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 427.03 - 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 427.03.
Service
Model
Unit of
							 Service
Rate
Alternative Lock-up Program
A
Month
$12,725
B
Month
$21,928
C
Month
$27,967
Conflict of Interest Services
1 Family
Month
$1,248
5 Families
Month
$6,202
Extraordinary Circumstances/Flex
							 Funding
N/A
N/A
I.C.
Teen Pregnancy Prevention Program
In school
Curriculum Hour
$380.85
Outside school
Curriculum Hour
$476.06
Remote Add-on
Hour
$95.21
Peer Leadership & Youth
							 Development
N/A
Contact Hour
$285.64
Partnership Development
N/A
Hour
$53.81
Therapeutic Day Services
Model 1
Month
$32,797
Model 2
Month
$27,789
Model 3A
Month
$29,917
Model 3B
Month
$40,722
Model 4A
Month
$23,425
Model 4B
Month
$43,943
Young Parent Support Program (YPS)
A
Month
$9,295
B
Month
$18,590
YPS Specialty Direct Care III Add-on (.5
							 FTE)
A
Month
$2,708
YPS Specialty Direct Care III Add-on (1
							 FTE)
B
Month
$5,415
Add-on Staff for Teen Pregnancy
							 Prevention Program
Title
Unit of
							 Service
Rate
Direct Care
Hourly
$24.49
Direct Care III
Hourly
$31.24
Add-on Staff for Therapeutic Day
							 Services
Title
Unit of
							 Service
.25 FTE
.5 FTE
.75 FTE
1 FTE
Clinical (LICSW)
Monthly
$1,965
$3,929
$5,894
$7,858
Peer/Direct Care
Monthly
$1,061
$2,122
$3,183
$4,245
Direct Care III
Monthly
$1,354
$2,708
$4,061
$5,415