Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 313b - Establishment of Rates for Community Living Arrangements Licensed by the Department of Mental Retardation › Section 17-313b-8 - Client-based service rate determination process

Current through July 10, 2024
The client-based service rate is for payment of costs for the
				provision of services for eligible persons in community living arrangements
				whose admission into the CLA is authorized by the Department of Mental
				Retardation pursuant to 17a-228 of the Connecticut General Statutes and
				regulations promulgated thereunder. Residential client needs assessments serve
				to establish basic staffing patterns used in the annual negotiation of this
				rate.
(1) Cost settlement
(i) An organization will not be reimbursed
			 for costs in excess of the sum of the negotiated rates for all community living
			 arrangements operated by the organization, unless such reimbursement is
			 otherwise authorized pursuant to these regulations. The ACOR will serve as the
			 basis for review of actual expenditures for the preceding contract year. There
			 shall be a bottom line cost settlement for costs at or below the sum total of
			 the negotiated rates for the preceding contract year. Cost settlement decisions
			 shall be made within approximately 120 days of the filing of the ACOR for the
			 preceding contract year. Such decisions shall be effected through the
			 adjustment of current payments for the three months after cost settlement
			 decisions are made or shall be reimbursed entirely to the Department of Mental
			 Retardation for community living arrangements which cease operation.
(ii) Cost settlement occurs when actual
			 expenditures are below the sum total of the established rates for all community
			 living arrangements operated by the organization for the preceding contract
			 year. For all allowable expenditures made pursuant to such contract with the
			 department of mental retardation by an organization in compliance with
			 performance requirements thereof, 50% of the difference between such actual
			 expenditures made and the amount received by the organization from the
			 department of mental retardation per such contract shall be reimbursed to the
			 department of mental retardation.
(iii) Reductions may be made to the
			 negotiated rate for community living arrangements to the extent they fall below
			 85% of the total available occupancy for the preceding contract year, for
			 reasons other than the failure of the Department of Mental Retardation to place
			 clients, if the organization fails to adequately justify the reduced occupancy
			 rate. For purposes of this section occupancy is the actual client days in
			 residence based on attendance records. Total available occupancy is the number
			 of clients for whom the rate was established times 365. The occupancy rate is
			 established by dividing actual client days in residence by the total available
			 occupancy. Reductions made pursuant to this section shall be reflected in the
			 bottom line cost settlement.
(iv)
			 Grants, gifts, fundraising or endowment income, and expenditures from such
			 income, shall be reported in the ACOR. To the extent such income is
			 specifically designated for operating costs included in the client-based
			 service rate the expenditures from such income shall be deducted from the total
			 operating costs which serve as the basis for negotiating the next year's rate.
			 If an organization demonstrated that such income is not available for the
			 succeeding contract year there will be no deduction and the overpayment shall
			 be recovered through the line item cost settlement.
Grants, gifts, fundraising, or endowment income not
				specifically designated but used for payment of operating costs reported in the
				ACOR shall be deducted from the total operating costs which serve as the basis
				for negotiating the next year's rate.
(v) For the 1992 contract year only, an
			 organization may elect the cost settlement methodology in effect immediately
			 prior to the effective date of these regulations. Such election shall be made
			 at the time of submission of the organization's 1992 contract year
			 ACOR.