Respite Discussion Forum

From Linda Wolf

Director In-Home/Family Support Services

NextStep for Life

Mapaville, MO

This was a big issue in Missouri over 10 years ago for exactly the same reasons.  The practice of classifying the respite providers families hire as contractors was determined improper after some cases involving and St. Louis agency and respite providers who filed unemployment from other employers while they were also working for families in respite program.  We tried unsuccessfully to get changes in our state’s law.  We held several workshops on this issue to give respite agencies the information they ultimately needed to decide how to restructure.  Some changed to employer models and others went to a family reimbursement model.  The agency where I work decided to do the family reimbursement model.  We made this change over 10 years ago and it has worked well so far.  We have recently merged with a larger nonprofit and in the near future I anticipate there will be a full internal review of this practice.  I like this model and most of our families love it because it allows them flexibility and control.  It also allows us to make the maximum amount of funding available per family.  We hope to develop an employee model of in-home supports eventually that will include respite and primarily be funded by Medicaid payments but I am hopeful that we will be allowed to continue the family reimbursement model as well.  This was an extremely painful issue in our state but it motivated many of us who support individuals with developmental disabilities to do a better job of networking.  I only wish we could find the same energy to get the lifespan respite coalition moving. 

I would be interested in learning how other states respond to this question.  If someone has designed a model that is as cost effective without shifting the tax and paperwork burden to families I would love to learn about it.  I suspect most of our families are at risk of consequences for failing to do the required tax reporting.  I try to give them information but it always puts a few in panic.  I tried to figure out how to become a fiscal intermediary but couldn’t figure it out.  This may be something for our future since I now work at an agency with a business department and comptroller but it remains just a thought in the back of my mind.  I am happy to dust off the cobwebs in my mind if there are any other specific questions about how this issue was handled in our state.  Mark Keeley would also be a good source and he may also reply to this questions. 

From Joy Liebeskin with CT Lifespan Respite Coalition

This has become an issue here, as well as for all my advocates I used to have ( long Story)  Anyway- he outcome with the state is to be a contractor they must carry their own workman's comp, have a contract written to provide the services, and be able to prove that they do that for more than 1 contract, the exact same thing.  That they pay all taxes & fees.  Stipends don';t fly if Pd by check, so we now use pre-paid visa cards for 25, 50 & 1000 dollar stipends for meetings, workshops, and when I need to use an advocate for a family.    This issue is part of what caused my huge budget cut, as to take the 5 advocates who worked a total of 60 hours a week & pay them as employees, made their service too expensive. 

The non-profit that I share office space with has made a deal with the state, & they are paying the unemployement tax on what they give as stipends and to a few small contractors, show a written contract with each, and a statement that they consider themselves self employed.  So no taxes are coming out, so no match there, but not everyone was willing to sign, especially those who only got 300-500 a yr & in the past were not paying taxes r getting a 1090-   Families are really being hurt by this--   For our TitleV respite program, we give the families 500.00 to hire who they want, so they do not get a 1099, under 600.00 for the year,  & it is up to them how to spend it, they respond back with a form, but not great details.