reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 414.00 - Rates For Family Stabilization Services › Section 414.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
. 101 CMR 414.00 establishes the payment rates
			 for family stabilization services that provide support to individuals and
			 families to promote family stability and to prevent unnecessary out-of-home
			 placements. These rates are established for the services listed in
			 101
			 CMR 414.03(6). The rates for
			 other family stabilization services are established by other EOHHS regulations
			 as listed in
			 101
			 CMR 414.01(3).
(2)
Applicable Dates of
			 Service
. Rates contained in 101 CMR 414.00 apply for dates of
			 service provided on or after January 1, 2024.
(3)
Services and Rates Covered by
			 Other Regulations
. Payment rates for the following services are
			 not included within the scope of 101 CMR 414.00 and are governed by other
			 regulations promulgated by EOHHS as follows.
Service
Regulation
Individual Support and Community
							 Habilitation
101 CMR 423.00:
Rates for Certain In-home
							 Basic Living Supports
(4)
Disclaimer of Authorization of Services
. 101 CMR
			 414.00 is neither authorization for nor approval of the services for which
			 rates are determined pursuant to 101 CMR 414.00. Governmental units that
			 purchase family stabilization services are responsible for the definition,
			 authorization, and approval of services provided to participants.
(5)
Administrative
			 Bulletins
. EOHHS may issue administrative bulletins to clarify its
			 policy on substantive provisions of 101 CMR 414.00.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 414.00 - Rates For Family Stabilization Services › Section 414.04 - 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 414.00 - Rates For Family Stabilization Services › Section 414.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of 101 CMR 414.00 are severable. If any
				provision of 101 CMR 414.00 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 414.00 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 415.00 - Rates for Community-based Day Support Services › Section 415.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR
			 415.00 governs the payment rates for community-based
			 day support services that assist individuals to participate in community
			 activities by improving communication, self-care, and relationship-building
			 skills.
(2)
Applicable
			 Dates of Service
. The rates contained in
			 101 CMR
			 415.00 apply for dates of service provided on or after
			 July 1, 2023.
(3)
Disclaimer of Authorization of Services
.
			 101 CMR
			 415.00 is neither authorization for nor approval of
			 the services for which the regulation establishes payment rates. Purchasing
			 agencies are responsible for the definition, authorization, and approval of
			 services as specified in a contract between the provider and the purchasing
			 agency.
(4)
Administrative Bulletins
. EOHHS may issue
			 administrative bulletins to clarify its policy on substantive provisions of
			 101 CMR
			 415.00.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 415.00 - Rates for Community-based Day Support Services › Section 415.02 - Definitions

Current through Register 1525, July 5, 2024
As used in
				101 CMR
				415.00, unless the context requires otherwise, terms
				have the meanings in
				101
				CMR 415.02.
Active Treatment
. Care and services to
				improve and/or maintain the client's quality of life in a nursing facility by
				promoting the optimal level of functioning that allows as much
				self-determination as possible and strives to prevent a regression of current
				optimal status.
Client
. An individual who receives
				services purchased by a governmental unit.
Community-based Day Support Services
				(Services)
. Community-based day support services assist clients to
				build and maintain their ability to participate in community activities by
				focusing on skill areas that include communication, self-care,
				relationship-building, and community involvement.
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.
Nursing Facility
. An inpatient
				health-care facility with the staff and equipment to provide skilled care,
				rehabilitation, and other related health services to patients who need nursing
				care, but do not require hospitalization.
Provider
. Any individual, group,
				partnership, trust, corporation, or other legal entity that contracts with a
				purchasing agency to provide community-based day support services.
Purchasing Agency
. A governmental unit
				that purchases community-based day support services.
State Funding
. The aggregate state
				fiscal year amount of payments to a provider by a governmental unit for
				services purchased at rates established in
				101 CMR 415.00. State
				funding does not include any amounts attributable to federal funding or grant
				funds.
Workforce Initiatives
. Funds directed
				to a provider for workforce development.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 415.00 - Rates for Community-based Day Support Services › Section 415.03 - Rate Provisions

Current through Register 1525, July 5, 2024
(1)
Services Included in the Rate
. The payment rates in
			 101 CMR
			 415.00 are payment for all services provided to a
			 client by a provider, subject to the terms of the contract between the provider
			 and the purchasing agency.
(2)
Reimbursement as Full Payment
. Each provider must, as
			 a condition of acceptance of payment by a purchasing agency for services
			 provided to a client, accept the payment rates established by
			 101 CMR
			 415.00 as full payment and discharge of all
			 obligations for the services provided. The provider may not seek additional or
			 supplemental payment from clients or other third parties for services for which
			 rates are established by
			 101 CMR
			 415.00. If a provider receives any client funds or
			 third-party payments for services provided to a client, the purchasing agency's
			 obligation for services to the client will be offset by the amount
			 received.
(3)
Payment
			 Limitations
. Except as provided in
			 101
			 CMR 415.03(2), each
			 purchasing agency pays for services at the rates established in
			 101
			 CMR 415.03(5).
(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 payment rate for services is based
			 on the intensity level assigned to each client by the purchasing agency.
Level
Unit
Rate
A
15 Minutes
$15.02
B
15 Minutes
$8.62
C
15 Minutes
$6.16
D
15 Minutes
$5.28
I
15 Minutes
$11.32
W
15 Minutes
$7.01
Active
							 Treatment
Unit
Rate
Adult Nursing Facility Active
							 Treatment
15 Minutes
$17.82
Pediatric Nursing Facility Active
							 Treatment
15 Minutes
$21.02
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 415.00 - Rates for Community-based Day Support Services › Section 415.04 - 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
			 agency 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 415.00 - Rates for Community-based Day Support Services › Section 415.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				101 CMR
				415.00 are severable. If any provision of
				101 CMR
				415.00 or the application of any provision of
				101 CMR
				415.00 is held invalid or unconstitutional, such
				provision will not be construed to affect the validity or constitutionality of
				any other provision of
				101 CMR
				415.00 or the application of any other
				provision.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 416.00 - Rates For Clubhouse Services › Section 416.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
. 101 CMR 416.00 governs the payment rates for
			 clubhouse services purchased by a governmental unit.
(2)
Applicable Dates of
			 Services
. Rates contained in 101 CMR 416.00 apply for dates of
			 service provided on or after January 1, 2024.
(3)
Disclaimer of Authorization
			 of Services
. 101 CMR 416.00 is neither authorization for nor
			 approval of the services for which rates are determined pursuant to 101 CMR
			 416.00. The governmental unit that purchases the services is responsible for
			 the definition, authorization, and approval of services provided to
			 clients.
(4)
Administrative Bulletins
. EOHHS may issue
			 administrative bulletins to clarify its policy on substantive provisions of 101
			 CMR 416.00.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 416.00 - Rates For Clubhouse Services › Section 416.02 - Definitions

Current through Register 1525, July 5, 2024
As used in 101 CMR 416.00, unless the context requires
				otherwise, terms have the meanings in
				101
				CMR 416.02.
Average Daily Attendance
. A measure of
				the average number of clients served each day by a program. The average daily
				attendance is assigned to the program based on prior fiscal year attendance
				data.
Client
. An adult for whom a
				governmental unit purchases clubhouse services.
Clubhouse Services
. Services provided
				under a clubhouse program to individuals with behavioral and/or mental health
				issues, including employment, educational, social, and support services.
				Clubhouse services assist individuals to develop social networking, independent
				living, budgeting, self-care, and other skills that will assist them to live in
				the community and to secure and retain employment.
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 clubhouse
				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).
Service Day
. A service day is the unit
				of service used to bill the governmental unit. In general, a service day is a
				day during which an enrolled client either participates in a clubhouse services
				activity or activities related to a specific goal or objective documented in
				the client's Action Plan. The governmental unit will determine the specific
				events and conditions that qualify as billable activity. A provider can invoice
				only one unit of service per member per day.
State Funding
. The aggregate state
				fiscal year amount of payments to a provider by a governmental unit for
				services purchased at rates established in
				101
				CMR 416.00. State funding does not include any amounts
				attributable to federal funding or grant funds.
Workforce Initiatives
. Funds directed
				to a provider for workforce development.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 416.00 - Rates For Clubhouse Services › Section 416.03 - 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 by the purchasing
			 governmental unit(s).
(2)
Reimbursement as Full Payment
. Each eligible provider
			 must, as a condition of payment by any purchasing governmental unit, accept the
			 approved rate as full payment and discharge of all obligations for the services
			 rendered. Payment by the purchasing governmental unit for services rendered to
			 the client will be reduced by the amount of any payment from any other
			 source.
(3)
Payment
			 Limitations
. No purchasing governmental unit may pay less than, or
			 more than, the approved 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 416.03(4).
Club House Services
							 Rates
Unit
Rate
Average Daily Attendance of 29 and
							 under
Per Service Day
$80.06
Average Daily Attendance of 30 through
							 70
Per Service Day
$76.72
Average Daily Attendance of 71 and
							 above
Per Service Day
$57.16
Program located in Nantucket or Dukes
							 County
Per Service Day
$99.92
Add-on Rates
Unit
Rate
Workforce Initiatives
Annual
2.9% of the Provider's FY18 State Funding
Workforce Initiatives
Half-year
1.45% of the Provider's FY18 State Funding
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 416.00 - Rates For Clubhouse Services › Section 416.04 - 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 416.00 - Rates For Clubhouse Services › Section 416.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of 101 CMR 416.00 are severable. If any
				provision of 101 CMR 416.00 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 416.00 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 417.00 - Rates For Certain Elder Care Services › Section 417.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR
			 417.00 governs the payment rates for certain elder
			 care services provided to clients of the Executive Office of Elder Affairs
			 (EOEA) by Aging Services Access Points (ASAPs) and other designated
			 providers.
(2)
Applicable Dates of Service
. Rates contained in
			 101 CMR
			 417.00 apply for dates of service provided on or after
			 January 1, 2024.
(3)
Disclaimer of Authorization of Services
.
			 101 CMR
			 417.00 is neither authorization for, nor approval of,
			 the services for which rates are determined pursuant to
			 101 CMR
			 417.00. Governmental units that purchase ASAP services
			 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
			 417.00.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 417.00 - Rates For Certain Elder Care Services › Section 417.03 - 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 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 417.03(4).
Service
Unit
Rate
Enhanced Community Options Program (ECOP) Direct
							 Services
Per client per month
$976.08
Home Care Program Services Direct
							 Services
Per client per month
$424.34
Congregate Housing Services
							 Coordination
Per client per month
$339.48
Central Intake and Assessment Program
Per month
$208,338
Basic Home Care Case Management
Per client per month
$194.91
ECOP Case Management
Per client per month
$346.01
Protective Services
Per client per month
$605.86
Protective Services Intake
Per protective service report
$77.64
Supportive Senior Housing
Per site per month
$16,086
Money Management Services
Per client per month
$138.48
Guardianship Services
Per client per month
$892.78
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 417.00 - Rates For Certain Elder Care Services › Section 417.04 - 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 will 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 417.00 - Rates For Certain Elder Care Services › Section 417.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				101 CMR
				417.00 are severable. If any provision of
				101 CMR
				417.00 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
				417.00 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 418.00 - Payments For Youth Short-Term Stabilization and Emergency Placement Services › Section 418.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR 418.00 governs the
			 payment rates for youth short-term stabilization and emergency placement
			 services provided to clients of governmental units under the jurisdiction of
			 the Executive Office of Health and Human Services (EOHHS).
(2)
Disclaimer of Authorization
			 of Services
.
			 101 CMR 418.00 is neither
			 authorization for nor approval of the services for which rates are determined
			 pursuant to
			 101 CMR 418.00. Governmental
			 units that purchase the services described in
			 101 CMR 418.00 are
			 responsible for the definition, authorization, and approval of services
			 extended to clients.
(3)
Administrative Bulletins
. EOHHS may issue
			 administrative bulletins to clarify its policy on substantive provisions of
			 101 CMR 418.00.
(4)
Applicable Dates of
			 Service
. Rates contained in
			 101 CMR 418.00 apply for
			 dates of service provided on or after October 1, 2022.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 418.00 - Payments For Youth Short-Term Stabilization and Emergency Placement Services › Section 418.04 - 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 418.00 - Payments For Youth Short-Term Stabilization and Emergency Placement Services › Section 418.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				101 CMR 418.00 are
				severable. If any provision of
				101 CMR 418.00 or
				application of such provision to any eligible provider or fiscal intermediary
				is held invalid or unconstitutional, such determination does not affect the
				validity or constitutionality of any remaining provisions of
				101 CMR 418.00 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 419.00 - Rates For Supported Employment Services › Section 419.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR
			 419.00 governs the payment rates for supported
			 employment services purchased by a governmental unit. Supported employment
			 services provide individual and group employment in the community for clients
			 that require provider support and/or supervision.
(2)
Applicable Dates of
			 Service
. The rates contained in
			 101 CMR
			 419.00 apply for dates of service provided on or after
			 July 1, 2023.
(3)
Disclaimer of Authorization of Services
.
			 101 CMR
			 419.00 is neither authorization for nor approval of
			 the services for which rates are determined pursuant to
			 101 CMR
			 419.00. Governmental units that purchase supported
			 employment services 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
			 419.00.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 419.00 - Rates For Supported Employment Services › Section 419.03 - 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 a provider, as explicitly set forth in the terms of the purchase
			 agreement between the provider and the purchasing governmental
			 unit(s).
(2)
Reimbursement as Full Payment
. Each 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 except as authorized by
			 101
			 CMR 419.03(2).
(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 419.03(5). Providers
			 must bill for services in 15-minute units.
Base Service
Rate (15 mins) per Client
Individual Supported Employment ($65.48
							 hourly)
$16.37
Ongoing Individual Supported Employment ($48.36
							 hourly)
$12.09
Group Supported Employment ($23.52
							 hourly)
$5.88
High-intensity Service/Specialized Program
							 Rates
Rate (15 mins) per Client
High-intensity Group Supported Employment ($30.96
							 hourly) $7.74
Add-on Services
Rate (15 mins) per Client
Direct Care ($26.08 hourly)
$6.52
Direct Care III ($33.28 hourly)
$8.32
Transportation to Individual Job
							 Sites
Rate (15 mins) per Client
Travel to and from ISE job sites up to one hour
							 ($36.12 hourly) $9.03
Enhanced Staffing for Higher Intensity Clients
							 (Combined Add-on and Base Service Rates)
Rate (15 mins) per Client
1:1 Group Supported Employment ($49.04
							 hourly)
$12.26
1:3 Group Supported Employment ($32.04
							 hourly)
$8.01
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 419.00 - Rates For Supported Employment Services › Section 419.04 - 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 419.00 - Rates For Supported Employment Services › Section 419.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				101 CMR
				419.00 are severable. If any provision of
				101 CMR
				419.00 or application of such provision to any
				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
				419.00 or application of such provisions to any
				provider or fiscal intermediary in circumstances other than those held
				invalid.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 420.00 - Rates for Adult Long-term Residential Services › Section 420.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR 420.00 governs the
			 payment rates for adult long-term residential (ALTR) services purchased by a
			 governmental unit including, but not limited to, the Department of
			 Developmental Services (DDS), the Massachusetts Commission for the Blind (MCB),
			 and the Massachusetts Rehabilitation Commission (MRC).
(2)
Applicable Dates of
			 Service
. Rates are applicable for dates of service on and after
			 July 1, 2022.
(3)
Disclaimer of Authorization of Services
.
			 101 CMR 420.00 is neither
			 authorization for nor approval of the services for which rates are determined
			 pursuant to
			 101 CMR 420.00. Governmental
			 units that purchase the services described in
			 101 CMR 420.00 are
			 responsible for the definition, authorization, and approval of services
			 extended to clients.
(4)
Administrative Bulletins
. The Executive Office of
			 Health and Human Services may issue administrative bulletins to clarify its
			 policy on substantive provisions of
			 101 CMR 420.00.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 420.00 - Rates for Adult Long-term Residential Services › Section 420.04 - 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 420.00 - Rates for Adult Long-term Residential Services › Section 420.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				101 CMR 420.00 are
				severable. If any provision of
				101 CMR 420.00 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 420.00 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 421.00 - Rates For Adult Housing And Community Support Services › Section 421.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR
			 421.00 governs the payment rates for adult housing and
			 community support services purchased by a governmental unit. These services are
			 designed to provide various types of assistance to homeless individuals and,
			 following stabilization, promote more structured supports for them.
(2)
Applicable Dates of
			 Service
. The rates contained in
			 101 CMR
			 421.00 apply for dates of service provided on or after
			 July 1, 2023.
(3)
Disclaimer of Authorization of Services
.
			 101 CMR
			 421.00 is neither authorization for nor approval of
			 the services for which rates are determined pursuant to
			 101 CMR
			 421.00. Governmental units that purchase adult housing
			 and community support services 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
			 421.00.
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 421.00 - Rates For Adult Housing And Community Support Services › Section 421.03 - 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 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 the 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 a
			 provider's charge or amount accepted as payment from another payer or the rate
			 listed in
			 101
			 CMR 421.03(5).
Program/Service Type
Rate
Unit
Outreach and Engagement
$35,983
Month
Safe Haven: ten to 12 beds
$207.14
Enrolled day
Safe Haven: seven to nine beds
$229.46
Enrolled day
Dual Diagnosis Shelter - donated
							 space
$189.38
Enrolled day
Dual Diagnosis Shelter - with occupancy
							 costs
$210.62
Enrolled day
Housing Options Program: Level 1
$45.43
Enrolled month
Housing Options Program: Level 2
$189.97
Enrolled month
Assertive Treatment and Relapse Prevention:
Model A - nine to 12 clients
$58.01
Enrolled day
Assertive Treatment and Relapse Prevention: Model B -
							 six to eight clients
$55.62
Enrolled day
Program Staffing Supports
Rates
FTE Basis
0.25
0.5
1
Position Titles
Per
							 Diem
Monthly
Direct Care
$184.00
$1,061.00
$2,122.00
$4,244.00
Direct Care III
$234.00
$1,354.00
$2,708.00
$5,415.00
LICSW
$340.00
$1,965.00
$3,929.00
$7,858.00
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 421.00 - Rates For Adult Housing And Community Support Services › Section 421.04 - 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 421.00 - Rates For Adult Housing And Community Support Services › Section 421.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				101 CMR
				421.00 are severable. If any provision of
				101 CMR
				421.00 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
				421.00 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 422.00 - Rates for General Programs - Disability Services › Section 422.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR 422.00 governs the
			 payment rates for general programs - disability services purchased by a
			 governmental unit. General programs - disability services are services designed
			 to provide various types of assistance to disabled individuals to aid them in
			 achieving personal independence.
(2)
Applicable Dates of
			 Service
. The rates contained in
			 101 CMR 422.00 apply for
			 dates of service provided on or after January 1, 2022.
(3)
Disclaimer of Authorization
			 of Services
.
			 101 CMR 422.00 is neither
			 authorization for nor approval of the services for which rates are determined
			 pursuant to
			 101 CMR 422.00. Governmental
			 units that purchase the services described in
			 101 CMR 422.00 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 422.00.
(5)
Services and Rates Covered by
			 Other Regulations
. Payment rates for the following services are
			 not included within the scope of
			 101 CMR 422.00 and are
			 governed by other regulations promulgated by EOHHS as follows.
Service
Regulation
Client Financial Assistance/Flex Funding
							 Administration
101 CMR 414.00:
Rates for Family Stabilization Services
Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 422.00 - Rates for General Programs - Disability Services › Section 422.04 - 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 422.00 - Rates for General Programs - Disability Services › Section 422.05 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				101 CMR 422.00 are
				severable. If any provision of
				101 CMR 422.00 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 422.00 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 423.00 - Rates For Certain In-Home Basic Living Supports › Section 423.01 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 101 CMR 423.00 governs the
			 payment rates for certain in-home basic living support services that are
			 purchased by a governmental unit including, but not limited to, the Department
			 of Developmental Services (DDS), Massachusetts Commission for the Blind (MCB),
			 and the Massachusetts Rehabilitation Commission (MRC).
(2)
Applicable Dates of
			 Service
. Rates contained in
			 101 CMR 423.00 apply for
			 dates of service on or after July 1, 2022.
(3)
Disclaimer of Authorization
			 of Services
.
			 101 CMR 423.00 is neither
			 authorization for nor approval of the services for which rates are determined
			 pursuant to
			 101 CMR 423.00. Governmental
			 units that purchase the services described in
			 101 CMR 423.00 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 423.00.
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 423.02 - Definitions

Current through Register 1525, July 5, 2024
As used in
				101 CMR 423.00, unless the
				context requires otherwise, terms have the meanings in 101 CMR 423.02.
Client
. An individual that receives
				in-home basic living 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.
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.
In-home Basic Living Supports
. A broad
				range of service levels that assist clients in living as independently as
				possible within the community, encompassing support services customized to
				their specific needs in a variety of life activities on a regular or
				intermittent basis, and determined as necessary to prevent
				institutionalization. These services provide the assistance and supervision
				necessary for clients to establish, live in, and maintain, on an on-going
				basis, a household of their choosing in a personal home or the family home, to
				meet their habilitative needs. These services may include teaching and
				fostering the acquisition, retention, or improvement of skills related to
				personal finance, health, shopping, use of community resources, community
				safety, and other social and adaptive skills to live in the community. They may
				also include training and education in self-determination and self-advocacy,
				enabling clients to acquire skills to exercise control and responsibility over
				the services and supports they receive and to become more independent,
				integrated, and productive in their communities. In-home basic living support
				services do not include room and board, the cost of facility upkeep and
				maintenance, and are not provided to clients living in 24-hour licensed group
				home settings.
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).