Maryland Home and Community Based Service Programs: Program Information & Instructions

Maryland Home and Community

Based Service Programs:

Program Information &

Instructions

This packet contains information and instructions regarding the required employer

enrollment paperwork that you must complete and return to PPL. Please review the

informational forms and instructions to ensure that you understand the program

roles and responsibilities. Please fill out all required fields, including Social

Paperwork Signature Requirements

For all forms that require a signature, the following are acceptable signatures:

- A participant serving as their own employer may sign with their traditional signature - A participant can have a power of attorney sign the documents on their behalf

 PPL must receive POA documents in support

 Participant must file IRS Form 2848 (Power of Attorney and Declaration of Representative) with the State Comptroller’s Office

o For more information on Power of Attorney filings, please refer to:

http://taxes.marylandtaxes.com/Resource_Library/Tax_La w_and_Regulations/Power_of_Attorney.shtml.

 Participant must provide a copy of the Durable Power of Attorney form which states that the participant gives legal permission to another person

Any other form of signature other the ones listed above will not be accepted. If you have

any questions, please contact Customer service at 1-800-686-0734 or email us at

MD HCBSP Program Information & Instructions 1

TABLE OF CONTENTS

Instruction for Employer Agreement Form

Instructions for Emergency Contact Designation Form

Instructions for Participant Employer & PCP Confirmation of Information Instructions for IRS Form SS-4

Instructions for IRS form 2678 Instructions for IRS from 8821

Information Packet for Application for Tax Exemption Payroll Schedule Information

Maryland Home and Community Based Service Programs

Frequently Asked Questions (FAQ)

Who is Public Partnerships, LLC and what do they do?

The Maryland Department of Health and Mental Hygiene (DHMH) has contracted with Public Partnerships, LLC (PPL) to act as the Vendor /Fiscal Employer Agent in the Home and

Community Based Service Programs. This means that PPL will manage all payroll matters on behalf of you, the employer, including all federal, state, and county employment taxes. PPL performs this role in similar programs across the country, so it has a lot of experience that it brings to providing this service for you.

What is my role as an employer? What is PPL’s role in the process?

Self-directing your services allows you to use Medicaid funds to choose and hire your own employees to serve as Personal Care Provider(s) (PCP). You are the employer and PPL is your Fiscal/Employer Agent.

As an employer, you will:

 Recruit, hire, and fire all PCPs

 Establish wage rates and performance evaluation criteria for each PCP

 Establish schedules and tasks to be completed by each PCP As your Fiscal/Employer Agent, PPL will:

 Issue payments to PCPs bi-weekly after confirmation of the times worked using the ISAS telephone system.

 Withhold and file appropriate taxes, at the federal, state, and county for each PCP.

 Withhold union fees or dues as appropriate.

 File monthly, quarterly, and annual forms and tax deposits with local, state and federal agencies.

 Issue W-2 Statements to each PCP in January reflecting their previous years earnings.

 Arrange to purchase Workers’ Compensation insurance to cover your PCPs.

 Provide you with monthly expenditure reports to assist you in managing your budget.

 Answer all questions that you and your PCPs have about enrollment and payments

 Help you and your PCP with the enrollment process through our Customer Service Center at (800) 686-0734 or email at: [email protected]

Which taxes are withheld for my each of my Personal Care Providers?

All PCPs must pay taxes on their earnings. PPL will withhold Social Security, Medicaid (FICA), and state and federal income taxes, as well as county taxes from each PCP’s paycheck. A

summary of all PCP tax withholdings will appear on each paycheck stub.

MD HCBSP Program Information & Instructions 3

Do employers pay taxes too?

Yes, employers pay taxes. As an employer, you must match each PCP’s Social Security and Medicaid (FICA) contribution. In addition, you must pay contributions to the federal and state unemployment insurance funds for each PCP. Acting as your agent, PPL will complete all paperwork related to these taxes. PPL will make these tax payments automatically using your Home and Community Based Service Programs funds.

Will I be required to pay for services out of my own pocket?

You do not need to make any out-of-pocket payments. All payroll related expenses are funded using Medicaid funds. These expenses include PCP wages and taxes, employer payroll taxes, workers’ compensation insurance and unemployment insurance.

Do the personal care provider(s) have a union?

Personal care providers in the Home and Community Based Services Program have the opportunity to join the American Federation of State and Municipal Employees (AFSCME) union. Providers who elect to join the union agree to have DHMH and PPL withhold union dues at a rate of 2% of payroll, up to a maximum of $25 per month.

What paperwork must personal care provider(s) complete?

Each PCP must complete and return all required forms included in Section 1, Required Program

Enrollment Forms, of this enrollment packet to PPL before beginning work.

What do I do if I want to hire a new personal care provider(s)?

Please notify your Supports Planner when you choose to hire new personal care providers.

What actions must the employer and personal care provider(s) take, to ensure that the PCP starts receiving payment?

As the employer, in addition to ensuring that you are properly enrolled, you must present each PCP with the Employment Attestation, a document found in the PCP’s enrollment packet. You and your PCP must sign and date this document, and PPL must confirm the form was processed successfully before your PCP can begin working

Who is responsible for submitting time worked to PPL?

As an employer, it is your responsibility to ensure that your worker’s time is submitted through the In-home Support Assurance System (ISAS) daily. PPL will then receive this information in order to make payments.

How can I contact PPL?

Toll Free Phone Number: (800) 686-0734 TTY: (800) 360-5899

Document Submittal Email: [email protected] Customer Service Email: [email protected] Fax: (855) 347-4978

Mail: Public Partnerships, LLC Attention: MD DHMH

7776 S Point Parkway, STE 150 Phoenix, AZ 85044

Vistit our Webpage!

Find program documents, instruction manuals, and other helpful tools.

 Visit www.publicpartnerships.com

 Select a Program: Maryland

 Select “Self-Directed Home Care Programs (SDHCP)

PPL’s customer service phone line is open Monday through Friday, 8:00 am to 5:00 pm Eastern. If you are on hold, it offers you the option to leave a voicemail message and retain your place in line. PPL will automatically call you back when it’s your turn. PPL returns all voicemail messages within one business day of receiving the message.

More than half of our customer service representatives are fluent in both Spanish and English. We also have access to translation services for assisting callers who speak other languages. PPL never charges callers for translation services.

Will PPL ever contact me?

PPL may need to contact you or your PCP(s) for a number of reasons, including:

 To notify you of missing or incorrect documents that may prevent you from receiving services in the Home and Community Bases Services Programs.

 If an error has been made in issuing payment to your personal care providers

Please call us at (800) 686-0734 if you have any questions or email us at:

[email protected]

MD HSBSP Program Information & Instructions 5

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When you should use the Employer

Agreement Form?

This form is an attestation that you agree to act as the Employer of Record in the Home and Community Based Service Program, and that you understand your responsibilities.

Instructions to complete the

Participant Employer Agreement

Form:

 Review the Employer Agreement

 Review the Employer Attestation  Print your name, sign, and date the

What is the purpose of the Emergency

Contact Designation Form?

This form is provided by Public

Partnerships, LLC (PPL) so in the event

PPL is unable to get in contact with you,

we have someone on record to contact.

The designation portion is designed so that

you have a representative to contact PPL.

For example, if you are ill and unable to

contact PPL, this representative will be

able to contact PPL and speak on your

behalf.

Instructions to fill out:

Please fill out the form with the

appropriate contact information.

Employer & Personal Care Provider

Confirmation of Information

Instructions

What is the purpose of the

Confirmation of Information Forms?

PPL has pre-populated many of the

forms included in this packet with

information about you and your personal

care provider(s).

To do so, demographic information

provided by the Maryland Department

of Health and Mental Hygiene (DHMH)

was used.

Do I need to return these forms to

PPL?

Yes. Please confirm that all information

is correct including you and your

personal assistant’s SSN and date of

birth. However, if any of the information

listed on the forms for either you or your

personal assistant is incorrect, we will

need to send you updated Enrollment

forms.

Who do I call if there is incorrect

Information?

If any information included on these

forms is incorrect, please contact your

Supports Planner.

What is the purpose of the

IRS Form SS-4?

This form tells the IRS that you are going to be an employer and allows you to obtain an Employer Identification Number (EIN) from the IRS. This EIN is used to open state employer accounts and designate all tax deposit and filing responsibility to PPL.

Why isn’t my address listed on lines

4a and 4b?

Lines 4a and 4b ask for the mailing address to be attached to this employer account. PPL does not intend to burden you with IRS paperwork. By establishing PPL’s address as the mailing address on your employer account, PPL ensures that you will not receive IRS paperwork relating to this program at your home. Instead, we will receive it on your

behalf.

Who are the people listed in the ‘Third Party Designee’ section?

These are the three PPL staff members who have experience obtaining EINs on behalf of Individual Employers. These individuals are the only people who can obtain an EIN on your behalf.

What lines should I complete?

In all cases, the employer must add their SSN, if not already prepopulated, and sign and date the bottom of the form. Only if you have applied for an EIN in the past, you must complete lines 16a, 16b, and 16c. You do not need to complete any other portions.

IRS FORM SS-4

Application for Employer Identification No.

MD HCBSP Program Information & Instructions 9

What is the purpose of the IRS

Form 2678?

This form tells the IRS that you give PPL permission to act as your Vender

Fiscal/Employment Agent. By signing this form, you authorize PPL to withhold taxes from your employees’ paychecks and deposit those taxes with the IRS. With this form, you delegate the employer tax responsibility to PPL.

If I appoint you as my agent with the

IRS Form 2678, what will you be

able to do?

The IRS Form 2678 only allows PPL to withhold taxes from your employee’s

paychecks and deposit those taxes to the IRS. This form is recognized only by the IRS; other tax agencies do not recognize this form. The 2678 does not authorize us to perform any other tax responsibilities.

What liability does PPL take on when I sign the 2678?

The IRS Form 2678 subjects PPL to all provisions of the law, including penalties that the employer incurs. When you authorize PPL as your agent with Form 2678, PPL is

responsible by law for correctly representing you. PPL incurs any penalties for incorrectly filing or depositing your employer taxes.

Does the IRS Form 2678 authorize you to file my personal income taxes?

What sections must I complete?

You must review, sign, and date the form, and return it to PPL. You should not complete anything else on the form, as it is completed for you.

IRS Form 2678

Employer Appointment of Agent

What is the purpose of the IRS Form

8821?

This form allows PPL to discuss your employer withholding account with the IRS. It does not allow these representatives to sign any

documents.

How is this different than the IRS

Power of Attorney form?

The IRS Power of Attorney Form only allows PPL’s CPA to sign employer tax reports. This form allows three specified PPL representatives, and no one else, to talk and write to the IRS about your employer tax account.

Will PPL be able to discuss my

personal tax account with the IRS?

able to obtain or discuss any personal income tax information.

I make all decisions about my life. If I sign this, what decisions can the

Fiscal Reporting Agent (FRA) make for me?

This form only lets PPL talk and write to the IRS. PPL cannot make decisions about your personal life.

What portion should I complete?

You must sign and date this form in Section 7. You do not need to complete any other portion; PPL has completed the information for you.

Guide to Tax Exemptions Based on Age, Student Status, and Family Relationship

Employee Copy – Keep for your records

Employees providing domestic services such as personal assistance may be exempt from paying certain federal and state taxes based on the employee’s age, student status or family relationship to the employer. In some cases, the employer may also be exempt from paying certain taxes based on the employee’s status. IMPORTANT: Please see IRS Publication: #926 – Household Employer’s Tax Guide, and IRS website article: “Foreign Student Liability for Social Security and Medicare Taxes” for additional information.

IMPORTANT:

• These exemptions are not optional. If the employee and employer qualify for these tax exemptions they must be taken.

• If the employee’s earnings are exempt from these taxes, the employee may not qualify for the related benefits, such as retirement benefits and unemployment compensation.

• The questions regarding family relationship refer to the relationship between the employee and the employer of record (common law employer). In some cases, the program participant is the employer of record. In other cases, the employer of record may be someone other than the program participant. Check program rules.

• Program rules may prohibit some types of employees. For example, most Medicaid-funded programs do not permit a spouse to be paid as an employee for providing services to a spouse. Check program rules.

• PCG Public Partnerships will determine the tax exemptions that apply to the employee and employer based on the information provided by the employee. PCG Public Partnerships cannot provide tax advice.

Tax Exemptions for Non-Resident Students

For a non-resident student in the United States on an F-1, J-1, M-1, or Q-1 visa admitted to the US for the purpose of providing domestic services, the employer and employee are exempt from paying FICA (Social Security and Medicare taxes) and the employer is exempt from paying FUTA (Federal Unemployment Tax) on wages paid to this employee. The employer may also be exempt from paying State Unemployment Insurance, depending on the rules in the state.

Tax Exemptions for Children Employed by Parent

For a child under 21 employed by his or her parent, the employer and employee are exempt from paying FICA (Social Security and Medicare taxes) and the employer is exempt from paying FUTA (Federal Unemployment Tax) on wages paid to this employee until the child (employee) turns 21 years of age. The employer may also be exempt from paying State Unemployment Insurance, depending on the rules in the state.

Tax Exemptions for Spouses Employed Spouses

For a spouse (husband, wife, or domestic partner in some states) employed by his or her spouse, the employer and employee are exempt from paying FICA (Social Security and Medicare taxes) and the employer is exempt from paying FUTA (Federal Unemployment Tax) on wages paid to this employee. The employer may also be exempt from paying State Unemployment Insurance, depending on the rules in the state.

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Tax Exemptions for Parents Employed by Children

For a parent employed by his or her child and answering “No” to any of the additional questions under

Question #6 regarding caring for a grandchild or step grandchild, the employer and employee are exempt from paying FICA (Social Security and Medicare taxes) and the employer is exempt from paying FUTA (Federal Unemployment Tax) on wages paid to this employee. The employer may also be exempt from paying State Unemployment Insurance, depending on the rules in the state.

For a parent employed by his or her child and answering “Yes” to all of the additional questions regarding caring for a grandchild or step grandchild, the employer is exempt from paying Federal Unemployment Tax (FUTA) on wages paid to this employee. The employer may also be exempt from paying State Unemployment Insurance, depending on the rules in the state.

Tax Exemptions for Employee under Age 18

For employees under the age of 18 or turning 18 in the calendar year: If the employee is a student, domestic services are deemed not to be the employee’s principle occupation and the employer and employee are exempt from paying FICA (Social Security and Medicare taxes).

Employment Relationship Status

Federal Insurance Contributions Act - Social Security and Medicare Taxes

Federal Unemployment Tax Act

State Unemployment Insurance

(FICA) (FUTA) (SUI)

Foreign Student on VISA in US for Purpose of Providing Domestic Service

FICA exempt FUTA exempt See footnote (1)

Child Employed by Parent FICA exempt only until 21st birthday

FUTA exempt only until 21st birthday

See footnote(2)

Spouse Employed by Spouse FICA exempt FUTA exempt SUI exempt (3)

Parent Employed by Child FICA exempt only if not also caring for dependent child of the employer (employee’s grandchild)

FUTA exempt SUI exempt except in NY and WA. See footnote (4)

Employee Under 18 or Turning Age 18 in Calendar Year

FICA exempt through year of 18th birthday only if enrolled as a

full-time student

Not Applicable Not Applicable

(1) Foreign student in the United States on F-1/J-1 VISA is exempt from SUI in the following states: PA, WA. (2) Child under 18 employed by parent is SUI exempt in the following states: CA, IL, MA, ME, NJ, NV, OH,

OR, PA, SC, TN, WA, WV.

Child under 21 employed by parent is SUI exempt in the following states: AZ, GA, IN, KS, NY, OK, VA, WY, and District of Columbia.

(3) For California only, a registered domestic partner employed by his/her registered domestic partner is SUI exempt.

(4) Parent employed by child is SUI exempt in all states and the District of Columbia with the exception of NY and WA.

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Maryland Department of Health and Mental Hygiene

Home and Community Based Service Programs

Payroll Information

IMPORTANT INFORMATION PLEASE READ

PPL issues payroll to personal assistants based on the service information provided by ISAS on a biweekly basis. Personal assistants are responsible to call in/out through the ISAS system for days

worked. Failure to report time via ISAS will be reflected in the payroll.

Approved Time Recorded

By: Payroll Date

Wednesday Friday 12/31/2014 1/9/2015 1/14/2015 1/23/2015 1/28/2015 2/6/2015 2/11/2015 2/20/2015 2/25/2015 3/6/2015 3/11/2015 3/20/2015 3/25/2015 4/3/2015 4/8/2015 4/17/2015 4/22/2015 5/1/2015 5/6/2015 5/15/2015 5/20/2015 5/29/2015 6/3/2015 6/12/2015 6/17/2015 6/26/2015 7/1/2015 7/10/2015 7/15/2015 7/24/2015 7/29/2015 8/7/2015 8/12/2015 8/21/2015 8/26/2015 9/4/2015 9/9/2015 9/18/2015 9/23/2015 10/2/2015 10/7/2015 10/16/2015 10/21/2015 10/30/2015 11/4/2015 11/13/2015 11/18/2015 11/27/2015 12/2/2015 12/11/2015 12/16/2015 12/25/2015 12/30/2015 1/8/2016

(Rev. December 2012)

What Is the EIC?

The EIC is a refundable tax credit for certain workers.

Who May Claim the EIC?

You may be able to claim the EIC for 2012 if you worked and all four of the following conditions apply.

Notice 797

(Continued on back) 2. Your 2012 earned income and adjusted gross income are both under $36,920 ($42,130 if married filing jointly) if you have one qualifying child; under $41,952 ($47,162 if married filing jointly) if you have two qualifying children; under $45,060 ($50,270 if married filing jointly) if you have three or more qualifying children; or under $13,980 ($19,190 if married filing jointly) if you do not have a qualifying child. For a definition of earned income, see the 2012 instructions for Form 1040, 1040A, or 1040EZ.

3. Your filing status on your 2012 tax return is any status except married filing a separate return.

4. You were not a qualifying child of another taxpayer in 2012. If you do not have a qualifying child, you must also meet these

conditions.

a. You, or your spouse if filing a joint return, were at least age 25 but under age 65 at the end of 2012. (You meet this condition if you, or your spouse if filing a joint return, were born after

December 31, 1947, and before January 2, 1988.) If your spouse died in 2012, see Pub. 596.

b. You cannot be claimed as a dependent on someone else’s 2012 tax return.

c. Your home, and your spouse’s if filing a joint return, was in the United States for over half of 2012. If you are in the military on extended active duty outside the United States, your home is considered to be in the United States during that duty period and you may be able to claim the EIC.

You cannot claim EIC if any of the following conditions apply.

1. Your 2012 investment income (such as interest and dividends) is over $3,200. See Pub. 596 for more information.

1. You (and your spouse, if filing a joint return) have a valid social security number (SSN) issued by the Social Security Administration. For more information on valid SSNs, see Pub. 596, Earned Income Credit (EIC).

2. You file either Form 2555 or Form 2555-EZ (relating to foreign earned income).

3. You were a nonresident alien for any part of 2012 unless you were married to a U.S. citizen or resident and elected to be taxed as a resident alien for the entire year. See Pub. 519, U.S. Tax Guide for Aliens, for more information.

Department of the Treasury

Internal Revenue Service

If eligible, you can claim the EIC to get a refund even if you have no tax withheld from your pay or owe no tax. For example, if you had no tax withheld in 2012 and owe no tax but are eligible for a credit of $800, you must file a 2012 income tax return to get the $800 refund.

Notice 797 (Rev. 12-2012)

How Do You Claim the EIC?

If you are eligible, claim the EIC on your 2012 income tax return. If you have a qualifying child, you must also fill in Schedule EIC and attach it to your Form 1040 or Form 1040A.

2. At the end of 2012, the child was under age 19 and younger than you (or your spouse, if filing jointly); or under age 24, a student, and younger than you (or your spouse, if filing jointly); or any age and permanently and totally disabled.

3. The child lived with you in the United States for over half of 2012. If the child did not live with you for the required time, there are exceptions if the child was born or died during the year, the child is presumed to have been kidnapped by someone who is not a family member, or there was a temporary absence.

Who Is a Qualifying Child?

Any child who meets all four of the following conditions is a qualifying child.

1. The child is your son, daughter, stepchild, foster child, brother, sister, half brother, half sister, stepbrother, stepsister, or a descendant of any of them (for example, your grandchild, niece, or nephew). An adopted child is always treated as your own child. An adopted child includes a child lawfully placed with you for legal adoption. A foster child is any child placed with you by an authorized placement agency or by judgment, decree, or other order of any court of competent jurisdiction.

More Information

This notice provides the basic requirements to qualify for the EIC. Refer to the instructions for Form 1040, 1040A, or 1040EZ; Pub. 596; or www.irs.gov/eitc for details. You can get IRS forms and publications at IRS.gov or by calling 1-800-TAX-FORM (1-800-829-3676).

There are additional rules if a child is married or is the qualifying child of more than one person. For details, see the 2012 instructions for Form 1040, 1040A, or 1040EZ.

Maryland Home and Community Based Service

Programs:

Personal Care Provider Enrollment Requirements

Under the rules of Maryland’s Home and Community Based Service Programs, each personal care provider may not begin providing services until all of the following are complete:

 PCP Employment Attestation Form

 PCP Application for Tax Exemption Form

 USCIS Form I-9

 IRS From W-4

 Maryland Form MW 507

 Your PCP receives notification from PPL, that he or she may provide services to you.

Personal Care Provider Qualifications:

The personal care provider(s) you hire must meet certain qualifications defined by the Maryland Department of Health and Mental Hygiene (DHMH) before they may provide services to you.

 Your PCP must have met all licensing and other requirements as determined by Maryland DHMH.

 If you are using a Representative to assist you with your responsibilities as the employer, your Representative is not eligible to provide services to you as a personal care provider.

 Personal care providers must complete all required training sponsored by the Department of Health and Mental Hygiene for the Home and Community Based Service Programs.

How your Personal Care Providers is paid:

Payments are made directly to your personal care providers(s). The Home and Community Based Service Programs will make payments to personal care providers either by depositing payment directly via Money Network Services Debit Card, directly into a bank account using Automated Clearing House (ACH) transaction or via paper check.