101 CMR, § 418.03

Current through Register 1536, December 6, 2024

Section 418.03 - Rate Provisions

(1)Services Included in the Rate. The approved rate includes payment for all care and services that are part of the program of services of an eligible provider, as explicitly set forth by the purchasing governmental unit(s).

(2)Reimbursement as Full Payment. Each eligible provider must, as a condition of payment by any purchasing governmental unit, accept the approved rate as full payment and discharge of all obligations for the services rendered. Payment by the purchasing governmental unit for services rendered to the client are reduced by the amount of any payment from any other source.

(3)Payment Limitations. Except as provided in 101 CMR 418.03(2), (4) and (5), each purchasing governmental unit pays for services at the rates established in 101 CMR 418.03(4).

(4)Approved Rates. The rates set forth in 101 CMR 418.03(4) govern payments for services provided pursuant to contracts executed under the FY 2013 or subsequent procurements of the governmental unit procuring the service. The approved rate is the lower of the provider's charge or amount accepted as payment from another payer or the rate listed below.

ADJUDICATED YOUTH SECURE DETENTION AND ASSESSMENT BASE RATES

Provider Owned/Leased Facilities
# Clients:	12-14	15-17	18-22
Utilization %	90%	$430.96	$393.45	$352.28
85%	$456.32	$416.59	$373.00
80%	$484.84	$442.63	$396.31
75%	$517.16	$472.14	$422.73
70%	$554.10	$505.86	$452.93
65%	$596.72	$544.78	$487.77
60%	$646.45	$590.17	$528.41
55%	$705.22	$643.83	$576.45
50%	$775.74	$708.21	$634.10
State Owned - Co-located
# Clients:	12-14	15-17	18-22
Utilization %	90%	$366.62	$334.44	$297.39
85%	$388.18	$354.11	$314.88
80%	$412.44	$376.25	$334.56
75%	$439.94	$401.33	$356.86
70%	$471.36	$429.99	$382.35
65%	$507.62	$463.07	$411.77
60%	$549.92	$501.66	$446.08
55%	$599.92	$547.27	$486.63
50%	$659.91	$601.99	$535.30
State Owned - Separate
# Clients:	12-14	15-17	18-22
Utilization %	90%	$390.26	$352.75	$311.57
85%	$413.22	$373.50	$329.90
80%	$439.05	$396.84	$350.52
75%	$468.32	$423.30	$373.89
70%	$501.77	$453.53	$400.60
# Clients:	12-14	15-17	18-22
Utilization %	65%	$540.36	$488.42	$431.41
60%	$585.40	$529.12	$467.36
55%	$638.61	$577.22	$509.85
50%	$702.47	$634.95	$560.83

RATES FOR HIGHER-NEED YOUTH

Provider Owned/Leased Facilities
# Clients:	12-14	15-17	18-22
Utilization %	90%	$459.71	$415.67	$369.53
85%	$486.76	$440.12	$391.27
80%	$517.18	$467.63	$415.72
75%	$551.66	$498.80	$443.44
70%	$591.06	$534.43	$475.11
65%	$636.53	$575.54	$511.66
60%	$689.57	$623.50	$554.30
55%	$752.26	$680.19	$604.69
50%	$827.49	$748.21	$665.16
State Owned - Co-located
# Clients:	12-14	15-17	18-22
Utilization %	90%	$407.19	$365.81	$321.74
85%	$431.14	$387.33	$340.66
80%	$458.09	$411.54	$361.95
75%	$488.63	$438.98	$386.08
70%	$523.53	$470.33	$413.66
65%	$563.80	$506.51	$445.48
60%	$610.78	$548.72	$482.60
55%	$666.31	$598.61	$526.48
50%	$732.94	$658.47	$579.12
State Owned - Separate
# Clients:	12-14	15-17	18-22
Utilization %	90%	$419.01	$374.97	$328.83
85%	$443.66	$397.03	$348.17
80%	$471.39	$421.84	$369.93
75%	$502.82	$449.96	$394.60
70%	$538.73	$482.10	$422.78
# Clients:	12-14	15-17	18-22
Utilization %	65%	$580.17	$519.19	$455.30
60%	$628.52	$562.45	$493.24
55%	$685.66	$613.58	$538.09
50%	$754.22	$674.94	$591.89

ADD-ON RATES

Clinician Add-on
Level A: 0.5 FTE
# Clients:	12-14	15-17	18-22
Utilization %	90%	$10.04	$7.77	$6.02
85%	$10.63	$8.23	$6.38
80%	$11.29	$8.74	$6.77
75%	$12.04	$9.32	$7.23
70%	$12.90	$9.99	$7.74
65%	$13.90	$10.76	$8.34
60%	$15.05	$11.65	$9.03
55%	$16.42	$12.71	$9.85
50%	$18.06	$13.99	$10.84
Level B: 1.0 FTE
# Clients:	12-14	15-17	18-22
Utilization %	90%	$10.87	$8.41	$6.52
85%	$11.50	$8.91	$6.90
80%	$12.22	$9.46	$7.33
75%	$13.04	$10.09	$7.82
70%	$13.97	$10.82	$8.38
65%	$15.04	$11.65	$9.03
60%	$16.30	$12.62	$9.78
55%	$17.78	$13.76	$10.67
50%	$19.56	$15.14	$11.73
Clinical Director Add-on
Level A: 0.5 FTE
# Clients:	12-14	15-17	18-22
Utilization %	90%	$11.59	$8.97	$6.95
85%	$12.27	$9.50	$7.36
80%	$13.04	$10.10	$7.82
75%	$13.91	$10.77	$8.35
70%	$14.90	$11.54	$8.94
65%	$16.05	$12.43	$9.63
60%	$17.39	$13.46	$10.43
55%	$18.97	$14.68	$11.38
50%	$20.86	$16.15	$12.52
Level B: 1.0 FTE
# Clients:	12-14	15-17	18-22
Utilization %	90%	$23.18	$17.95	$13.91
85%	$24.55	$19.00	$14.73
80%	$26.08	$20.19	$15.65
75%	$27.82	$21.54	$16.69
70%	$29.81	$23.08	$17.88
65%	$32.10	$24.85	$19.26
60%	$34.77	$26.92	$20.86
55%	$37.94	$29.37	$22.76
50%	$41.73	$32.31	$25.04
Direct Care Worker Add-on
Level A: 0.5 FTE
# Clients:	12-14	15-17	18-22
Utilization %	90%	$5.43	$4.21	$3.26
85%	$5.75	$4.45	$3.45
80%	$6.11	$4.73	$3.67
75%	$6.52	$5.05	$3.91
70%	$6.98	$5.41	$4.19
65%	$7.52	$5.82	$4.51
60%	$8.15	$6.31	$4.89
55%	$8.89	$6.88	$5.33
50%	$9.78	$7.57	$5.87
Level B: 1.0 FTE
# Clients:	12-14	15-17	18-22
Utilization %	90%	$10.87	$8.41	$6.52
85%	$11.50	$8.91	$6.90
80%	$12.22	$9.46	$7.33
75%	$13.04	$10.09	$7.82
70%	$13.97	$10.82	$8.38
65%	$15.04	$11.65	$9.03
60%	$16.30	$12.62	$9.78
55%	$17.78	$13.76	$10.67
50%	$19.56	$15.14	$11.73
Nursing Add-on
Level A: 0.25 FTE
# Clients:	12-14	15-17	18-22
Utilization %	90%	$6.25	$4.84	$3.75
85%	$6.61	$5.12	$3.97
80%	$7.03	$5.44	$4.22
75%	$7.50	$5.80	$4.50
70%	$8.03	$6.22	$4.82
65%	$8.65	$6.70	$5.19
60%	$9.37	$7.25	$5.62
55%	$10.22	$7.91	$6.13
50%	$11.25	$8.71	$6.75
Level B: 0.5 FTE
# Clients:	12-14	15-17	18-22
Utilization %	90%	$12.49	$9.67	$7.50
85%	$13.23	$10.24	$7.94
80%	$14.06	$10.88	$8.43
75%	$14.99	$11.61	$9.00
70%	$16.06	$12.44	$9.64
65%	$17.30	$13.39	$10.38
60%	$18.74	$14.51	$11.25
55%	$20.45	$15.83	$12.27
50%	$22.49	$17.41	$13.49
Level B: 1.0 FTE
# Clients:	12-14	15-17	18-22
Utilization %	90%	$24.99	$19.35	$14.99
85%	$26.46	$20.48	$15.88
80%	$28.11	$21.76	$16.87
75%	$29.99	$23.22	$17.99
70%	$32.13	$24.87	$19.28
65%	$34.60	$26.79	$20.76
60%	$37.48	$29.02	$22.49
55%	$40.89	$31.66	$24.53
50%	$44.98	$34.82	$26.99

RATES FOR THE ALTERNATIVE LOCK-UP PROGRAM

Capacity	Monthly Rate
Per Site	$45,477

RATES FOR STAFFING SUPPORT

Positions	Per Diem Rate	Hourly Rate	30-Minute Rate
Clinical Director	$476.90	N/A	N/A
Clinical (LICSW)	$387.52	N/A	N/A
Clinical (MA Level)	$321.91	N/A	N/A
Direct Care III	$296.19	$33.12	$16.56
Direct Care Staff	$236.79	$26.48	$13.24
Maintenance I General	$232.49	$26.00	$13.00
Maintenance II Skilled	$291.84	$32.64	$16.32
Maintenance III Licensed	$328.48	$36.74	$18.37
Food Service I	$236.79	$26.48	$13.24
Food Service II	$266.49	$29.80	$14.90
Food Service III	$296.19	$33.12	$16.56
Transporter	$236.79	$26.48	$13.24
Security	$236.79	$26.48	$13.24
Trainer	$296.19	$33.12	$16.56
Clerical Support	$236.79	$26.48	$13.24

RATES FOR YOUTH AND TRANSITIONAL AGE YOUTH DETOXIFICATION AND STABILIZATION PROGRAMS

Capacity	Per Diem Rate
12 Beds	$680.87

(5)Administrative Adjustment for Extraordinary Circumstances. A purchasing governmental unit may request an adjustment to the published rates to reflect increases in per diem 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 a serious nature that affect program operations or viability to the extent that there exists a threat to the stability of service provision such that client or consumer access to necessary services is at risk. The purchasing governmental unit evaluates the need for the administrative adjustment, identifies the duration of the need, determines whether funding is available, and conveys that information to EOHHS for review to determine the amount of any adjustment.