Ongoing Rate and Unit Increase

Definition:

If the person needs both an increase to the rate and the units 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 and the total units will permanently increase.  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 both rate and unit increases, the worker must include documentation that justifies the rate increase separately from the documentation for the unit increase.  The justifications for both increases should explain the nature of the situation or circumstance in the person’s life that requires the change.

Procedure:

If the person satisfies the service’s criteria, then the worker must respond to four questions that dynamically and automatically build the budget line for the “Ongoing Rate and Unit Increase”.  Each one contributes information toward a holistic view regarding how the rate/unit increase will impact the person’s needs.  

The worker must ensure they have selected the correct budget line in the Active PCSP that will receive at least part of the rate/unit increase.  Only the information from the selected budget line will be available for use in the Request.

The following four questions must be completed in order to submit the Request for the “Ongoing Rate and Unit Increase”.  In this scenario, both the rate and the units in the selected budget line are expected to 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 increase start?
This question asks for the date the increase will begin for the service.   The date cannot be arbitrary.  Rather, it must accurately reflect the expected date the provider will begin delivering the higher rate and units.  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 and units.  

How many extra units are needed in the Active plan?
This question asks for the exact number of additional units that are needed in the Active PCSP.  The number of extra 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 extra units are needed to cover 12 months in the next plan cycle?
This question asks for the exact number of additional units that will be used in the next plan cycle.  The sum of the additional units and the original units from the Active Plan represent the total number that will be implemented in the next plan cycle.  If the additional units are not accurate, then the Plan Max may provide insufficient funds to cover the person’s need.