Page updated: 6/30/23

The provider recommends the initial service level needed based on information from the person’s support plan and other relevant documents.

The lead agency reviews the provider’s recommendation. If the lead agency agrees with the information provided, it enters the information into the Rate Management System (RMS) to calculate a rate. If the lead agency does not agree, it continues to work with the provider to reach an agreement on an appropriate staffing ratio.

For more information about service planning, refer to RMS User Manual – Service planning and authorization.

Information needed to determine the average daily staffing ratio

To calculate the appropriate service level, the provider needs to determine the average daily staffing ratio.

To do this for people currently receiving services, the provider will need the following:

· Direct care hours required to meet a person's assessed needs
(Note: Do not use staff schedules or payroll reports)

· A specific, recent time period as a base for calculating the average daily staffing ratio

· The types of activities and associated direct care staffing requirements for the person.

To do this for people new to receiving services, the provider should use projected staffing hours.

What to leave out

When calculating average staffing hours, do not include the following items because they are included in another part of the framework:

· Non-direct care staff (e.g., drivers, program directors, cooks)

· Paid vacation, sick leave, training time, on-call hours, holidays, etc.

· Monitoring technology used in place of direct-care staffing.

How to determine the average daily staffing ratio

Providers use Day Services Individual Client Worksheet (.XLS) to help determine the average daily staffing ratio for people who receives disability waiver day services.

Tips

· Consider the time period (i.e., how many weeks) you will use as a basis for determining average daily staffing hours.

· If people’s schedules do not vary much from week to week, you may not need to use many weeks of data to calculate average daily staffing hours.

· If people’s schedules vary significantly from week to week, you may want to use more weeks of data to calculate average daily staffing hours.

· For specific definitions, refer to RMS User Manual – Glossary.

Rules to follow

· Decide how many weeks you will use as a basis for averaging.

· Use the most recent, consecutive time period from one to 52 weeks.

· Use actual hours provided to people; do not use staff work schedules or payroll records.

· Do not include transportation time.

· If one person receives more intense support, then other people receive less intense support for that time period (e.g., their ratios change from 1:6 to 1:10); this is true unless you bring in additional direct care staff for that time period.

Topic	Instructions
How to complete the worksheet	To complete the worksheet, the provider should: 1. Save a blank copy of Day Services Individual Client Worksheet (.XLS). (Note: Use this template for each person.) 2. Open the worksheet. 3. Save the worksheet under the name of the person receiving services. 4. Record the following at the top of the worksheet: · The provider organization’s name · The person’s name · The date the provider completes the worksheet. 5. Calculate an average daily ratio by selecting the drop-down options in each cell (or refer to the how to calculate the average daily staffing ratio section to manually calculate the daily ratio). 6. Review the average staffing ratio per unit of service on line 18. 7. Populate the applicable RMS Day Service Worksheet, DHS-6790 (PDF) with the calculated average staffing ratio per unit of service. 8. Send the completed RMS day service worksheet to the lead agency.
How to calculate the average daily staffing ratio	To determine the staffing ratio, the provider records and describes the activity taking place each hour the person receives services from the provider. Do this by considering, in a typical week, what day and what hour the person arrives at your location or begins to receive services from you. For each day the person receives services from you, use the following example to calculate an average daily ratio: 1. A person receives services for six hours on Monday, and the hourly ratios are: · 9 – 10 a.m., 1:6 · 10 – 11 a.m., 1:6 · 11 a.m. – 12 p.m., 1:6 · 12 p.m. – 1 p.m., 1:2 · 1 – 2 p.m., 1:4 · 2 – 3 p.m., 1:4 2. Take the average of the second number in each ratio (6 + 6 + 6 + 2 + 4 + 4 = 28/6 hours = 4.66, or an average daily staffing ratio of 1:5). 3. Take the average of the first numbers in the hourly ratios if there is any variation in the first number of the ratio (e.g., when there are two staff per person, or a 2:1 ratio). 4. Record that ratio in the gray cells on line 17.