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CWI 2009 Self Directed Services Tool Kit A Resource for Individuals compiled by Community, Work & Independence, Inc. Funding for this project provided.

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Presentation on theme: "CWI 2009 Self Directed Services Tool Kit A Resource for Individuals compiled by Community, Work & Independence, Inc. Funding for this project provided."— Presentation transcript:

1 CWI 2009 Self Directed Services Tool Kit A Resource for Individuals compiled by Community, Work & Independence, Inc. Funding for this project provided by NYS Office of Mental Retardation and Developmental Disabilities – Workforce Development Grant

2 CWI 20092 Tool Kit Goals This tool kit contains resources to assist individuals with self directing support services The tool kit will:  provide background and educational information about self directed services  highlight benefits and responsibilities associated with self directed services  highlight the types of resources available

3 CWI 20093 What are Self Directed Services? Self direction of publicly funded support services is a relatively new philosophical approach The driving force behind this approach is to allow individuals input and control, to the greatest extend possible, in meeting their needs for a meaningful life Successful self direction requires competence, cooperation and commitment

4 CWI 20094 Self Directed Choices Self directing programs allow consumer input:  Choosing an agency to assist with co-managing  Choosing workers to provide the direct services  Setting wages and hours  Directing goals and activities of service OMRDD currently offers self direction of services for At Home Residential Habilitation and In Home Respite services

5 CWI 20095 Benefits of Self Direction Empowers individuals and allows greater control over life Provides a more individual approach to individual needs Assists with worker shortages Increases availability of services in rural regions Allows individuals to remain living at home longer

6 CWI 20096 Responsibilities of Self Direction Individuals “co-manage” the responsibilities in a self directed service model  By choosing an agency, individuals are choosing their co-manager  Individuals act as the employing manager  Agencies act as the fiscal intermediary and often provide the needed clinical component necessary for funding

7 CWI 20097 Employing Manager The employing manager (individual) is responsible for recruitment, hiring, training, setting wages (within a range), scheduling, performance evaluation, discipline and dismissal of direct care workers. It is key for the employing manager to work closely and communicate with the fiscal intermediary to ensure services run smoothly and all areas of the program are in compliance with state and federal laws.

8 CWI 20098 Self Directing Other If an individual is unable or unwilling to assume the responsibilities associated with self directed services, a Self Directing Other may be designated to fulfill these responsibilities.  This individual is often a family member, but that is not a requirement.  It cannot be an employee of fiscal intermediary agency that serves the individual in any other capacity through the agency.

9 CWI 20099 Fiscal Intermediary Definition A fiscal intermediary manages funds, makes payments, and accounts for expenditures made on behalf of the consumer as directed by the consumer, family, or circle of support. The fiscal intermediary is not a direct service provider, but handles the business end of securing services and supports. A fiscal intermediary must be able to provide payroll services, bill payments, benefit administration, contract negotiation, rate setting functions, and record keeping services. Without a fiscal intermediary, the individual or family could be affected by state and federal labor laws, be responsible for filing tax records, and have additional obligations with regard to the Social Security Administration.*

10 CWI 200910 Employer of Record The fiscal intermediary is the employer of record for persons providing support services and is responsible for completing tax, labor, and social security documents as needed. The employer agent calculates and files tax documents, distributes wages to support providers, manages workers’ compensation, disability, and benefit insurances, and verifies citizenship/legal alien status of support providers along with all other background checks required by the funding source.

11 CWI 200911 Fiscal Conduit The fiscal intermediary also acts as a Fiscal Conduit and completes administrative tasks, such as collecting time sheets, submitting invoices, billing the funding source etc.

12 CWI 200912 Operational Structure Self directed services operate with four primary components Personnel Considerations Fiscal Considerations Compliance Considerations Service and Support Considerations

13 CWI 200913 Personnel Considerations Recruitment Hiring Scheduling Managing Evaluating Disciplining Dismissing

14 CWI 200914 Recruitment/Hiring Selecting the right person for the job is key to successful outcomes  Canvas for potential employees Newspaper ads, area bulletin boards, word of mouth, internet, local colleges  Set up an interviewing and reference checking system  Be aware of legal dos and don’ts

15 CWI 200915 Selection Concepts to keep in mind  Compatibility  Experience and Competence  Work history  Potential conflicts  Communication Style Certain family members are not eligible for hire through self directed programs:  Spouse, natural or adoptive parent, son/daughter, son/daughter-in-law

16 CWI 200916 Sample Recruitment/Hiring Resources Recruitment\Interview Questions Recruitment\Employment interviewing and evaluation form Recruitment\Employment interviewing and evaluation form Recruitment\Interpersonal Skills Job Interview Recruitment\Interpersonal Skills Job Interview Recruitment\Practical tips for interviewing job candidates Recruitment\Practical tips for interviewing job candidates Recruitment\Illegal Interview Questions

17 CWI 200917 Sample Recruitment/Hiring Resources Recruitment\Reference Checking Recruitment\Reference Check Guide Recruitment\Employee Recruitment Best Practices Recruitment\Employee Recruitment Best Practices U.S. Equal Employment Opportunity Commission Americans with Disabilities Act

18 CWI 200918 Managing Management styles vary from person to person, but there are some basics to managing people that all good managers should be aware of. All styles will be complimented by applying:  Consistency  Logic  Honesty  Clear expectations

19 CWI 200919 Managing There are numerous facets to managing people. Some of the more typical duties include:  Scheduling  Monitoring timesheets/shift reports  Evaluating performance  Disciplining

20 CWI 200920 Sample Managing Resources Managing\Basic rules to follow with at-will Employees Managing\Basic rules to follow with at-will Employees Managing\Employee feedback script Managing\Sample absence policies Managing\Sample tardiness policy Managing\Progressive discipline checklist Managing\Sample verbal warning Managing\Sample written warning form

21 CWI 200921 Sample Managing Resources Managing\Effective Employee Eval Managing\About Employee Evaluation An excellent resource that can be overlooked is the co-managing agency. Often a conversation with an experienced manager or HR staff person will point you in the right direction.

22 CWI 200922 Dismissal A situation may arise when dismissal of a direct care worker is necessary. Never an easy decision or situation, it should be approached thoughtfully. Below are some sample resources for guidance: Dismissal\Checklist of general concerns related to termination Dismissal\Checklist of general concerns related to termination Dismissal\Termination meeting checklist Dismissal\Behaviors to avoid during a termination meeting Dismissal\Behaviors to avoid during a termination meeting Dismissal\How to Fire With Compassion and Class Dismissal\How to Fire With Compassion and Class

23 CWI 200923 Fiscal Considerations Funding  It is paramount to keep in mind that the dollars supporting the services are public dollars, more often than not – MEDICAID  Public dollars require a high level of accountability  Documentation must be timely and in order  All parties must be aware of compliance requirements and be able to identify instances of fraud

24 CWI 200924 Documentation Fiscal documentation  Timesheets – the backbone of payroll Indicates hours worked, benefit time (if applicable) Authorization by the worker, consumer and program coordinator Service documentation  Shift report – services rendered Indicates what services were provided and what the outcome(s) was Medicaid is paying for the service delivered

25 CWI 200925 Documentation Service Documentation (continued)  The Office of Mental Retardation and Developmental Disabilities (OMRDD) has specific service documentation requirements: Proper notation of service in the Individual Service Plan (ISP) by the Service Coordinator Development & maintenance of the Habilitation Plan by the agency QMRP Shift reports completed by the direct care worker Monthly summary of services and outcomes by the QMRP Signed Memorandum of Understanding outlining responsibilities

26 CWI 200926 Documentation Below are samples of required service documentation for OMRDD  Forms\AHRH-SD DAILY NOTE Forms\AHRH-SD DAILY NOTE  Forms\AHRH-SD PLAN Forms\AHRH-SD PLAN  Forms\SD-AHRH MOU 2009 Forms\SD-AHRH MOU 2009

27 CWI 200927 Compliance The laws – local, state and federal – are numerous and clear about the proper usage of public funds. Knowledge of and compliance with these laws is mandatory. The consequences of non-compliance (FRAUD) can run the gamut: termination of workers, loss of services, paybacks, ineligibility to be a Medicaid provider or to work in a Medicaid program

28 CWI 200928 Examples of Fraud Forged signatures Inaccurate or false times on timesheets or shift reports Submitting overlapping hours worked for two or more programs Pre-filling documentation ahead of service delivery

29 CWI 200929 CWI’s Corporate Compliance Plan All parties involved with any service that is paid with public dollars should be aware of the laws governing fiscal compliance, how to identify fraud and the consequences of fraud. CC\Corporate Compliance Power Point! CWI Code of Conduct

30 CWI 200930 Service Design No one knows more about what support services an individual needs than the person in need. Participate fully in the Individual Service Plan Meeting! Make sure you self advocate or have the Self Directing Other advocate for what is needed and how services should be designed, including:  When  How  By Whom Review the Habilitation Plan closely to ensure it mirrors what is needed. Make sure all direct care workers are familiar with the plan.

31 CWI 200931 Support Resources Self directing individuals are not expected to “go it alone” and should reach out to available resources when necessary. Below are some of the resources that can be of assistance: Agency Internet Support Groups

32 CWI 200932 Agency Remember, the agency is your co-manager. Take advantage of the expertise and resources available. Timely communication is essential and often prevents a small concern from growing into a large concern. The agency may also be able to tap into other resources more easily than you for answers, for example, the funding source, legal advisor or law enforcement.

33 CWI 200933 Internet The internet has information about almost anything….just take a look! If you don’t have access to the internet check out your local library or school Use a search engine, such as Google, to get started. Keep in mind that different states have different rules. It is always a good idea to double check information from the internet from questionable sources.

34 CWI 200934 Support Groups Whether it is you that requires support services or you are a caregiver of someone who requires support services, a little understanding, empathy and conversation with someone who “has been there” can be invaluable. Look in your area for local support groups. Places to start include:  Department of Social Services  Office for the Aging  Developmental Disabilities Service Organization (DDSO)  NYSARC  School District  Religious Institutions

35 CWI 200935 The quality of Self Directed services is related directly to the quality of the management of services. We hope this presentation has provided you with some valuable resources and wish you a successful participation in the a Self Directed Services Program.

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