Ongoing Rate Decrease

Definition:

If the person needs a decrease to the rate of an existing Ongoing 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 decrease from the rate originally loaded in the PCSP.  In order to submit the Request that involves a rate decrease, 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.

Procedure:

A permanent decrease in the rate for a service does not have to be justified by criteria in the Request for Services.  Rather, the decrease can be implemented directly on the budget screen inside the request.  In order to implement the reduction, the worker must respond to four questions that dynamically and automatically build the budget line for the “Ongoing Rate Decrease”.  Each one contributes information toward a holistic view regarding how much of the rate increase will impact the person’s needs.

Explanation:

The following four questions must be completed in order to submit the Request for the “Ongoing Rate Decrease”.

What will the (total) rate become after the decrease is implemented?

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

What date will the new Rate (decrease) start?

This question asks for the date the rate decrease 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.    

How many units will be permanently decreased in the Active plan?

This questions asks for the number of units the person is expected to use in the Active PCSP at the lower rate.  Considering the original prescription of units for

the service is not changing, the number of units that will be affected by the rate decrease are those which remain unspent up the date the rate decrease starts.  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.

How many units will be permanently decreased in the next plan cycle?

This question asks for the total number of units the person is expected to use in the next plan cycle.  Considering that the original prescription of units for the service is not changing, the units in the next plan will equal the same number in the Active plan.  The number of units cannot be arbitrary.  Rather, they must accurately reflect the amount the person needs to use over the course of twelve months.  If the units are not accurate, then the Plan Max may provide insufficient funds to cover the person’s need.