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Dual Enrollment in DDD and DDS-PPP Self-Directed Options
NJ Division of Developmental Disabilities NJ Division of Disability Services May 17, 2017
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Purpose Introduce PCG Public Partnerships
Review Changes in the DDD Model of Self-Direction Review Changes in the DDS Personal Preference Program (PPP) Explain Special Requirements for Dual Enrollment in DDD and PPP Review Enrollment Processes Provide Customer Service Contact Info Answer Questions This is not a “How To” session. Information on the enrollment process for employers and employees for both programs is available on our website.
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Public Partnerships has been serving the NJ Division of Aging Services since We are excited to be expanding our work in NJ.
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Why was Public Partnerships selected as the statewide Fiscal Intermediary?
In 2015 the NJ Department of Human Services issued a Request for Proposals (RFP) for a new statewide fiscal intermediary. The proposal submitted by Public Partnerships: Was the only one that met or exceeded the requirements for each of the three main criteria: Personnel Experience Ability of the firm to complete the scope of work Clearly demonstrated the firm’s capacity for transitioning DHS' three incumbent solutions in a timely manner Clearly demonstrated a high probability the business needs of DHS' three divisions and five managed care organizations would be met Earned the highest ranked technical score for its blending and integration of the RFP's specifications, particularly its approach to working with three diverse incumbent contractors, and solid experience with the Vendor Fiscal/ Employer Agent (VF/ EA) model and managed care Of the five firms, only one firm's Proposal exceeded the requirements.
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Who We Are Choice Control Services Supports
Founded in 1999 after working with the Robert Wood Johnson Foundation national self-determination grant program. Choice Control Services Supports Currently we support programs in 26 states and serve Individuals with Intellectual/ Developmental Disabilities in 13 states. Our team of employees come from many diverse fields and backgrounds. We have served the NJ Division of Aging Services (DOAS) since 2006.
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National Experience Office locations in Newark, Princeton, and Hammonton, NJ
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Responsibilities of a Fiscal Intermediary
Support individuals and employees through the enrollment process Complete federal and state employer registrations Ensure required background checks on employees are completed Broker Workers’ Compensation Process employee payroll Withhold, file, and pay employer and employee taxes Process provider payment vouchers Issue W-2s and 1099s
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During the transition, Public Partnerships will:
Transfer 9,500 PPP participants and over 15,000 employees from Community Access Unlimited (CAU); Transfer 1,500 DDD program participants and over 2,000 employees from Easter Seals of New Jersey; Enroll 2,500 new DDD program participants and their employees; Transfer 1,500 DoAS participants and over 2,000 providers enrolled in Jersey Assistance for Community Caregiving (JACC); and Transfer 15 veterans and their employees from CAU. In total, Public Partnerships will enroll over 11,000 employers and 19,000 employees, providing orientation and training, enrolling employers and employees with the IRS and the New Jersey Department of Treasury – Division of Revenue, and purchase worker’s compensation insurance from the New Jersey Compensation Ratings and Investigations Bureau.
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Overview of the New DDD Self-Directed Option
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Changes in the DDD Model of Self-Direction
Based on significant feedback from the I/DD community over the past several years, the Division approved a shift from an Agency with Choice model to a Vendor Fiscal/Employer Agent model. Individuals and families expressed their desire for maximum control and choice over their support services. CCW Fee-For-Service was recently approved on 3/31/17 by the Center for Medicaid Services (CMS). Individuals currently funded through the Interim Supports Program will transition to the Supports Program throughout FY18 (7/1/17 - 6/30/18).
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What will change in DDD? The individual or their legal guardian or program representative will act as the employer. Employers can offer a wage above the previous $15 per hour cap. Self-Directed Employees (SDEs) are required to complete professional development training provided by the College of Direct Supports. Individuals must purchase Worker’s Compensation insurance for DDD. The current rate is $92 per year for $500,000 of coverage per accident/per policy/per employee. Employees must complete required training within six months. Individuals cannot permit employees to work over 40 hours per week across PPP and DDD, unless the employee qualifies for the live-in exemption from overtime pay. Individuals can take advantage of important employer and employee tax exemptions. Employers may adjust wages to allow employees who had health benefits to retain coverage through COBRA.
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What is not changing in DDD?
Individuals and families will still: Choose services and supports (who, what, when, where, how much); Determine employee wage rates (between minimum wage and the program limit). Individuals and families still cannot hire parents, stepparents, guardians, or spouses, but may hire other household members. Public Partnerships will not pay for hours worked that exceed the monthly budget. Self-Directed Employees transitioning from Easter Seals will not need to be fingerprinted to enroll.
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Background Checks for DDD
New employees will have to pass the following background checks before they can provide services to the individual: U.S. Office of Inspector General NJ Central Registry of Offenders State/Federal Fingerprinting Background Check Complete the NJ Universal Fingerprinting Form to schedule and attend an appointment at Morpho-Trust to be fingerprinted. Employees providing transportation services will need to provide a valid driver’s license and consent to have a Driver’s Abstract History Report conducted.
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Overview of Changes to the DDS Personal Preference Program (PPP)
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What is changing in PPP? Individuals must use direct hire PCA services. Individuals must purchase Worker’s Compensation insurance for PPP. The current rate is $92 per year for $500,000 of coverage per accident/per policy/per employee. The direct service portion of the budget will decrease from 90% to 87.5%. This reflects a 2.5% increase in administrative costs. The check cutting fee will increase $.95 to $2 per check or transaction. Bi-weekly pay periods will begin on Monday and go to the next following Sunday. To comply with NJ wage law, pay dates will be Wednesdays (10 days after pay period end). Individuals cannot permit employees to work over 40 hours per week across PPP and DDD unless the employee qualifies for the live-in exemption from overtime. Savings carry over from month-to-month, for up to six months. The IRS requires Public Partnerships to report cash disbursements as miscellaneous income if over $600 per year. Individuals can take advantage of important employer and employee tax exemptions.
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What is not changing in PPP?
Individuals will still: Act as the employer (with help of legal guardian or program representative as needed) Choose services and supports (who, what, when, where, how much); Control the monthly budget using the Cash Management Plan (CMP); Revise the CMP as needed; Request cash for miscellaneous expenses; Determine employee wage rates (within minimum wage and the program limit). Individuals still cannot allow employees to work over 40 hours per week in PPP. Public Partnerships will not pay for hours worked that exceed the monthly budget. Public Partnerships has hired CAU consultants wherever possible.
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What You Need to Know About Dual Enrollment in DDD and PPP
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What is dual enrollment?
NJ DHS permits individuals to be dually enrolled in PPP (administered by the Division of Disability Services), and either the Supports Program or Community Care Waiver (CCW) Program (administered by the Division of Developmental Disabilities) The programs are separately administered by DDD and DDS and have unique features, including different eligibility criteria, individual budgets, services, rates, authorizations, provider credentials, etc. For these reasons, Public Partnerships cannot combine the two programs.
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Why must the individual appoint a program representative to act as the employer in DDD?
In order to comply with IRS rules and regulations, Public Partnerships cannot combine wage and tax reporting for individuals dually enrolled in PPP and the Supports Program or CCW Program. The individual is always the employer in PPP – therefore, a dually enrolled individual must appoint someone else as a program representative to register with the IRS as the employer of record for DDD services. (Individual cannot be employer of record for both PPP and DDD.) The program representative may not be a self-directed employee. Public Partnerships will assist the program representative to register as an employer with the IRS. The IRS will assign the program representative an Employer Identification Number (EIN) that is not the program representative’s Social Security number.
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Does registering with the IRS as an employer for DDD services under the F/EA model put family members at increased risk? Under the Agency With Choice (AWC) Model Easter Seals is the “employer of record” with the IRS. However, this has no bearing on labor law. Easter Seals and the individual or family are considered “co-employers” under the US Department of Labor. Acting as the “managing employer”, if a family member violated an employee’s rights, the family member could already be held liable as a co-employer. Under the Fiscal/Employer Agent Model The individual or family is the sole employer, and solely responsible for safeguarding employee’s rights. Bottom Line: As co-employers under the AWC model, family assets are already at risk for violation of employee rights under labor law.
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What if the individual or family are unwilling or unable to appoint a program representative to act as the employer for DDD services? If the individual is not willing or able to appoint a program representative as the employer of record for DDD services, the individual may choose to receive DDD services from a traditional agency provider.
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What are the other requirements of dual enrollment?
Program representatives appointed by individuals enrolled in PPP must purchase an additional workers’ compensation policy for DDD services provided by self-directed employees (one WC policy for each program) Public Partnerships will assist the program representative in obtaining an additional workers’ compensation policy for DDD services. The workers’ compensation policy premiums and fees will be paid out of the individualized budget as part of the service plan.
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Why can’t employees work over 40 hours per week across DDD and DDS unless they qualify for the live-in exemption from overtime pay? Appointing a program representative for IRS purposes has no bearing on how the U.S. Department of Labor views employment. The U.S. Department of Labor views anyone who determines the employee’s economic realities as an employer (including both the individual and family). Under the Fair Labor Standards Act, employers who allow employees to work more than 40 hours per week across PPP and DDD combined are responsible for paying overtime rates unless the employee qualifies for the live-in exemption. In other words, 40 hours per week is the maximum a self-directed employee can work unless they qualify for the live-in exemption, regardless of whether those 40 hours are PPP hours, DDD hours, or a combination of PPP/DDD hours. Exception: An employee may work over 40 hours for separate DDD employers
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Are there other benefits of preventing payment for overtime?
Yes! Limiting overtime to self-directed employees who qualify for the live-in exemption: Ensures individuals do not spend their available budget before the end of the plan year Enables DDD to serve more individuals by conserving limited state resources
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What is the live-in exemption from overtime pay?
Self-directed employees qualify for the live-in exemption if the employee resides on the employer's premises either permanently or for extended periods of time. “Employer’s premises” means the individual’s home, regardless of who owns the home. “Permanently or for extended periods of time” means the employee lives, works, and sleeps in the individual’s home for at least five days (120 hours) per week. In other words, if the self-directed employee lives, works, and sleeps where he/she works for at least five days per week, the individual/representative acting as the employer is not required to pay overtime. 25
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For additional information on DDD/PPP Dual Enrollments:
Visit the Public Partnerships website at: Select Learn More Select NJ Division of Developmental Disabilities Select Program Documents
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Enrollment Process for DDD and PPP
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Enrollment Methods Public Partnerships is conducting group enrollments for DDD In our experience, individuals and families enjoy learning and enrolling together. Public Partnerships is conducting home-based enrollments for PPP This is because we provide the Financial Counseling Services for PPP. Our consultants are responsible for helping the individual to develop the Cash Management Plan (CMP).
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DDD Employer Enrollment with Public Partnerships
Online Enrollment Over-the-Phone Enrollment
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DDD Online Enrollment Process
Employer registers an account on BetterOnline™ Employer completes online packet Employer prints packet to sign some forms Scans and uploads signed documents Employer will receives confirmation Employer receives approval from Customer Service
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DDD Online Enrollment Online enrollment ensures documentation is properly completed in real-time Individuals will need an address and access to: Computer Internet connection Printer Scanner/Smartphone App (TinyScanner)
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DDD Over-the-Phone Enrollment
Individual calls Customer Service (CS) CS collects information from Individual CS sends pre-filled packet to Individual Individual reviews and signs forms Individual sends signed forms to PPL CS calls Employer to confirm employment
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Employee Training Requirements for DDD
The trainings must be completed within the first 6 months of hire. Most of the trainings will be provided online, and self-guided through the College of Direct Support. CPR/First Aid training is classroom based and recertification is required every two years. NJ DDD will pay for training hours and fees. Public Partnerships will register the employee for the College of Direct Supports Trainings. The DDD System Mandatory Training Bundle, which includes DDD Shifting Expectations Preventing Abuse/Neglect/Exploitation training and practicum DDD Life Threatening Emergencies (Danielle’s Law) CPR/First Aid, which requires re-certification every 2 years; Medication training and practicum, if applicable; Behavior Plan training if applicable; and, Individual/Family Orientation
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Complaints and Grievances
Grievance – a concern or disagreement that was not able to be addressed in the complaint process If any employer or employee are ever dissatisfied, they may submit a complaint or grievance for resolution and/or response. Call Public Partnerships Customer Service and indicate that you would like to file a formal grievance.
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Customer Service Phone Numbers & Emails
Division of Disability Services (DDS) Personal Preference Program (PPP) These people may reference Community Access Unlimited (CAU) (English) (Spanish) Division of Developmental Disabilities Self-Directed Options - Community Care Waiver (CCW), Supports, Interim These people may reference Easter Seals (ES) (English) (Spanish)
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Questions? Frequently Asked Questions (FAQ) are posted on our website ? 36
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