DLTC Memo Series 2008-10
STATE OF WISCONSIN
Department of Health Services DLTC Memo Series 2008-10
Division of Long Term Care Date: July 1, 2008
Index Title: RATE INFORMATION FOR BILLING FOR SERVICES
PROVIDED BY THE CENTERS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
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 Services reviews and revises
the rates charged for services at the centers for persons with
developmental disabilities.
RATE SCHEDULE
CENTERS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
July 1, 2008 - June 30, 2009
The Wisconsin Department of Health 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 rates for long term care services and for intensive
treatment services. The rate increase indicated below reflects increases
in labor costs as well as increases in fuel and utilities costs.
At the centers for persons with developmental disabilities, county
agencies are billed for long-term care services 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 DHS payment to the county through the CARS system.
INTENSIVE TREATMENT PROGRAM (ITP) SERVICES: ITP services are provided
to individuals with developmental disabilities who require active
treatment and 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 agency is 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 all
three centers. A uniform statewide ITP rate will enable counties to access
the closest facility or select the facility that best suits the person'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 changes as the
Medicaid rate per day and/or the non-federal share changes. On October 1,
2008 the non-federal share of Medicaid will decrease from 42.38 percent to
40.62 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 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 Services notified the counties
regarding the implementation of this surcharge on October 12, 2006 in the
DDES Information Memo 2006-18.
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.). Further information on
this process can be found in DLTC Information Memo Series 2008-4.
RATES AT CENTERS
CENTRAL NORTHERN SOUTHERN
| RATES AT CENTERS |
CENTRAL |
NORTHERN |
SOUTHERN |
| Daily
Rate for Long Term Care |
$723.00 |
$1,281.00 |
$668.00 |
| Intensive
Treatment Services - Per
Day |
$888.00 |
$888.00 |
$888.00 |
| Non
Federal Share (7/1/08
– 9/30/08) |
|
a. Up to agreed upon discharge date |
$376.23 |
$376.23 |
$376.23 |
b. After agreed upon
discharge date
*The 10% surcharge increases during each six-month
period after the agreed upon discharge date. |
$413.85 |
$413.85 |
$413.85 |
| Non
Federal Share (10/1/08
– 6/30/09) |
|
a. Up to agreed upon discharge date |
$360.60 |
$360.60 |
$360.60 |
b. After agreed upon
discharge date
*The 10% surcharge increases during each six-month
period after the agreed upon discharge date. |
$396.66 |
$396.66 |
$396.66 |
REGIONAL OFFICE CONTACT: N/A
CENTRAL OFFICE CONTACT: Michael Hughes
Division of Enterprise Services
1 West Wilson Street, P.O. Box 7851
Madison, WI 53707-7851
(608) 267-2254
MEMO WEB SITE: http://dhs.wisconsin.gov/partners/local.htm
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