reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 423.00 - Rates For Certain In-Home Basic Living Supports › Section 423.03 - Rate Provisions

Current through Register 1525, July 5, 2024
(1)
Services Included in the Rate
. The approved rate
			 includes payment for all care and services that are part of the program of
			 services of an eligible provider, as explicitly set forth in the terms of the
			 purchase agreement between the eligible provider and the purchasing
			 governmental unit(s).
(2)
Reimbursement as Full Payment
. Each eligible provider
			 must, as a condition of acceptance of payment made by any purchasing
			 governmental units for services rendered, accept the approved program rate as
			 full payment and discharge of all obligations for the services rendered.
			 Payment from any other source will be used to offset the amount of the
			 purchasing governmental unit's obligation for services rendered to the publicly
			 assisted client.
(3)
Payment Limitations
. Except as provided in 101 CMR
			 423.03(2) and (4), each purchasing governmental unit pays for services at the
			 rates established in 101 CMR 423.03(5).
(4)
Administrative Adjustment for
			 Extraordinary Circumstances
. A provider may petition the
			 purchasing governmental unit for an administrative adjustment to reflect
			 increases in operating costs due to unusual and unforeseen circumstances or
			 extraordinary client service requirements not considered in the development of
			 the current rates. Unusual and unforeseen circumstances are events of
			 catastrophic nature
(e.g.,
fire, flood, or earthquake) that
			 are not covered by insurance that the prudent provider would carry. The
			 provider must demonstrate that such cost increases gravely threaten the
			 stability of service provision such that client or consumer access to necessary
			 services is at risk. The purchasing governmental unit will evaluate the need
			 for the administrative adjustment, determine whether funding is available, and
			 convey that information to EOHHS for review to determine the amount of any
			 adjustment.
(5)
Approved Rates
. The rate for a particular service is
			 based on the level (A - K) assigned by the purchasing agency, and is based on
			 the intensity of identified needs and characteristics of the client receiving
			 the service. The approved rate is the lower of the provider's charge or amount
			 accepted as payment from another payer or the rate listed in 101 CMR 423.03(5).
Level
Rate
Unit
A
$7.28
15 minutes
B
$8.20
15 minutes
C
$9.09
15 minutes
D
$9.54
15 minutes
E
$10.43
15 minutes
F
$11.50
15 minutes
G
$12.80
15 minutes
H
$13.79
15 minutes
I
$15.39
15 minutes
J
$18.88
15 minutes
K
$20.50
15 minutes
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 423.00 - Rates For Certain In-Home Basic Living Supports › Section 423.04 - Filing and Reporting Requirements

Current through Register 1525, July 5, 2024
(1)
General Provisions
.
(a)
Accurate Data
.
			 All reports, schedules, additional information, books, and records that are
			 filed or made available to EOHHS must be certified under pains and penalties of
			 perjury as true, correct, and accurate by the executive director or chief
			 financial officer of the provider.
(b)
Examination of
			 Records
. Each provider must make available to EOHHS or purchasing
			 governmental unit upon request all records relating to its reported costs,
			 including costs of any entity related by common ownership or control.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 423.00 - Rates For Certain In-Home Basic Living Supports › Section 423.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				101 CMR 423.00 are
				severable. If any provision of
				101 CMR 423.00 or
				application of such provision to any eligible provider or fiscal intermediary
				is held invalid or unconstitutional, such determination will not affect the
				validity or constitutionality of any remaining provisions of
				101 CMR 423.00 or
				application of such provisions to eligible providers or fiscal intermediaries
				in circumstances other than those held invalid.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 424.00 - Rates for Certain Developmental and Support Services › Section 424.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR
			 424.00 governs the payment rates for certain
			 developmental and support services purchased by a governmental unit including,
			 but not limited to, the Department of Developmental Services (DDS) and the
			 Massachusetts Rehabilitation Commission (MRC).
(2)
Applicable Dates of
			 Service
. Rates contained in
			 101 CMR
			 424.00 apply for dates of service provided on or after
			 January 1, 2023.
(3)
Disclaimer of Authorization of Services
.
			 101 CMR
			 424.00 is neither authorization for nor approval of
			 the services for which rates are determined pursuant to
			 101 CMR
			 424.00. Governmental units that purchase the services
			 described in
			 101 CMR
			 424.00 are responsible for the definition,
			 authorization, and approval of services extended to clients.
(4)
Administrative
			 Bulletins
. EOHHS may issue administrative bulletins to clarify its
			 policy on substantive provisions of
			 101 CMR
			 424.00.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 424.00 - Rates for Certain Developmental and Support Services › Section 424.02 - Definitions

Current through Register 1525, July 5, 2024
As used in
				101 CMR
				424.00, unless the context requires otherwise, terms
				have the meanings in
				101
				CMR 424.02.
Client
. An individual that receives
				developmental and support services purchased by a governmental unit.
Clinical Team
. The clinical team is
				comprised of medical, psychological, and social service professionals, and
				provides around-the-clock on-call response to individuals in crisis.
Corporate Representative Payee
.
				Individualized financial supports and advocacy for individuals who benefit from
				support in managing their own funds. The program supports the individual in his
				or her personal movement toward integration into the larger community by
				handling or supporting various aspects of the individual's bank accounts, bill
				payments, and personal expenditures. Intensity levels are differentiated by
				complexity of the individual's finances and level of 1:1 support
				provided.
Cost Report
. The document used to
				report costs and other financial and statistical data. The Uniform Financial
				Statements and Independent Auditor's Report (UFR) is used when required.
Day Habilitation Supplemental Service
				Supports
. Certain clients may need supplemental services in the
				form of additional staff assistance to enable their participation in the day
				habilitation program listed in
				101 CMR 348.02:
General Definitions.
For those qualifying clients, the
				approved individual aide rate includes salary, payroll taxes, and fringe
				benefits for an individual aide for a specific client.
(a) The supplemental rate applies when both
			 of the following conditions exist.
1. The
			 purchasing agency determines that the specific client could not participate in
			 a day habilitation program without supplemental one-to-one care.
2. The need for supplemental services is
			 documented in the client's individual service plan or similar plan of
			 care.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 424.00 - Rates for Certain Developmental and Support Services › Section 424.03 - Rate Provisions

Current through Register 1525, July 5, 2024
(1)
Services Included in the Rate
. The approved rate
			 includes payment for all care and services that are part of the program of
			 services of an eligible provider, as explicitly set forth in the terms of the
			 purchase agreement between the eligible provider and the purchasing
			 governmental unit(s).
(2)
Reimbursement as Full Payment
. Each eligible provider
			 must, as a condition of acceptance of payment made by any purchasing
			 governmental units for services rendered, accept the approved program rate as
			 full payment and discharge of all obligations for the services rendered.
			 Payment from any other source will be used to offset the amount of the
			 purchasing governmental unit's obligation for services rendered to the publicly
			 assisted client.
(3)
Payment Limitations
. No purchasing governmental unit
			 may pay less than or more than the approved program rate.
(4)
Approved Rates
.
			 The approved rate is the lower of the provider's charge or amount accepted as
			 payment from another payer or the rate listed in
			 101
			 CMR 424.03.
Program
Rate
Unit
Corporate Representative Payee
Basic Intensity
$54.28
Client per Month
Moderate Intensity
$76.31
Client per Month
High Intensity
$177.49
Client per Month
Transition to Adulthood Program
$83.03
Hour
Day Habilitation Supplemental Supports
Direct Care/Program Staff
$5.69
% Hour
Licensed Practical Nurse (LPN)
$10.82
% Hour
Registered Nurse (RN)
$16.30
% Hour
Clinical Team Staff
							 Title
Level
Hourly Rate
Clinical Team Program Manager
1
$47.52
Clinical Team Program Manager
2
$54.72
Clinical Team Program Manager
3
$63.16
Clinical Team Program Manager
4
$74.84
Clinical Team Psychiatrist
1
$120.56
Clinical Team Psychiatrist
2
$141.08
Clinical Team Psychiatrist
3
$153.88
Clinical Team Nurse (LPN)
1
$47.20
Clinical Team Nurse (RN)
2
$70.84
Clinical Team Nurse (APRN)
3
$93.40
Clinical Team Specialist
1
$46.52
Clinical Team Specialist
2
$50.40
Clinical Team Specialist
3
$54.92
Clinical Team Specialist
4
$65.88
Clinical Team Specialist
5
$77.92
Clinical Team Direct Care/Clerical
1
$32.76
Clinical Team Direct Care III
2
$39.40
Clinical Team Direct
							 Care/Social/Caseworker
3
$39.76
Clinical Team Direct Care/Social/Case
							 Manager
4
$46.52
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 424.00 - Rates for Certain Developmental and Support Services › Section 424.04 - Filing and Reporting Requirements

Current through Register 1525, July 5, 2024
(1)
General Provisions
.
(a)
Accurate Data
.
			 All reports, schedules, additional information, books, and records that are
			 filed or made available to EOHHS must be certified under pains and penalties of
			 perjury as true, correct, and accurate by the executive director or chief
			 financial officer of the provider.
(b)
Examination of
			 Records
. Each provider must make available to EOHHS or purchasing
			 governmental unit upon request all records relating to its reported costs,
			 including costs of any entity related by common ownership or control.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 424.00 - Rates for Certain Developmental and Support Services › Section 424.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				101 CMR
				424.00 are severable. If any provision of
				101 CMR
				424.00 or application of such provision to any
				eligible provider or fiscal intermediary is held invalid or unconstitutional,
				such determination will not affect the validity or constitutionality of any
				remaining provisions of
				101 CMR
				424.00 or application of such provisions to eligible
				providers or fiscal intermediaries in circumstances other than those held
				invalid.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 425.00 - Rates for Certain Young Parent Support Programs › Section 425.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
. 101 CMR 425.00 governs the payment rates for
			 certain young parent support services purchased by a governmental unit
			 including, but not limited to, the Department of Transitional Assistance
			 (DTA).
(2)
Applicable
			 Dates of Service
. Rates contained in 101 CMR 425.00 apply for
			 dates of service provided on or after July 1, 2024.
(3)
Disclaimer of Authorization
			 of Services
. 101 CMR 425.00 is neither authorization for nor
			 approval of the services for which rates are determined pursuant to 101 CMR
			 425.00. Governmental units that purchase the services described in 101 CMR
			 425.00 are responsible for the definition, authorization, and approval of
			 services extended to clients.
(4)
Administrative Bulletins
. EOHHS may issue
			 administrative bulletins to clarify its policy on substantive provisions of 101
			 CMR 425.00.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 425.00 - Rates for Certain Young Parent Support Programs › Section 425.02 - Definitions

Current through Register 1525, July 5, 2024
As used in 101 CMR 425.00, unless the context requires
				otherwise, terms have the meanings in
				101
				CMR 425.02.
Client
. An individual that receives
				young parent support services purchased by a governmental unit.
Cost Report
. The document used to
				report costs and other financial and statistical data. The Uniform Financial
				Statements and Independent Auditor's Report (UFR) is used when required.
Enrollment Completion
. An enrollment
				payment occurs when a YPP enrollee has been accepted into the Young Parent
				Program by the contractor and has participated in program activities for a
				minimum of 40 hours. The official enrollment date reflects the date of the
				start of participation, at a minimum 100% attendance.
EOHHS
. The Executive Office of Health
				and Human Services established under M.G.L. c. 6A.
Governmental Unit
. The Commonwealth,
				any board, commission, department, division, or agency of the Commonwealth and
				any political subdivision of the Commonwealth.
Outcome Completion
. Achievement of a
				high school diploma or HiSETT. At a minimum, eight weeks at 100% attendance is
				required prior to completion. An outcome can also be defined as a job
				placement, acceptance into skills training, acceptance into a community
				college, transitioning to a college program, a progress payment with two grade
				levels of improvement, work program placement, full employment program
				placement, or high school placement. Outcome completions are further defined by
				the purchasing agency in the scope of services and contracts.
Placement Completion
. The start date
				of the placement must occur while the participant is actively participating in
				YPP or within 90 days of a reimbursable completion (HiSETT). A placement is
				counted as a completion only after 30 days of employment. Placement completions
				are further defined by the purchasing agency in the scope of services and
				contracts.
Provider
. Any individual, group,
				partnership, trust, corporation, or other legal entity that offers services for
				purchase by a governmental unit and that meets the conditions of purchase or
				licensure that have been adopted by a purchasing governmental unit.
Reporting Year
. The provider's fiscal
				year for which costs incurred are reported to the Operational Services Division
				on the Uniform Financial Statements and Independent Auditor's Report
				(UFR).
Young Parent Program
. The Young Parent
				Program (YPP) is a part of the Department of Transitional Assistance's
				Employment Services Program (ESP). These services are provided for Transitional
				Aid to Families with Dependent Children (TAFDC) participants. The YPP is
				directed toward reducing welfare dependency among young parents, 14 through 24
				years of age, who have not achieved a high school diploma or its
				equivalent.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 425.00 - Rates for Certain Young Parent Support Programs › Section 425.03 - Rate Provisions

Current through Register 1525, July 5, 2024
(1)
Services Included in the Rate
. The approved rate
			 includes payment for all care and services that are part of the program of
			 services of an eligible provider, as explicitly set forth in the terms of the
			 purchase agreement between the eligible provider and the purchasing
			 governmental unit(s).
(2)
Reimbursement as Full Payment
. Each eligible provider
			 must, as a condition of acceptance of payment made by any purchasing
			 governmental units for services rendered, accept the approved program rate as
			 full payment and discharge of all obligations for the services rendered.
			 Payment from any other source will be used to offset the amount of the
			 purchasing governmental unit's obligation for services rendered to the publicly
			 assisted client.
(3)
Payment Limitations
. No purchasing governmental unit
			 may pay less than or more than the approved program rate.
(4)
Administrative Adjustment for
			 Extraordinary Circumstances
. A provider may petition the
			 purchasing governmental unit for an administrative adjustment to reflect
			 increases in operating costs due to unusual and unforeseen circumstances or
			 extraordinary client service requirements not considered in the development of
			 the current rates. Unusual and unforeseen circumstances are events of
			 catastrophic nature (
e.g
., fire, flood, or earthquake) that
			 are not covered by insurance that the prudent provider would carry. The
			 provider must demonstrate that such cost increases gravely threaten the
			 stability of service provision such that client or consumer access to necessary
			 services is at risk. The purchasing governmental unit will evaluate the need
			 for the administrative adjustment, determine whether funding is available, and
			 convey that information to EOHHS for review to determine the amount of any
			 adjustment.
(5)
Approved Rates
. The approved rate is the lower of the
			 provider's charge or amount accepted as payment from another payer or the rate
			 listed in
			 101
			 CMR 425.03(5).
Service
Rate
Enrollment Completion
$4,566
Outcome/Placement Completion
$4,696
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 425.00 - Rates for Certain Young Parent Support Programs › Section 425.04 - Filing and Reporting Requirements

Current through Register 1525, July 5, 2024
(1)
General Provisions
.
(a)
Accurate Data
.
			 All reports, schedules, additional information, books, and records that are
			 filed or made available to EOHHS must be certified under pains and penalties of
			 perjury as true, correct, and accurate by the executive director or chief
			 financial officer of the provider.
(b)
Examination of
			 Records
. Each provider must make available to EOHHS or purchasing
			 governmental unit upon request all records relating to its reported costs,
			 including costs of any entity related by common ownership or control.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 425.00 - Rates for Certain Young Parent Support Programs › Section 425.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of 101 CMR 425.00 are severable. If any
				provision of 101 CMR 425.00 or application of any provision to an applicable
				individual, entity, or circumstance is held invalid or unconstitutional, that
				holding will not be construed to affect the validity or constitutionality of
				any remaining provisions of 101 CMR 425.00 or application of those provisions
				to applicable individuals, entities, or circumstances.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 426.00 - Rates for Certain Adult Community Mental Health Services › Section 426.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR
			 426.00 governs the payment rates for certain adult
			 community mental health services purchased by governmental units.
(2)
Applicable Dates of
			 Service
. Rates contained in
			 101 CMR
			 426.00 apply for dates of service provided on or after
			 January 1, 2023.
(3)
Disclaimer of Authorization of Services
.
			 101 CMR
			 426.00 is neither authorization for nor approval of
			 the services for which rates are determined pursuant to
			 101 CMR
			 426.00. Governmental units that purchase the services
			 described in
			 101 CMR
			 426.00 are responsible for the definition,
			 authorization, and approval of services extended to clients.
(4)
Administrative
			 Bulletins
. EOHHS may issue administrative bulletins to clarify its
			 policy on substantive provisions of
			 101 CMR
			 426.00.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 426.00 - Rates for Certain Adult Community Mental Health Services › Section 426.03 - Rate Provisions

Current through Register 1525, July 5, 2024
(1)
Services Included in the Rate
. The approved rate
			 includes payment for all care and services that are part of the program of
			 services of an eligible provider, as explicitly set forth in the terms of the
			 purchase agreement between the eligible provider and the purchasing
			 governmental unit(s).
(2)
Reimbursement as Full Payment
. Each eligible provider
			 must, as a condition of acceptance of payment made by any purchasing
			 governmental units for services rendered, accept the approved program rate as
			 full payment and discharge of all obligations for the services rendered.
			 Payment from any other source will be used to offset the amount of the
			 purchasing governmental unit's obligation for services rendered to the publicly
			 assisted client.
(3)
Payment Limitations
.
(a) No purchasing governmental unit may pay
			 less than or more than the approved program rate.
(b) Governmental units do not pay for
			 Integrated Team services for clients residing in Intensive Group Living
			 Environment service locations.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 426.00 - Rates for Certain Adult Community Mental Health Services › Section 426.04 - Filing and Reporting Requirements

Current through Register 1525, July 5, 2024
(1)
General Provisions
.
(a)
Accurate Data
.
			 All reports, schedules, additional information, books, and records that are
			 filed or made available to EOHHS must be certified under pains and penalties of
			 perjury as true, correct, and accurate by the executive director or chief
			 financial officer of the provider.
(b)
Examination of
			 Records
. Each provider must make available to EOHHS or the
			 purchasing governmental unit upon request all records relating to its reported
			 costs, including costs of any entity related by common ownership or
			 control.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 426.00 - Rates for Certain Adult Community Mental Health Services › Section 426.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				101 CMR 426.00 are
				severable. If any provision of
				101 CMR 426.00 or
				application of such provision to any eligible provider or fiscal intermediary
				is held invalid or unconstitutional, such determination will not affect the
				validity or constitutionality of any remaining provisions of
				101 CMR 426.00 or
				application of such provisions to eligible providers or fiscal intermediaries
				in circumstances other than those held invalid.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 427.00 - Rates for Certain Youth and Young Adult Support Services › Section 427.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR
			 427.00 governs the payment rates for certain youth and
			 young adult support services purchased by a governmental unit, including the
			 Department of Children and Families, the Department of Mental Health, and the
			 Department of Public Health.
(2)
Applicable Dates of Service
. Rates contained in
			 101 CMR
			 427.00 apply for dates of service provided on or after
			 July 1, 2023.
(3)
Disclaimer of Authorization of Services
.
			 101 CMR
			 427.00 is neither authorization for nor approval of
			 the services for which rates are determined pursuant to
			 101 CMR
			 427.00. Governmental units that purchase the services
			 described in
			 101 CMR
			 427.00 are responsible for the definition,
			 authorization, and approval of services extended to clients.
(4)
Administrative
			 Bulletins
. EOHHS may issue administrative bulletins to clarify its
			 policy on substantive provisions of
			 101 CMR
			 427.00.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 427.00 - Rates for Certain Youth and Young Adult Support Services › Section 427.04 - Filing and Reporting Requirements

Current through Register 1525, July 5, 2024
(1)
General Provisions
.
(a)
Accurate Data
.
			 All reports, schedules, additional information, books, and records that are
			 filed or made available to EOHHS must be certified under pains and penalties of
			 perjury as true, correct, and accurate by the executive director or chief
			 financial officer of the provider.
(b)
Examination of
			 Records
. Each provider must make available to EOHHS or the
			 purchasing governmental unit upon request all records relating to its reported
			 costs, including costs of any entity related by common ownership or
			 control.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 427.00 - Rates for Certain Youth and Young Adult Support Services › Section 427.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				101 CMR
				427.00 are severable. If any provision of
				101 CMR
				427.00 or application of such provision to any
				eligible provider or fiscal intermediary is held invalid or unconstitutional,
				such determination will not affect the validity or constitutionality of any
				remaining provisions of
				101 CMR
				427.00 or application of such provisions to eligible
				providers or fiscal intermediaries in circumstances other than those held
				invalid.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 428.00 - Rates for Certain Independent Living Communities and Services › Section 428.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR
			 428.00 governs the payment rates for certain
			 independent living communities and services purchased by a governmental unit
			 including, but not limited to, the Department of Mental Health (DMH), the
			 Massachusetts Commission for the Deaf and Hard of Hearing (MCDHH), and the
			 Massachusetts Rehabilitation Commission (MRC).
(2)
Applicable Dates of
			 Service
. Rates contained in
			 101 CMR
			 428.00 apply for dates of service provided on or after
			 July 1, 2023.
(3)
Disclaimer of Authorization of Services
.
			 101 CMR
			 428.00 is neither authorization for nor approval of
			 the services for which rates are determined pursuant to
			 101 CMR
			 428.00. Governmental units that purchase the services
			 described in
			 101 CMR
			 428.00 are responsible for the definition,
			 authorization, and approval of services extended to clients.
(4)
Administrative
			 Bulletins
. EOHHS may issue administrative bulletins to clarify its
			 policy on substantive provisions of
			 101 CMR
			 428.00 and to update the initial payment percentages
			 provided in
			 101
			 CMR 428.03(3)(c).
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 428.00 - Rates for Certain Independent Living Communities and Services › Section 428.02 - Definitions

Current through Register 1525, July 5, 2024
As used in
				101 CMR
				428.00, unless the context requires otherwise, terms
				have the meanings in
				101
				CMR 428.02.
Client
. An individual that receives
				certain independent living community services purchased by a governmental
				unit.
Cost Report
. The document used to
				report costs and other financial and statistical data. The Uniform Financial
				Statements and Independent Auditor's Report (UFR) is used when required.
Deaf and Hard of Hearing Independent Living
				Services (DHILS)
. This service provides person-specific supports
				to deaf and hard of hearing individuals across the Commonwealth. The goal of
				this program is to ensure that deaf and hard of hearing individuals have access
				to information, services, education, economic self-sufficiency, and
				opportunities equal to those of individuals who are not deaf or hard of
				hearing.
EOHHS
. The Executive Office of Health
				and Human Services, established under M.G.L. c. 6A.
Governmental Unit
. The Commonwealth,
				any board, commission, department, division, or agency of the Commonwealth and
				any political subdivision of the Commonwealth.
Provider
. Any individual, group,
				partnership, trust, corporation, or other legal entity that offers services for
				purchase by a governmental unit and that meets the conditions of purchase or
				licensure that have been adopted by a purchasing governmental unit.
Recovery Learning Community (RLC)
. A
				peer support service provided to individuals identifying as having mental
				illness. Peer services are designed to offer person-specific supports,
				connection to a variety of community resources, support services, training, and
				education as needed. Recovery Learning Communities also support peers through
				training, and consultation and provide a forum for community education aimed at
				reducing the stigmas around mental illness and assist communities to engage and
				coordinate efforts to improve service delivery for people experiencing mental
				illness.
Reporting Year
. The provider's fiscal
				year for which costs incurred are reported to the Operational Services Division
				on the Uniform Financial Statements and Independent Auditor's Report
				(UFR).
Vocational Rehabilitation Independent Living
				Services
. A service comprised of various components, as described
				in 101 CMR
				428.03(4), which provide
				person-specific vocational/independent living training and supports to
				individuals seeking employment. The goal of the program is to ensure
				individuals seeking employment have adequate environmental conditions to
				support their search for and maintenance of employment.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 428.00 - Rates for Certain Independent Living Communities and Services › Section 428.03 - Rate Provisions

Current through Register 1525, July 5, 2024
(1)
Services Included in the Rate
. The approved rate
			 includes payment for all care and services that are part of the program of
			 services of an eligible provider, as explicitly set forth in the terms of the
			 purchase agreement between the eligible provider and the purchasing
			 governmental unit(s).
(2)
Reimbursement as Full Payment
. Each eligible provider
			 must, as a condition of acceptance of payment made by any purchasing
			 governmental units for services rendered, accept the approved program rate as
			 full payment and discharge of all obligations for the services rendered.
			 Payment from any other source will be used to offset the amount of the
			 purchasing governmental unit's obligation for services rendered to the publicly
			 assisted client.
(3)
Service Component Payment Methods
.
(a)
General
.
			 Purchasing governmental units will pay providers a total payment per completed
			 service component as defined in
			 101
			 CMR 428.03(4).
(b)
Standard Progress
			 Documentation
. Providers must use a standard form to document
			 initiation and completion of a service component for each client. Providers
			 must submit all progress documentation, billing, and performance reporting
			 through the Enterprise Invoice Management Service.
(c)
Initial Payment
.
			 The purchasing governmental unit pays the provider an initial payment based on
			 a specified percentage of the total payment at the initiation of a service
			 component for a client. For assessment, the purchasing governmental unit makes
			 an initial payment equal to 20% of the service component payment in
			 101
			 CMR 428.03(4). For all other
			 service components, except ongoing and interim supports, the purchasing agency
			 makes an initial payment equal to 40% of the service component payment in
			 101
			 CMR 428.03(4). EOHHS may
			 revise these percentages by administrative bulletin.
(d)
Final Payment
.
			 The purchasing governmental unit pays the difference between the initial
			 payment and the total service component payment upon completion of the service
			 component and submission of required documentation pursuant to
			 101
			 CMR
			 428.03(3)(b).
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 428.00 - Rates for Certain Independent Living Communities and Services › Section 428.04 - Filing and Reporting Requirements

Current through Register 1525, July 5, 2024
(1)
General Provisions
.
(a)
Accurate Data
.
			 All reports, schedules, additional information, books, and records that are
			 filed or made available to EOHHS must be certified under pains and penalties of
			 perjury as true, correct, and accurate by the executive director or chief
			 financial officer of the provider.
(b)
Examination of
			 Records
. Each provider must make available to EOHHS or the
			 purchasing governmental unit upon request all records relating to its reported
			 costs, including costs of any entity related by common ownership or
			 control.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 428.00 - Rates for Certain Independent Living Communities and Services › Section 428.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				101 CMR
				428.00 are severable. If any provision of
				101 CMR
				428.00 or application of such provision to any
				eligible provider or fiscal intermediary is held invalid or unconstitutional,
				such determination will not affect the validity or constitutionality of any
				remaining provisions of
				101 CMR
				428.00 or application of such provisions to eligible
				providers or fiscal intermediaries in circumstances other than those held
				invalid.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 429.00 - Rates for Certain Sexual and Domestic Violence Services › Section 429.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR
			 429.00 governs the payment rates for certain sexual
			 and domestic violence services purchased by a governmental unit.
(2)
Applicable Dates of
			 Service
. Rates contained in
			 101 CMR
			 429.00 apply for dates of service provided on or after
			 July 1, 2023.
(3)
Disclaimer of Authorization of Services
.
			 101 CMR
			 429.00 is neither authorization for nor approval of
			 the services for which rates are determined pursuant to
			 101 CMR
			 429.00. Governmental units that purchase the services
			 described in
			 101 CMR
			 429.00 are responsible for the definition,
			 authorization, and approval of services extended to clients.
(4)
Administrative
			 Bulletins
. EOHHS may issue administrative bulletins to clarify its
			 policy on substantive provisions of
			 101 CMR
			 429.00.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 429.00 - Rates for Certain Sexual and Domestic Violence Services › Section 429.04 - Filing and Reporting Requirements

Current through Register 1525, July 5, 2024
(1)
General Provisions
.
(a)
Accurate Data
.
			 All reports, schedules, additional information, books, and records that are
			 filed or made available to EOHHS must be certified under pains and penalties of
			 perjury as true, correct, and accurate by the executive director or chief
			 financial officer of the provider.
(b)
Examination of
			 Records
. Each provider must make available to EOHHS or the
			 purchasing governmental unit upon request all records relating to its reported
			 costs, including costs of any entity related by common ownership or
			 control.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 429.00 - Rates for Certain Sexual and Domestic Violence Services › Section 429.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				101 CMR
				429.00 are severable. If any provision of
				101 CMR
				429.00 or application of such provision to any
				eligible provider or fiscal intermediary is held invalid or unconstitutional,
				such determination will not affect the validity or constitutionality of any
				remaining provisions of
				101 CMR
				429.00 or application of such provisions to eligible
				providers or fiscal intermediaries in circumstances other than those held
				invalid.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 430.00 - Rates for Program of Assertive Community Treatment Services › Section 430.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR
			 430.00 governs the payment rates for certain Program
			 of Assertive Community Treatment services purchased by governmental units,
			 including the Department of Mental Health.
(2)
Applicable Dates of
			 Service
. Rates contained within
			 101 CMR
			 430.00 apply for dates of service provided on or after
			 July 1, 2023.
(3)
Disclaimer of Authorization of Services
.
			 101 CMR
			 430.00 is neither authorization for nor approval of
			 the services for which rates are determined pursuant to
			 101 CMR
			 430.00. Governmental units that purchase the services
			 described in
			 101 CMR
			 430.00 are responsible for the definition,
			 authorization, and approval of services extended to clients.
(4)
Administrative
			 Bulletins
. EOHHS may issue administrative bulletins to clarify its
			 policy on substantive provisions of
			 101 CMR
			 430.00.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 430.00 - Rates for Program of Assertive Community Treatment Services › Section 430.03 - Rate Provisions

Current through Register 1525, July 5, 2024
(1)
Services Included in the Rate
. The approved rate
			 includes payment for all care and services that are part of the program of
			 services of an eligible provider, as explicitly set forth in the terms of the
			 purchase agreement between the eligible provider and the purchasing
			 governmental unit(s).
(2)
Reimbursement as Full Payment
. Each eligible provider
			 must, as a condition of acceptance of payment made by any purchasing
			 governmental units for services rendered, accept the approved program rate as
			 full payment and discharge of all obligations for the services rendered.
			 Payment from any other source will be used to offset the amount of the
			 purchasing governmental unit's obligation for services rendered to the publicly
			 assisted client.
(3)
Payment Limitations
. No purchasing governmental unit
			 may pay less than or more than the approved program rate.
(4)
Administrative Adjustment for
			 Extraordinary Circumstances
. A method whereby, subject to
			 availability of funds, a purchasing governmental unit may provide additional
			 resource allocations to a qualified provider in response to unusual and
			 unforeseen circumstances that substantially increase the cost of service
			 delivery in ways not contemplated in the development of current rates. It must
			 be demonstrated that such cost increases gravely threaten the stability of
			 service provision such that client or consumer access to necessary services is
			 at risk. The purchasing governmental unit will evaluate the need for the
			 administrative adjustment, determine whether funding is available, and convey
			 that information to EOHHS for review to determine the amount of any
			 adjustment.
(5)
Approved Rates
. The approved rate is the lower of the
			 provider's charge or amount accepted as payment from another payer or the rate
			 listed in
			 101
			 CMR 430.03.
Service
Model
Rate
Unit of
							 Service
Program of Assertive Community
							 Treatment
PACT 50
$67.10
Enrollment Day
PACT 80
$58.38
Enrollment Day
Forensic PACT
$90.36
Enrollment Day
Forensic GLE
$385.21
Bed Day
PACT Youth
$207.00
Enrollment Day
Extraordinary Circumstances/Flex
							 Funding
Add-on
I.C.
N/A
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 430.00 - Rates for Program of Assertive Community Treatment Services › Section 430.04 - Filing and Reporting Requirements

Current through Register 1525, July 5, 2024
(1)
General Provisions
.
(a)
Accurate Data
.
			 All reports, schedules, additional information, books, and records that are
			 filed or made available to EOHHS must be certified under pains and penalties of
			 perjury as true, correct, and accurate by the executive director or chief
			 financial officer of the provider.
(b)
Examination of
			 Records
. Each provider must make available to EOHHS or the
			 purchasing governmental unit upon request all records relating to its reported
			 costs, including costs of any entity related by common ownership or
			 control.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 430.00 - Rates for Program of Assertive Community Treatment Services › Section 430.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				101 CMR
				430.00 are severable. If any provision of
				101 CMR
				430.00 or application of such provision to any
				eligible provider or fiscal intermediary is held invalid or unconstitutional,
				such determination will not affect the validity or constitutionality of any
				remaining provisions of
				101 CMR
				430.00 or application of such provisions to eligible
				providers or fiscal intermediaries in circumstances other than those held
				invalid.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 431.00 - Rates for Certain Respite Services › Section 431.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR
			 431.00 governs the payment rates for certain respite
			 services purchased by governmental units including the Department of Mental
			 Health.
(2)
Applicable
			 Dates of Service
. Rates contained within
			 101 CMR
			 431.00 apply for dates of service provided on or after
			 July 1, 2023.
(3)
Disclaimer of Authorization of Services
.
			 101 CMR
			 431.00 is neither authorization for nor approval of
			 the services for which rates are determined pursuant to
			 101 CMR
			 431.00. Governmental units that purchase the services
			 described in
			 101 CMR
			 431.00 are responsible for the definition,
			 authorization, and approval of services extended to clients.
(4)
Administrative
			 Bulletins
. EOHHS may issue administrative bulletins to clarify its
			 policy on substantive provisions of
			 101 CMR
			 431.00.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 431.00 - Rates for Certain Respite Services › Section 431.02 - Definitions

Current through Register 1525, July 5, 2024
As used in
				101 CMR
				431.00, unless the context requires otherwise, terms
				have the meanings in
				101
				CMR 431.02.
Client
. An individual who receives
				certain respite services purchased by a governmental unit.
Cost Report
. The document used to
				report costs and other financial and statistical data. The Uniform Financial
				Statements and Independent Auditor's Report (UFR) is used when required.
EOHHS
. The Executive Office of Health
				and Human Services established under M.G.L. c. 6A.
Governmental Unit
. The Commonwealth,
				any board, commission, department, division, or agency of the Commonwealth and
				any political subdivision of the Commonwealth.
Provider
. Any individual, group,
				partnership, trust, corporation, or other legal entity that offers services for
				purchase by a governmental unit and that meets the conditions of purchase or
				licensure that have been or may be adopted by a purchasing governmental
				unit.
Reporting Year
. The provider's fiscal
				year for which costs incurred are reported to the Operational Services Division
				on the Uniform Financial Statements and Independent Auditor's Report
				(UFR).
Respite Services
. These services
				provide temporary short-term, community-based clinical and rehabilitative
				services that enable an individual to live in the community as fully and
				independently as possible.
Respite Services
are
				strength-based and person-centered in supporting clients to maintain, enter, or
				return to permanent living situations and are available in both site-based and
				mobile settings.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 431.00 - Rates for Certain Respite Services › Section 431.03 - Rate Provisions

Current through Register 1525, July 5, 2024
(1)
Services Included in the Rate
. The approved rate
			 includes payment for all care and services that are part of the program of
			 services of an eligible provider, as explicitly set forth in the terms of the
			 purchase agreement between the eligible provider and the purchasing
			 governmental unit(s).
(2)
Reimbursement as Full Payment
. Each eligible provider
			 must, as a condition of acceptance of payment made by any purchasing
			 governmental units for services rendered, accept the approved program rate as
			 full payment and discharge of all obligations for the services rendered.
			 Payment from any other source will be used to offset the amount of the
			 purchasing governmental unit's obligation for services rendered to the publicly
			 assisted client.
(3)
Payment Limitations
. No purchasing governmental unit
			 may pay less than or more than the approved program rate.
(4)
Administrative Adjustment for
			 Extraordinary Circumstances
. A method whereby, subject to
			 availability of funds, a purchasing governmental unit may provide additional
			 resource allocations to a qualified provider in response to unusual and
			 unforeseen circumstances that substantially increase the cost of service
			 delivery in ways not contemplated in the development of current rates. It must
			 be demonstrated that such cost increases gravely threaten the stability of
			 service provision such that client or consumer access to necessary services is
			 at risk. The purchasing governmental unit will evaluate the need for the
			 administrative adjustment, determine whether funding is available, and convey
			 that information to EOHHS for review to determine the amount of any
			 adjustment.
(5)
Approved Rates
. The approved rate is the lower of the
			 provider's charge or amount accepted as payment from another payer or the rate
			 listed in
			 101
			 CMR 431.03.
Service
Model
Unit of
							 Service
Rate
Respite
A
Month
$75,312
B
Month
$98,802
C
Month
$211,448
Peer Model
Month
$50,457
Site Only
Per Diem
$302.00
Mobile Only
Per Diem
$151.04