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-.12 - VALUE-BASED RATE SETTING METHODOLOGY FOR SUPPORTED EMPLOYMENT-SMALL GROUP

Universal Citation: TN Comp Rules and Regs 0465-01-02-.12

Current through September 24, 2024

(1) Supported employment-small group is reimbursed on a fee-for-service basis.

(2) The unit of service is 15 minutes.

(3) The fee-for-service rate is calculated using the following factors:

(a) Average cost of job coach hour of service divided by four (4), including these component costs:
1. DSP reimbursement rate;

2. Employee-related expenses;

3. Administrative costs;

4. Productivity assumptions, including projected average waiver participant absentee rate of 8.23 percent; and

5. Travel costs;

(b) Participant transportation cost per unit per person;

(c) Administrative adjustment based on the number of waiver participants in the small group and the expected job coach-to-waiver participant staffing ratio (one job coach for a group of two, three, or four waiver participants); and

(d) Value-based adjustment to incentivize smaller group size.

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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