California’s Self Determination Program. They let you choose the services you want, who provides them,and when.Every state requires participants to engage a Financial Management Services (FMS) provider to help with many aspects of the program, but not all FMS providers are created equal, and your SDC experience can be greatly affected by your choice.California, for instance, lets you choose between 28 state-approved FMS providers, each promising comprehensive support. How do you begin to decide which one will best serve your needs? Well, it turns out it’s not that hard. Here are eight things to look out for before
making a decision.
1. Flexible Enrollment
You want to get started on your SDC journey as soon as possible. Some providers require you to already have a budget plan, leaving you to figure out the (often confusing) enrollment process alone. Others want to put you on a waitlist before you can get going.
You’ll want to look for:
- Any-Stage Enrollment: Providers should welcome you wherever you are in your journey—whether you’re just investigating your options, already have a spending plan draft, or are already enrolled.
- No Waitlists: You want onboarding to start as happen as possible, so you can start receiving services without unnecessary delays. Why should an FMS’s limitations become your problem?
2. Dedicated, One-on-One Support
Many aspects of self-directed care can be confusing (figuring out eligibility, understanding your budget, hiring and managing your employee…). You want to keep the ball rolling—and stay within the program rules.
Personalized support dramatically improves your experience. You’ll want an FMS who provides:
- Dedicated Case Managers: Your FMS should assign you a single, knowledgeable support specialist; someone who’ll get to know you personally, understand your situation and needs, and won’t require you to rehash an issue to a new person every time you reach out.
- Reasonable Response Times: Look for a commitment to addressing your issues promptly, ideally within no more than 72 hours.
3. Great Technology & User Experience
Digital tools can really simplify a lot of the administrative tasks that are required in the program rules. In extreme cases, failing to stay compliant could make you ineligible for the program, and you could be removed.
So, it’s important to have tools that support compliance, but it’s also important that they are full-featured and easy to use.
You should expect:
- A Participant Portal: You want all your tools in one place, accessible from anywhere, 24 hours a day. You should be able to:
- track your spending against your budget in real-time
- enter, approve, and submit worker timesheets and invoices
- allow documentation upload
- submit purchase requests
- Detailed Reporting: The ability to quickly create easy-to-read reports will help you to see where you might want to adjust your budget, spot any spending red flags, and stay compliant with program rules.
4. Transparent, Flexible Cost Structure
“Employer burden” is just a wordy way of talking about the costs you incur by being your worker’s employer. It includes things like:
- Workers’ compensation insurance
- Unemployment insurance
- Payroll taxes (FICA, FUTA, SUTA)
- Employer portion of Medicare
- Payroll processing fees
- Background checks and employment verification
- State disability insurance (in CA, NY, NJ, RI, HI, PR)
These costs come straight out of your budget, so you definitely want to know exactly what you’re paying, and get the best price possible.
At a minimum, you want to see:
- Clearly Defined Fees: Providers should openly and clearly tell you what you’ll pay for their services and all the items listed above.
- No Budget Caps: The FMS has to pay your service costs upfront, before the state reimburses them. Because of this, some don’t want to work with participants with large monthly budgets, to limit their financial risk. You should look for a provider who’ll partner with you regardless of your budget.
5. Flexible Fees for Family Caregivers
Compared to caregivers hired from the general public, its costs the FMS less to provide services when the caregiver is a close family member. A close relative likely already knows the participant’s needs and routine, so there’s less orientation and training to get them up to speed. They are less likely to leave, so turnover and retraining costs are lower; there’s less chance of compliance or HR issues because the caregiver is invested in the well-being of their loved one.
Additionally, in states like California, certain family members (in specific situations) may be exempt from some of the employer burden items, like social security and Medicare taxes, worker’s comp insurance, or FICA.
If you are planning on hiring an immediate family member, you should check that your FMS offers:
- Reduced Family-Caregiver Rates: Some California FMS providers charge overhead rates as high as 24.86%—and don’t reduce it when the caregiver is a close relative. Others will significantly lower their rates, down in the 5% area. That difference can be substantial, and in many cases means more of your budget can be spent on care instead of overhead.
6. Language & Cultural Competence
If you have questions and English isn’t your first language, the last thing you need is to be struggling to understand complex, unfamiliar terms. The best FMS providers recognize this, and offer:
- Full Bilingual Capability in English & Spanish): All support, documentation, and training should be available in both languages.
- On-Demand Professional Translation: If you speak a language other than English or Spanish, your provider should be able to provide real-time human translation services for any other language.
7. Comprehensive Training & Education
When you enroll (and after), there’s a lot to learn. Any good FMS will offer high quality education to smooth the journey for both you and your caregiver.
- Initial Training: Your personalized one-on-one enrollment plan includes interactive workshops to make sure you understand essential management skills, budgeting, compliance, and how to handle issues that may arise.
- Ongoing Training: Program rules can change, and there’s always more to learn. Regularly updated educational materials and webinars make sure you always have the most current information at hand.
8. Community Engagement & Thought Leadership
The best FMS providers are passionate about self-directed care, and you can gauge this by how actively they engage with the SDC community. It’s a good sign if the FMS shows:
- Active Industry Involvement: Staff regularly participating in policy forums, serving on industry panels, and community workshops are all good signs.
- Peer-Networking Assistance: Helping participants and caregivers to interact and learn from each other through meetups and support groups shows genuine care about the people they serve.
Conclusion
Choosing an FMS is one of the biggest decisions you’ll make in your self-directed care journey. The right one can keep things moving, make the rules easier to follow, and help you avoid unnecessary stress. The wrong one can make you wonder if SDC is worth the hassle.
Look for a provider that’s easy to work with, explains things clearly, helps you from the very beginning (and at every step), and doesn’t nickel-and-dime you on fees—especially if you’re hiring a family member. A good FMS should speak your language (literally), train you well, and stay involved in the SDC community.
It’s your program, your budget, your care. Make sure your FMS is really on your team.
To learn more about PPL’s role as an FMS within California Self-Determination program visit our Website.
