New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter II - Administrative Rules and Regulations › Subchapter L - Hospitals and Related Facilities › Part 86 - Reporting and Rate Certifications for Facilities › Subpart 86-10 - Rates for Non-state Providers of Residential Habilitation in Community Residences, Including Individualized Residential, Including Individualizad Residential Alternatives (iras) and for Non-state Providers of Day Habilitation › Section 86-10.5 - Trend Factor, Increases to Compensation and Other Adjustments

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
Trend
					 factor.
For years in which the department does not update the
						base year, subject to the approval of the Director of Budget, the department
						may use a compounded trend factor to bring base year costs forward to the
						appropriate rate period. The trend factor shall be taken from applicable years
						from consumer and producer price indices, including, but not limited to the
						Medical Care Services Index; U.S. city average, by expenditure category and
						commodity and service group for the period April to April of each year.
(b)
Increases to
					 compensation.
(1) Applicability. On or
					 after January 1, 2015, rates of reimbursement for providers that operate
					 eligible programs as defined in this section will be revised to incorporate
					 funding for compensation increases to their direct support professional
					 employees. Such rate increases will be effective January 1, 2015. The
					 compensation increase funding will be included in the provider's rate issued
					 for January 1, 2015 or in a subsequent rate with the inclusion of funding in
					 the amount necessary to achieve the same funding impact as if the rate had been
					 issued on January 1, 2015. The compensation increase funding will be inclusive
					 of associated fringe benefits.
(2)
					 Definitions. As used in this section, the following terms shall have the
					 following meanings:
(i)
Direct
					 support professionals
are those defined as direct care and support per
					 consolidated fiscal report (CFR) appendix R and reported on the CFR under the
					 position title code identifiers of 100 or 200. Contracted staff salary
					 information will not be utilized.
(ii)
Clinical staff
are
					 those defined as clinical per CFR appendix R and reported on the CFR under the
					 position title code identifier of 300. Contracted staff salary information will
					 not be utilized.
(iii)
Eligible rate based programs
shall mean supervised community
					 residences (including supervised IRAs), supportive community residences
					 (including supportive IRAs), or group day habilitation programs.
(3) Increases for eligible rate
					 based programs. Increases for eligible rate based programs.
(i) January 1, 2015 increase. Rates for
					 eligible rate based programs will be revised to incorporate funding for
					 compensation increases to direct support professional employees. Such rate
					 increases will be effective January 1, 2015. The compensation increase funding
					 will be included in the provider's rate issued for January 1, 2015, or in a
					 subsequent rate with the inclusion of funding in the amount necessary to
					 achieve the same funding impact as if the rate had been issued on January 1,
					 2015. The compensation increase funding will be inclusive of associated fringe
					 benefits.
(ii) April 1, 2015
					 increase. In addition to the compensation funding effective January 1, 2015
					 providers that operate supervised IRAs, including supervised community
					 residences, supportive IRAs, including supportive community residences, and
					 group day habilitation will receive a compensation increase targeted to direct
					 support professional and clinical employees to be effective April 1, 2015. The
					 compensation increase funding will be inclusive of associated fringe benefits.
					 The April 1, 2015 direct support professionals' compensation funding will be
					 the same, on an annualized basis, as that compounded on the amount which was
					 calculated for the January 1, 2015 compensation increase and will be an
					 augmentation to the January 1, 2015 increase.
(iii) Calculations. The basis for the
					 calculation of provider and regional direct care, support and clinical salary
					 averages and associated fringe benefit percentages will be the data in
					 providers's CFRs for July 1, 2010 through June 30, 2011 for providers reporting
					 on a fiscal year basis or January 1, 2011 through December 31, 2011 for
					 providers reporting on a calendar year basis.
(a) The January 1, 2015 and April 1, 2015
					 direct support professionals compensation increase funding formula will be as
					 follows:
(1) The annual impact of a two
					 percent increase to 2010-11 or 2011 salaried direct care dollars, salaried
					 support dollars and associated fringe benefits will be calculated.
(2) The annual impact of the two percent
					 increase for salaried direct care dollars, salaried support dollars and
					 associated fringe will be added to the appropriate operating components in the
					 rate methodology. This will result in a recalculation of provider and regional
					 average direct care wages, provider and regional average employee-related
					 components, provider and regional average program support components, and
					 provider and regional average direct care hourly rates.
(3) The provider direct care hourly rate ""
					 adjusted for wage equalization factor will be recalculated to utilize the
					 provider average direct care hourly rate and regional average direct care
					 hourly rate, as calculated in subclause (
2
) of this
					 clause.
(4) An identification will
					 be made of the dollar difference between the provider direct care hourly rate
					 "" adjusted for wage equalization factor, which is in the rate in effect on
					 December 31, 2014, and the provider direct care hourly rate "" adjusted for
					 wage equalization factor, as calculated in subclause (
3
) of
					 this clause.
(5) The rate
					 difference identified in subclause (
4
) of this clause will be
					 multiplied by the calculated direct care hours in the rate in effect on
					 December 31, 2014 to calculate the additional funding generated by the direct
					 care compensation adjustment.
(6)
					 The rate add-on for the compensation increase shall be determined by dividing
					 the additional funding, as calculated in subclause (
5
) of this
					 clause by the rate sheet units in effect on January 1, 2015.
(b) The April 1, 2015 clinical
					 compensation increase funding formula will be as follows:
(1) The annual impact of a two percent
					 increase to 2010-11 or 2011 salaried clinical dollars and associated fringe
					 benefits will be calculated.
(2)
					 The annual impact of the two percent increase for salaried clinical dollars and
					 associated fringe will be added to the appropriate operating components in the
					 rate methodology. This will result in a recalculation of provider and regional
					 average employee-related components, provider and regional average clinical
					 hourly wages.
(3) The provider
					 clinical hourly wage "" adjusted for wage equalization factor will be
					 recalculated to utilize the provider average clinical hourly wage and regional
					 average clinical hourly wage, as calculated in subclause (
2
)
					 of this clause.
(4) An
					 identification will be made of the dollar difference between the provider
					 clinical hourly wage "" adjusted for wage equalization factor, which is in the
					 rate in effect on December 31, 2014, and the provider clinical hourly wage ""
					 adjusted for wage equalization factor, as calculated in subclause
					 (
3
) of this clause.
(5) The rate difference identified in
					 subclause (
4
) of this clause will be multiplied by the
					 provider salaried clinical hours in the rate in effect on December 31, 2014 to
					 calculate the additional funding generated by the clinical compensation
					 adjustment.
(6) The rate add-on for
					 the compensation increase shall be determined by dividing the additional
					 funding, as calculated in subclause (
5
) of this clause by the
					 rate sheet units in effect on January 1, 2015.
(c) Other Adjustments. Effective July 1,
					 2016, the reimbursement for Supervised Residential Habilitation and Day
					 Habilitation will exclude costs for direct clinical services. Direct clinical
					 services are defined as face-to-face clinical interventions delivered by
					 clinical staff directly to program participants. Direct clinical services
					 include occupational therapy (OT), physical therapy (PT), speech language
					 pathology (SLP), psychology and social work, where OT, PT and SLP direct
					 services are provided by staff who are licensed clinicians, and where
					 psychology and social work services are not related to the provision or
					 oversight of habilitation services and are delivered or supervised by licensed
					 clinical staff.