Tenn. Comp. R. & Regs. 0465-01-02-.16
Rate Setting Methodology for Residential Special Needs Adjustment-homebound and Non-residential Homebound Support Services
Effective Jan 5, 2020Authority: 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.Tennessee Department of Intellectual and Developmental Disabilities/, Disability and Aging
- (1) Residential special needs adjustment-homebound and non-residential homebound support service are reimbursed on a fee-for-service basis.
- (2) The unit of service is a day, constituting staff coverage for 6 hours each day.
(3) The fee-for-service rate is calculated using the following factors: SERVICE PROVIDERS (RATE STRUCTURE)
- (a) DSP reimbursement rate;
- (b) Non-direct program costs at the allowable percentage;
- (c) Administrative costs;
- (d) Projected average waiver participant absentee rate percentage based on 20 leave days per year; and
- (e) Rate level factor as defined in 0465-01-02-.03.
- (f) This setting is provided in a waiver participant’s home and has no transportation cost included.
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. Administrative History: Original rule filed December 12, 2013; effective March 12, 2014. Amendments filed October 7, 2019; effective January 5, 2020.