DDES Memo Series
2005-22
December 27, 2005
To:
Area Administrators/Assistant Area Administrators
Autism Service Providers - Intensive In-Home Services
Bureau Directors
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
County Children's Waiver Leads
Licensing Chiefs/Section Chiefs
Lutheran Social Services
St. Francis Children's Center
Tribal Chairpersons/Human Services Facilitators
From:
Sinikka Santala
Administrator
Re:
Rate Structure Clarification for Intensive In-Home Autism Services under
the
Children's Long-Term Support Waivers
Document Summary
This numbered Memorandum
announces a change to the rate structure used for intensive in-home autism
services under the Children’s Home and Community-Based Services waivers.
Specifically provides a revision to Attachment B so that services
are reimbursed on a $22.50 per hour rather than the weekly schedule
effective January 1, 2006.
DHS
, with the involvement and commitment from Wisconsin Counties,
implemented the children's long-term support waivers in January 2004.
Children receiving intensive autism services were then quickly transferred
from the fee for service system to the waiver.
The Children's Long Term Support Home and Community-Based Services
Waivers (CLTS Waivers) include a service for autism treatment,
"Intensive In-Home Treatment" for Children with Autism Spectrum
Disorders: Autism, Asperger's and Pervasive Developmental Disorder- Not
Otherwise Specified. This service was approved as a bundled service by the
Centers for Medicare and Medicaid Services (CMS). This means that travel,
consultation and face-to-face service delivery are factored into the rate
that is paid for the service. The rate structure and a description of the
calculation of payment to providers based upon actual services delivered
to the child are attached to this memorandum.
The Department of Health and Family Services (DHS
) made a commitment
to the providers of this service that the rate structure would be
standardized statewide. This service is unique from other Home and
Community-Based Services Waivers in that the DHS
has set the rate. Total
reimbursement for these services is to be calculated based on this rate
structure.
This memo is to clarify that in paying for intensive in-home treatment
services, counties and agencies responsible for these services must use
the rate structure as set by the DHS
without additional restrictions or
changes. This includes, but is not limited to: limitations in profit that
are more restrictive than the DHS
Allowable Cost Policy Manual,
restrictions of paying for only face-to-face treatment time, or paying a
different rate to a provider than specified.
Furthermore, providers reporting hours to Counties for intensive
in-home autism treatment services must identify hours broken down by the
categories of travel, consultation, and face-to-face service delivery
using the attached reporting form. CLTS Waiver reporting by the county
only requires total hours for each participant but the DHS
will need to
know the impact of additional travel hours that were approved for some
recipients of Intensive In-Home Autism Treatment Services. DHS
will be
asking for the breakdown of hours of each type of service independent of
the Human Services Reporting System (HSRS). Counties will be able to use
the same form as the one received from providers and will submit this to
DHS
monthly.
Counties may disallow payment for services under this service if a
provider fails to meet requirements of that service specified in the
Bureau of Long-Term Support (BLTS) Home and Community-Based Services
Waivers Manual (see attached service definition). This includes: denial of
reimbursement for services that were provided by staff who do not meet
waiver requirements, hours claimed by providers for activities not
included in the bundled rate. Examples of these activities include: staff
recruitment, travel time not actually paid to staff, services delivered by
staff who do not meet service requirements or standards, or excessive
travel time.
REGIONAL OFFICE CONTACT:
Area Administrator
CENTRAL OFFICE CONTACT:
Kristina Stuart
608-235-6636
stuarkc@wisconsin.gov
MEMO WEB SITE:
http://www.dhs.wisconsin.gov/partners/local.htm
Attachments:
Intensive
In-Home Treatment for Children with Autism, Asperger’s and Pervasive
Developmental Disorders (attachment A)
Intensive
In-Home Autism Services (attachment B)
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