Current through Register Vol. 48, No. 39, March 25, 2024
Subpart 1.
Established by
commissioner.
The commissioner shall establish the special needs rate
exception payment according to subparts
2 to
5.
Subp. 2.
Allowable costs.
Unless otherwise reimbursable by the Department of Vocational
Rehabilitation or by direct payments under parts
9505.0170 to
9505.0475, the following costs, if
approved by the commissioner in accordance with parts
9510.1020 to
9510.1140 and
9553.0010 to
9553.0080, are allowable for
purposes of establishing the special needs rate exception payment:
A. additional salary, employee benefits, and
payroll-related costs for direct care staff required to meet the client's needs
as identified in the provider's application;
B. additional costs of services provided by a
licensed medical, therapeutic, or rehabilitation practitioner; a mental health
practitioner supervised by a board-certified psychiatrist; or a licensed
psychologist or licensed consulting psychologist;
C. the costs of equipment required to meet
the client's needs as identified in the provider's application.
Subp. 3.
Nonallowable
costs.
Only costs listed in subpart
2 are allowable for purposes
of establishing the special needs rate exception. All other costs shall be
disallowed.
Subp. 4.
Limitation.
The combined per diem costs of training and habilitation
services, ICF/DD services, and the special needs rate exception payment and any
other special needs rate exception payments in effect for the same client,
shall not exceed the medical assistance per diem cost of providing services to
persons with developmental disabilities in regional treatment centers. For the
purpose of determining this limitation, items A to F apply.
A. The training and habilitation services per
diem in effect on the date the provider's completed application is submitted to
the county must be multiplied by the number of days the services are provided
annually.
B. The ICF/DD's temporary
or final payment rate in effect on the date the provider's completed
application is submitted to the county must be multiplied by 365.
C. The special needs rate exception amount
must not exceed the total of the costs allowable under subpart
2. If a special needs rate
exception is necessary for a client in both the ICF/DD and the training and
habilitation service program, the amounts of both special needs rate exceptions
must be combined. If the client is currently receiving a special needs rate
exception, that amount must also be included.
D. The amounts determined in items A to C
must be combined and divided by 365 to determine the combined per diem
cost.
E. The regional treatment
center medical assistance per diem rate must be the rate in effect on the date
the provider's completed application is submitted to the county.
F. If the per diem cost in item D exceeds the
per diem cost in item E, the commissioner shall deny the special needs rate
exception application unless the per diem cost can be adjusted to meet the
client's needs within the per diem cost in item E or the commissioner grants a
variance under part
9510.1100.
Subp. 5.
Computation of special needs
rate exception payment.
The special needs rate exception payment must be calculated
as follows:
A. The cost of additional
equipment allowed in accordance with subpart
2, item C shall be paid as a
lump sum payment during the first billing period following approval of the
special needs rate exception.
B.
Except as provided in item C, in order to compute the special needs rate
exception payment for personnel costs, the costs of additional personnel
allowable according to subpart
2, items A and B, must be
divided by the estimated number of days the staff intervention will be
needed.
C. In order to compute the
special needs rate exception payment for personnel costs which vary during the
estimated staff intervention period, the costs must be assigned on a monthly
basis proportionate to the actual personnel costs incurred and then divided by
the number of client days in the month.
D. Costs computed under items B and C shall
be reimbursed as incurred and billed.
Statutory Authority: MS s
252.46;
256B.501
