May 5, 2023
There are a lot of nitty-gritty details that are helpful to know about consumer direction in North Carolina. From terminology to employee pay to budgeting, controlling your care means knowing the ins and outs of how things work. So let’s dive into some frequently asked questions (FAQs) about consumer direction.
How long does the referral process take?
GT Independence can be contacted for referrals via email at email@example.com. We confirm that we’ve received all referrals within 48 hours. Then, we conduct background checks on all employees. We will communicate the results to the case manager within three business days. Once employees are approved to work by the participant, we set up an enrollment meeting.
Does the FMS continue to run background checks on current employees? Does the case manager need to notify the FMS regarding the need for a renewal of background checks?
GT Independence does all necessary subsequent background checks on current employees. It is the responsibility of the FMS (GT Independence) to initiate these checks, not the case manager.
Does GT Independence do in-home enrollments?
Yes, GT Independence will do an in-home enrollment if the participant wants it done that way. If a participant has a preference of virtual or in-home, please let us know by including that info in the referral.
What Is Self-Direction and How Does It Work in a
What does DCW stand for?
DCW stands for Direct Care Worker. NC Medicaid defines a direct care worker as, “a non-licensed individual who […] provides to individual Medicaid- and/or NC Health Choice-enrolled patients, clients or residents direct contact assistance with personal care or activities of daily living, exclusive of qualified professionals.”
What happens if an employer chooses not to purchase worker’s compensation and a paid caregiver is injured on the job?
If an employer decides not to purchase a worker’s compensation policy and one of their employees is injured while working, the employee is not covered. This means that any expenses related to the injury, such as medical bills or lost wages, would not be covered by worker’s compensation insurance.
Also, not having worker’s comp puts both the employee and employer in potential financial risk. If an employee is injured, they are legally allowed file a claim against their employer. This could result in legal and financial consequences for the employer. NC Medicaid requires employers with two or more employees to purchase a worker’s compensation policy.
Is an employee (caregiver) able to work for two employers at the same time? And if so, can their service hours be the same?
No, each employer must have a separate budget and hours of service. Two people can have the same caregiver, but there should not be any overlap in the hours worked for each person receiving services.
Do authorized hours expire, or can they be used at a later date?
This depends on the service code. For example, respite can be used any time throughout the State fiscal year (July-June). However, personal care and personal assistant services are authorized monthly. This means those hours must be used within the calendar month. Unused hours do not carry over.
What is the max rate that can be paid to PAs? Is there a guide that tells us the base rate and what is too much to pay?
The max rate depends on the service code, the budgeting process, and the costs that need to be calculated. Some participants budget more overtime than others. Some may have one worker at a higher pay rate and another worker with a lower pay rate. You must take all expected costs and spread them across the authorization period.
GT will soon be launching an updated budget tool. It will determine the calculated rate per hour and factors in pay rate, overtime, employer and employee taxes, and more. We will also be creating a quick reference guide that can help you get a maximum pay rate by code (as long as there are no variations, such as overtime). This will be available once rates are stable.
Should employees be allowed to enter a manual shift on the Caregiver app? As opposed to clocking-in and clocking-out at the employer’s home?
The Caregiver app meets all the requirements of the 21st Century Cures Act. It allows for flexibility — which includes the ability to manually enter a shift. This feature is designed for use if the employee forgot to clock-in and clock-out. Its not for a caregiver to enter all shifts at the end of the pay period.
There is a report on the GT Portal that shows who is using the manual shift feature and how often. If there is an employee that is using this feature for all shifts, it is an area of concern. We are able to reach out and encourage them to use the clock-in/clock-out feature. This supports the prevention of fraud, waste, and abuse.
How can case managers get a GT portal account? Can they see budget reports on the GT portal?
Please email firstname.lastname@example.org to let us know you’d like a case manager portal account. We need your information, along with the names of individuals you support. A case manager portal account allows you to see individual budget reports, EVV reports, and more for your entire caseload.
What should I do if my case manager can’t see my budget report in the GT portal?
This is likely because we don’t have their account linked to your participant account in our system. Ask your case manager to email email@example.com with the details on who they support so we can connect the accounts.
Is CPR required for CAP/DA? Has this been communicated with caregivers?
Starting April 1, 2023, all caregivers in the CAP/DA program must have CPR certification. GT Independence notified employees of this rule through multiple channels. We also reached out to caregivers who didn’t have CPR certification before the deadline.
Case managers can check the CPR certification status of employees of the people they support. Simply log into the GT Portal and run the Employee Eligibility Items report.