SI SEA00820.100 Treatment of Chore Service, Personal Care and Attendant Care Service Payments in Alaska, Idaho, Oregon and Washington (RTS 002 - 08/2007)
Personal care, chore services and attendant care services allow disabled and elderly persons to remain in their homes rather than live in a skilled nursing facility. All states in the Seattle Region (AK, ID, OR and WA) have programs that provide payment to workers who perform personal care, attendant care or chore services. The method for delivering home care services and paying care providers varies from state to state. This Regional POMS supplement describes home care programs in AK, ID, OR and WA.
Except as noted below, in all states in the Seattle Region, payments made to a personal service provider or chore worker who provides in-home services for an individual should be treated as wages.
Payments made to an ineligible spouse or parent for providing in-home supportive services to his or her eligible spouse or eligible child are excluded from income for deeming purposes (SI 01320.175).
Payments made to an ineligible spouse or parent for in-home service provided to anyone other than his or her eligible spouse or eligible child are countable wages subject to deeming (SI 01320.175).
Payments made to in-home service providers to reimburse them for expenses already incurred are not income (SI 00830.100).
IRS rulings state that work for a spouse or for a parent by children under 21 is not covered wages (RS 01901.250) and consequently will not appear on a DEQY query response. Nevertheless, the earnings are to be treated as wages for SSI purposes.
C. Seattle Region Home Care Programs By State
Alaska provides home care services through the Personal Care Program administered by the Alaska Department of Health and Social Services Senior and Disability Services. The Alaska Personal Care Program provides services to disabled, handicapped, and elderly Alaskans to allow them to live in their own homes or communities rather than long-term care institutions. Persons eligible for home care services through Alaska’s Personal Care Program can choose one of two Personal Care Assistance (PCA) programs:
a. Agency-Based PCA Program (ABPCA)
Allows recipients to receive services through an agency that oversees, manages and supervises their care. The agency hires, trains, pays and maintains payroll information on the personal care assistants (PCA) and is considered the PCA’s employer.
b. Consumer-Directed PCA Program (CDPCA)
Recipients manage their own care by hiring, firing and supervising their own personal care assistant (PCA). A personal care agency still provides payroll services and is considered the PCA’s employer for wage payment and tax withholding.
2. Idaho – Personal Care Services (PCS)
PCS case management and Chore Services are available to Idaho residents who are eligible for Medicaid and who qualify under the Idaho Home and Community-based waiver program. Eligibility criteria are available on Idaho’s Personal Care Services website. The Idaho Department of Health and Welfare provides Title XIX funds to private agencies that hire personal care providers; the private agencies are considered the employers for the personal care providers.
The providers help qualified PCS clients with personal care and hygiene and medically related household duties such as shopping and transportation. PCS clients may also qualify for case management in which the client is assisted by a case manager to locate a care provider and to manage his or her services. More information on Idaho PCS can be found on the Personal Care Services website.
The Oregon Department of Human Services (DHS), Seniors and People with Disabilities Division, offers personal services for seniors and disabled individuals. The services are described in “Help in Your Home” on the DHS web site. Services include personal assistance, nursing tasks and help with housekeeping. Medicaid pays for some services. Care providers are considered employees of the service recipient.
a. Client-Employed Employer Program (CEP)
Allows Medicaid clients to select and hire their own care provider (worker); those workers may be friends or relatives or may be chosen from a DHS list of providers. DHS provides case managers to help the client select a worker and decide what services are needed.
b. Spousal Pay
The Spousal Pay Program is a limited, state-funded program that allows payment for services that are provided by the spouse of an eligible person. Services must be provided in the client’s home. Clients must be eligible for Medicaid and qualify for care giving services. They must have a medically diagnosed, progressive debilitating condition which limits their activities of daily living or a spinal cord injury or similar disability which permanently impairs their ability to perform activities. Spouses must provide care that exceeds what would usually be expected of a husband or wife. The spouse must be able to meet the client’s care needs.
c. Independent Choices
Allows clients to purchase the medical and social services they require. To accomplish this, a 5-year pilot demonstration project that allows consumers of personal services a cash allowance allowing them to choose and purchase services from providers they feel would best meet their needs. Personal care providers are paid by the social service client instead of by the state of Oregon.
NOTE: Oregon DHS requires that recipients participating in this project keep funds received for services in an account especially designated for this purpose. SSA interviewers may encounter accounts holding enough funds to potentially put them over the SSI resource limit. The funds in these accounts are not countable resources.
There are two personal care programs in the state administered by the Department of Social and Health Services (DSHS):
a. The Community Options Program Entry System (COPES)
COPES is a Title XIX funded waiver program. Attendant care service providers are trained and certified to provide personal care, housekeeping, medical supervision, and transportation to and from medical treatment. The providers are considered to be employees of the care recipient but are paid directly by the state. As part of this arrangement, the state provides payroll services such as withholding federal income and FICA taxes.
b. The Title XX Chore Service Program
The Title XX Chore Service program provides funds to the chore service recipient who is responsible for paying wages and withholding taxes for chore service providers. Some chore service recipients who receive other income (e.g., Title II) are expected to provide a co-payment to the chore provider that supplements the wage payment by DSHS. The co-payment amount is determined by DSHS and deducted from the amount paid the chore worker by DSHS. If it is determined that the chore service recipient did not make the co-payment to the provider, do not count it as income or input it to the SSR.
Follow procedures in SI 00820.130 to verify wages received by eligible individuals or deemors. If the individual is unable to provide proof of earnings, it will be necessary to obtain proof from the employer. Following are the methods of verifying wages in each of the states in the Seattle Region.
Since in-home service providers in Alaska are hired, trained and paid by private agencies, it will be necessary to obtain wage evidence from the agency who paid the recipient. There is a Personal Care Assistance agency list on the Alaska HHS website at Alaska Senior and Disability Services
Idaho Health and Welfare contracts with private agencies who handle the hiring, training and payroll function for personal care providers. Contact the agency that paid your recipient for evidence of wages. The agencies that perform the payroll services for the personal care providers are listed in each city’s phone directory under Home Health Services.
If the personal service provider (worker) does not have evidence of wages, contact the local Oregon welfare office and request a printout of the wages for the period needed. If the local welfare office is unable to provide the wage printout, write to: DHS, Provider and Consumer Services
PO Box 14960
Salem, OR 97309
Personal service workers of clients participating in the 5-year Independent Choices demonstration project are paid by the assistance recipient. Oregon Human Services sends a monthly check to the services beneficiary who must deposit the check into a special account. If the recipient has a need for personal services, he or she hires a care provider and pays wages from the account. Income and FICA taxes are withheld and paid to IRS by the services recipient. Evidence of wages for work in the independent choices program will have to be obtained from the service recipient.
Evidence of chore and personal care service wages may be obtained by completing and faxing the DSHS wage verification form shown in the EXHIBIT below to (360) 664-6103.
Request for Wage Verification for In-Home Supportive Services from DSHS of Washington
P O Box 45812
Olympia, WA 98504-5812
DSHS PHONE (360) 664-6161
DSHS FAX (360) 664-6103
NH Name: ___________________________ [ ] TII [ ] TXVI [ ] Both
NH SSN: __________________________
Reason for Request: [ ] Initial Claim [ ] Redetermination
[ ] S2/K6/K7 Alert [ ] CDR
Social Security Administration is requesting wage verification on:
Name of Employee __________ __________ ___________ AKA _____________
Employee's Address _________________________________________________
Employee's SSN __________________ SSPS Vendor Number _____________
SSPS Provider Number ____________________
Wage verification is needed for: [ ] 2003 [ ] 2004 [ ] 2005 [ ] 2006 [ ] 2007
Note: Verification is not available for periods prior to January 1997.
Please return the requested information to:
Social Security Administration
Attention: ________________________ FAX: (____)____________________
Address: _________________________ Phone: (____)__________________
___________________________________ Extension: ___________________
RO. WA Wage Ver. 07/07