract with WY DDD, and PPL will be held liable, not the employer/participant.
WY DDD is contracted with PPL, the Financial Management Services organization. Employers too will have a relationship with PPL. As part of the enrollment process, the employer will sign an IRS Form 2678. By signing this form, the employer delegates the employer payroll and tax responsibility to PPL – withholding taxes from his or her employee’s paychecks and depositing these with the IRS – and PPL becomes the employer’s payroll agent. According to the IRS, the agent:
...must follow the procedures in Revenue Procedure 70-6 for employment taxes…All agents…remain liable for filing all returns and making all tax deposits and payments while this appointment is in effect.
As indicated in the quote above, Form 2678 assigns responsibility to PPL for payroll and tax responsibilities. PPL is also held responsible for any mistakes in filing.
If a provider gives false information and this causes funds to be paid out falsely, then the provider is liable, not the employer/participant. This assumes that the employer/participant has no knowledge of misinformation or wrong-doing by the provider.
Q: What if any personal tax filing implications are raised for parents/clients (as opposed to providers) as a result of the State’s actions that force us to become employers!?
A: This program will not impact personal tax filing for individuals serving as employers. Since program funds go from WY DDD to PPL and then to the providers, employers do not recognize any income from this program. As such, employers’ personal income tax filings will not be impacted by the self-direction program. As the employer’s payroll agent, PPL handles all of the employment tax responsibilities.
Agency with Choice
Q: How do I become an Agency with Choice?
A: Contact your Division Provider Support Specialist to find out the requirements for becoming an Agency with Choice. You can request changes to your provider certification after June 1st.
Q: Can we choose a Certified Public Accountant to be our Agency with Choice? What training will they get from the DDD?
A: Yes, they will need to become a Medicaid provider [following the provider certification process], and they will get the standard training from Developmental Disabilities Division. For more information, contact your local Provider Support Specialist.
Q. If an employee is hired by an Agency with Choice, can that employee work with other participants other than the participant who chose that employee?
A. Yes, however you must be available when the participant wants/needs you to provide services.