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DD Medicaid Waivers 

 

Proposed FY 2008 Rate Sheet
Effective July 1, 2007 (pdf)

Program Name DHS-DD Code FY06/07 Base Rate Effective 07/01/2005 FY08 Base Rate Effective 07/01/2007 Unit Max. Type Maximum/Minimum
Residential Services
CGH - Children's Group Home (New in FY08) 17D Varies Varies Day Units 365(6) Days/FY
CILA - Individual Rate Model 60D Varies Varies Day Units 365(6) Days/FY
CILA - Purchase of Service (POS) 61D Varies Varies Day Units 365(6) Days/FY
POS Hourly CILA 65H Varies Varies Hour Dollars Provider 65H annual allocation.
Community Living Facility (CLF) 16 and fewer 67D Varies Varies Day Units 365(6) Days/FY
Adult Home-Based Support Services (A-HBS)
Service Facilitation 55A $39.04 $39.04 Hour Dollars Within the individual's monthly maximum.
Training for Unpaid Caregivers 55B N/A Varies Event Dollars Within the individual's monthly maximum
Counseling for Unpaid Caregivers 55C N/A $29.82 Hour Dollars Within the individual's monthly maximum
Personal Support 55D Varies Varies Hour Dollars Within the individual's monthly maximum
Respite-Out-of-Home (Terminated effective 6/30/07) 55V Closed Closed N/A N/A N/A
Transportation 55T Varies Varies Event Dollars Actual miles @ $0.37 per mile and a maximum of $500 per month; within the individual's monthly maximum
Emergency Home Response 55W          
Level 1 - System Installation L1 Varies $30.00 Event Units No more than once per state FY; within the individuals monthly maximum.
Level 2 - Monthly Rate for Monitoring L2 Varies $28.00 Event Units No more than once per month per provider per person; within the individual's monthly maximum.
Nursing - RN 55N $31.13 $31.13 Hour Units 365 Hrs./FY; within the individual's monthly maximum.
Nursing - LPN 55P $28.19 $28.19 Hour Units 365 Hrs./FY; within the individual's monthly maximum.
Children's Home-Based Services (C-HBS)
Service Facilitation 55A N/A $39.04 Hour Dollars Within the individual's monthly maximum.
Training for Unpaid Caregivers 55B N/A Varies Event Dollars Within the individual's monthly maximum.
Counseling for Unpaid Caregivers 55C N/A $29.82 Hour Dollars Within the individual's monthly maximum.
Personal Support 55D N/A Varies Hour Dollars Within the individual's monthly maximum.
Individual Service and Support Advocacy (ISSA) 50D $39.04 $39.04 Hour Units 25 Hrs./FY, unless a written extension request is submitted and approved.
Day Programs
Developmental Training - Advance & Reconcile 31A $10.14 $10.14 Hour Units 115 Hrs./month; 1,100 Hrs./FY; any day program combination.
Developmental Training 31U $10.14 $10.14 Hour Units 115 Hrs./month; 1,100 Hrs./FY; any day program combination.
Adult Day Care (Rate equal to DOA) 35U $8.68 $8.68 Hour Units 115 Hrs./month; 1,100 Hrs./FY; any day program combination.
Supported Employment - No Job Coach - Group 36G $11.34 $11.34 Hour Units 115 Hrs./month; 1,100 Hrs./FY; any day program combination.
Supported Employment - No Job Coach - Individual 36U $12.72 $12.72 Hour Units 115 Hrs./month; 1,100 Hrs./FY; any day program combination.
At Home Day Program 37U $10.14 $10.14 Hour Units 115 Hrs./month; 1,100 Hrs./FY; any day program combination.
Supported Employment - Job Coach - Group 39G $11.34 $11.34 Hour Units 115 Hrs./month; 1,100 Hrs./FY; any day program combination.
Supported Employment - Job Coach - Individual 39U $12.72 $12.72 Hour Units 115 Hrs./month; 1,100 Hrs./FY; any day program combination.
Therapies
Occupational Therapy 52O $37.00 $37.00 Hour Units 26 Hrs./FY unless a written extension request is submitted and approved.(Same as HFS Rate)
Physical Therapy 52P $37.00 $37.00 Hour Units 26 Hrs./FY unless a written extension request is submitted and approved.(Same as HFS Rate)
Speech/Communication Therapy 52S $37.00 $37.00 Hour Units 26 Hrs./FY unless a written extension request is submitted and approved.(Same as HFS Rate)
Behavior Intervention and Treatment 56U $58.27        
Level 1 - Statewide Rate L1 N/A $75.96 Hour Units 66 Hrs. combined levels per state FY. Must be Licensed Psychologist or BCBA.
Level 2 or no level specified - Statewide Rate L2 N/A $60.76 Hour Units 66 Hrs. combined levels per state FY. Other approved credentials.
Behavior Counseling - Group 57G $9.94 $9.94 Hour Units 60 Hrs./FY; combined hours for any behavior therapy/counseling.
Behavior Counseling - Individual 57U $29.82 $29.82 Hour Units 60 Hrs./FY; combined hours for any behavior therapy/counseling.
Behavior Therapy - Group 58G $12.42 $12.42 Hour Units 60 Hrs./FY; combined hours for any behavior therapy/counseling.
Behavior Therapy - Individual 58U $37.28 $37.28 Hour Units 60 Hrs./FY; combined hours for any behavior therapy/counseling.
Transitional Staffing (Phase-Out effective 7/1/07) 53S $12.60 $12.60 Hour Units One-to-one staffing. No new FY08 approvals; remaining previously approved hours may be billed.
Temporary Intensive Staffing - DT (31A/31U only) 53D N/A $12.60 Hour Units Individually approved hours
Temporary Intensive Staffing - CILA (60D only) 53R N/A $12.60 Hour Units Individually approved hours
Crisis Services (Adult-HBS only) 53C N/A Varies Hour Units Individually approved hours;60 consecutive days, not to exeed $2,000 in any single month. Not within monthly max.
Adaptive Equipment 53E Varies Varies Event Dollars $15,000 over five years for combined 53E, 53H, 53V & 53T.
Assistive Technology 53T Varies Varies Event Dollars $15,000 over five years for combined 53E, 53H, 53V & 53T.
Minor Home Accessibility Modifications 53H Varies Varies Event Dollars $5,000/$7,500 maximum per address for permanent modifications to rented/new construction homes. $15,000 over five years for combined 53E, 53H, 53V & 53T.
Minor Vehicle Accessibility Modifications 53V Varies Varies Event Dollars $15,000 over five years for combined 53E, 53H, 53V & 53T.
Staff Training N/A Varies Varies Event Dollars Varies by training type for staff working in waiver eligible programs.

NOTE 1. Prior to receiving any services, the individual(s) and program(s) must be authorized by an award letter issued by the Division Director.

NOTE 2. Prior Division approval, in writing, is required for all staff add-on rates.

NOTE 3. Published Day Program base rates do not include 1:1 staff add-on rates developed to meet individual needs.

Bureau of Community Reimbursement
June 18, 2007

 
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