Consumer Direction Models
Learn What Model Best Fits Your Life
GT Independence + ARC
Let’s talk about the…
Employer of Record Model
EOR
What is the employer of record (EOR) model? • Employer of Record (EOR) model is full budget authority model. • The client or their representative can become the EOR. • The EOR has full control over the budget and legal decisions. This also includes authority over hiring, firing, and training employees.
EOR
EOR Responsibilities • Participate in training and complete an assessment with the Care Coordinator • Determine the skills and training that are needed by employees • Lead/Participate in the development or update of the ISP • Decide job duties and schedules • Determine pay and benefits • Complete hiring packets for employees
EOR
EOR Responsibilities • Train or arrange for training of employees • Replace employees when necessary • Review monthly reports to track expenses and to stay within the Individual & Family-Directed Services Budget • Make sure services are provided as written in the ISP • Produce and maintain records for audit
• Complete incident reports, including a quarterly report to the agency
EOR
• Required service within the Employer of Record model • Cannot be the employer of record
Financial Support Services Responsibilities
• Files claims for services • Conducts background checks • Withholds taxes and unemployment insurance • Maintains accounts on participant funds • Purchases goods & services • Tracks and monitors budget expenditures
EOR • Pay employees, including benefits • Pay the bills • Keep track of the individual’s waiver dollars • Withholds taxes and unemployment insurance
How Financial Support Services Help the EOR
• File tax forms • Provide a monthly expenditure report • Following state and federal rules about waiver funding • Producing records that the agency maintains for audit • Employers of Record produce and maintain other records, for example, service documentation that employees complete and personnel records on employees
How Background Checks Work
EOR
Step 1 Background Check completed by the Financial Support Agency upon referral by the Employer of Record. (Agency must follow state rules.)
Step 2 Results of background checks are sent to the Employer of Record. These are confidential and maintained by the Employer of Record. Results include: • Criminal history • Driver’s license • Health care registry • Health and Human Services List of Excluded Individuals and Entities database
Step 3 Employer of Record checks references.
EOR
Important Note About Background Checks • The employer of record may not hire (offer a job to) an employee until the employer has received the results of the background check from the Financial Support Services Agency • The employer may not share the results of the Background Check with anyone
EOR
What Managing Staff Looks Like The employer of record oversees managing staff. This includes: • Providing or arranging training • Scheduling employees • Evaluating employees • Replacing employees as needed • Community Guide trains the employer to manage staff as needed
• Community Guide can help the employer of record find resources for training staff
EOR Final thoughts on the…
Employer of Record Model It Takes Time to Start EOR •
Most Employers need three or more months to begin Individual & Family-Directed Supports
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“Begin” means an employee is hired and starts to provide services to the participant
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All the steps must be followed for the employer to be successful
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The Community Guide helps the employer start the EOR model
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The participant continues in provider-directed services until the EOR model is started
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New participants should choose a provider until they are ready for self-directed services
Let’s talk about the…
Agency With Choice Model
AWC
What is the Agency With Choice (AWC) model? • In Agency With Choice, the provider is the known as the common law employer (the employer of record with IRS) •
The individual or legally responsible person is known as the managing employer
• The managing employer can be the person receiving services or a family member • Training is provided for the managing employer through Community Navigation
AWC
AWC Responsibilities •
Conducts background checks
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Sets employee pay rates, in partnership with Managing Employer
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Pays employees
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Withholds taxes for employees and pays unemployment insurance
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Carries Workers’ Compensation Insurance on employees
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Files claims for services
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Maintains accounting for individual funds
AWC
AWC Responsibilities • Purchases Individual Goods and Services • Sends quarterly report to the managing employer and care coordinator • This report tells the employer how much services have been used and how much Individual Goods and Services have been used • Answers questions about the report • Follows state and federal rules about waiver funding or other service funding • Produces records for audit • Is available to answer supervisory and training questions that arise
AWC
Managing Employer Responsibilities •
Participates in training with Supports Manager (clinical supervisor)
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Creates job description to outline skills and training employees need
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Participates in development of the ISP or update of the ISP
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Works with Agency With Choice to determine starting pay rates
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Screens and interviews potential candidates to hire
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Refers prospective employees to the Agency With Choice for hiring and state required training
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Works with Agency With Choice to make sure employees are trained
AWC
Managing Employer Responsibilities •
Schedules staff to meet the person’s needs and choices • Monitors so staff do not exceed the hours authorized in ISP • Coordinates to avoid overtime and stay within budgeted limits
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Ensures timesheets and documentation are submitted on time
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Works with AWC to ensure staff time and documentation match
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Communicates staff concerns promptly to Agency With Choice
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Resolves issues or recommends replacement of employees
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Reviews quarterly reports from Agency with Choice and stays within the Individual and Family Directed Supports Budget
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Ensures that the individual is healthy and safe
AWC
What is included in the Innovations service rate? This is the Medicaid service rate that Agency With Choice uses to pay for: • Financial support functions • Employee training and supplies • Employment advertisement
• Employee pay, benefits • Employer taxes • Workers Compensation and professional liability Insurance
• Qualified Professional supervision • Record keeping and retention
AWC
Recruiting • Managing employer recruits the staff • Can request that an ad be run by the Agency With Choice • Employer Handbook suggests ideas for recruiting • Resource advocate trains the managing employer as needed on recruiting
AWC
How Background Checks Work Step 1 Background check completed by the Agency With Choice upon referral by managing employer (must follow state rules).
Step 2 Agency With Choice makes decisions based on the results Results include:
• • • •
Criminal Drivers license if driving Sex offender Health care registries
Step 3 Agency With Choice checks references.
AWC
Supports Coordination Agreement • Completed with supports manager (Agency With Choice) • Outlines responsibilities of both Agency With Choice and managing employer • Outlines processes, establishes expectations of each party
AWC
Pay Rates and Benefits for Employees • Pay rates determined by the partners – managing employer and Agency With Choice – and based on personal budget • Benefits determined by Agency With Choice and affordability in personal budgets and overall agency budget • Projected budget tool will be utilized to determine starting wages and any increases
AWC
Managing Staff Agency With Choice and managing employer work together to manage staff: •
Provide or arrange training
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Schedule employees
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Evaluate employees
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Replace staff as needed
Consider If a Representative Needs to be Appointed A representative is someone who can assist the managing employer in performing some (or all) of the duties. Your care coordinator will help you appoint a representative if you choose (or are required) to have a representative.
AWC
Individual Support Plan • Determine staff qualifications and supervision requirements of staff • Document back-up staffing plan • Consider emergency plans that need to be developed • Make sure the plan addresses how the individual will be involved in self-directing services • Update the monitoring plan • Include long range goals and outcomes in the plan • Determine effective date
AWC
Specific Skills Employees May Need •
The Agency With Choice will ensure that staff meet the minimum qualifications to provide the services
• The Agency With Choice and managing employer need to add to the ISP any additional skills they require for the staff related to services they will be providing
Thank You We’re so glad you joined us for this training on the Employer of Record (EOR) model and the Agency With Choice (AWC) model.