Program Issues, Contract Requirements or Payments

Contact Tina Bumgarner

Tina.Bumgarner@ncmail.net

(704) 462-2686

Cost Report & Time Study questions

Contact Mike Thompson Mike.Thompson@ncmail.net

(919) 855-3684

2009 IV-E Foster Care Cost Report Training

Medicaid Services

Medicaid services reporting questionsContact Christal KellyChristal.Kelly@ncmail.net(919) 855-4218

NC Department of Health and Human ServicesDivision of Medical Assistance2501 Mail Service CenterRaleigh, NC 27699-2501

Agenda

1) Rate Setting Process

2) Cost report package

3) Foster Care definitions

4) Relationship between the Time Study and the Cost Report

5) Daily Supervision vs Foster Care Activities/Social Service

6) Tips

Rate Setting Process

• Agencies must qualify through the Division of Social Services

• Agencies submit their Audit, Cost Report and Time Study to Office of the Controller

• Cost Report and Time Study are reviewed by Office of the Controller

Cost Report Package

In order to obtain a foster care rate, an agency must submit the following no later than the due date (March 16, 2009)

* Residential Treatment and Foster Care Cost Report

* Documentation of Child Care days

* Financial Audit

* Time Study participation

* Supplemental Schedules/Reports

Agencies should perform a self check on the cost report using the:

* Rate Review Work Sheet

Cost Report Basics

Cost report is based on the audit

Child care days must be separated by service

Total expense on Schedule C must match audit

The expense for each program in the audit should match that program on the cost report

Admin should be reported in the admin column, unless it is allocated in the audit

Audit Requirements

• Audits must show both revenues and expenditures.

• Revenues must be broken out by fund type.

• Expenditures must show a separation between administrative costs and program costs.

• Administrative costs must also delineate between management and fund-raising costs.

• Program costs must be delineated by type as well as identify specific allowable foster care costs within each type.

Terms for Cost Reporting

• Therapeutic vs. treatment or Foster Care?

• Medical necessity and Medicaid authorization for mental health service

Terms for Cost Reporting

Foster Care Maintenance Payment

Payment to cover the cost of, and the cost of providing:

Food Clothing Shelter

Daily Supervision School supplies

Personal Incidentals Liability Insurance

Travel to the child’s home for visitation

Includes reasonable administration and operation for institutional care

Non-Allowable Costs: Items Not Covered by IV-E Funding

Recreation other than the occasional expense allowed in Personal Incidentals

Expenses not directly related to providing room, board, supervision and necessary administration, such as swimming pools, gymnasiums, chapels/churches, housing other than the residential facilities occupied by the children in care.

Medical and social services treatment or services

Educational expenses other than school supplies

Gifts

Food served at banquets, or training

Recreation is NOT an allowable item of expense, except where it clearly substitutes for daily supervision – CWPM 8.3B.1 (1)d.

A child’s personal incidentals can include the reasonable and occasional cost of such items as tickets or other admission fees for sporting, entertainment or cultural events or dues for clubs. – CWPM 8.3B.1 (2)

Successful Time Study Participation

Only time performing FC/SS activities is reported on time study

All time performing as FC/SS is reported on time study

Communication is key

Ensure participants have the definitions

Daily Supervision vs FCA/SS

Daily supervision – performing routine day-to-day care and supervision of children.

Foster Care Activities/Social Services – performing activities described in the Foster Care Service Definitions, such as case management, referral to services, etc.

Daily Supervision vs FCA/SS

Daily Supervision

NOT reported on the Time Study

Expense is reported on lines 14-16 of the Cost Report

FCA/SS

IS reported on the Time Study

Expense is reported on lines 18-20 of the Cost Report

Time Study - General Instructions

• Required by federal regulations

• To document allowable activities for inclusion in the rates

• Participation is based on activities, not title or position.

• Use DSS Definitions of Foster Care Activities

• Agency staff will collect the reports, verify that all entries are complete and Program Codes are correct.

•Agencies are requested to submit the completed time sheets to the Controller’s Office, to be received by March 16, 2009.

•Retain a copy of the daily work sheets for your files and audit purposes and mail (paper originals) or email (Excel) sheets to:

DHHS FC Rate SettingOffice of the Controller2019 Mail Service CenterRaleigh, North Carolina 27699-2019

mike.thompson@ncmail.net

Time Study - General Instructions

• Agency ID - Changed to DSS Agency ID; auto fill

Time Study - Specific Instructions

Agency Totals Worksheet

• Agency Name - Dropdown list

• Service Type - Residential or Family Foster Placement

• Agency ID and Name – from Agency Totals Worksheet

Time Study - Specific Instructions

Employee Worksheets

• Employee Last & First Name – text

• Date - Enter the numeric date. Excel is limited to numbers 1-31, dropdown list

• Line Number - Pre-printed

• Description of Activity - Enter category from Foster Care Activities Definitions; dropdown list

• Minutes - Enter in 15 or multiples of 15. Excel limited to multiples of 15 from 15 – 720.

• Service and Program Codes – Entered automatically based on Description of Activity

Allocation of Program Code AIt is used to allow for the inclusion of time/expense allocated to social service activities not detailed in O or Z such as expense for absences due to sickness or vacation. The Time sheets have been modified to capture this information.

For example: Allowed Non-allowed Absences Total %Minutes A

Day Z O A

1 employee went home sick 120 15 345 480

2 240 240 The remainder of this employee’s time was spent in task not expensed (allocated) to social service activities.

3 360 120 480

End of Month Total 720 135 345 120

A Allocation% 84.210526% 15.7894737% 100. %

A Minutes Allocated 290.52632 54.4737 345

End of Month Total 1010.5263 189.474 1200

Time Study - General Instructions

• Use DSS Definitions of Foster Care Activities

• Agency staff will collect the reports, verify that all entries are complete

and Program Codes are correct.

• Submit the completed time study workbook to the Controller’s Office, to be received by March 16, 2009.

•Retain a copy of the time study workbook for your files and audit purposes

Tip - Participants can combine minutes of the same activity performed on a single day.

Tips

• Please submit everything that you can electronically

• Please do not send hardcopies of anything submitted electronically

• If your agency does not provide any of the treatment services that must be reported on Schedule C-1, use the smaller cost report

• Be sure to include any supplemental schedules used to complete the report

• If “Other Programs” tie in total from the audit to the cost report, the total of “Other Programs” can be entered on line 88

All information, forms and schedules for completing the Residential Treatment and Foster Care Cost Report are available at http://www.ncdhhs.gov/control/

under Program Specific Information for:

Look for Residential Treatment and Foster Care in the list to link to pertinent information.

QuestionsQuestions