Rate Provisions

(1) Payment Methods. (a) General. Purchasing governmental units will pay providers a total payment per completed service component as defined in 101 CMR 410.03(2). 1. Standard Progress Documentation. Providers must use a standard form to document initiation and completion of a service component for each client. Providers must submit all progress documentation, billing, and performance reporting through the Enterprise Invoice Management Service. 2. Initial Payment. The purchasing governmental unit pays the provider an initial payment based on a specified percentage of the total payment at the initiation of a service component for a client. For intake, evaluation, and assessment, the purchasing governmental unit makes an initial payment equal to 20% of the service component payment in 101 CMR 410.03(3). For all other service components, except ongoing and interim supports, the purchasing agency makes an initial payment equal to 40% of the service component payment in 101 CMR 410.03(3). EOHHS may revise these percentages by administrative bulletin. 3. Final Payment. The purchasing governmental unit pays the difference between the initial payment and the total service component payment upon completion of the service component and submission of required documentation. 4. Administrative Adjustment for Extraordinary Circumstances. A provider may petition the purchasing governmental unit for an administrative adjustment to reflect increases in operating costs due to unusual and unforeseen circumstances or extraordinary client service requirements not considered in the development of the current rates. Unusual and unforeseen circumstances are events of catastrophic nature (e.g., fire, flood, or earthquake) that are not covered by insurance that the prudent provider would carry. The provider must demonstrate 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. (b) Services Provided in Dukes or Nantucket County. In accordance with the provisions of St. 2015, c. 46, payment for services provided in programs located in Dukes or Nantucket County will be the rate for the service contained in 101 CMR 410.03(3) times a factor of 1.07. (2) Service Components. Payment is based on the following five separate service components. (a) Intake, Evaluation, and Assessment. This service component requires the client to articulate initial goals, commit to a service plan, and engage in services. Provider activities included in this service component include, but are not limited to, solicitation of client referrals; review of applications; initial client screening; interview of applicants; assessment of client interests and skills; performance of a situational assessment; identification of recommended support services; and completion of a comprehensive service plan. (b) Job-targeted Educational and Skills Training Activities. This service component is designed to ensure that the client has sufficient training and/or education to enter job search and placement for initial employment in a competitive environment in accordance with their job goals or to reach stabilization in a competitive work environment with additional supports, if necessary. Specific provider activities include, but are not limited to, depending on client skills and learning style, vocational English language training; “fast-track” HiSET testing; short-term “soft” or “technical” job skills training; and work adjustment, job search, and interviewing skills. (c) Job Development and Placement. This service component is designed to assist the client to sustain initial employment for at least 30 days. Provider activities in this service component include, but are not limited to: employment exploration; career plan development; development of collaborative employer relationships; job try-outs; job matching; and job placement. (d) Initial Employment Supports. This service component is designed to assist the client to sustain employment for at least 90 days and to demonstrate progress toward stability and confidence in job duties and workplace relationships. Provider activities in this service component include, but are not limited to, counseling, life, and community skills development; continued development of employer education; and collaboration, training, and conflict resolution. (e) Ongoing and Interim Supports. This service component is designed to assist the client to maintain stable employment with additional supports if necessary. Provider activities in this service component include, but are not limited to, counseling, life, and community skills development; continued development of employer education; and collaboration, training, and conflict resolution, provided on an as-needed basis. This service component is paid on an hourly basis. Interim supports are used to assist a client who does not require full participation in another service component to achieve re-employment or a job upgrade. (f) Sustained Employment Supports. These service components are designed for 1. acknowledgement that the client has successfully completed the first week of employment due to high quality provider engagement and employment services; and 2. acknowledgement that the client has sustained employment for 90 consecutive days following employment support services provided by the provider. (3) Approved Rates. Within each service component, there are two service levels that reflect the staff-to-client ratios necessary to meet client needs. The appropriate level is determined by the purchasing governmental unit. Description Completed Component Rates Hourly Rates Level A Level B Level A Level B Intake, Evaluation, and Assessment $27.35 $60.78 Job-targeted Educational and Skills Training Activities $27.35 $60.78 Job Development and Placement $27.35 $60.78 Initial Employment Supports $27.35 $60.78 Ongoing and Interim Supports N/A N/A N/A $60.78 Extraordinary Circumstances/Flex Funding Add-on IC IC IC IC Sustained Employment Supports N/A N/A