SFY 23 Home Health Agency Shift Differentials Increase Background 2021 R.I. Public Law 162 directed EOHHS to oversee a wage passthrough program related to home and community service (HCBS) shift differential payment. Shift differentials are paid between 3:00 PM and 7:00 AM on weekdays and all hours on weekends and State holidays (referred to herein as “off-shift”) for Personal Care (S5125) and Combined Personal Care/Homemaker (S5125-U1) services, Effective July 1, 2021 (SFY 222), the existing shift differential ($0.37) was increased by $0.19 to $0.56 per 15-minute unit of service. One hundred percent (100%) of the $0.19 per 15-minute service unit (or $0.76 per hour) increase must be passed through to the nursing assistant that rendered the service. Employers must annually, on or before 10/31, submit to EOHHS an attestation affirming that all eligible employees received one-hundred percent (100%) of the increase in shift differential ($0.76/hour) for all hours worked “off shift” during the preceding July 1 – June 30. (For SFY 23, the attestation period is 7/1/2022 through 6/30/2023). Employers must maintain payroll records that itemize the shift differential paid to eligible employees. Such payroll records shall indicate the shift differential, if any, that employees received, and shall demonstrate that all eligible employees received an increase of at least $0.76/hour for all “off-shift” hours worked between July 1, 2022 – June 30, 2023. Agency Name Agency Name NPI NPI # Contact Name Name of agency lead contact submitting report Contact Job Title Job title of lead contact Contact Phone Phone for lead contact Contact Email Email of lead contact Total Shift Units Total off-shift UNITS of service (S5125 and S5125-U1) provided during reporting period Total amount of increase in shift differential paid to employees for “off-shift-hours” worked during the reporting period. Attestation I, hereby attest, to the best of my knowledge and belief, that all eligible employees received 100% of the increase in the shift differential ($0.76/hour) for all “off-shift” hours worked between July 1, 2022 – June 30, 2023. I have maintained payroll records to support this attestation and acknowledge that such payroll records may be subject to audit by EOHHS. Attestation Name Contact Name and Title Agency name Agency Name Signature SignatureBy typing your name you agree to the terms above. Attestation Date Date Leave this field blank