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Department of Human Services
Michelle R.B. Saddler, Secretary
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DDD Waiver Manual
XI. Appendices - Forms and Instructions
DDD FY13 Rates Table - Effective July 1, 2012
DDD PROGRAM NAME
Program
Code
HCB
Medicaid
Waiver
Service
Unit
Type
Maximum
Per FY
FY2013
Rate
FY2013
Rate
CHILDREN'S SERVICES - PURCHASE OF SERVICE (POS)
Children's Group Homes (CGH)
17D
Y
24-Hr Day
365
varies
varies
Child Care Institutions (CCI)
19D
N
24-Hr Day
365
varies
varies
CCI (LTC Campus Facilities) Last COLA Eff 1/1/06
19D
N
24-Hr Day
365
varies
varies
DAY PROGRAMS - POS
Developmental Training
31U
Y
Client Hour
1,100
$10.39
$11,427
Developmental Training - Advance & Reconcile
31A
Y
Client Hour
1,100
$10.39
$11,427
Regular Work
38U
N
Client Hour
1,100
$10.39
$11,427
Supported Emp. (Group) No Job Coach
36G
Y
Client Hour
1,100
$11.63
$12,790
Supported Emp. (Group) Job Coach
39G
Y
Client Hour
1,100
$11.63
$12,790
Supported Emp. (Indiv.) No Job Coach
36U
Y
Client Hour
1,100
$13.03
$14,337
Supported Emp. (Indiv.) Job Coach
39U
Y
Client Hour
1,100
$13.03
$14,337
Adult Day Care
35U
Y
Client Hour
1,100
$12.34
$13,574
Other Day Program
30U
N
Client Hour
1,100
$10.39
$11,427
At-Home Day Program
37U
Y
Client Hour
1,100
$10.39
$11,427
SODC DT
31S
N
Client Hour
N/A
varies
varies
DAY PROGRAMS - GRANT
Client & Family Support
160
N
Client Hour/Day
Grant $$
N/A
Annual Grant
Vocational Development
320
N
Client Hour
Grant $$
N/A
Annual Grant
Regular Work
380
N
Client Hour
Grant $$
N/A
Annual Grant
Supported Employment
390
N
Client Hour
Grant $$
N/A
Annual Grant
OTHER - GRANTS
Special Projects - Diagnostic/Evaluation
150
N
N/A
Grant $$
N/A
Annual Grant
Epilepsy
250
N
N/A
Grant $$
N/A
Annual Grant
Dental
400
N
N/A
Grant $$
N/A
Annual Grant
Leisure Time
430
N
N/A
Grant $$
N/A
Annual Grant
Special Projects
450
N
N/A
Grant $$
N/A
Annual Grant
Pre-Admission Screening (PAS) - Case Coordiantion
500
N
Client Hour
Grant $$
N/A
Annual Grant
PAS-Bogard
781
N
N/A
Grant $$
N/A
Annual Grant
PAS - Case Coordiantion Non-Waiver
780
N
N/A
Grant $$
N/A
Annual Grant
Group Respite
880
N
Client Hour
Grant $$
N/A
Annual Grant
ADULT RESIDENTIAL SUPPORTS
Special Home Placement (SHP) - No new authorizations
41D
N
24-Hr Day
365
$42.23
$15,415
Supported Living Arrangements (SLA) - No new authorizations
42D
N
Client Day
365
varies
varies
Community Integrated Living Arrangement (CILA) - Individual Rate Model
60D
Y
Client Day
365
varies
varies
POS CILA - No new authorizations
61D
Y
24-Hr Day
365
varies
varies
POS Hourly CILA - No new authorizations
65H
Y
Client Hour
Annual Allocation
varies
Annual Allocation
Community Living Facility (CLF) 16 or fewer
67D
Y
24-Hr Day
365
varies
varies
CLF greater than 16
67D
N
24-Hr Day
365
varies
varies
Home/Individual Placement (HIP) - No new authorizations
68D
N
24-Hr Day
365
varies
varies
WAIVER SUPPORT
Indiv Serv & Support Advocacy (ISSA)
50D
Y - Admin.
Client Hour
25
$40.01
$1,000
OTHER SERVICES
Related Support - No new authorizations
73D
N
Client Day
365
varies
varies
Respite Services
In-Home - Level 1
87D
N
Client Hour
360
$16.66
Respite Allocation
In-Home - Level 2
Client Hour
$12.48
Respite Allocation
In-Home - Level 3
Client Hour
$9.76
Respite Allocation
Residential Respite
89D
N
24-Hr Day
60
varies
Respite Allocation
LONG TERM CARE (LTC)
ICFDD (Includes SNFPED/SLC)
varies
varies
Exceptional Care
varies
varies
ICFDD-DT
varies
varies
THERAPIES
Physical Therapy
52P
Y
Client Hour
52
$36.00
$1,872
Occupational Therapy
52O
Y
Client Hour
52
$36.00
$1,872
Speech Therapy
52S
Y
Client Hour
52
$36.00
$1,872
Behavior Intervention and Treatment
56U
Level 1 - Licensed Professional - Statewide Rate
L1
Y
Hour
66
$77.86
$5,139
Level 2 - Other Credentials or No Level Specified - Statewide Rate
L2
Y
Hour
66
$62.28
$4,110
Individual Counseling
57U
Y
Client Hour
60
$30.57
$1,834
Group Counseling
57G
Y
Client Hour
60
$10.19
$611
Individual Therapy
58U
Y
Client Hour
60
$38.21
$2,292
Group Therapy
58G
Y
Client Hour
60
$12.74
$764
STAFF TRAINING
N/A
Y - Admin.
Hour
Tied to DSP wage rate
varies
varies
HOME-BASED SUPPORTS
HBS Service Facilitator (children & adults)
55A
Y
Hour
24 or 2/Mo. Min.
$40.01
Annual Max. $$
HBS Training for Unpaid Caregivers (children & adults)
55B
Y
Event
Mo. Max.
varies
Annual Max. $$
HBS Counseling for Unpaid Caregivers (children & adults)
55C
Y
Hour
Mo. Max.
$30.57
Annual Max. $$
HBS Personal Support (children & adults)
55D
Y
Event
Mo. Max.
varies
Annual Max. $$
HBS Nursing - Registered Nurse (adults only)
55N
Y
Hour
365 or Mo.Max $$
$31.90
Annual Max. $$
HBS Nursing - Licensed Practical Nurse (adults only)
55P
Y
Hour
365 or Mo.Max $$
$28.90
Annual Max. $$
HBS Transportation (adults only)
55T
Y
Events/Miles
$500/Mo.
$0.38
Annual Max. $$
HBS Emergency Home Response (adults only)
55W
Level 1 - System Installation
L1
Y
Event
1/State FY
$30.75
$31
Level 2 - Monthly Rate for Monitoring
L2
Y
Event
1/Month
$28.70
Annual Max. $$
OTHER SUPPORTS AND SERVICES
Crisis Services (Adult HBS only)
53C
Y
Hour
60 Consecutive Days
varies
varies
Adaptive Equipment
53E
Y
Event
$15,000 / 5 Yr Max
varies
varies
Assistive Technology
53T
Y
Event
$15,000 / 5 Yr Max
varies
varies
Minor Home Accessibility Modification
53H
Y
Event
$15,000 / 5 Yr Max
varies
varies
Temporary Intensive Staffing - Day (DT only)
53D
Y
Hour
Tied to DSP wage rate
$12.86
varies
Temporary Intensive Staffing - Residential (60D only)
53R
Y
Hour
Tied to DSP wage rate
$12.86
varies
Minor Vehicle Accessibility Modification
53V
Y
Event
$15,000 / 5 Yr Max
varies
varies
Family Assist Prog (FAP) - DD & MH-Child
69
N
Month
12
N/A
Annual $$ Amount
Service Facilitation - HBSS MH Adults
69B
N
Hour
48
$40.01
$1,921
Service Facilitation - FAP DD & MH-Child
69Y
N
Hour
20
$40.01
$800
SPECIALIZED SERVICES
75..
.76
N
varies
varies
varies
varies
Staff Hourly Wage Table
DSP
$10.50
$12.60
QMRP
$14.82
$17.78
Supervisor
$13.14
$15.76
LPN
$16.97
RN
$21.10
Dietician
$30.21
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