Rules & Regulations of the State of Tennessee
Title 0465 - Intellectual and Developmental Disabilities
Subtitle 0465-01 - General Rules
Chapter 0465-01-02 - Methodology Utilized to Determine Payments to Service Providers (Rate Structure)
Section 0465-01-02-.05 - RATE SETTING METHODOLOGIES FOR RESIDENTIAL AND SUPPORTED LIVING SERVICES
Universal Citation: TN Comp Rules and Regs 0465-01-02-.05
Current through September 24, 2024
(1) Residential Habilitation and Supported Living (Shift-Staffed) Model.
(a) For residential services that are
shift-staffed, staff coverage is calculated as follows:
1.
138 hours per week - 5 days at 18 hours per day and 2 days at 24
hours per day is equal to one week.
2. The unit of service for these residential
services is a day.
(b)
The calculation of the daily cost per person for a Full Time Equivalent (FTE)
is:
1. Hourly direct support staff wages plus
% for benefits for the hourly cost for direct support staff.
2. Annual salary for direct supervision plus
% for benefits divided by four residents equals the cost per person per
year.
3. Divide the cost per person
per year by 52 weeks and by 138 hours to arrive at the hourly cost for
supervision.
4. Add together the
hourly cost for direct support staff and the hourly cost for
supervision.
5. Multiply the result
from Step four by one and the % allowed for non-direct program costs.
6. Multiply the result from Step five by one
and the % allowed for administrative costs to arrive at the hourly cost for
coverage.
7. Multiply the hourly
cost for an FTE by 138 hours to arrive at the weekly cost for
coverage.
8. Divide the weekly cost
by 7 days to arrive at the daily cost for coverage.
9. Divide the daily cost by allowable FTEs to
arrive at the daily FTE cost per person.
(c) Calculation for the daily rate per person
is:
1. For each Rate Level and Home Size,
multiply the daily per person FTE cost by the rate level factor.
2. Divide the result of Step one by the
facility size.
3. Multiply the
result of Step two by 385 (to allow for 20 absent days).
4. Divide the result of Step three by 365 to
arrive at the daily rate.
(2) Supported Living-Companion Model.
(a) For non-shift staffed, companion model
the unit of service is a day. The calculations are as follows:
(b) Calculate the daily rate per person.
1. Multiply the annual stipend by one and the
% for benefits.
2. Add the
companion room and board allowance.
3. Add the number of hours per year at the
hourly rate for relief staff divided by 365 days.
4. Add costs in steps one through
three.
5. Multiply the result of
step four by one and the % for non-direct program costs.
6. Multiply the result of step five by one
and the % for administrative costs.
7. Divide the result of step six by
365.
8. Multiply the result of step
seven by 385 (to allow for 20 absent days).
9. Divide the result of step eight by 365 to
arrive at the daily rate.
(3) Family Model for Residential Services.
(a) Family Model Residential Services are
those provided in a family home under the supervision of a residential services
agency. The unit of service is a day.
(b) Calculate the daily rate per person.
1. Multiply the annual stipend by one and the
% for benefits.
2. Add the number
of hours per year at the hourly rate for relief staff divided by 365
days.
3. Add direct supervision at
annual salary plus % for benefits divided by 10 waiver participants divided by
365 days.
4. Add costs in steps 1
through 3 above.
5. Multiply the
result of step four by one and the percent for non-direct program
costs.
6. Multiply the result of
step five by one and the percent for administrative costs.
7. Divide the result of step six by 365
days.
8. Multiply the result of
step seven by 385 days (to allow for 20 absent days).
9. Divide the result of step eight by 365
days to arrive at the daily rate.
Authority: T.C.A. §§ 4-3-2701, 4-3-2707, 4-4-103, 4-5-201, et seq., 4-5-208, et seq. and its applicable regulations concerning emergency rules, 33-1-201, 33-1-202, 33-1-203(1) and (6), 33-1-204, 33-1-301, 33-1-302, 33-1-302(a)(3) and (a)(4), 33-1-303, 33-1-303(3) and (11), 33-1-304, 33-1-305(1), and 33-1-309(d); Executive Order of the State of Tennessee No. 23, dated October 19, 1999; State of Tennessee Delegated Purchase Authority DP 10-28649-00 Reg. 515; and the "Reimbursement Rate" for Medical Services under DIDD federal waiver(s) for provision of services as administered by TennCare.
Disclaimer: These regulations may not be the most recent version. Tennessee may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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