0465-01-02-.08
Value-Based
Cite as Tenn. Comp. R. & Regs. 0465-01-02-.08
RATE
SETTING
METHODOLOGY
FOR
SUPPORTED
EMPLOYMENT-INDIVIDUAL EXPLORATION.
(1)
Supported employment-individual exploration is paid for on an outcome basis.
(2)
The unit is a complete episode of the service as defined in the approved Section 1915(c)
waiver application and includes all of the service required to deliver the expected outcome.
(3)
The outcome-based rate is calculated using the following factors:
(a)
Average cost of job coach hour of service (as described in 0465-01-02-.11(3)(a)),
including these component costs:
1.
DSP reimbursement rate;
2.
Employee-related expenses;
3.
Administrative costs;
4.
Productivity assumptions; and
5.
Travel costs;
(b)
A value-based incentive of $4.30/hour above actual cost (rate model) to reward
provision of services expected to result in the person identifying a goal of competitive
integrated employment;
(c)
Average number of job coach hours required to complete service; and
(d)
Billable service adjustment for percentage of waiver participants that do not complete
the service due to reasons beyond the purview of the provider’s control.