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Your Guide to FMS Agencies: Part 1

By Caroline Garrett, Service Navigator


For those in the Self-Determination Program, a Financial Management Service (FMS) is required. However, with so many FMS agencies working across the state, how do you know which one is right for you? What does an FMS even do? Are they all the same? One of the most common questions we get at NeuroNav is how to select an FMS.


NeuroNav is here with Part 1 of our series on FMS Information - we asked Robert Bacsik of ARCC Center Foundation, Tamra Flaherty of GT Independence, and Huyen Tran and Alma Morales of Aveanna some of your most common questions, from what models they provide, to the benefits they offer, and even how to get services like Uber, an iPad, or an emotional support animal!


We spoke with each FMS representative briefly via phone or Zoom to ask in-depth questions and sent an additional survey via Google Forms to gather additional information. We’ve included the results in the table below, written in first-person and as close to the representatives’ words as possible. Some answers have been edited for length or clarity.

GENERAL INFORMATION


What experience have you had with the Self Determination Program and with being a Financial Management Service provider?


ARCC

ARCC has over 12 years of experience as a respite agency and has now expanded to provide FMS services. We’ve provided all 3 models for both the self-determination pilot as well as participant-related services related to the ongoing COVID-19 pandemic.


GT Independence

GT has been in SDP for a long time, starting in Michigan. The company’s CEO has a brother who was in SDP back in 2003. We’ve worked with 11 states. GT only does FMS and we are comfortable being experts in this service.


Aveanna

Aveanna, formerly Premier, is a founding member of California’s SDP state workgroup and has provided FMS services for over 10 years and traditional services for over 15 years. Aveanna was the first California based FMS and the first FMS from CA to join the national FMS trade organization, Applied Self Direction. We proudly served the first case that transitioned into SDP. Our system allows for different types of purchases, subscriptions, and service provider payments. At Aveanna, each SDP team member is certified in Person Centered Planning. Our team is also skilled at providing SDP training, spending plan development, revisions and much more.


Which models of FMS do you provide?


ARCC

Bill payer, co-employer, and sole employer.


GT Independence

Bill payer, co-employer, and sole employer.


Aveanna

The bill payer and co-employer models.


What regional centers do you serve?


ARCC

All 21


GT Independence

All 21


Aveanna

All 21


Is there a maximum budget size you can work with?


ARCC

We’re generally equipped for any budget size and will tell clients within the first 10 minutes of a phone call whether or not we can work with their budget. Our average budget is $150,000 per year. Sometimes under the co-employer model we can’t accept large budgets because we’ll have to make payments up-front for some of their services.


GT Independence

There’s no limit because we’re a bigger player. We can accept any budget size.


Aveanna

We have a wide range of budget sizes - anything over $200,000 requires review from upper management. Our top budget size right now is 450k.

CLIENT COMMUNICATION


How do you communicate with clients and families?


ARCC

We communicate via Zoom, telephone, and email depending on the type of question and the client’s preference. We have about 7 different admin staff that people can reach depending on their question.


GT Independence

At the beginning, we work together with a main field service representative. Eventually they have access to customer service representatives for day-to-day support. For bigger issues, they would reach out to the field service representative.


Aveanna

Our team consists of multilingual staff that communicates via email, phone, video calls and in-person. We can meet in-person with people who live near Campbell, Culver City, or Orange County. Currently, we have team members that speak English, Spanish, Vietnamese, multiple Chinese dialects, and Tagalog.


If a client has a question about developing their individual budget, how might you support them?


ARCC

We are happy to help any participant with budget development - in fact, in many cases it’s critical that the FMS agency has input, as workers’ comp rates vary by job.


GT Independence

Generally, developing the budget goes to the service coordinator. The field service rep makes sure the budget aligns with the spending plan. If families want help developing the budget too, we can help with that too and can assist and provide advocacy at the IPP if we’re invited.


Aveanna

Individual budgets have to be based on the last 12 months of funds spent on services in the traditional system. Unmet needs may also be added in, resulting in an increase in the overall budget. Aveanna is happy to assist with developing the spending plan to ensure that you are getting the most out of your budget. Our spending plan tool was developed to lay out all costs that would be included for your services.


How will you send clients monthly reports on how they are spending their individual budget?


ARCC

All client expenses are input into our accounting software. A monthly report is generated by our FMS staff and sent directly to the Participant as well as the Participant's Service coordinator. We also have implemented automatic warnings which allow us to contact our client if they are close to the allotted amount in any budget category.


GT Independence

By email, and families can also call customer service representatives if needed. Once families are using GT as their FMS agency, they will get a welcome letter with all contact info for customer service associates whom they can call and email.


Aveanna

Participants receive messages notifying them of their monthly budget report on the 6th of every month after 3 p.m.


If a client is spending more than they should be in the budget, how will you tell them?


ARCC

We have automatic systems in place to notify our clients in case they reach a certain threshold of allotted budget amounts. This will allow the client to make decisions on whether to adjust budget categories or adjust spending in some other fashion.


GT Independence

Families can check to see where they’re at on a monthly budget. We’re considering alerting families 1-2 months before the end of the year to let them know where they’re at on their annual budget.


Aveanna

Along with monthly budget reports, our AveannaCare portal for the participant has resources that allow the participant to track their spending. We have also developed tools outside of our portal for participants to utilize that tell them if they are under or overspending. In addition, our team monitors the spending of all participants and provides courtesy emails and calls to ensure that the participant is aware of their expenditures.


How do you keep client information secure?


ARCC

All client data is fully secured and protected. We won't go too in depth in discussing our various encryption systems as disclosing this information could make our systems more vulnerable, however I can assure the reader that client data breaches have not happened to us at any time.


GT Independence

All of their information is encrypted. Even the employees’ work laptops are on a VPN. Privacy/HIPAA standards are taken seriously. Attachments are automatically encrypted before it comes in or gets sent out.


Aveanna

Information is kept secure in a highly encrypted database that exceeds current acceptable cyber security standards.

STAFF DETAILS


What percentage of staff’s hourly rate do you charge for things like employment taxes and workers’ compensation?


ARCC

We have a direct pass-through of employer expenses and in no case will we 'keep' any excess. Standard rates for social security and Medicare apply and workers’ comp rates vary by job. The reader should be aware that certain California taxes disappear after the employee has reached $7,000 of annual earnings, so this will allow the participant some relief in budget categories.


GT Independence

For the co-employer model, we charge 19.5%. For the sole employer model, it’s based on the area. We have a calculator that uses a map and lets them know where they are in the territory with a rating system of 1-4. Then we see what the employee is paid by hour and do the reverse math. For example, in Central Valley, it’s usually 20.23%.


Aveanna

Currently, we charge 13.76%. However, please keep in mind the government and labor market change these rates annually.


If you are a co-employer, what role will you play in the hiring of workers?


ARCC

If a participant has an employee they would like to hire, we have an electronic onboarding system which will be sent to all new hires. This will gather all necessary documentation and, if necessary, facilitate a background check. Employees are eligible for direct deposit and benefits are offered if the client is interested in offering this.


GT Independence

We leave that up to the family. SDP is all about their flexibility; we don’t want to come in and be that traditional respite agency. We don’t want to dictate any of that.We do have resources to find workers if the family is asking and is struggling. We have a list of providers, people who have come through GT before, who have said they’re willing to work with other families. We will check to see if they have support staff willing to pick up more shifts in the area.


Aveanna

The participant is in charge of finding, interviewing, training, managing, and setting schedules and pay rates for service providers. As an FMS, we assist with the onboarding process along with verifying employment eligibility/qualification and background checks. Aveanna believes that the participant should be in control as much as possible.


How do you collect time sheets from workers?


ARCC

Paper and electronically.


GT Independence

Workers use the GT app for all time entry. We do paper entries as well, but we want to make sure that we’re one step ahead of the game. We tell our families to use our app as much as possible for time entry. The employer has to review and sign the hours.


Aveanna

Aveanna provides an electronic portal, AveannaCare, for workers to submit their hours worked and for the participant to sign-off electronically, all from the comfort of their own home or on the go.


Do you offer any benefits to Direct Support Staff who are under either model?


ARCC

Yes, but this is completely dependent on the client's budget. We can offer any benefits that the clients may be interested in offering. If they want to offer health insurance we do so through coverage california. This comes out of the client budget.


GT Independence

We offer workers’ comp and taxes. Benefits can be more pricey with the sole employer model because families can offer health insurance. Benefits are usually included in the percentage we charge.


Aveanna

Aveanna provides all the mandated benefits to support staff such as sick leave, COVID sick leave, and Affordable Care Act benefits.

Participant’s often include additional benefits in their spending plan such as bonus payments, increased wages for healthcare benefits and vacation time.

ADDITIONAL INFORMATION


I have a lot of different providers that I want to work with from using Uber to purchasing an iPad to having an emotional support animal trained. How will you work with me and my service providers to ensure prompt payment for such diverse items?


ARCC

Some things are super simple, like horse therapy → services → bill through quickbooks that we pay through credit card. Those payments are usually completed the same day. With more complex items, we have to look at everything on a case-by-case basis. We can’t do reimbursements because the DDS has been clear about that, but we work with each provider as best we can to ensure prompt payment, like preauthorization to buy a gift card and accounting for that in our software. We want to make everything work as smoothly and promptly as possible.


GT Independence

Usually, if they work in one of the service codes, it’s easier. Some stuff is more tricky, if we have to register vendors and employee support or community support - it will “semi-fit the code” but make it hard for it to get rejected. If the regional center says they can’t provide something, we tend to get more creative with the language. Our job is to make sure if the family wants it and it’s been discussed in the IPP or PCP. We’ll rarely say no, you can’t do this.


Aveanna

The spending plan will guide our approach to getting each of your items paid. We already have agreements in place with Uber and Lyft, so we would consult with you and use your spending plan to make sure you had the transportation dollars available to use with these rideshare platforms. We have an Amazon account that allows us to purchase your iPad directly, or we can use our SDP credit card to purchase it from your vendor of choice. Lastly, we will work with your support animal trainer directly to enroll them as a service provider and make sure they are paid within 30 days or less of receiving their invoice.


What would you like to share with our clients about why a client would or would not be a good match for your services? Why would someone choose you over another FMS?


ARCC

We’re local to California (San Diego County) and a medium-sized agency compared to others. Some agencies are really large and work with multiple states. Only a few FMS agencies are participating in just California SDP. We take interest in providing great customer service and addressing issues right away and developing long-term relationships. Our number one concern is the well being of the Participant. The executive director (Robert Bacsik) is the father of a six year old girl, who has a dual diagnosis of Down Syndrome and Autism, so we have a very personal interest in ensuring that every single client of ours is taken care of. Phone calls and emails are returned as quickly as possible and we try to encourage vendors/employees to complete paperwork as quickly as we can so that the participant may start receiving services ASAP.


GT Independence

I would never say they should always choose GT. They do have the choice of the provider that fits best for them.” Families should choose GT if we fit better into the kind of relationships they need. We have the background outside of CA with tangible success stories; we’re not starting from scratch. We pride ourselves on being SDP advocates first, and an FMS agency second. A lot of our company values mirror SDP. If families want a company that lives and breathes by those values, then GT will be a good company for them. We’re there to support them from beginning to end, no matter where they are.


Aveanna

Our diverse, multilingual SDP teams are trained in Person-Centered Planning and Thinking. We provide free consultations with participants to explain our services, our role, our experience and answer any questions or concerns they may have. We want to ensure that our participants are making informed decisions to find the best fit for their program needs. Our local knowledge, Regional Center experience and systems make us a great fit for most families.

Hopefully, this helps you get started on selecting an FMS agency as the next step in making your self-determined dreams come true. You can also check out this video from Disability Voices United SDP Connect on choosing and working with an FMS agency, which provides an in-depth explanation of what each of the three models (bill payer, co-employer, and sole employer) provides. Stay tuned for next month’s newsletter, where we’ll interview some more FMS providers!

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