Therapeutic Foster Care Rates 623-05-20-35

(Revised 2/17/17 ML #3493)

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PI 18-08

 

 

ND Therapeutic Providers:

  1. PATH, Inc.
    1202 Westrac Dr S, Suite 100
    Fargo, ND 58103
    Phone: 701-280-8545

    Billing Address:
    PATH, Inc. ND
    Rice Creek Professional Building
    5985 Rice Creek Pkwy, Suite 202
    Shoreview, MN 55126

PATH Maintenance Rates (July 1, 2015) Payments are made using the daily rate times the number of days in care.

 

LEVEL OF CARE OFFERED BY THE THERAPEUTIC PROVIDER DAILY RATE MONTHLY RATE
(30 days)

Therapeutic Treatment

PATH provides case management

 $108.18 $3,245.40

PATH Regular (Step Down)

PATH provides case management

 $66.23 $1,986.90

County (Flow Through)

Sibling placement - Custodian provides case management to the child.

 Family Foster Care
Maintenance Rate
(Based on Child Age)		 Varied

 

The therapeutic 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 to determine the appropriate level of care. If placement in the PATH Regular (Step Down) option is appropriate, 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.

 

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 (Tx 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 therapeutic provider to another is not allowed. Example: A child changes placement from one therapeutic home to another on the 3rd of the month, only one therapeutic 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. Eligibility workers must wait for the bill prior to authorizing payments. 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.

 

The monthly bill from the agency must provide an itemization of each placement with each provider:

  1. 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.
  2. 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 therapeutic placement are not reimbursable (PATH to PATH). However, if the child is transitioning to a PATH home from a non-PATH provider (county home, group home, etc.) the “pre-placement” can be reimbursed as a secondary placement.
  4. 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. If there is not a placement with the specified provider, CFS will generate a letter for PATH to reimburse NDDHS directly.

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 approved as set forth in policy and should be documented in the Child and Family Team Meeting notes.
  2. Case managers must provide the eligibility worker with documentation of the approved irregular expenses.
  3. After approval to purchase, the PATH foster care provider will email/fax/mail 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 county case manager will provide the eligibility worker with a copy of the receipts and the PATH worker will provide the PATH billing office with a copy of the receipts (unless other arrangements have been made between the PATH worker and the County case managers in regard to distribution of the receipts).
  5. PATH DOES NOT bill the irregular expenses for PATH Regular (Step Down) or County (Flow Through) placements to the county. They will only bill the rate for the therapeutic level of care. It is the responsibility of the county to reimburse the irregular payments to PATH. In turn, PATH will reimburse the foster parents the amount of payment received from the county to cover the irregular expenses for the billing cycle.
  6. 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 all therapeutic providers:

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

These irregular payments must be authorized separately and on the irregular payment screen.

 

All other allowable irregular payments for PATH Regular (Step Down) and County (Flow Through) must be added to the maintenance payment amount for the billable month.

 

Example: PATH Regular March 2016 for 15 days + daycare for 7 days.

  • The CCWIPS payment/rate for March 2016 would be entered as $1183.45.