Section 52.66. Rate methodology.

 

(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.

(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.

(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.

(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.

History: EmR1106 : emerg. cr., eff. 9-16-11; CR 11-026 : cr. Register December 2011 No. 672 , eff. 1-1-12.

Note

The cost and service report form is available at http://dcf.wisconsin.gov/childrenresidential/rate_regulation.htm . Microsoft Windows NT 6.1.7601 Service Pack 1 The rate request form is available at http://dcf.wisconsin.gov/childrenresidential/rate_regulation.htm . Microsoft Windows NT 6.1.7601 Service Pack 1 The notification will be sent to the electronic mail address that the licensee has provided to the department. Microsoft Windows NT 6.1.7601 Service Pack 1