(1) COST AND SERVICE INFORMATION. Each year
by July 1, a licensee shall submit the following information to the department:
(a) A cost and service report in which the
licensee reports the group home'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 group home's most recent audit report
under s.
DCF 57.07(1).
(2) MAXIMUM ALLOWABLE RATE. Each year no
later than September 1, the department shall notify licensees of the per client
rate that no group home 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 group home 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 group home's most
recent cost and service report under sub. (1) (a).
(c) The group home's most recent audit report
under sub. (1) (b).
(d) Whether
the group home's reported costs are within a range of similar costs reported by
other group homes for similar items and services.
(e) The group home'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 group
homes 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 group home 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 group home 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 the information as
required under subs. (1) and (3) of the maximum approved per client rate for
the group home 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) 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 57.56 and
s.
48.715,
Stats., including license revocation.
