Community-Based Services Manual (CBSM)

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Community-Based Services Manual (CBSM)

CBSM Financial management Disability specific

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Market rate services (BI, CAC, CADI and DD)

Page posted: 2/6/19		Page reviewed:	Page updated: 2/12/19
Legal authority	Federally approved BI, CAC, CADI and DD waiver plans
Definition	Disability Waiver Rate System (DWRS): The method of determining individualized payment rates for BI, CAC, CADI and DD waiver services. DWRS divides disability waiver services into three categories: · Framework rate services · Market rate · Pre-determined rate services. For more information, see CBSM – DWRS.
Background	Market rates allow lead agencies and providers to determine rates that: · Meet the person’s assessed needs · Are appropriate according to identifiable service costs · Are allowable Medical Assistance expenses.
Covered services	The following service rates are market rate services: · 24-hour emergency assistance · Assistive technology · Caregiver living expenses · Crisis respite · Environmental accessibility adaptations · Family training and counseling · Homemaker (cleaning) · Respite (daily) · Specialist services · Specialized equipment and supplies · Transitional services (BI, CAC, CADI, DD) · Transportation (waiver transportation and DT&H transportation).
Rate-setting methods	Lead agencies should use specific components of the service and support needs of the person to work with the provider to determine an appropriate service rate. The following items may be appropriate components to consider when setting a market rate: · Wage and expertise of the person providing the service · The number of people sharing the service · Administrative and indirect costs associated with providing the service · Program or facility costs · Local rates for comparable services not provided through Medical Assistance. The following are not appropriate methods of setting a market rate: · Lead agencies or providers setting a rate that does not reflect the person’s assessed needs or costs of providing the service · Incorporating costs into a rate that are not allowable under Medical Assistance.
Additional resources	CBSM – Disability Waiver Rate System (DWRS) CBSM – Rate Management System (RMS) CBSM – Financial management overview CBSM – Waiver/AC service provider overview

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