(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 eligible provider
must, as a condition of acceptance of payment made by any purchasing
governmental units for services rendered, accept the approved 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 the services rendered to the publicly
assisted client.
(3)
Payment Limitations. No purchasing governmental unit
may pay less than or more than the approved program rate.
(4)
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.
(5)
Approved Rates. The approved rate is the lower of a
provider's charge or amount accepted as payment from another payer or the rate
listed in
101
CMR
421.03(5).
|
Program/Service Type
|
Rate
|
Unit
|
|
Outreach and Engagement
|
$35,983
|
Month
|
|
Safe Haven: ten to 12 beds
|
$207.14
|
Enrolled day
|
|
Safe Haven: seven to nine beds
|
$229.46
|
Enrolled day
|
|
Dual Diagnosis Shelter - donated
space
|
$189.38
|
Enrolled day
|
|
Dual Diagnosis Shelter - with occupancy
costs
|
$210.62
|
Enrolled day
|
|
Housing Options Program: Level 1
|
$45.43
|
Enrolled month
|
|
Housing Options Program: Level 2
|
$189.97
|
Enrolled month
|
|
Assertive Treatment and Relapse Prevention:
Model A - nine to 12 clients
|
$58.01
|
Enrolled day
|
|
Assertive Treatment and Relapse Prevention: Model B -
six to eight clients
|
$55.62
|
Enrolled day
|
|
Program Staffing Supports
|
Rates
|
|
FTE Basis
|
|
0.25
|
0.5
|
1
|
|
Position Titles
|
Per
Diem
|
Monthly
|
|
Direct Care
|
$184.00
|
$1,061.00
|
$2,122.00
|
$4,244.00
|
|
Direct Care III
|
$234.00
|
$1,354.00
|
$2,708.00
|
$5,415.00
|
|
LICSW
|
$340.00
|
$1,965.00
|
$3,929.00
|
$7,858.00
|
Notes
Adopted by
Mass
Register Issue 1296, eff. 9/25/2015.
Amended by
Mass
Register Issue 1332, eff.
2/10/2017.
Amended by
Mass
Register Issue 1351, eff.
11/3/2017.
Amended by
Mass
Register Issue 1394, eff.
6/28/2019.
Amended by
Mass
Register Issue 1407, eff.
12/27/2019.
Amended by
Mass
Register Issue 1446, eff.
6/25/2021.
Amended by
Mass
Register Issue 1505, eff.
9/29/2023.
