One-Time Rate Increase

Definition:

If the person needs a temporary increase to the rate of an existing service in the Person Centered Support Plan (PCSP), then it means the new rate is likely based on a worksheet calculation.  The rates for worksheet services, one-time purchase services and summer program services are allowed to increase from the rate originally loaded in the PCSP.  In order to submit the Request that involves  one-time a rate increase, the support coordinator must include documentation that justifies it.  The justification should explain the nature of the situation or circumstance in the person’s life that requires the increase.

If the person satisfies the service’s criteria, then the worker must respond to five questions that dynamically and automatically build the budget line for the “One-Time Rate Increase”.  Each one contributes information toward a holistic view regarding how much of the rate increase will impact the person’s needs.

The following five questions must be completed in order to submit the Request for the “One-Time Rate Increase”.

What is the new (total) ongoing rate?

This question asks for new value the rate will have after the increase is applied.

What date will the new one-time rate start?

This question asks for the date the rate increase is scheduled to begin and represents its Effective Start Date.  The date cannot be arbitrary.  Rather, it must accurately reflect the expected date the provider will begin delivering the service at the higher rate.  If the date is unknown, then the worker should select the first day of the month in which the provider is expected to begin delivering the higher rate.    

What date will the new one-time rate end?

This question asks for the date the rate increase is expected to end and represents its Effective End Date.  The date cannot be arbitrary.  Rather, it must accurately reflect the expected date the provider will stop delivering the service at the higher rate.  If the date is unknown and the increase is expected to begin in the Active Plan, then the worker should use the Active Plan’s Effective End Date.  

How many units are needed at the new one-time rate in the Active plan?

This questions asks for the number of units the person is expected to use in the Active PCSP at the higher rate.  Considering the original prescription of units for the service is not changing, the number of units that can be affected by the rate increase in the Active plan are those which have not been spent.  The number of units cannot be arbitrary.  Rather, they must accurately reflect the amount the person needs to use between the Request’s Effective Start Date and the Active plan’s Effective End Date.  If the units are not accurate, then the Plan Max may provide insufficient funds to cover the person’s need.

If the Effective End Date falls into the next plan cycle, how many units are needed at the new one-time rate in the next plan?

This question asks for the total number of units the person is expected to use in the next plan cycle for the rate increase.  Typically, one-time money does not flow into the next plan cycle simply because planning that far into the future is difficult.  Even so, if the support coordinator has accurately determined some portion of the one-time rate’s duration will fall into the next plan cycle, then they must determine exactly how many units will be billed at the higher rate in the next plan.  The number of units cannot be arbitrary.  If the units are not accurate, then the Plan Max may provide insufficient funds to cover the person’s need.