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What's New? Q&A on the Self Directed Care Program 5/2/2004 - What is the Self-Directed Care Program? The Self-Directed Care Program is a consumer driven program that Elder Services of Worcester has developed to allow its clients to have more control over their own home care. The elder or his/her designee, as the employer is trained to recruit, hire, schedule, supervise and, if necessary fire their own workers. Elder Services of Worcester serves as a Fiscal and Supportive Intermediary Service Organization for clients enrolled in this program. Who is eligible for the Self-Directed Care Program? In order to enroll in the Self-Directed Care Program the elder must be eligible for either Elder Services of Worcester's Home Care or Respite Program. Eligibility criteria includes: The client lives at home, not in an institutional setting. The client is 60 years of age or older or has a documented diagnosis of Alzheimer's Disease and his/her caregiver is in need of respite services. The client meets the income guidelines for either the Home Care or Respite Program. The client needs the type of assistance offered by the Home Care or Respite Program. The client agrees to the care plan developed with the assistance of his/her Case Manager. The client and/or his/her designee are willing and able to meet the employer responsibilities of the program. What types of services can a client enrolled in the Self-Directed Care Program receive? The following services are provided under the Self-Directed Care Program: Homemakers to assist with cleaning, laundry, shopping and meal preparation. Personal Care Chore Companion A Self-Directed Care client may require additional services (i.e. home delivered meals, Social Day Care etc.) to meet their needs. These services can also be provided as long as the cost of total service plan does not exceed the client's monthly service dollar allotment. Elder Services of Worcester is not a skilled nursing agency. Clients who have a skilled nursing need (Nursing, Physical Therapy, Occupational Therapy, Speech Therapy) will be encouraged to speak to his/her physician about making a referral to a Certified Home Health Agency for delivery of these services under his/her Medicare benefit. Are there limits on the amount of services that a client can receive under the Self-Directed Care Program? An assessment is conducted by the case manager to identify any unmet needs that the client may have. Following the assessment Elder Services of Worcester will authorize payment for an amount of services based on a care plan that is developed by the client and case manager. The total cost of the service plan must fit within the agency's budget as a whole. What services does Elder Services of Worcester provide to clients enrolled in the Self-Directed Care Program? Elder Services of Worcester serves as a Fiscal and Supportive Intermediary Service Organization (ISO) for clients of the Self-Directed Care Program. ISO services include: Facilitate employer-related functions such as payroll, tax withholding, tax reporting, and benefits management. Perform criminal background checks on workers on behalf of clients. Receive time sheets from the clients and facilitate the issuance of paychecks to workers through a payroll service. Assist clients with assessment of their needs, develop a care plan, and provide written resources about recruiting, hiring, scheduling and supervising workers. Assist clients in problem solving around issues of recruiting, supervising or firing a worker. What are the benefits of being enrolled in the Self-Directed Care Program? Serving as the employer empowers the client by increasing his/her role in the decision making process as it pertains to his/her service plan and how the services are managed and delivered. Savings to service plans are realized through the reduction in administration costs which are accrued in managing a service plan. This means additional service dollars for the client's care. What does the client's designee mean? This term refers to a family member, friend or neighbor who agrees to help the elder with the employer of record responsibilities including: recruiting, hiring, scheduling, supervising and, if necessary, firing a worker. The designee cannot also serve as the paid home care worker. May clients hire family members as workers? Clients can hire family members to serve as their paid home care worker. Family members can live in the home of the client however, Elder Services of Worcester's case manager has the discretion to adjust the client's care plan to reflect the assistance already provided by the live-in family member (i.e. housekeeping or meal preparation). A spouse cannot serve as the client's paid home care worker. How are pay rates and benefits established for workers? Elder Services of Worcester will negotiate the worker's rate of pay directly with the client. The case manager will inform the client of the total amount of monthly service dollars authorized and the average hourly rate for the services that are required. With this information the client/designee is responsible for negotiating a set hourly rate with his/her worker. The rate will be documented on the Contract of Employer and Worker. Workers are covered under the Social Security program, the federal/state unemployment compensation program, and the stat workers compensation program. There are no other benefits currently offered to workers in this program. Back to What's New?
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