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DDES Memo Series 2005-10

July 1, 2005

STATE OF WISCONSIN
Department of Health and Family Services
Division of Disability and Elder Services

To: 
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

Re: Rate Information for Billing for Services Provided by the Centers  for People with Developmental Disabilities
(Replaces the portion of DDES Memo 2004-12 that discusses rates
for the Centers for Developmentally Disabled)

Document Summary  

Each year, the Wisconsin Department of Health and Family Services reviews and revises the rates charged for services at the centers for people with developmental disabilities.  The developmental disability center rates are effective on July 1, 2005.  Previously, these rates were published as part of the rate letter for all DDES facilities.  As of July 2005, the rates for the centers for people with developmental disabilities are being published separately from the rates for the mental health institutes.  

RATE SCHEDULE
CENTERS FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES
July 1, 2005 - June 30, 2006

The Wisconsin Department of Health and Family Services develops and approves the rates for the centers for people with developmental disabilities. Previously, these rates were published as part of the rate letter for all DDES facilities. As of July 2005, the rates for the centers for people with developmental disabilities are being published separately from the rates for the mental health institutes. Rates are based on the actual cost of providing these services. The department has established two rates for services at the centers for people 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, 2005 the non-federal share of Medicaid will increase from 41.68 percent to 42.35 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 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.).

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 Coordinators.
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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