Hiring Your First Caregiver Under Self-Determination

You have a spending plan, a budget and a person in mind. Now you want to hire your first caregiver under California's Self-Determination Program (SDP). Here is what has to happen, in order, and which parts belong to you and which belong to your Financial Management Service (FMS).

Your caregivers work for you, not for Sentinel Four. You are the managing employer: you choose who is hired, set the schedule and direct the work. Sentinel Four is the co-employer for payroll, taxes and workers' compensation, so the paperwork is handled and you stay in charge.

Which model lets you hire someone?

SDP has three FMS models. The model decides whether you can hire an individual at all.

• Bill Payer. The FMS pays invoices from vendors and agencies, tracks spending and reports to the regional center. There is no payroll and no individually hired staff. If you want to hire a person directly, this model does not fit.
• Co-Employer. You recruit, hire, schedule and supervise the caregiver. The FMS handles payroll, tax filings, workers' compensation coverage and employer compliance. This is the most common model.
• Sole Employer. You (the participant or your representative) are the legal employer of record. The FMS acts as payroll agent: timesheets, paychecks, tax filings and employment records. You may carry your own workers' compensation policy or use the FMS's. Families often choose this for skilled nursing or specialized staff.

If you have not picked a model yet, How to choose an FMS walks through the tradeoffs.

Write the job before you post it

A caregiver job has three parts: duties, schedule and wage. Write all three down before you talk to anyone.

• Duties. What the person will actually do, tied to a service in your spending plan. "Personal care and community outings, four afternoons a week" is a job. "Help with Sam" is not.
• Schedule. Days, hours and whether the hours are fixed or vary. Overtime, meal and rest break and minimum wage rules apply to household employees in California, so a schedule that runs long has real cost. Ask your case manager before you promise hours that push past a normal week.
• Wage. The number you tell the caregiver is not the number that leaves your budget. Employer taxes, workers' compensation and paid sick leave sit on top of the hourly wage. This is called employer burden, and it typically adds 19% to 25% on top of wages. A $20-an-hour caregiver costs about $23 to $25 an hour all-in. Set the wage so the all-in cost fits the budget, not just the wage. Employer burden explained shows the arithmetic.

Recruiting and interviewing is your job

Under both hiring models, the family recruits. Neither the FMS nor the regional center finds caregivers for you. Post the job, screen the applicants, interview, check references and pick the person.

If the person you want to hire is a relative, read Paying family members and legally responsible persons first. Parents of minor children and spouses generally cannot be paid for services they would normally provide.

Clearance before day one

Any participant caregiver who gives direct personal care needs criminal background clearance before starting work. Family members who live in the same home are exempt. The provider pays for the check, and the FMS directs the person to fingerprinting.

Clearance takes time, and the caregiver cannot start until it comes through. Background checks for SDP caregivers covers the steps.

Paperwork, the spending plan and the calendar

Three things have to line up before the first shift.

1. Onboarding documents and the wage notice. The FMS collects the caregiver's hiring documents and the written wage notice. Sentinel Four sets caregivers up in ADP for payroll after this is complete.
2. The spending plan. The plan must identify the provider type and qualifications even if you have not chosen the person yet, and the line for this service must cover the all-in cost for the year. If the plan says "agency respite" and you hire an individual, that mismatch will stop payroll. Talk to your service coordinator or independent facilitator if the plan needs a change.
3. The calendar. A signed and approved spending plan must reach Sentinel Four by the 10th of the month before the intended start date, and regional center authorizations should be in place the week before the start date. Payroll cannot start until both exist. Your regional center may set its own deadline on top of this.

The first week

Everyone paid with SDP funds is subject to Electronic Visit Verification (EVV). Your caregiver clocks in and out of each shift with the AxisCare app on their phone. That record becomes the timesheet. Pay periods run Monday through Sunday and paydays are on Mondays.

Your part is approval. You review the hours and approve them. Nothing is paid that you have not approved. If a clock-in is missed, tell your case manager the same day so it can be corrected before payroll runs. How caregiver payroll works follows the approved hours through to the paycheck.

How Sentinel Four handles this

Every family has a dedicated case manager. That person reviews your spending plan and authorizations before the caregiver starts, collects the onboarding documents and wage notice, and sets the caregiver up in ADP. In the Co-Employer model we carry workers' compensation and handle payroll taxes and filings. In the Sole Employer model we run payroll as your agent and help you sort out coverage.

Payroll is weekly, with paydays every Monday. Caregivers clock in and out with AxisCare and receive a $2.50 per-pay-period reimbursement for using their own phone. You approve hours, and the portal shows you the budget, the remaining balance by category and every payment record.

What we do not do: find or supervise your caregiver, or decide how your funds are spent. The payroll service page has the full list of what is included.