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DSP Retention Payments

The Ohio Department of Developmental Disabilities (DODD) launched the county board-funded Direct Support Professional (DSP) retention payment initiative for independent providers and DSPs of agency waiver providers.

On Tuesday, December 13, the Ohio Legislature amended language to authorize the payments into House Bill 45. The bill passed the Ohio Senate and Ohio House on Thursday, December 15. Governor DeWine signed an executive order which authorized DODD to file an emergency rule and launch the initiative. DODD and county boards of developmental disabilities are issuing payments.

How the initiative works

In July, the federal Centers for Medicare and Medicaid Services (CMS) approved the initiative with an effective date of July 1. This allowed for these payments to be retroactive to that date. Quarterly payments were distributed to participating home and community-based waiver providers that opted-in. The vast majority of the payment was distributed to eligible DSPs. Participating agency providers are required to quarterly report certain data elements and attest that the funds were used in accordance with all requirements. Independent providers were also eligible for payments and did not need to opt-in or report to participate.

This investment assisted Ohio's developmental disabilities system by addressing the workforce crisis through retention incentives for DSPs. With a federal match, county boards generated approximately $143 million annually for retention payments to the DSP workforce.

Retention payments will be distributed quarterly from DODD to participating home and community-based waiver providers, and providers will then send retention payments to each eligible DSP. Every quarter, participating agency providers will be required to report certain data elements and attest that the funds were used in accordance with all requirements. Independent providers are eligible for payments and will not need to opt-in or report to participate. Waiver providers, including independent providers, of the following services are eligible for the payments:   

·    Homemaker/Personal Care (HPC);   

·    HPC - Daily Billing Unit;   

·    HPC - Participant-Directed;   

·    On-Site/On-Call;   

·    Shared Living;   

·    Non-Medical Transportation;   

·    Transportation;   

·    Adult Day Support;   

·    Career Planning;   

·    Group Employment Support;   

·    Vocational Habilitation; and   

·    Individual Employment Support.   

First payment structure

Because the initiative is retroactive to July, initial payments covered  three quarters of payments. This allowed DODD to expedite payments and put the initiative on schedule with rule requirements by April. DODD staggered the three initial payments to providers, which assists providers in tracking how funds are passed along to DSPs. The table below shows how the first payments were issued.

Provider agencies and independent providers will receive the first payments in mid-January. Eligible DSPs employed by agency providers will receive payment from their employers by mid-March. Agency DSPs should talk with their employer to determine when they will receive their retention payments.

Thank you!

DODD thanks our partners once again for their collaboration on this initiative. This creative and first-of-its-kind proposal was led by Ohio's county boards of developmental disabilities and the Ohio Association of County Boards of Developmental Disabilities (OACB). County boards, OACB, and DODD worked with the DODD Workforce Crisis Task Force, the Ohio Provider Resource Network, the Ohio Health Care Association, the Ohio Waiver Network, the Values and Faith Alliance, and the Arc of Ohio in the development of this proposal to invest local funds to support the DSP workforce. 

Thank you to all the DSPs across Ohio who provide essential daily support to Ohioans with developmental disabilities. This effort and this investment is for you. Thank you.

Additional information

Please read the frequently asked questions below and refer to the following attachments for additional information.

  • One-pager for independent providers
  • One-page for agency providers
  • eMBS opt-in guide for agency providers
  • Template to assist agency providers calculate payments
  • Administrative rule

Please contact retentionpay@dodd.ohio.gov with further questions.

Reporting and Payment Timelines

Service provision

Provider Opt-In Start

Provider Opt-In End

Retention Payment Processing Date

Retention Payment to agency DSP

Data Collection From Provider

April-June 2022

1/3/23

1/16/23

1/18/23

3/15/23

4/15/23

July- September 2022

1/3/23

1/16/23

1/25/23

3/15/23

4/15/23

October-December 2022

1/3/23

1/16/23

2/1/23

3/15/23

4/15/23

January-March 2023

4/3/23

4/18/23

5/3/23

6/15/23

7/15/23

April-June 2023

7/3/23

7/16/23

8/2/23

9/15/23

10/15/23

*All dates are estimated as of the time of this writing

*Payment dates (provider and DSP) are not the exact date payments will be processed

*Retention payments to the DSP must be issued by date listed

FAQ

What is a retention payment?

The retention payment is a quarterly payment being sent to the agency and independent providers of direct services to people enrolled in home and community-based services waivers administered by DODD. These payments are intended to help limit the impact of the nationwide workforce crisis on people in need of services by providing additional financial support to professionals providing direct support. The funding for these payments is available through local funds provided by county boards of developmental disabilities and the federal Medicaid match from the local funds.

How is the retention payment calculated?

The retention payment is calculated by multiplying 6.5% by the total amount of claims paid during the applicable calendar quarter for eligible services.

The following services are included in the paid claims universe: Homemaker/Personal Care (HP), HPC-Daily Billing Unit, HPC-participant directed, On-Site/On-Call, Shared Living, Transportation, Adult Day Support, Career Planning, Group Employment Support, Vocational Habilitation, Individual Employment Support, & Non-Medical Transportation.

How is the retention payment transferred to providers?

The retention payment will be coded in the same manner as claims for services but will be issued separately from claims.  The retention payment invoice will be available in the Year End Summary report in eMBS.

How do I get a retention payment?

Agency and independent providers in good standing that have paid claims during the applicable calendar quarter are eligible for a retention payment. To receive a retention payment, an agency provider must opt-in, provide all required data (every quarter), and attest that the funds were used in accordance with all requirements. Independent providers will receive these payments automatically.

What does it mean to be in good standing?

A provider is in good standing if the provider is not under suspension, suspension pending revocation, or revocation by DODD.  For purposes of these retention payments, providers who are not in good standing at the time of payment distribution will not receive payment, even if the provider was in good standing during the opt in period and at the time of attestation.

How do I opt in and submit all the required data/attestation elements?

Eligible agency providers will opt in and submit required data and attestations using the eMBS application. Providers will select the “Employee Retention Payment” tab within the application to opt in or out of the program, attest to adhering to program requirements, and reporting the distribution of the funds to eligible employees.  A training document can be found on this page.

Why is an attestation required at opt in?

The attestation provides assurances that the provider has reviewed and understands program and reporting requirements. While the attestation is made prior to the release of the funds, this serves as the provider’s commitment that once received, the funds will be used in accordance with the rule and the provider will comply with the reporting requirements by entering data into our web-based portal. 

 

Are independent providers included in the retention payments?

Independent providers in good standing that have paid claims during the applicable calendar quarter will automatically be included in the retention payments. Independent providers do not need to do anything to receive the quarterly retention payment.

Can independent providers opt out of this program?

No.  Independent providers will automatically receive 6.5% of their eligible billing for the quarter in which payment is issued.

How can independent providers find out what their retention payment is for each quarter?

Independent providers can identify their retention payment by logging in to eMBS.  The provider will select the quarter to review under the opt-in option.  Please see the instructions at https://dodd.ohio.gov/providers/RetentionPayment  for detailed instructions.

Who are eligible employees?

To be eligible to receive an employee payment, staff 1) must have provided direct support or otherwise supported the provision of direct support during the applicable calendar quarter and 2) must still be employed at the time the retention payments are processed by the participating agency provider.

Eligible staff for an applicable quarter is defined as a person that has the opportunity to be alone with or exercises supervision or control over one or more individuals with developmental disabilities and engaged in such support for at least 50% of their total hours worked in the applicable quarter. This includes direct support professionals, front-line supervisors, vehicle drivers, and similar employees.

In general, non-staff, contracted workers, administrators, owners, and/or executive staff are not eligible employees. Some limited exceptions may apply such as 1) smaller agencies where executive staff routinely provide direct support as a regular part of their job responsibilities or 2) shared living providers that contract with an agency provider.

How do I determine how much to pay each eligible employee?

Participating agency providers have only two options for calculating eligible employee payments:

  1. Total wages
    1. Each employee gets the same percentage of their total wages (regular and overtime combined)
    2. Total amount available / total wages (regular and overtime) = % adjustment in wages
    3. % adjustment in wages X eligible employee total wages = employee payment

 

  1. Total eligible employees
    1. Each eligible employee gets the same amount
    2. Total amount available / number of eligible employees = employee payment

Agency providers can withhold up to 18% of the total retention payment to use for implementation and other costs. If an agency provider chooses to do this, additional reporting requirements are required.

A template is available to assist agency providers with the payment calculation as well as the required data elements. Using the provided template is highly encouraged.

Does the retention payment affect overtime compensation?

Any questions related to Department of Labor regulations should be addressed to your legal counsel.

What are the OT implications?

We cannot give legal or accounting advice on the impact of overtime laws on  the calculation of employee retention payments.  We can explain the concepts behind the creation of the template.  However, it is important to note that use of the template is not required, and others may have different interpretations on the impact the retention payments have on the calculation of overtime.  Agencies should seek appropriate counsel.

The template was designed using ‘total wages’ for calculating eligible employee payments. Total wages include all compensation paid for both straight-time and overtime.  Using this method, each employee is paid a fixed percentage of their total wages.  When the payments are calculated in this way, additional overtime is being considered in the calculation.  FLSA2019-7  states:

An employer, however, is not required to retrospectively recalculate the regular rate if the employer pays a fixed percentage bonus that simultaneously pays overtime compensation due on the bonus.  See 29 C.F.R. § 778.210; Brock v. Two R Drilling Co., 789 F.2d 1177, 1179–81 (5th Cir. 1986).  For example, a bonus that is 10 percent of straight-time wages (the contractual hourly rate × straight-time hours worked up to 40) and 10 percent of overtime wages (1.5 × the contractual hourly rate × straight-time hours worked over 40) does not require recalculation of the regular rate because the bonus includes the overtime compensation due on the bonus as an arithmetic fact, fully satisfying the FLSA’s overtime requirements.  See 29 C.F.R. §§ 778.210, 778.503.3.  Similarly, a bonus that is 10 percent of total compensation—including hourly wages, overtime, bonuses, commissions, etc.—does not require recalculation.  See, e.g., 29 C.F.R. § 778.210; WHD Opinion Letter FLSA2006-4NA, 2006 WL 4512946, at *1 (Feb. 17, 2006).

In addition, the template also includes an alternative calculation method that compensates each eligible employee the same amount regardless of total compensation.  This may have overtime implications that are not addressed appropriately in the template. 

When do I use the OT box?

 If you believe or have been advised that overtime is warranted, in addition to what is described above, an optional box was added that calculates OT on the amount of the bonus.  This amount is added to the calculation of the employee payment amount.  As such, the additional amount must be deducted from any administrative withholding amount (up to 18%) or will require additional provider funds outside of the retention payment.

 

 

How long will the retention payments be available?

There is no definitive end date for the retention payments. However, we will continue to work with stakeholders and funding partners to evaluate the effectiveness of the payments. The data collected from participating agency providers, as well as continual feedback from those participating and their eligible employees, will be critical components of any evaluation.

If an agency provider already does its own incentives or other bonus programs, can these funds be used for those programs?

By participating in these retention payments, agency providers are attesting that these funds will be used to compensate eligible employees as explained above. The retention funds can only be used to expand or enhance existing programs by utilizing the available funds for program administration (18%).

If an agency provider bills for shared living but contracts with a shared living provider, should the shared living provider receive a retention payment?

Yes. This is the primary exception where it is appropriate to include contract staff in the employee payment calculation. Shared living contractors should be considered eligible employees if the provider agency bills for the shared living service and contracts with the shared living provider.

If an agency provider contracts with a shared living provider, what should be reported for the number of hours provided for that service?

The amount paid to the shared living contractor for the applicable calendar quarter is reported as regular wages. Hours worked are not reported for shared living contractors. If the provided template is being used, indicate the entry is for a shared living contractor in the appropriate column. If the template is not being used, the amount paid to shared living contractors is reported separately from other employee wages.

Can I increase hourly wages with this money?

No. As discussed above, there are only two options for calculating eligible employee payments (bonus as a % of total wages or flat bonus per employee). Although there are a few reasons for this restriction, the main reasons are consistency among eligible employees, the ability to verify what occurred, and lastly, this method prevents wage reductions if the retention payments were to come to an end.

Is the provided template required?

The provided template is not required but is highly encouraged. Whether the template is used or not, participating providers must follow the standardized methodology for determining payments to eligible employees and maintain all records documenting the calculation.

How quickly must eligible employees be paid after receipt of the retention payment from DODD?

The first two quarterly payments, representing the second and third quarters of CY 2022, must be distributed according to the table below. 

Beginning with the fourth quarter payment for CY 2022, eligible employees payment must be dispersed by the 15th day of the third month of the quarter in which the payment was made to the provider. Guidance regarding timelines for payment can be found on this page.

If the employee separates from service before payments are processed, the employee is not eligible for payment. 

What if eligible employees work in multiple locations some of which are not funded by waiver funds?

If eligible employees provide direct support funded by multiple funding streams and it is the employer’s discretion for which funding stream the employee provides that support, participating providers should include all eligible employees and all eligible employees’ regular and overtime wages (all sources) when calculating employee payments. By including all eligible employees in the calculation, the methodology equitably allocates the retention payment to all eligible employees in proportion to the benefit.

In this situation, the cost of implementing methods to track actual paid wages by location by employee outweighs the benefit. Doing this also has the undesirable effect of including or excluding  eligible employees based solely on the work location which is assigned by the employer.

The agency provider must ensure that expenditures made using these funds are not claimed in any other program (e.g., ICF cost report).

If the employee would never provide direct support funded by an HCBS waiver, then that employee would not be eligible.

What are the required data elements?

  1. Total regular wages for eligible employees for the applicable quarter
  2. Total regular hours worked for eligible employees for the applicable quarter
  3. Total overtime wages for eligible employees for the applicable quarter
  4. Total overtime hours worked for eligible employees for the applicable quarter
  5. Shared living contracts (if applicable)
  6. Number of eligible employees receiving payment for the applicable quarter
  7. Number of eligible shared living contractors receiving payment
  8. The total amount of the retention payment received from the Department (auto-populated)
  9. Total amount distributed to eligible employees
  10. Total amount distributed to shared living contractors
  11. Additional overtime paid to eligible employees (if applicable)
  12. Employer payroll taxes allowance (auto-populated in Department provided spreadsheet)
  13. Total amount withheld for implementation or other costs (auto-populated in Department provided spreadsheet)
  14. If the total amount withheld for implementation or other costs is >$0, how did you (or do you) plan to use the remaining funds?
    1. Implementation expenses (Y/N)
    2. Additional employee compensation (Y/N)
    3. Employee incentives (Y/N)
    4. Training (Y/N)
    5. Direct support professional recruitment (Y/N)

What types of activities are appropriate uses for the withholding amount (up to 18%)?

The following is not an exhaustive list of all appropriate activities but hopefully provides insight to the overall expectations. In general, these funds should be used for implementation, additional employee compensation, or activities that enhance the experience of the direct service professional and/or improve service delivery.

Implementation expenses- Additional payroll expenses, tax obligations not covered by the standard formula, increased worker's compensation expenses, etc.

Additional employee compensation- Paid time off, childcare services, transportation vouchers, health insurance benefits, 401K match, etc.

Employee incentives- Wellness programs, performance/attendance bonuses, employee recognition initiatives, etc.

Training- Employee certification programs, skill-based professional development, competency-based add-on training, etc.

Direct support professional recruitment- Marketing, advertising, hiring/sign-on bonuses, etc.

Can the withholding amount be used for existing retention or other workforce enhancement programs?

The withholding allowance may be used for existing retention or workforce enhancement programs if such use results in a net increase in expenses that is equal to or greater than the amount withheld.  In other words, these funds should add to the program, not replace funds already dedicated to existing retention or other workforce enhancement programs.