Nexus-PATH Foster Care Rates 623-05-20-35

(Revised 9/15/20 ML #3592)

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PI 21-19

PI 21-14

Attachment A

Attachment B

Attachment C

 

 

PATH ND is a private non-profit child and family services agency that began operations in North Dakota in 1994. PATH has provided evidenced-based services and supports to children and families in North Dakota as a child placing agency. PATH is accredited by the Council on Accreditation for Services to Children and Families (COA).

 

Billing Address:

PATH, Inc. ND
1202 Westrac Dr S, Suite 400
Fargo, ND 58103

 

Maintenance rates effective July 1, 2020:

NEXUS-PATH RATES BY PROVIDER TYPE & LEVEL	Avg. Monthly Rate (30 day)	Daily Rate
PATH TREATMENT FOSTER CARE PROVIDERS
Intensive Treatment Foster Care (ITFC)	$6,263	$208.76
Treatment Foster Care (TFC)	$3,393	$113.10
Step Down from TFC	$2,077	$69.24
Flow Through	$ VARIED $	$ State Rate $
PATH REGULAR PROVIDERS
Regular Foster Care	$2,077	$69.24

Resources: PATH Program Components

PATH Payment Chart

 

NOTE: The “monthly” rate is provided for reference. The child’s foster care reimbursement is paid at a daily rate, specific to the actual number of days in placement for the service month. The payment is made to the licensed child placing agency, inclusive of administrative costs embedded into the rate for the agency. LSS reimburses the licensed foster parents after removing administrative and service fees from the established maintenance rate.

 

ND foster care rates are reviewed and revised annually, based on legislative action. The custodian and the child's team will evaluate the child’s progress at quarterly meetings to determine the appropriate level of care. If a child begins as a treatment foster care (TFC) placement, it may be determined that PATH Step Down is necessary and appropriate over time. If so, the custodian and PATH will sign the needed documentation at the Child & Family Team meeting. The foster care case manager will be responsible to notify the county eligibility worker of any changes in placement level/rate, inclusive of completing a new SFN 45 immediately.

 

PATH MONTHLY BILLING

Payments to PATH should not be authorized until a billing statement has been received for the appropriate month. The amount billed is based on the level of care (ITFC rate, TFC Rate, Step Down rate, Regular rate, County rate) and number of days in placement, not to exceed the number of days in the month. Reimbursement of overlapping days of placement from one PATH provider to another is not allowed.

• Example: A child changes placement from one PATH home to another on the 3rd of the month, only one PATH provider can be reimbursed for the 3rd.

The PATH billing office will send a separate bill to the financial county for each child monthly. The county should receive the bill on or around the 12th of the month following the month of service. The payment amount is not automatically calculated by the payment system and will require manual data entry by the county eligibility worker. The bill must be kept in the foster care eligibility file for auditing purposes.

 

Itemized Bill:

1. Child specific - one bill per child
   
   
2. Provider specific - for bills containing multiple providers, each provider must have an approved placement in FRAME and payment authorization must be made to each provider based on the billed dates and amount specific to that provider. Do not authorize a lump sum payment to only one provider if multiple placements exist during the billing cycle.
   
   
3. Secondary placements in a therapeutic home when a child is in a primary treatment placement are not reimbursable (PATH to PATH). However, if the child is transitioning to a PATH home from a non-PATH provider (county home, residential, etc.) the “pre-placement” can be reimbursed as a secondary placement.
   
   
4. Irregular Payments pre-approved by the primary case manager. Receipts and signed approval form will be submitted for verification purposes.
   
   
5. The county will authorize reimbursement to PATH as the designated payee on behalf of the licensed provider.

PATH Overpayments

If there is an overpayment made to a PATH provider, Children & Family Services (CFS) can auto-recoup the overpayment during either the supplemental or standard check write so long as the provider has a foster care placement.

 

PATH Irregular Payments

Allowable irregular payment reimbursements per policy 623-05-25-05 are authorized through the county as follows:

1. All irregular payments must be eligible and pre-approved as set forth in policy; monitored by the primary foster care case manager.
   
   
2. Foster care case managers must provide the eligibility worker with documentation of the approved irregular expenses.
   
   
3. After approval to purchase, the PATH provider will deliver receipts to a designated PATH case worker. The PATH case worker will distribute the receipts to the county case manager for reimbursement to PATH.
   
   
4. The PATH case worker will distribute the receipts to the PATH billing office to request reimbursement for the provider.
   
   
5. PATH will bill the county itemizing the standard maintenance rate for the specific level of care placement dates and any pre-approved irregular expenses. PATH will submit a copy of the required irregular payment receipts along with the bill for reimbursement.
   
   
6. PATH, the agency, will directly reimburse the foster parents.
   
   
7. If PATH’s billing office has questions regarding the amount received over and above the standard foster care rate, the county worker will be contacted for clarification.

 

How to Authorize the Irregular Payments in the payment system:

The ND payment system allows only two irregular payment codes to be authorized to PATH ITFC or TFC providers:

1. Code 53 - transportation to school
2. Code 71 – parent/infant care

All other allowable irregular payments for PATH Step Down, County Flow Through offered by a TFC provider must be added to the maintenance payment amount for the billable month.

 

PATH Regular Foster Care: Eligibility workers must authorize irregular payments separately when a child is placed in a PATH Regular foster home. If a child is considered a “PATH Regular” placement but is in a PATH TFC home due to specific circumstances, any irregular payments for the child will need to be added manually to the standard maintenance payment. The payment system limits which irregular payments can be authorized for a TFC provider.