Case Study: Fiscal/Employer Agent Services

The Client:
Maryland Department of Health and Mental Hygiene (MD DHMH)

The Projects:
Fiscal/Employer Agent (F/EA) for Living at Home Waiver Program (LAH) Fiscal Intermediary (FI) services for Medical Assistance Personal Care Services and Older Adults Waiver Program (MAPCS/OAW)

The Challenge:
In April 2004 Maryland DHMH awarded PPL a five year contract to provide F/EA services replacing two incumbent vendors. The LAH program is a Medicaid Home and Community-Based Services Waiver program serving consumers with physical disabilities and chronic health care problems from 18-50 years of age. The MAPCS program serves provides assistance with activities of daily living to Medicaid recipients who have a chronic illness, medical condition or disability. The Older Adults Waiver serves individuals 50+ in age with physical disabilities and chronic health care problems. Services are provided in the eligible individual's home or community residence. Due to our successful transition of this program MD DHMH asked PPL to amend our contract to include the Voluntary Tax Withholding service. This new program was designed to help independent personal care contractors throughout the state manage their self employment tax responsibilities.

The PPL Approach:
PPL took a number of steps to develop a system that suited MD DHMH’s needs, including:

• Worked with the state to clean up paperwork left by the two previous contractors
• Developed and executed new program rules and more efficient business processes;
• Configured PPL’s information technology platforms to the state’s unique program requirements;
• Established internal processes to better serve providers, including a focus on customer service training, executing an annual quality assurance survey, and establishing a off-cycle check run every other week.
• Launched direct deposit option for providers, a feature not offered by the prior vendors
• Developed a series of reports to suit the state’s unique program requirements;
•  Provided a state-wide launch of PPL services with on-site provider enrollment sessions for the Voluntary Tax Withholding program to explain self employment tax requirements.
  

The Result:

• Since 2004 the number of LAH Providers increased by 37%, from 220 to 350. The number of consumers served by the providers increased by 40%, from 150 to 250. This program continues to grow each month by one or two participants and by two or more providers.
•  The results of the QA surveys went from roughly 70% satisfaction rating at the start of the program to 90% satisfaction rating today.
• On average PPL fields 35 calls per week, and issues 350 checks every other week.
• PPL worked with the state to establish a service advance that fully supported program growth and worked with the state insurance agency to streamline the administration of workers compensation.
• PPL works in partnership with local support coordinator staff and the State to ensure a successful experience for participants.
• MD DHMH has an estimated 2500 additional providers that they would like us to serve with the FI services on the Voluntary Tax Withholding service,
• PPL continues to work with the State and other stakeholders to implement program design improvements.