ANOTHER DAY, INC. Home and Community Based Services (HCBS) Waiver Program Kansas Self-Directing Informational Packet
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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: support@anotherday.info rev. 3/2015What 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
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: support@anotherday.info rev.1/2018PLEASE 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 not limited to the following:
Hire and direct the workers who provide the services in accordance with the Plan of Care (“POC”);
Understand and perform its roles and responsibilities as employer, including but not limited to obtaining all
necessary licenses and identifications as an employer under applicable state and federal law;
Understand the roles and responsibilities of the FMS provider, and its assistance with participant with its role as a
sole employer of the DSW;
Receive initial and ongoing employer related training as requested to enable participants or representatives to
independently direct and manage HCBS services such as recruiting and hiring direct service workers, managing
workers, including effective communication and problem-solving;
Receive explanation of all aspects of participant-direction and subjects pertinent to the participant or participant’s
representative in managing and directing services;
Receive assistance in arranging for, directing and managing services;
Receive assistance in identifying immediate and long-term needs, developing options to meet those needs and
accessing identified supports and services in accordance with the POC;
Assist in developing back up plan in the event the DSW does not report to work or fails to perform required
services in accordance with the POC;
Receive explanation on the use of the AuthentiCare Phone system as the required tool for reporting of DSW’s
time and attendance;
Responsible for providing resources and training to DSWs on the use of the AuthentiCare system;
Employer related responsibilities, such as
UNDERSTANDS HIS/HER ROLE AS THE SOLE EMPLOYER OF A DSW
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; AND APPROVE AND
VALIDATE TIME WORKED ELECTRONICALLY OR BY EXCEPTION PAPER TIMESHEETS.
ASSURE UTILIZATION OF EVV SYSTEM TO RECORD DSW TIME WORKED AND ALL OTHER REQUIRED
DOCUMENTS TO THE FMS PROVIDER FOR PROCESSING AND PAYMENT IN ACCORDANCE WITH
ESTABLISHED FMS, STATE, AND FEDERAL REQUIREMENTS. THE EVV/TIMESHEET WILL BE REFLECTIVE OF
ACTUAL HOURS WORKED IN ACCORDANCE WITH AN APPROVED POC.
ASSURE DSW ACCURATELY AND CONSISTENTLY USES THE AUTHENTICARE SYSTEM TO RECORD DSW TIME
WORKED AND THAT THE HOURS WORKED AND TASKS PERFORMED ARE WITHIN THE POC LIMITS.
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 his or her 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.
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: support@anotherday.info rev. 3/2015 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.
Maintain evidence of certifications, agreements, and affiliations as required by waiver or policy.
Assure required DSW enrollment documents are received by the FMS provider prior to the DSW start of
employment.
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: support@anotherday.info rev. 3/2015FMS 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.
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: support@anotherday.info rev. 9/2013 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
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: support@anotherday.info rev. 9/2013Self-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. 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: support@anotherday.info rev.3/2015
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. 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: support@anotherday.info rev.3/2015
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:
x A court-appointed Guardian, with approved papers authorizing them to sign on behalf of the HCSR.
x Someone with IRS authorization (attained by executing Form 2848, Power of Attorney Declaration of
Representative).
x 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.
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: support@anotherday.info rev.3/2015Department 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.
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 Comments
Available
Consumer’sName:
(First)(MiddleInitial) (Last)
PhysicalAddressChange
ChangePhysicalAddressWhereConsumerLives:
Address:____________________________________________City:_____________________________________
County:_____________________________________________State:________________Zip:_______________
ServiceRelatedContactInformationChange
ChangeMailingAddresswhereServiceRelatedInformationissent:
Address:____________________________________________City:_____________________________________
State:___________________Zip:_______________
ChangePhoneandEmailwhereservicerelatedinformationissent(includingmissedvisitsandservicedocuments):
Phone:(______)______________________________Email:____________________________________________
SecondaryContactAdditions/Changes
Name:___________________________________________
Relation: පLegalGuardianofConsumerපParentofConsumerපDesignatedRepපOther
Address:____________________________________________City:_____________________________________
State:___________________Zip:_______________
Phone:(______)______________________________Email:____________________________________________
_____________________________________________________________________________________
Consumer/RepresentativeName(Print)
Consumer/Representative Name (Print) Consumer/RepresentativeSignatureDate
Consumer/Representative Signature Date
Address:11802W77th St.,Lenexa,KS66214Phone:913Ͳ599Ͳ2221 TollFree:1Ͳ866Ͳ599Ͳ2221 Fax:913Ͳ599Ͳ5660
Website:www.anotherday.info EͲmail:support@anotherday.info rev.1/2018 2021 Consumer Directed Program Payroll Disbursement Dates Service Period Payroll Disbursement Date Dec 1 – 15, 2020 Jan 04, 2021 Dec 16 – 31, 2020 Jan 15, 2021 Jan 1 – 15, 2021 Feb 3, 2021 Jan 16 – 31, 2021 Feb 18, 2021 Feb 1 – 15, 2021 Mar 3, 2021 Feb 16 – 28, 2021 Mar 18, 2021 Mar 1 – 15, 2021 Apr 2, 2021 Mar 16 – 31, 2021 Apr 16, 2021 Apr 1 – 15, 2021 May 3, 2021 Apr 16 – 30, 2021 May 18, 2021 May 1 – 15, 2021 Jun 3, 2021 May 16 – 31, 2021 Jun 18, 2021 Jun 1 – 15, 2021 Jul 2, 2021 Jun 16 – 30, 2021 Jul 16, 2021 Jul 1 – 15, 2021 Aug 3, 2021 Jul 16 – 31, 2021 Aug 18, 2021 Aug 1 – 15, 2021 Sep 3, 2021 Aug 16 – 31, 2021 Sep 17, 2021 Sep 1 – 15, 2021 Oct 1, 2021 Sep 16 – 30, 2021 Oct 18, 2021 Oct 1 – 15, 2021 Nov 3, 2021 Oct 16 – 31, 2021 Nov 18, 2021 Nov 1 – 15, 2021 Dec 3, 2021 Nov 16 – 30, 2021 Dec 17, 2021 Dec 1 – 15, 2021 Jan 3, 2022 Dec 16 – 31, 2021 Jan 18, 2022 Jan 1 – 15, 2021 Feb 3, 2022
Accessing Your Paystubs Online: NON Card holders ONLY. If you have a Global Cash Card You
will receive separate instructions for activating your card and online access. If you have any
questions about setting up your paystub access, please contact My Wisely customer service
at 1‐866‐313‐6901.
Step 1: Go to https://cardholder.globalcashcard.com and Step 5: Create a USER NAME and PASSWORD for accessing
click on ‘Login/Sign Up’ from the top menu your account. Enter all required fields (*) and make sure
your mailing address is correct. If not, notify Another Day
Step 2: Click on ‘Sign Up Now!’
Payroll immediately!
Step 3: On Activate Account Select NO
Step 4: Enter your Name, Social Security Number and
Another Day, Inc.
You can now log in using the username and password you
created.
For Employer Enter:
Another Day, Inc.
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