Residential Foster Care Maintenance Methodology

PURPOSE: 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. (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 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 (CPIU). For State Fiscal Year 2005, the adjustment will be two and ninety-two hundredths percent (2.92%). The annual change in the 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) 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. AUTHORITY: section 207.020, RSMo 2000.* Emergency rule filed Jan. 16, 2004, effective Jan. 26, 2004, expired July 23, 2004. Original rule filed Jan. 16, 2004, effective Aug. 30, 2004. Emergency amendment filed Sept. 22, 2004, effective Oct. 2, 2004, expired March 30, 2005. Amended: Filed Sept. 22, 2004, effective March 30, 2005. *Original authority: 207.020, RSMo 1945, amended 1961, 1965, 1977, 1981, 1982, 1986, 1993.