+ Fiscal Intermediary Choosing The Right One To Assist Your Employer Journey

+ Who Benefits From FI Program? All individuals with Intellectual and Developmental Disabilities Intellectual disability: Limitations in intellectual functioning and difficulties in a variety of everyday social and practical skills Developmental disability: Cognitive or physical impairment that results in limitations in areas such as self-care, language, and mobility

+ Making Sure that Individual Enjoys: Self-Determination Secured Fundamental, Human, and Civil Rights An end to Institutionalization, Abuse, and Neglect More Choice, Control, Flexibility, and Freedom A Meaningful Life in the Community

+ Self-Determination is a concept that people served by the Public Mental Health System (PMHS) must have the support needed to have a Meaningful Life in the community In Michigan, the PMHS is implemented by Prepaid Inpatient Health Plans (PIHP) which oversees 46 Community Mental Health Services Programs (CMHSP) Michigan’s SD Policy & Practice Guidelines requires that PIHP/CMHSPs offer arrangements that support SD

+ Self-Determination is based on four principles: Freedom Authority Support Responsibility FI

+ S-D Gives Authority to Make Decisions such as:  Where you live  Where you work  Are you part of the community  How you spend your day  What to buy  Who provides you the supports  What supports are provided  When they’re provided  Where they’re provided  How to control your budget

+ Funds/Individual Budget/PCP/IPOS Federal Medicare/Medicaid Funding pays for the services and supports in your plan (IPOS) developed through PCP process The Center for Medicare and Medicaid Services (CMS) defines an Individual Budget as “the total dollar value of the services and supports, as specified in the plan of care, under the control and direction of the program participant”

+ Employer Pros & Cons Good News: Individual Becomes the Employer and has Control on the Supports & Services hired by them Bad News: Employer has to Deal with Complex Issues

+ EMPLOYER STRESS  Managing Employees  Recruiting new Employees  Comprehensive/Extensive background screening  All forms/documents required by tax authority/CMHA  W4, I9  Employment contract  Rate of pay, hours  Evaluation performance  Correcting problems  Discipline  Termination – must follow specific laws/guidelines  Year-End  Payroll tax reconciliation  Employee W2  Social Security Administration W3

+ EMPLOYER STRESS  Payroll Processing  Verification of amounts  Direct deposits  Tax payments  Tax filings  Workers Compensation Insurance  Unemployment Insurance  Wage Reports  Tax Payments  Claims Administration  Workers Compensation  Insurance Policy  Wage Reports  Annual Audits  Claims Administration

+ Idealistic Situation for the Individual? Maintain Employer Control Remove Employer Stress Hire Fiscal Intermediary

+ * FISCAL INTERMEDIARY FI manages the funding on behalf of the Individual, pays for the approved services when the Individual authorizes it, & handles Employer’s complex issues & responsibilities Alliance Choice Care claims to be the Best Fit FI in your journey to being an Employer

+ Fiscal Intermediary: Your Choice. Your Care. ALLIANCE CHOICE CARE

+ Alliance Choice Care Advantages Licensed by the State – Requirement NOT fulfilled by many Strong Infrastructure – Top Payroll processing Software/Backup PEO business for years – Full Capacity to Complete Tasks Meet all Provider & Medicare Requirements Outstanding Customer Service, Communication, & Support Maintains Professional & Business Liability Insurance in Excess of County Requirements

+ Alliance Choice Care Roles Bookkeeper – Compiles all information regarding Individual budget and provides Individual up-to-date reports to monitor budget Tax Accountant – Responsible for tasks related to taxes Payroll Agent – Responsible for tasks related to employment & staffing Financial Advisor – Provides Advice/Information on how best to utilize resources Employment Consultant – Answers Questions, Concerns regarding Employees & Employment Issues

+ Employer of Record – Alliance Choice Care Legal, Tax, & Administrative Tasks 1. Financial Management Tasks 2. Human Resources Tasks

+ Alliance Choice Care as FI Assists With: Payroll/Payroll Taxes/Payroll Reports Workers’ Compensation Insurance State and Federal Unemployment Insurance Employee Benefits

+ Payroll/Payroll Taxes/Payroll Reports Payroll processing Direct Deposits Tax payments – Federal, State, Local withholdings Court-ordered Garnishments Tax reports: Filing Deadlines, Bi-weekly, Monthly, Quarterly Reports End-of-year: W-2 and W-3 forms

+ Workers’ Compensation Insurance Filing Wage Reports Insurance premium payments Claims management Year-end wage audits

+ State and Federal Unemployment Insurance Quarterly Wage reports FUTA, SUTA payments Wage reports: 1017, 1020

+ Recap: FINANCIAL MANAGEMENT Confirm & authenticate work schedule & job description with individual Process Payroll Withholding, filing & paying Federal & State income tax withholding, unemployment taxes, FICA, FUTA, SUTA Pay worker’s compensation insurance premiums Issue forms W-2 Maintain current financial records, all agreement copies & supporting documents

+ Recap: HUMAN RESOURCES TASKS Confirm if prospective workers meet Medicaid provider manual requirements Complete criminal background & reference checks Confirm prospective workers’ citizenship or legal alien status Provide workers training as required by PIHP/CMHSP and/or the AWC provider and/or directed by individual

+ FI & S-D Alliance Choice Care (FI) works directly with the PIHP/CMHSA & the Individual to support S-D principles.

+ The Four Principles, Individual & Alliance Choice Care Freedom:  Individual chooses personal lifestyle established through IPOS. Decides where & with whom to live, how & with whom to connect with, & what opportunities to contribute.  Alliance Choice Care (FI) allows for the efficient utilization of the Individual BUDGET

+ The Four Principles, Individual & Alliance Choice Care Authority: Individual Controls the Resources needed to maintain personal lifestyle Alliance Choice Care (FI) provides the INFORMATION about the budget allowing them to gain more control & efficiency

+ The Four Principles, Individual & Alliance Choice Care Support: Individual fully participates in the arrangements of resources and personnel to assist her/him in living a desired life rich in community association and contributions Alliance Choice Care (FI) Co-Manages Employment (hired support) along with the Individual

+ The Four Principles, Individual & Alliance Choice Care Responsibility: Individual must use public funds efficiently and should contribute to the community through responsible citizenship. Alliance Choice Care (FI) has policies and procedures that ensure COMPLIANCE – meet Medicare requirements, Ensure compliance with Tax Laws, and maintains proper Workers’ Compensation – Insurance policy

+ Alliance Choice Care (FI) helps the Individual become the Managing Employer. Keeps Control. Drops Stress. Individual’s Control/Responsibility Determines Work Schedule and Job Duties Authorizes Payroll by Signing Timesheets Supervises and Evaluate Workers

+ Managing Employer Individual’s Responsibilities Drops Down To:  Reporting wages and hours to FI  Monitoring wages and taxes through secure web portal  Reporting workplace injuries to FI  Reporting changes in employee work status to FI: Terminations, Lay-offs, Leave time

+ Confidentiality: Careful Handling of Privacy Issues Exposure to Privacy details of Individual and their Employees: ACC has Policies and procedures in place to handle privacy issues Equipped with a system that is Extremely careful of privacy issue Careful Handling of Sensitive Information distinguishes ACC from other FI

+ Available Employer Options: Direct Employment – Most Risky with ALL Liabilities Agency with Choice – Least Risky with NO Liabilities

+ Alliance Choice Care. Your Choice. Your Care. Please Contact Us At: Schoolcraft Rd, #108, Livonia, MI Office: Fax:

+ References questions