Frequently Asked Questions

Individuals and Families

Question:

I am currently not part of the “fee-for-service environment,” do I have to transition?

Answer:

Yes. All individuals with self-directing budgets must transition over to the fee-for-service model.


Question:

Do I need to get an Employer Identification Number (EIN) if I choose the Agency with Choice model?

Answer:

No. Under the Agency with Choice model, the fiscal intermediary uses its EIN for payroll purposes so you don’t have to.


Question:

I also have services under the Personal Preference Program. Can I have two fiscal intermediaries?

Answer:

Yes, in select circumstances. The Agency with Choice model is only offered to individuals with self-directing budgets under the Division of Developmental Disabilities (DDD). If you also have services under the Division of Disability Services (DDS), then you could have two fiscal intermediaries.


Question:

Can I hire a family member to work for me under the Agency with Choice model?

Answer:

Yes, BUT parents, guardians, and spouses CANNOT be hired. However, any other family members can be hired to work for you under the Agency with Choice model.


Question:

If one of my Self-Directed Employees (SDE) calls out, can another SDE use their hours to fill in?

Answer:

Yes, BUT Self-Directed Employees can only work under the service or services that they are approved to perform. If one SDE calls out and another comes to work, the time would be recorded under the service the replacement SDE is authorized to work in. REMEMBER, SDEs can still only work the weekly authorized hours for their service so keep the in mind when you are filling shift hours.


Question:

Can my SDEs work over 40 hours in a week?

Answer:

No. SDEs can only work the authorized weekly hours that are in the plan. Overtime is not approved in the fee-for-service environment. Even if an SDE works for multiple people, the total number of hours that SDE can work is still 40.


Question:

What happens if my SDE works more than 40 hours in a week? Will they be paid for overtime?

Answer:

They will NOT be paid overtime as it is not approved per the service description for a self-hire. Any hours worked by the SDE that exceed the weekly authorized hours becomes the responsibility of the Managing Employer to reimburse the SDE.


Question:

How many hours does an SDE have to work to get benefits? Answer: Any SDE hired to work 30 hours a week or more, will be offered medical, dental and vision benefits. Question: How much will I need to budget for benefits?

Answer:

When you hire an SDE you will need to budget for their hourly rate plus the employer-related taxes. If your SDE elects to participate in our benefits program, the Per-Member-Per-Month fee will cover that expense and will vary depending on the SDE’s “tier” rating (see next question for more information). You will need to work with you Support Coordinator to assess how much should be budgeted for benefits.


Question:

What is a Per-Member-Per-Month fee?

Answer:

The Per Member Per Month (PMPM) fee is a monthly service cost for using the Agency with Choice model. SDEs are considered employees-of-record of Fiscal Management Services and are offered benefits per the Affordable Care Act. To assist each individual in making the service affordable, there are four tiers of the PMPM based on the number of SDEs working for them (if they elect for benefits). The staff at AwC will inform your Support Coordinator of which “PMPM tier” will need to be added to your plan.


Question:

Does my SDE need any special trainings or certifications?

Answer:

Yes. There are mandatory trainings that need to be completed either prior to employment or within a certain amount of time from hire. Please refer to the “Training Requirements” schedule [hyperlink to schedule] for more information.


Question:

Is there a cap on the hourly rate for a SDE?

Answer:

The hourly rate must be “reasonable and customary” for the work that is being asked of the SDE. This will vary depending on the services provided.