DDES Memo Series 2006-12
Date: June 26, 2006
To: Listserv
For: County Departments of Community Programs Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
County Departments of Social Services Directors
From: Sinikka Santala
Administrator
Subject: Rate Information For Billing For Services Provided By The
Centers For Persons With Developmental Disabilities
Document Summary
Each year, the Wisconsin Department of Health and Family Services
reviews and revises the rates charged for services at the centers for
persons with developmental disabilities. The developmental disability
center rates are effective on July 1, 2006.
RATE SCHEDULE
CENTERS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
July 1, 2006 - June 30, 2007
The Wisconsin Department of Health and Family Services develops and
approves the rates for the centers for persons with developmental
disabilities. Rates are based on the actual cost of providing these
services. The department has established two rates for services at the
centers for persons with developmental disabilities. One rate is for long
term care services and the other rate is for intensive treatment services.
At the centers for people with developmental disabilities, the county
departments of developmental disabilities services are billed only for
individuals ineligible for Medicaid, designated as inappropriately placed,
and/or admitted for intensive treatment program services described below.
Per s. 51.437(4rm)(c)1, the county has 60 days to pay the bill. If payment
is not received within 60 days, the amount will automatically be deducted
from the next DHFS payment to the county through the CARS system.
INTENSIVE TREATMENT PROGRAM (ITP) SERVICES were established at Southern
Wisconsin Center (SWC) and Northern Wisconsin Center (NWC) per 1993
Wisconsin Act 16 and at Central Wisconsin Center (CWC) per 1999 Wisconsin
Act 9. ITP services are available for individuals at the centers
statewide. Services are provided to individuals with developmental
disabilities who are also diagnosed as having a mental illness or who
exhibit extremely aggressive and challenging behaviors.
Under s. 51.437(4rm)(c)2m, the county department of developmental
disabilities services will be billed the non-federal share for services
provided to individuals under s. 51.06(1m)(d) who are eligible for
Medicaid. The ITP rates were calculated to create a uniform statewide rate
for intensive treatment program services provided at the centers. A
uniform statewide ITP rate will enable counties to access the closest
facility or select the facility that best suits the resident's needs
without regard to rate differences.
The Billing and Collections Unit of the Bureau of Fiscal Services will
bill the counties for the non-federal share of the Medicaid ITP rates for
the care of the persons receiving ITP services. The amount charged to the
counties will be lower if some portion of the care is covered by
non-Medicaid dollars. The amount charged to the counties will also change
as the Medicaid rate per day and/or the non-federal share changes. On
October 1, 2006 the non-federal share of Medicaid will increase from 42.35
percent to 42.53 percent. The county will not be billed for the
non-federal share of the Medicaid payments for clients admitted for ITP
services whose cost of care is covered by a Family Care CMO (Care
Management Organization).
EXTENDED INTENSIVE TREATMENT SURCHARGE: Per newly created s. 51.06(5),
the department is authorized to assess a surcharge equal to 10% of the
total cost of care provided to individuals in the ITP's based on their
length of stay. The surcharge is imposed for each six-month period in
which a resident remains at a center beyond his or her discharge date,
which is set by the center and the individual's county of residence. The
surcharge amount will increase by 10% of the total cost of care provided
during each six-month period thereafter. The Department of Health and
Family Services will send a letter to the counties regarding the
implementation date of the Extended Intensive Treatment Surcharge.
TRANSITIONING PERSONS TO COMMUNITY CARE: The county will be billed
$48.00 per day if an independent professional review established under 42
USC 1396a(a)(31) determines the person served is appropriate for community
care, and there is adequate state and federal funding to provide these
community services (Per s. 51.437(4rm)(c)2.b.).
| RATES AT
CENTERS |
CENTRAL |
NORTHERN |
SOUTHERN |
| Long Term
Care Rate - Per day |
$604.00 |
$1,057.00 |
$541.00 |
| Intensive
Treatment Services - Per Day |
$660.50 |
$660.50 |
$660.50 |
| Non
Federal Share (7/1/06 - 9/30/06) |
$279.72 |
$279.72 |
$279.72 |
| Non
Federal Share (10/1/06 - 6/30/07) |
$280.91 |
$280.91 |
$280.91 |
REGIONAL OFFICE CONTACT: N/A
CENTRAL OFFICE CONTACT: Michael Hughes
Division of Disability and Elder Services
1 West Wilson Street, P.O. Box 7851
Madison, WI 53707-7851
(608) 267-2254
MEMO WEB SITE: http://dhfs.wisconsin.gov/partners/local.htm
cc Area Administrators/Human Service Area Administrators
Area Agencies on Aging Directors
Bureau/Office Directors
County 51 Boards Program Directors/Fiscal staff
County IM Managers/Supervisors/Lead Workers
County/Tribal Aging Directors
DDES Facility Central Office Staff
DDES Center Directors
DD Service Coordinators
Program Bureau Directors/Section Chiefs
Tribal Chairpersons/Human Services Facilitators
Tribal IM Directors
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Last Revised: October 24, 2008 |
