ANOTHER DAY, INC....If the Consumer/Employer’s DSW works less than 40 hours per week, these new regulations may not impact the Consumer/Employer. To support the Consumer, Another

Address: 11802 W 77th St., Lenexa, KS 66214 Phone: 913-599-2221 Toll Free: 1-866-599-2221 Fax: 913-599-5660 Website: www.anotherday.info E-mail: [email protected] rev. 3/2015

ANOTHER DAY, INC.

Home and Community Based Services (HCBS) Waiver Program

Kansas

Self-Directing Informational Packet

KEEP FOR REFERENCE

Address: 11802 W 77th St., Lenexa, KS 66214 Phone: 913-599-2221 Toll Free: 1-866-599-2221 Fax: 913-599-5660 Website: www.anotherday.info E-mail: [email protected] rev.1/2018

What is in my packet?

Contents: 1. Packet Contents 2. Employer Resources – I9, Household Employer Tax Guide, Self-Direction Handbook 3. Federal Employer Tax Identification Number (FEIN) Q & A 4. Department of Labor Fact Sheets 5. Emergency Contact Form – Place on your refrigerator or somewhere accessible 6. Backup Plan 7. Change of Address –send to Another Day if you change your contact information. 8. Another Day Payroll Disbursement Schedule 9. Paystub Access Instructions for your DSWs 10. KS AuthentiCare Instructions and Activity Codes


PLEASE READ – This Document outlines your Responsibilities as a Self-Directing Individual.

Consumer Responsibilities The self-directing individual (also known and referred to as the “Consumer”) is the sole employer of the direct service worker (“DSW”), and has the following roles and responsibilities as an employer under participant-direction, which include but are not limited to the following:

Hire and direct the workers who provide the services in accordance with the Plan of Care (“POC”); Understands Consumer’s role as the sole employer of DSW(s). Manage and supervise the day-to-day HCBS activities of DSW(s) and ongoing performance expectations. Verify time worked by DSW(s) was delivered according to the POC. Assure utilization of State AuthentiCare system to record DSW time worked. Ensure time and

attendance information recorded through the AuthentiCare system is reflective of actual hours worked in accordance with an approved POC.

Direct DSW to submit all required documents to the FMS provider for processing in accordance with established state, and federal requirements.

Maintains control and oversight of his or her DSW to prevent fraud, waste, abuse, and ensure compliance with all federal and state rules and regulations.

Understand and comply with federal and state policies and procedures Obtain an awareness of Consumer’s requirements and responsibilities to the DSWs, including having a

signed Employment Service Agreement that specifies the responsibilities of the parties in a language/format that is understandable to the DSW, and ensure each DSW is aware of the employment requirements and job responsibilities owing to the self-directing participant and FMS provider on the participant’s behalf.

Determine tasks to be performed by DSW(s) and where and when they are to be performed in accordance with the approved and authorized POC or others as identified and/or are appropriate.

Process for reporting work-related injuries incurred by DSW(s) to the FMS provider. Develop an emergency worker back-up plan in case a substitute DSW is ever needed on short notice or

as a back-up (short-term replacement worker). Assure all appropriate service documentation is recorded as required by the State of Kansas HCBS

Waiver program policies, procedures, or by Medicaid Provider Agreement. Inform the FMS provider of any changes in the status of DSW(s), such as changes of address or

telephone number, in a timely fashion. Inform the FMS provider of the dismissal of a DSW within 3 working days. Inform the FMS provider of any changes in the status of the participant or participant’s representative,

such as the participant’s address, telephone number or hospitalizations within 3 working days. Participate in required quality assurance visits with MCOs, and State Quality Assurance Staff, or other

Federal and State authorized reviewers / auditors. Assure required DSW enrollment documents are received by the FMS provider prior to the DSW start of

employment.


FMS Provider Responsibilities

Comply with the provisions of the Home and Community Based Services Waiver program.

Comply with State Regulations, KDADS Provider Agreement requirements, Medicaid Provider Agreement requirements, policies, and procedures to provide services to eligible persons.

Develop and implement procedures, internal controls and other safeguards that reflect Kansas state law, the guiding principles of self-direction, to ensure individuals or an Individual’s representative, rather than the FMS provider, have the right to choose, direct, and control services and the DSWs who provide them without excessive restrictions or barriers. The procedures, internal controls and other safeguards must be written and include, at a minimum:

A mechanism to process DSW human resource documentation and payroll in a manner that supports Individuals or the individual’s representatives’ authority to select, recruit, hire, manage, dismiss, and train DSWs.

Applicable forms for enrolling the DSW as an employee of the self-directing individual.

Information for DSW that outlines AuthentiCare, payroll processing schedule, contact information

An assurance that the Individual or individual’s representative, and not the FMS provider, determines the terms and conditions of work (when and how the services are provided, such as establishing work schedules, determining the conditions of work and the tasks to be performed).

Internal controls to ensure Individuals or individual’s representative are afforded choice.

A process to respond, within a reasonable timeframe, to contact from any Individual or individual’s representative informing the FMS provider of the decision to dismiss a particular DSW.

Ensure the Self-Directing Individual or individual’s representative, and the Care Manager have the name and contact information of FMS provider.

Assume responsibilities in providing the following administrative services:

Establish and maintain all required records and documentation, to include a file for each self-directing individual as per State of Kansas regulations, policies and procedures and in accordance with Medicaid provider requirements. All files must be maintained in a confidential, HIPAA compliant manner.

Obtain authorizations to conduct criminal background checks, child abuse and adult registry checks in accordance with applicable waiver requirements.

Verify citizen and legal status of potential DSWs.

Collect and process all required federal, state, and local human resource forms required for employment and the production of payroll.

Support the Self-Directing Individual or the individual’s representative in establishing the pay rate for each DSW, as allowed under the procedures set by the State of Kansas.

Process time and attendance records of DSWs.

Compute, withhold, file and deposit federal, state, and local employment taxes.


Compute and pay Workers Compensation as contractually and statutorily required.

Approve and pay wages to DSWs in compliance with federal and state labor laws.

Perform all end-of-year federal, state, and local wage and tax filing requirements, as applicable

Have policies and procedures in place for the reporting of fraud and or abuse, neglect or exploitation by a DSW, to the appropriate authority and informs the Individual or individuals representative that if the DSW continues to work for the Individual that they will no longer be able to serve as the FMS provider for them.

Ensure that each Self-Directing Individual;

Is made aware of the benefits/services available to them;

Is made aware of the requirements/responsibilities of Self-Directing Individual to the FMS provider;

Is made aware of the requirements/responsibilities of the Self-Directing Individual to the DSWs:

In language/format that is understandable to the Individual;

Ensure each DSW hired by the Self-Directing Individual:

Is made aware of the services available to them;

Is made aware of the employment requirements/and job responsibilities of The Self-Directing Individual;

Develop, implement and maintain an internal quality assurance program that monitors for processing and auditing of time and attendance records


Self-Directing Resources Below is a list of common resources for self-directing consumers. Please know that we are an available resource to you and will do our best to get you answers to your questions. Please don’t hesitate to call if you need support.

I9 – Employer Guide Web address: http://www.uscis.gov/i-9

Description: Form I-9 is used for verifying the identity and employment authorization of individuals hired for employment in the United States. All U.S. employers must ensure proper completion of Form I-9 for each individual they hire for employment in the United States….

House Hold Employer Tax Guide Web Address: http://www.irs.gov/uac/About-Publication-926

Description: This publication will help you decide whether you have a household employee and, if you do, whether you need to pay federal employment taxes (social security tax, Medicare tax, FUTA, and federal income tax withholding).

Department of Labor: Homecare workers Web address: https://www.dol.gov/whd/homecare/homecare_guide.htm

Description: This guide is meant to help individuals, families, and households who use home care services determine their responsibilities under the Fair Labor Standards Act (FLSA), the federal minimum wage and overtime law that applies to most home care workers.

Self-Direction Toolkit The toolkit is available on the Another Day website. www.anotherday.info/Kansas/KSresources.aspx

Description: The self-direct toolkit covers activities a self-directing individual will need to perform during the course of directing services.


Federal Employer Identification Number (FEIN) Q & A Terms: Internal Revenue Service (IRS) – Government agency responsible for tax collection and tax law enforcement.

Federal Employer Identification Number (FEIN) – The number assigned by the IRS to each employer for identification purposes associated with paying taxes.

Federal Insurance Contributions Act (FICA) tax – Federal payroll tax imposed on both employees and employers to fund Social Security and Medicare. Sometimes Social Security and Medicare taxes are referred to separately, when referred to collectively, they are typically referred to as employer/employee FICA tax.

Federal Unemployment Tax Act (FUTA) tax – Provides payments of unemployment compensation to workers who lost their jobs. Most employers pay both Federal unemployment tax (FUTA) and State unemployment tax (SUTA).

Federal Income Tax (FIT) – Taxes paid on wages earned for the purposes of funding the Federal government operations.

Home Care Service Recipient (HCSR) – Term used by the IRS for individuals who have paid workers providing home health services. Sometimes referred to as Home Health Care Service Recipient (HHCSR). The HCSR refers to the beneficiary of services/Consumer/Self-Directing individual.

Third Party Designee (TPD) – For purposes of obtaining an FEIN – Individual/entity acting on behalf of the person/entity seeking the FEIN. A TPD is only approved to request/receive the FEIN on behalf of the individual/entity seeking the FEIN. The TPD is not approved for any other purpose.

Forms: IRS Form SS4 – Form used to obtain a Federal Employer Identification Number (FEIN).

IRS Form 2678 – Form used to designate a “payer agent” for the purposes of paying employer taxes on behalf of the HCSR. The FMS provider will be the “payer agent” for the HCSR and will pay employer FICA and FUTA taxes on behalf of the HCSR to the IRS. Use this form to both appoint and revoke a payer agent.

IRS Form 8821 – Form used to allow an individual/entity to receive tax-related information on behalf of the HCSR.

Q & A Questions related to obtaining an FEIN and Form SS4: Q: How is the FEIN obtained?

A: The FEIN is obtained by completing the IRS form SS4. The FEIN can be obtained online, over the phone, or by mailing in the Form SS4. However, a paper copy of the form must be completed and kept for record purposes.

Q: Who can obtain the FEIN?

A: The individual/employer who will be the FEIN holder or their TPD if one has been approved.

Q: Who should hold the FEIN?

A: The IRS confirmed whenever possible, the HCSR should be the FEIN holder/employer.


Q: Can the Guardian/Representative be the FEIN holder?

A: The IRS allows the Guardian/Representative to be the FEIN holder, however they prefer the HCSR be the FEIN holder. The Kansas Department of Aging and Disability Services (KDADS) states that the Consumer must be the FEIN holder.

Q: Who can sign for the HCSR?

A: The following can sign on behalf of the HCSR on form SS4:

A court-appointed Guardian, with approved papers authorizing them to sign on behalf of the HCSR. Someone with IRS authorization (attained by executing Form 2848, Power of Attorney Declaration of

Representative). A Parent of a minor child. The Parent must write “Parent of Minor SSN: xxx-xx-xxxx” at the bottom of the SS4.

Q: What if no one is authorized to sign for a participant?

A: The IRS accepts an “X” and hand-over-hand signatures. An “X” should be witnessed and signed at the bottom of the page by the witness.

Q: Can minors hold FEINS?

A: Yes, the IRS allows minors to hold an FEIN. If the FEIN is obtained on the minor’s behalf, the IRS requires Form SS4 to be completed in the minor’s name with the minor’s information, with one exception. The Parent/Guardian must write their SSN at the bottom of the page and identify themselves as the Parent/Guardian, “Parent/Guardian of Minor’s SSN: xxx-xx-xxxx.”

Q: Can the FEIN holder be a paid employee?

A: No. the IRS considers this self-employment. So if a Parent/Guardian is the FEIN holder, the IRS will not allow them to be a paid worker.

Q: What if the HCSR already has an FEIN?

A: The existing FEIN can be used. In this case, complete form SS4 again. The IRS will re-issue the same number.

Questions Related to Form 2678: Q: What is the purpose of form 2678, and do I need one?

A: This form authorizes the FMS provider to act as a “Payer Agent” and pay the employer-related taxes on behalf of the HCSR. This form is not required by the IRS if the HCSR wanted to pay their own employer taxes. KDADS does require this form.

Q: What happens if I switch FMS providers?

A: The form 2678 is specific to the payer agent, so if an HCSR switches FMS providers, they would need to revoke the current FMS provider as a payer agent, then appoint the new FMS provider as a payer agent.

Department of Labor (DOL) References and Selected Content The DOL has a new requirement that stipulates the Consumer’s Direct Support Worker (DSW) must be paid minimum wage and overtime, unless an exemption exists. As the sole employer, the Consumer/Employer should be aware of these requirements and maintain compliance. If the Consumer/Employer’s DSW works less than 40 hours per week, these new regulations may not impact the Consumer/Employer. To support the Consumer, Another Day, Inc. (ADI) has provided references to two DOL ”Fact Sheets” discussing exemptions that may be applicable to a Consumer/Employer whose DSW works over 40 hours per week. We are not allowed to provide legal advice, we therefore encourage the Consumer/Employer or their Representative to discuss these exemptions and DOL requirements with their legal counsel. If you have questions please call us, we are here to help you as much as we can.

Fact Sheet #79B: Live-in Domestic Service Workers Under the Fair Labor Standards Act (FLSA): http://www.dol.gov/whd/regs/compliance/whdfs79b.htm Excerpt from Fact Sheet 79B:

Persons employed in domestic service in private homes are covered by the FLSA; they must be paid at least the federal minimum wage for all hours worked and overtime pay at time and a half the regular rate of pay for all hours worked over 40 in a workweek, unless they are subject to an exemption…

Domestic service workers who reside in the employer's home (and thus are "live-in" domestic service workers) may be exempt from the FLSA's overtime pay requirement.

In order to be a live-in domestic service worker, a worker must reside on the employer's premises either "permanently" or for "extended periods of time."

A worker resides on the employer's premises permanently when he or she lives, works, and sleeps on the employer's premises seven days per week and therefore has no home of his or her own other than the one provided by the employer under the employment agreement.

A worker resides on the employer's premises for an extended period of time when he or she lives, works and sleeps on the employer's premises for five days a week (120 hours or more). If a domestic worker spends less than 120 hours per week working and sleeping on the employer's premises, but spends five consecutive days or nights residing on the premises, this also constitutes an extended period of time.

Example: An employee who resides on the employer's premises five consecutive days from 9:00 a.m. Monday until 5:00 p.m. Friday (sleeping four consecutive nights on the premises) is residing on the employer's premises for an extended period of time.

Employees who do not meet this definition are not considered live-in domestic service workers and must be paid at least the federal minimum wage for all hours worked and overtime pay at one and a half times the regular rate of pay for all hours worked over 40 in a workweek.

Domestic service workers who reside in the employer's home and are employed by an individual, family, or household are exempt from the overtime pay requirement, although they must be paid at least the federal minimum wage for all hours worked.

Fact Sheet # 79A: Companionship Services Under the Fair Labor Standards Act (FLSA): http://www.dol.gov/whd/regs/compliance/whdfs79a.htm Excerpt from Fact Sheet 79A:

The Department of Labor amended its regulations to revise the definition of companionship services that are exempt from FLSA protection. Under the revised regulations, the term “companionship services” means the provision of fellowship and protection for an elderly person or a person with an illness, injury, or disability who requires assistance in caring for himself or herself. Such individuals are sometimes referred to as “consumers” in this fact sheet. The term “companionship services” also includes the provision of care, when the care is provided attendant to and in conjunction with the provision of fellowship and protection, and does not exceed 20 percent of the total hours worked per consumer and per workweek.

The provision of “fellowship” means to engage the person in social, physical, and mental activities, such as conversation, reading, games, crafts, accompanying the person on walks, on errands, to appointments, or to social events.

The provision of “protection” means to be present with the person in their home, or to accompany the person when outside of the home, and to monitor the person’s safety and well-being.

The provision of “care” means assisting the person with:

Activities of Daily Living (ADLs) such as dressing, grooming, feeding, bathing, toileting and transferring; and Instrumental Activities of Daily Living (IADLs) which are tasks that enable a person to live independently at home, such as meal preparation, driving, light housework, managing finances, assistance with the physical taking of medications, and arranging medical care.

The companionship services exemption is not applicable when the employee spends more than 20 percent of his or her workweek performing care services; in such workweeks, the employee is entitled to minimum wage and overtime pay.

Emergency Contact Information

IF THIS IS A LIFE THREATENING EMERGENCY, CALL 911 IMMEDIATELY.

In times of emergency, easy access to contact information saves lives. Please complete this form and retain a copy in your home where Direct Support Workers can find it quickly.

Consumer’s Name:

Guardian/Representative’s Information:

Name: Phone Number:

Alternate Phone:

Doctor’s Information:

Name: Phone Number:

Address:

Hospital Preference:

Case Manager’s Information:

Name: Phone Number:

Additional contacts if Guardian/Representative cannot be reached:

Name: Phone Number:

Name: Phone Number:

Name: Phone Number:

Backup Plan & Contact Form If this is an emergency, call 911

Client Information

Name:____________________________________ Guardian/Representative:_________________________

Address:__________________________________ Phone 1:______________________________________

City:_____________________________________ Phone 2:______________________________________

Zip Code:_________________________________

Description Name Phone Comments

Medical Doctor

Pharmacy

Transportation Services

Mental Health Provider

Care Coordinator

Backup Plan Support Persons

Name Phone Days/Times Available

Comments

Address: 11802 W 77th St., Lenexa, KS 66214 Phone: 913 599 2221 Toll Free: 1 866 599 2221 Fax: 913 599 5660Website: www.anotherday.info E mail: [email protected] rev.1/2018

Consumer’s Name:(First) (Middle Initial) (Last)

Physical Address ChangeChange Physical Address Where Consumer Lives:

Address:____________________________________________ City:_____________________________________

County:_____________________________________________ State:________________ Zip:_______________

Service Related Contact Information ChangeChange Mailing Address where Service Related Information is sent:

Address:____________________________________________ City:_____________________________________

State:___________________ Zip:_______________

Change Phone and Email where service related information is sent (including missed visits and service documents):

Phone: (______)______________________________ Email: ____________________________________________

Secondary Contact Additions/ChangesName: ___________________________________________

Relation: Legal Guardian of Consumer Parent of Consumer Designated Rep Other

Address:____________________________________________ City:_____________________________________

State:___________________ Zip:_______________

Phone: (______)______________________________ Email: ____________________________________________

_______________________________________ _____________________________________ _________Consumer/Representative Name (Print) Consumer/Representative Signature DateConsumer/Representative Name (Print) Consumer/Representative Signature Date

Accessing Your Paystubs Online: NON Card holders ONLY. If you have a Global Cash Card Youwill receive separate instructions for activating your card and online access. If you have anyquestions about setting up your paystub access, please contact Global Cash Card customerservice at 1 888 220 4477.

Step 1: Go to www.globalcashcard.com and click on‘Login/Sign Up’ from the top menu

Step 2: Click on ‘Sign Up Now!’

Step 3: On Activate Account Select NO

Step 4: Enter your Name, Social Security Number andAnother Day, Inc.

Step 5: Create a USER NAME and PASSWORD for accessingyour account. Enter all required fields (*) and make sureyour mailing address is correct. If not, notify Another DayPayroll immediately!

You can now log in using the username and password youcreated.

For Employer Enter:Another Day, Inc.

Press Continue

rev. 1/2017

KS AuthentiCare DSW Check-in/Check-out Procedure:

Worker Name:

Worker ID: Service: IDD Self-Directed PCS

Instructions to Check-in 1 Dial 1-800-903-4676 from the client’s touch-tone phone. 2 Enter your worker ID number followed by the pound (#) sign when prompted. 3 Press 1 for Check-in. 4 You will then hear the name of the client you are there to serve. If it is correct, press 1.

If KS AuthentiCare does not recognize the phone number you are calling from, you will be asked to enter the client’s ID number (Medicaid number) followed by the pound (#) sign.

5 You will hear a list of services available for the client: Press 1 for IDD Self Directed PCS. Press 2 for IDD Sleep Cycle Support. and so on...

6 KS AuthentiCare will then repeat back your name, your agency’s name, the client’s name, and the service to be provided. If this is all correct, press 1. If the information is not correct, press 2. You will be able to correct the information before you finish the call.

7 If the information is correct, you will be told that the check-in was successful at (states the time). At this point, you will be instructed to press 2 to end the call.

Instructions to Check-out 1 Dial 1-800-903-4676 from the client’s touch-tone phone. 2 Enter your worker ID number followed by the pound (#) sign when prompted. 3 Press 2 for Check-out. 4 If you failed to check in, the IVR will read the client back to you. If it does not recognize the

phone number you are calling from, you will be asked to enter the client’s ID number (Medicaid number) followed by the pound (#) sign. You will also be asked to select a service.

5 Some services will require the entry of activity codes. You will be prompted to enter the activity codes one at a time. After the entry of each code, press the pound (#) sign. KS AuthentiCare reads the activity code, asks you confirm it as correct, and then asks you to enter another activity code if needed. Once you have entered all activity codes, press 8 to continue to the next step.

6 KS AuthentiCare will repeat back your name, your agency’s name, the client’s name, and the service you provided. If this is all correct, press 1. If the information is not correct, press 2. You will be able to correct the information before you finish the call.

7 If the information was correct, you will be told that you have successfully filed your claims, the time, and to press 2 to end your call.

rev. 1/2017

Activity Codes for Personal Assistant Services for I/DD Waiver

At the end of visit, when you are ready to time-out, use these codes:

Activity Code Bathing 11 Dressing 12 Oral Hygiene 13 Hair Care 14 Skin Care 15 Nail Care 16 Shaving 17 Prosthetic/Orthotic Assistance 18 Toileting 19 Transfer 20 Walking/Mobility 21 Wheelchair Maneuvering 22 Eating 23 Meal Planning/Preparation/Clean-Up 24 Shopping and Errands 25 Medications/Treatments 26 Transportation 27 Use of Telephone 28 Laundry 29 Housekeeping 30 Minor Sewing/Mending 31 Exercises/Range of Motion Activities 32 Other Health Maintenance Activities 33 Assistance in the community 34 Non-Physical Support/Supervision to Assure Health and Safety 35 Retainer Services 36 Direct Support Worker Training 37 Money Management 38 Teaching Opportunities 39 Leisure or Recreation 40

Documents

ANOTHER DAY, INC....If the Consumer/Employer’s DSW works less than 40 hours per week, these new regulations may not impact the Consumer/Employer. To support the Consumer, Another