Missouri Code of State Regulations › Title 13 - DEPARTMENT OF SOCIAL SERVICES › Division 35 - Children's Division › Chapter 80 - Payment of Residential Facilities › Section 13 CSR 35-80.020 - Residential Care Agency Cost Reporting System

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes a uniform cost
				  reporting system to be used in reporting actual cost incurred in the operation
				  of residential care agencies. The uniform cost reporting system provides the
				  data necessary for the determination of the costs and rates associated with the
				  provision of foster care maintenance.
(1) Objectives. This rule establishes a
				uniform cost reporting system to be used in reporting actual cost incurred in
				the operation of residential care agencies. The Residential Care Agency Cost
				Report included is one part of the two (2)-part process set forth by the State
				of Missouri Department of Social Services in fulfilling the requirements for
				identifying foster care maintenance related expenditures within residential
				care agencies. The other part of the process involves participation in either a
				time study or random moment sample to determine the portion of time direct care
				staff spend performing foster care maintenance related activities.
(2) General Cost Reporting Principles.
				Residential Care Agency Cost Report line specific reporting instructions are
				included as an appendix to this rule included herein. The cost report must
				include all costs incurred by the residential care agency. Costs included in
				the report can be grouped/categorized in several different ways and are subject
				to certain guidelines or requirements:
(A)
				Costs directly attributable to a function or activity may be charged in their
				entirety to that function or activity. Example: A staff person working in a
				single function or activity may have one hundred percent (100%) of their time
				charged to that function or activity.
(B) Costs not attributable to a single
				function or activity must be distributed based on an appropriate allocation
				methodology. Example: A staff person who spends a portion of their time working
				for several different functions or activities should have their related cost
				allocated across each program by some substantially documented
				methodology.
(C) Some staff will
				have their associated cost allocated through the application of activity-based
				time study or random moment sample (RMS) results: All agency staff responsible
				for the provision of direct daily supervision of children on a regular basis
				will be included in the activity based allocation time study process. Those
				staff that should NOT participate in the time study include:
1. Agency administration. It should be noted
				that, in some agencies, an agency administrator might perform a significant
				amount of direct care of residents. In these instances, the individual should
				participate in the time study process.
2. Staff involved in the provision of a
				single function such as the provision of counseling or therapy; medical
				service; food preparation; cleaning; or facility maintenance.
(D) Costs are either considered
				allowable or unallowable, based on federal definitions and guidelines, for
				inclusion in the calculation of the residential foster care maintenance
				rate.
(E) Costs must be net of
				applicable credits when determining the portion attributable to the residential
				foster care maintenance rate. Any credits to reported costs will be applied as
				a function of the rate calculation process. Examples of applicable credits may
				include, but are not limited to:
1. IV-E
				training payments;
2. USDA
				reimbursements;
3. Payments from
				school districts or the Department of Elementary and Secondary Education for
				the provision of educational services;
4. Reimbursements from the Department of
				Social Services (DSS), the Department of Mental Health (DMH) or other third
				party payors that offset reported costs such as, including but not limited to:
A. Reimbursements for the development of the
				initial treatment plan, quarterly updates to the initial treatment plan and
				other treatment planning services reimbursed by others;
B. Reimbursements for day treatment; and C.
				Reimbursements for counseling or other therapeutic services.
5. Reimbursements for medical and
				behavioral health services covered by the state's Medicaid State Plan (either
				directly or indirectly through MC+Plans) including, but not limited to:
A. Physician's services;
B. Pharmacy-related services;
C. Psychology and counseling services; and D.
				Targeted case management.
6. Other reimbursement from Medicaid or the
				MC+plans for the provision of other medically necessary services.
7. Reimbursements for medical and behavioral
				health services covered by other third party payors.