(1) COST AND SERVICE INFORMATION. Each year
no later than July 1, a licensee shall submit the following information to the
department:
(a) A cost and service report in
which the licensee reports the residential care center's costs, types of
services provided, and number of children served in the previous year. The
report shall be submitted on a department-prescribed form.
Note: The cost and service report form is
available at https://dcf.wisconsin.gov/ratereg.
(b) The residential care center's most recent
audit report under s.
DCF 52.11(6)
(a).
(2) MAXIMUM ALLOWABLE RATE. Each year no
later than September 1, the department shall notify licensees of the per client
rate that no residential care center may exceed for services provided in the
following calendar year.
(3)
PROPOSED RATES.
(a) Each year no later than
October 1, a licensee shall submit to the department a proposed rate for the
following calendar year for each residential care center program that the
licensee operates. The licensee shall submit the proposed rate on a
department-prescribed form.
(b) A
licensee may request an exception to the department's maximum rate under sub.
(2) if the licensee provides a specialized service or specialized programming
to a specific population of children. The exception request shall explain the
benefits of the service or programming and why the licensee cannot provide the
service or programming within the maximum rate. The exception request shall be
made on the rate request form.
Note: The rate request form is available at
https://dcf.wisconsin.gov/ratereg.
(4) REVIEW OF A PROPOSED RATE. In reviewing a
proposed rate submitted by a licensee under sub. (3), the department shall
consider all of the following:
(a) Whether
the proposed rate exceeds the maximum rate determined by the department under
sub. (2).
(b) The residential care
center's most recent cost and service report under sub. (1)(a).
(c) The residential care center's most recent
audit report under sub. (1) (b).
(d) Whether the residential care center's
reported costs are within a range of similar costs reported by other
residential care centers for similar items and services.
(e) The residential care center's per client
rate in previous years.
(f) Changes
in the consumer price index for all urban consumers, U.S. city average, as
determined by the U.S. department of labor, for the 12 months ending on June 30
of the year in which the proposed rate is submitted.
(g) Changes in the consumer price index for
all urban consumers, U.S. city average, for the medical care group, as
determined by the U.S. department of labor, for the 12 months ending on June 30
of the year in which the proposed rate is submitted.
(h) Changes in the allowable costs of
residential care centers based on current actual cost data or documented
projections of costs.
(i) Changes
in program utilization that affect the per client rate.
(j) Changes in the department's expectations
relating to service delivery.
(k)
Changes in service delivery proposed by a residential care center and agreed to
by the department.
(L) The loss of
any source of revenue that had been used to pay expenses, resulting in a lower
per client rate for services.
(m)
Whether the residential care center is accredited by a national accrediting
body that has developed child welfare standards.
(n) Changes in any state or federal laws,
rules, or regulations that result in any change in the cost of providing
services, including any changes in the minimum wage, as defined in s.
49.141(1) (g), Stats.
(o) Competitive factors.
(p) The availability of funding to pay for
the services to be provided under the proposed rate.
(5) RATE APPROVAL.
(a) Each year no later than November 1, the
department shall notify each licensee that submitted all information as
required under subs. (1) and (3) of the maximum approved per client rate for
the residential care center's program for the following year.
Note: The notification will be sent to the
electronic mail address that the licensee has provided to the
department.
(b) If the
department determines that a proposed rate submitted under sub. (3) is
appropriate based on the factors in sub. (4), the department shall approve the
proposed rate.
(c) If the
department determines that a proposed rate submitted under sub. (3) is not
appropriate based on the factors in sub. (4), the department shall negotiate
with a licensee to determine an agreed to rate. The department's approved rate
under par. (a) following negotiations shall be based on the factors in sub. (4)
and additional relevant information presented during negotiations.
(d) The department may grant a licensee's
request for an exception to the department's maximum rate under sub. (3) (b) if
the department determines that the licensee has shown by clear and convincing
evidence that the licensee's costs are reasonable and necessary given the costs
and benefits of the licensee's specialized service or specialized
programming.
(6)
NONCOMPLIANCE. If a licensee does not submit all information as required under
subs. (1) and (3), the department may impose sanctions and penalties under s.
DCF 52.62(5) and s.
48.715,
Stats., including license revocation.
