CURRENT FUNDING SYSTEM

Service providers have been mandated to deliver and bill for services using a “fee for service” system. Our operating budget is based on the number of units of service the agency provides to you. Your budget is set based on your needs and days of attendance. The agency counts on all the individualized budgets of the people we serve and support to be able to operate sufficiently. Sufficiently simply means that we are able to pay for our bills, insurances, supplies, equipment, and wages. As a Non-profit we are not permitted to make a profit. We are only permitted to save 3% of our budgeted expenses to use for cash flow purposes. If people we serve and support do not attend, we are not able to bill. This means we run short for the month. If we run short all year and can not pay our bills, we would have to close our doors.

 

Below are questions regarding attendance:

Q: What if you are sick, just want a day off, or want to go on vacation? 

A: A certain amount of absenteeism for any reason is anticipated and expected. We do not count on perfect attendance to function. It is when there are excessive call offs that we must become concerned.

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Q: How do excessive call -offs affect the agency? 

A: We will not have enough income to cover costs. As stated above, we would not be able to remain open. Then you would have to choose a different Provider Agency.

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As units of service are approved based on need, if you are not using the units of service in your budget on an on-going basis, it suggests that you don't really need them. Your budget may be reduced and you will have less to use. 

 

The "Provider Monitoring Tool" being used to monitor our agency asks the following questions:

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Q: "Are deviations from authorized services (any period where there is a gap in providing authorized services) resolved by unit adjustments requested?"

A: If you are off for a period of time, for example a medical reason, your units may be adjusted so that you don't get to "make them up" during the remainder of the year."

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Q: "For the prior fiscal year was the percentage of units billed to units authorized greater that 90% for each approved service?"

A: If you are not using 90% of your units they may be decreased so that your attendance does reflect 90%.

There are individuals with no services, and others who need more than they have.  There is limited funding available.  This will not be up to Whole Life Services to determine, but we may choose to discontinue your services if your attendance is poor.

 

Finally, please remember that your staff (especially when you receive 1:1) are only paid when you use your services.  If you call off, they are also off for the day.  If there are many call offs your staff will not able to make a living, and care for themselves and their families.  Think about how you would feel if you were called off from your job and thus could not provide for your family.  We all get sick and need a day off now and then, but excessive calling off for no good reason hurts you, your staff, the agency, and other families.

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Attendance Guidelines and Expectations

1.) Whole Life Services is monitored to report the number of units you use, and it is expected you will attend 90% of the time, and that number could be raised.

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2.)  If your attendance falls below 90% and stays lower for (30) days, we will discuss a plan to improve your attendance.

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3.)  If you are not attending due to dissatisfaction with your staff, our programs, or your Individualized Support Plan, please inform us so we may make the changes needed.

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4.) If you do not have a reason, and your attendance remains low, we may change your staff. If the Direct Support Professional who provides your services requires full time hours for insurance coverage, we will re-assign them work with a person who attends well.

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5.)  This does not mean we are discontinuing your services, but that we are changing your staff.  We may assign a part time staff person.  We may not assign any staff person and instead of having your days scheduled, you may call us in advance to let us know when you need services.

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6.)  If you are chronically absent your services at Whole Life may eventually be discontinued.  Your Supports Coordinator may assist you in finding a Provider Agency that may better meet your needs. There are no set rules for attendance, but we are following these guidelines to ensure services are being utilized. Every situation and person is different. You, and your Individual Support Plan Team will work together to determine an attendance plan that will be best for you and the agency. The number of day/hours and thus units approved in your plan should reflect your needs.  If we admit you to Whole Life Services for (5) hours on a given day, (5) hours of Outcomes and supportive goals for which you will receive support be must be identified in your plan.