13 CSR 35-80.010 - Residential Foster Care Maintenance Methodology
(1) Objectives. This rule establishes a
methodology for determination of the costs associated with the provision of
foster care maintenance based on the statutory criteria contained in
42 U.S.C.
672/675(4)(A) and related rates for
residential care agencies.
(2)
General Principles.
(A) Four (4)
child-specific foster care maintenance rates shall be determined in accordance
with section (3) Residential Foster Care Maintenance Rate
Methodology.
(B) Residential child
caring agencies will be required to complete a cost report detailing their most
recent fiscal year's operating costs. Providers must also submit audited
financial statements with their report for verification purposes.
(C) Foster care maintenance costs shall be
obtained from residential care providers using the standard cost report
completed in accordance with applicable instructions.
1. In order to be considered "Foster Care
Maintenance," agency costs shall first meet the general definition as ascribed
within federal regulation, accompanying clarification or audit finding and be
allowable as defined within OMB Circular A-122, OMB Circular A-87, and the
Child Welfare Policy Manual.
2. Reported agency costs shall be reasonable
in nature as defined with OMB Circular A-122 and OMB Circular A-87.
3. Cost must be appropriately allocated to
all benefiting programs or services offered by an agency.
4. The calculation of the foster care
maintenance rate must consider any applicable credits or payments received
either directly from federal or state funding sources or indirectly via
contracted services or reimbursement.
(D) Statewide foster care maintenance costs
shall be rebased every three (3) years.
(E) The Department of Social Services (DSS)
will submit budget items for the General Assembly's consideration to revise
rates in accordance with the results of the rate setting methodology. Rates
will be adjusted in accordance with the Truly Agreed and Finally Passed
appropriation by the General Assembly subject to veto by the
Governor.
(3) Residential
Foster Care Maintenance Rate Methodology. The foster care maintenance rate will
contain two (2) separate components. A statewide average room and board
component and a child-specific daily supervision component.
(A) Room and Board Component.
1. Because the general cost of providing room
and board will not vary based on a child's identified level of care or other
programmatic considerations, a core, statewide, board rate will be calculated
based on the average cost of all agencies providing such services.
2. The room and board component will be
calculated by dividing the total net applicable room and board related costs
for all agencies by the statewide total days of residential child caring
services provided.
(B)
Daily Supervision Component.
1. The daily
supervision component will vary based upon required staffing ratios as defined
within the Missouri Code of State Regulations "Rules of
Department of Social Services, Division 40-Division of Family Services, Chapter
71-Licensing Rules for Residential Care Agencies." This document establishes
basic expectations for staff/child ratios within residential care agencies as
identified within Exhibit 1, Residential Child Care Agency Staff/Child Ratios.
Exhibit 1
|
Category |
Age |
Child Awake |
Child Asleep |
|
Basic Core Requirements |
Birth-6 6-8 8-21 7-21 7-21 |
1:4 1:6 1:10 |
1:6 (staff awake) 1:12 (staff asleep) 1:20 (staff awake) |
|
Infant/Toddler/Preschool |
Birth-6 |
1:4 |
1:6 (staff awake) |
|
Residential Treatment (DFS Levels II & III) |
6 7 8-21 |
1:4 1:6 1:8 |
1:6 (staff awake) 1:6 (staff awake) 1:16 (staff awake) |
|
Intensive Residential Care (DFS Level IV) |
6 7-21 |
1:4 1:6 |
1:6 (staff awake) 1:6 (staff awake) |
2.
Agencies will report days by type of service provided. To determine the
child-specific daily supervision portion of the rate, agencies will be
classified into one of four categories based upon the average level of
supervision required by children in their care. This classification will allow
for adequate differentiation of cost incurred in the provision of daily
supervision across each category and permit calculation of the related rate
component. After categorization of agencies into each of the defined
categories, the daily supervision rate will be calculated by dividing the total
net applicable supervision costs for all agencies within a category by the
total days of child caring services provided by those agencies.
A. Days of service provided under the basic
core requirements regardless of payor source. Examples of services under this
category reimbursed by DSS include the following categories:
(I) Emergency shelter;
(II) REHAB-RT emergency crisis
intervention;
(III) Maternity care;
and
(IV) Maternity care with
infant.
B. Days of
service provided under the infant/toddler/preschool requirements regardless of
payor source. Examples of services under this category reimbursed by DSS
include the following contract categories:
(I)
Infant care; and
(II) Toddler
care.
C. Days of service
provided under residential treatment requirements regardless of payor source.
Examples of services under this category reimbursed by DSS include the
following contract categories:
(I) Moderate
need (Level II);
(II) REHAB-RT
moderate need (Level II);
(III)
Severe need (Level III);
(IV)
REHAB-RT severe need (Level III); and
(V) Family focused residential
services.
D. Days of
services provided under intensive residential care requirements regardless of
payor source. Examples of services under this category reimbursed by DSS
include the following contract categories:
(I)
Intensive need (Level IV); and
(II)
REHAB-RT intensive need (Level IV).
(4) Inflation/Trend Factor
Adjustments.
(A) For the purpose of
establishing base year costs, the room and board component will be adjusted
based on the change in the USDA Expenditures on Children by Families. For State
Fiscal Year 2005, the adjustment will be three and thirty hundredths percent
(3.30%). The child-specific daily supervision component will be adjusted based
on the change in the Midwest Region Consumer Price Index for all Urban
consumers (CPI-U). For State Fiscal Year 2005, the adjustment will be two and
ninety-two hundredths percent (2.92%). The annual change in the USDA index two
and twenty hundreths percent (2.20%) and CPI-U one and ninety-four hundreths
percent (1.94%) was determined for the most recent calendar year and multiplied
by a factor of 1.5 for the purpose of converting calendar year 2003 cost data
to the State Fiscal Year 2005 rate period.
(B) For the purpose of interim
inflation/trend factor adjustments until rates are rebased, the department will
submit budget items for the General Assembly's consideration to revise rates in
accordance with the results of the rate setting methodology. The change in the
USDA Expenditures on Children by Families will be used for the room and board
component and the Midwest Region Consumer Price Index for all Urban consumers
(CPI-U) will be used for the daily supervision component. Rates will be
adjusted in accordance with the Truly Agreed and Finally Passed appropriation
by the General Assembly subject to veto by the Governor.
Notes
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