Payment rate

1. The department shall determine the payment rates. Payment rates are developed in three parts: a. A base rate; b. Difficulty of care rate; and c. Performance-based contracting options. 2. Base rates established by the department include facility financial components of direct care wage, direct care fringe benefits, property, and administrative and other costs. 3. Difficulty of care is calculated by utilizing the individual resident assessment weighted score from the department-approved assessment tool. The difficulty of care rate is: a. Effective the date of admission; and b. Reassessed every ninety days in conjunction with the resident continued stay review. 4. Performance-based contracts will detail facility payment rates specific to admission and discharge and aftercare outcomes. 5. The daily rate for each resident accepted by the facility must follow the difficulty of care payment rates developed by the department. The daily rate charged must be consistent for all residents in placement regardless of the resident's custodian, parent, or guardian or payment source. The maximum authorized payment rate for a resident paid by the department will be determined by the resident's weighted score conducted by the qualified individual completing the assessment and the performance-based contracting options. 6. Limitations. a. The department may accumulate and analyze statistics on costs incurred by the facilities. The department may use these statistics to establish cost ceilings and incentives for efficiency and economy, based on a reasonable determination of the standards of operations necessary for efficient delivery of needed services. The department may establish limitations and incentives on the basis of the cost of comparable facilities and services and the department may apply these limitations and incentives as ceilings on the overall costs of providing services or on specific areas of operations. b. When federal regulations establish a ceiling on foster care rates for these facilities, that ceiling must also be considered the maximum payment under title IV-E of the Social Security Act, [42 U.S.C. 670 et seq.]. c. Administrative costs must be limited to the percent of total allowable costs exclusive of administrative costs, authorized by the department. 7. The department may apply rate adjustments if required by state or federal law or regulation, appropriation, or as determined necessary by the department.