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Department of Health and Family Services 
Division of Long Term Care
DLTC Info Memo Series 2008-4
Date: April 18, 2008

To: Listserv

For: Area Administrators/Human Services Area Coordinators
County Departments of Community Program Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
County Departments of Social Services Directors
Tribal Chairpersons/Human Services Facilitators
County Developmental Disability Coordinators
County Long Term Care Coordinators
From: Sinikka Santala

Subject: Charge Back Process for State Center Residents Who are Residents

This memo provides updated information regarding the $48.00 a day charge back rates for individuals residing at State Centers for people with developmental disabilities and who are residents of counties operating CIP Waiver programs. This information does not pertain to individuals who are residents of counties in which Family Care is available. See the last paragraph of this memorandum for additional information about Family Care Counties.

Changes are being made that will be effective in the Spring 2008 charge back process. The changes are the result of using Long Term Care Functional Screen (LTCFS) results to determine estimated average community costs for people residing in the State Centers and how those estimates relate to the current charge back policy. This memo also describes the intent of the Division of Long Term Care to ensure that people currently living in the State Centers have real opportunities and sufficient choices to live in the most integrated and least restrictive setting by enhancing the use of the annual WATTS protective placement review process. Finally, this memo references the future of the charge back process for counties involved in Family Care.

During the months of October and November 2007, the Division of Long Term Care conducted an analysis of the accuracy and reliability of the Long Term Care Functional Screen that was used in the Spring of 2007 to establish estimated community costs for people living in State Centers. The analysis was conducted as the result of some Center parents raising concerns about the accuracy of the Functional Screen to estimate community costs. The review was based on actual costs for all forty nine people relocated from the Centers during 2006 and October 2007 compared to the cost estimates derived from the Functional Screen. The results of this review confirmed the reliability of the Screen to accurately estimate the community costs of people now living in the Centers.

It has been concluded that most of the people living in state Centers can live in a community program at a cost of less than $325 per day. Please be alerted that most people currently in the Centers who are residents of counties operating CIP Waiver programs are expected to be included in the next round of the charge back process (Spring 2008).

As you may have noticed, the Division did not send letters of intent to charge back while this process has been undergoing review. However, the charge back process will resume in the Spring of 2008; likely in April or May. It is our plan to do the charge back annually during April/May of each year. The charge back will be based on the estimated average community costs resulting from Functional Screen assessments. As in the past, counties may continue to request to have this cost waived. (The waiver process is described in the July 25, 2006 DDES Memo Series 2006-14.)

County staff are responsible for conducting the Functional Screen process and for maintaining current data in the Functional Screen for individuals living in the State Centers. (This responsibility is described in the August 25, 2006 DDES Memo Series 2006-18.) Parents and guardians of State Center residents are encouraged to be involved in providing information they feel is important to an accurate Functional Screen and the resulting community cost estimate. Center staff and records are fully available to each county as a source for additional current information.

When a parent or guardian requests to be directly involved in providing information for the Functional Screen, it is desirable that county staff, parents/guardians, and if necessary, Center Interdisciplinary Team members, have a mutually agreeable time and place to meet. The Centers are available as a location for the meeting and Center staff are available by conference call or in person at another location.

It is also important to know that parents and guardians of Center residents have been encouraged to visit community residences to become familiar with the supports and services available. Scheduling a review of the Functional Screen on the same day as a visit to community programs can accommodate both activities. A copy of the letter that will be sent to parents and guardians is enclosed.

Parents and guardians have been informed of their right to review the results of the Functional Screen. They have also been advised to contact their county Case Managers with questions and to discuss the meaning of the results. We have also explained to parents and guardians that when a county needs additional information from the Centers, the Interdisciplinary Teams are available for questions that cannot be answered by county Case Managers.

Counties in which Family Care is available will continue to be exempted from the charge back requirement while the Division continues efforts to establish a consistent statewide process for ensuring a complete and thorough interdisciplinary review of every person protectively placed at a State Center through an enhanced annual WATTS protective placement review. The enhanced review is being developed in anticipation of statewide Family Care implementation.

For more information, please contact Jackie Neurohr in the Division of Long Term Care, Bureau of Long Term Care Services at (715)723-5542 ext. 4300.




cc: BLTS-CIS Field Staff
Office of Family Care Expansion
Managed Care Organizations
Aging and Disability Resource Centers
Office of Resource Center Development

Last Revised: July 12, 2010