DLTC Numbered Memo 2011-05
STATE OF WISCONSIN
Department of Health Services
Division of Long Term Care
DLTC Numbered Memo Series 2011-05
Date: September 15, 2011
Index Title: Rate Information for Billing for Services Provided by the
Centers for Persons with Developmental Disabilities
To: Listserv
For: County Departments of Community Programs Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
County Departments of Social Services Directors
From: Priscilla Boroniec
Division of Long Term Care Administrator
Subject: RATE INFORMATION FOR BILLING FOR SERVICES PROVIDED BY THE
CENTERS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
Document Summary
Each year, the Wisconsin Department of Health Services reviews and
revises the rates charged for services at the centers for persons with
developmental disabilities.
RATE SCHEDULE
CENTERS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
July 1, 2011 - June 30, 2012
The Wisconsin Department of Health Services develops and approves the
rates for the centers for persons with developmental disabilities. Rates
are based on the actual cost of providing these services. The department
has established rates for long term care services and for intensive
treatment services. The rate increase indicated below reflects increases
in labor costs as well as increases in fuel and utilities costs.
At the centers for persons with developmental disabilities, county
agencies are billed for long-term care services only for individuals
ineligible for Medicaid, designated as inappropriately placed, and/or
admitted for intensive treatment program services described below. Per s.
51.437(4rm)(c)1, the county has 60 days to pay the bill. If payment is not
received within 60 days, the amount will automatically be deducted from
the next DHS payment to the county through the CARS system.
INTENSIVE TREATMENT PROGRAM (ITP) SERVICES: ITP services are
provided to individuals with developmental disabilities who require active
treatment and who are also diagnosed as having a mental illness or who
exhibit extremely aggressive and challenging behaviors.
Under s. 51.437(4rm)(c)2m, the county agency is billed the non-federal
share for services provided to individuals under s. 51.06(1m)(d) who are
eligible for Medicaid. The ITP rates were calculated to create a uniform
statewide rate for intensive treatment program services provided at all
three centers. A uniform statewide ITP rate will enable counties to access
the closest facility or select the facility that best suits the person's
needs without regard to rate differences.
The Billing and Collections Unit of the Bureau of Fiscal Services will
bill the counties for the non-federal share of the Medicaid ITP rates for
the care of the persons receiving ITP services. The amount charged to the
counties will be lower if some portion of the care is covered by
non-Medicaid dollars. The amount charged to the counties changes as the
Medicaid rate per day and/or the non-federal share changes. On October 1,
2011 the non-federal share of Medicaid will decrease from 39.84 percent to
39.47 percent. The county will not be billed for the non-federal share of
the Medicaid payments for clients admitted for ITP services whose cost of
care is covered by a Family Care CMO (Care Management Organization).
EXTENDED INTENSIVE TREATMENT SURCHARGE: Per s. 51.06(5), the
department is authorized to assess a surcharge equal to 10% of the total
cost of care provided to individuals in the ITP's based on their length of
stay. The surcharge is imposed for each six-month period in which a
resident remains at a center beyond his or her discharge date, which is
set by the center and the individual's county of residence. The surcharge
amount will increase by 10% of the total cost of care provided during each
six-month period thereafter. The Department of Health Services notified
the counties regarding the implementation of this surcharge on October 12,
2006 in the DDES Information Memo 2006-18.
TRANSITIONING PERSONS TO COMMUNITY CARE: The county will be
billed $48.00 per day if an independent professional review established
under 42 USC 1396a(a)(31) determines the person served is appropriate for
community care, and there is adequate state and federal funding to provide
these community services (Per s. 51.437(4rm)(c)2.b.). Further information
on this process can be found in DLTC Information Memo Series 2008-4.
| RATES FOR CENTERS |
Central |
Northern |
Southern |
| Daily Rate for Long Term Care |
$858.00 |
$1,744.00 |
$849.00 |
| Intensive Treatment Services - Per Day |
$1,258.00 |
$1,258.00 |
$1,258.00 |
| Non Federal Share (7/1/11
- 9/30/11) |
| a. Up to agreed upon discharge date |
$500.56 |
$500.56 |
$500.56 |
b. After agreed upon discharge date
*The 10% surcharge increases during each six-month
period after the agreed upon discharge date. |
$550.62 |
$550.62 |
$550.62 |
| Non Federal Share (10/1/11
- 6/30/12) |
| a. Up to agreed upon discharge date |
$496.53 |
$496.53 |
$496.53 |
b. After agreed upon discharge date
*The 10% surcharge increases during each six-month
period after the agreed upon discharge date. |
$546.18 |
$546.18 |
$546.18 |
REGIONAL OFFICE CONTACT: N/A
CENTRAL OFFICE CONTACT:
Jennifer France
Division of Long Term Care
1 West Wilson Street, Room 550
Madison, WI 53703
(608) 266-3564
MEMO WEB SITE: http://www.dhs.wisconsin.gov/dsl_info/NumberedMemos/DLTC/CY2011/index.htm
cc
Area Administrators/Human Service Area Coordinators
Area Agencies on Aging Directors
Bureau/Office Directors
County 51 Boards Program Directors/Fiscal staff
County IM Managers/Supervisors/Lead Workers
County/Tribal Aging Directors
DLTC Facility Central Office Staff
DLTC Center Directors
DD Service Coordinators
Program Bureau Directors/Section Chiefs
Tribal Chairpersons/Human Services Facilitators
Tribal IM Directors
Last Revised: September 15, 2011 |
