Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 414.00 - Rates For Family Stabilization Services › Section 414.03 - 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 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 participant.
(3)
Payment
			 Limitations
. No purchasing governmental unit may pay less than or
			 more than the approved program rate.
(4)
Services Provided in Dukes or
			 Nantucket County
. In accordance with the provisions of St. 2016,
			 c. 133, payment for services provided in programs located in Dukes or Nantucket
			 County is the rate for the service contained in
			 101
			 CMR 414.03(6)  times a
			 factor of 1.07.
(5)
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.
(6)
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 414.03(6).
Service
Center
							 Size
Unit of Service
Agency Rate
Adolescent Support Network
Enrolled day
$26.75
Adult Companion
15 minutes
$9.75
Adult Companion Group Services Group of
							 2
15 minutes
$4.88
Adult Companion Group Services Group of
							 3
15 minutes
$3.25
After-school Respite
Half day
$64.30
After-school Respite
Full day
$110.58
Autism Support Center/Family Support
							 Center
0.5
Month
$5,827.56
Autism Support Center/Family Support
							 Center
1
Month
$11,655.12
Autism Support Center/Family Support
							 Center
1.5
Month
$17,482.68
Autism Support Center/Family Support
							 Center
2
Month
$23,310.25
Autism Support Center/Family Support
							 Center
2.5
Month
$27,676.70
Autism Support Center/Family Support
							 Center
3
Month
$32,540.52
Autism Support Center/Family Support
							 Center
3.5
Month
$37,348.43
Autism Support Center/Family Support
							 Center
4
Month
$42,098.18
Autism Support Center/Family Support
							 Center
4.5
Month
$46,797.24
Autism Support Center/Family Support
							 Center
5
Month
$51,462.55
Autism Support Center/Family Support
							 Center
5.5
Month
$56,101.18
Autism Support Center/Family Support
							 Center
6
Month
$60,854.56
Autism Support Center/Family Support
							 Center
6.5
Month
$65,610.75
Autism Support Center/Family Support
							 Center
7
Month
$70,322.03
Autism Support Center/Family Support
							 Center
7.5
Month
$75,044.46
Autism Support Center/Family Support
							 Center
8
Month
$79,686.55
Autism Support Center/Family Support
							 Center
8.5
Month
$84,218.28
Autism Support Center/Family Support
							 Center
9
Month
$88,710.24
Autism Support Center/Family Support
							 Center
9.5
Month
$93,202.21
Autism Support Center/Family Support
							 Center
10
Month
$97,659.00
Autism Support Center/Family Support
							 Center
10.5
Month
$102,123.03
Autism Support Center/Family Support
							 Center
11
Month
$106,569.56
Autism Support Center/Family Support
							 Center
11.5
Month
$111,034.12
Autism Support Center/Family Support
							 Center
12
Month
$115,507.30
Agency with Choice
N/A
I.C.
Agency with Choice Admin Fee
Month
$375.74
Behavioral Support Services
							 Bachelor's
15 minutes
$20.92
Behavioral Support Services
							 Master's
15 minutes
$33.14
Behavioral Support Services
							 PhD
15 minutes
$41.95
Client Financial Assistance/Flex
							 Funding
N/A
I.C.
Client Financial Assistance/Flex Funding
							 Administration
Transaction
$18.65
Combined Hourly Services:
Nonclinical
Hour
$68.84
Clinical
Hour
$103.65
Comprehensive Services:
Model A-1 Direct Care - Nonclinical Less
							 Intensive
Enrolled day
$47.98
Model A-2 Direct Care - Nonclinical More
							 Intensive
Enrolled day
$72.54
Model B Direct Care and Clinical Less
							 Intensive
Enrolled day
$91.20
Model C Direct Care and Clinical More
							 Intensive
Enrolled day
$92.52
Model D Clinical
Enrolled day
$91.29
Model E Direct Care and Clinical High
							 Intensive
Enrolled day
$132.37
Model F Direct Care and Clinical Highest
							 Intensive
Enrolled day
$220.98
Model G Direct Care and Clinical Higher
							 Intensive
Enrolled day
$163.54
Educational Coordination
Enrolled day
$22.66
Family Navigation
15 minutes
$18.70
Family Resource Center
Month
$61,097
Micro Family Resource Center
Month
$24,785
Micro Family Resource Center
							 Add-on
Month
$7,105
Family Resource Center
Per Diem
Add-on: Family Support Worker
Per Diem
$266.24
Family Resource Center
Per Diem
Add-on: Clinician (LCSW)
Per Diem
$372.56
Family Resource Center
Per Diem
Add-on: Clinician (LICSW)
Per Diem
$428.56
Family Resource Center
Per Diem
Add-on: Family Partner
Per Diem
$208.67
Family Resource Center
Per Diem
Add-on: School Liaison
Per Diem
$296.93
Family Training Groups:
Specialty Family Skills Development Program
							 Model
Session
$2,952.38
Add-ons for a Specialty Family Skills Development
							 Program Model:
Occupancy Purchase of Space
Session
$140.77
Family Skills Development Program
							 Model
Session
$2,059.32
Add-ons for a Family Skills Development Program
							 Model:
Facilitator/Coordinator
Session
$70.58
Meals
Session
$173.10
Child Care
Session
$49.91
Occupancy Purchase of Space
Session
$140.77
Transportation
Session
$168.94
Parent Skill Development Program
							 Model
Session
$1,532.93
Add-ons for a Parent Skill Development Program
							 Model:
Facilitator/Coordinator
Session
$70.58
Meals
Session
$173.10
Child Care
Session
$49.91
Occupancy Purchase of Space
Session
$140.77
Transportation
Session
$168.94
Family Training
15 minutes
$13.25
Family Training Group of 2
15 minutes
$6.63
Family Training Group of 5
15 minutes
$2.65
Intensive Flexible Family Support
							 Services
Enrolled day
$25.39
Medically Complex Programs
Month
$415.30
Peer Support
15 minutes
$9.75
Peer Support Group of 2
15 minutes
$4.88
Peer Support Group of 5
15 minutes
$1.95
Planned Site-based Respite for
							 Children
Day
$437.82
Planned Site-based Respite for Children,
							 High-intensity Support Needs
Day
$569.44
Planned Site-based Respite for
							 Children
30 minutes
$27.37
Planned Site-based Respite for Children,
							 High-intensity Support Needs
30 minutes
$35.59
Respite in Caregiver's Home, Level
							 1
Day
$145.19
Respite in Caregiver's Home, Level
							 2
Day
$176.03
Respite in Caregiver's Home, Level
							 3
Day
$206.86
Respite in Recipient's Home,
							 1:1
15 minutes
$9.75
Respite in Recipient's Home,
							 1:2
15 minutes
$4.88
Respite in Recipient's Home,
							 1:3
15 minutes
$3.25
Respite in Recipient's Home
Day
$351.00
Site-based Respite
Day
$302.19
Site-based Respite with
							 Nursing
Day
$380.96
Unbundled Intensive Foster Care Special
							 Support
Child day
$63.32
Family Navigation Administrative
							 Service
Transaction
$40.87
Flexible Supports
							 Service
Level
Hourly
							 Rate
Monthly Rate 1.0
							 FTE
Monthly Rate 0.75
							 FTE
Monthly Rate 0.5
							 FTE
Monthly Rate 0.25
							 FTE
Program Manager
1
N/A
$9,329
$6,997
$4,664
$2,332
Program Manager
2
N/A
$9,420
$7,065
$4,710
$2,355
Clinician
1
$94.66
$8,086
$6,064
$4,043
$2,021
Clinician
2
$111.30
$9,507
$7,130
$4,754
$2,377
Family Partner
1
$74.20
$5,880
$4,410
$2,940
$1,470
Family Partner
2
$88.72
$7,031
$5,273
$3,516
$1,758
Peer Mentor/Therapeutic Support
							 Specialist
1
$70.90
$5,702
$4,276
$2,851
$1,425
Peer Mentor/Therapeutic Support
							 Specialist
2
$85.22
$6,853
$5,140
$3,426
$1,713