protecting and promoting the health and safety of the people of wisconsin children’s long-term...

Protecting and promoting the health and safety of the people of Wisconsin

Children’s Long-Term Support (CLTS) Waivers Program:2016 Support and Service Coordination (SSC) Rates

Jeff Blankenheim

Budget and Policy Analyst, Advanced

9/24/15

2:00–3:00 p.m.



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CLTS Fiscal Teleconference Agenda

• Expected Calendar Year (CY) 2016 Support and Service Coordination (SSC) timeline

• Fundamental SSC rate-building principles• Administrative expense notes• Review of CY 2016 SSC rate forms• CY 2016 SSC rate form components• Useful SSC rate metrics• Question and answer session



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CY 2016 SSC Rate Timeline• CY 2016 forms are available through the

DHS forms library.• County Waiver Agencies (CWAs) can begin filling out the

forms now.– CLTS SSC Form: F-00539– Community Options Program (COP) SSC Form:

F-00539A• Forms are due by Friday, October 23, 2015. Please send

completed forms electronically to [email protected].

https://www.dhs.wisconsin.gov/forms/index.htm

https://www.dhs.wisconsin.gov/forms/f0/f00539.xlsx

https://www.dhs.wisconsin.gov/forms/f0/f00539a.xlsx

mailto:[email protected]


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SSC Rate Fundamentals• SSC Rates are made of three components:

– Direct billable service hours.– Allocated direct service staff time.– Non-salary costs related to SSC activities.

• SSC rates must not exceed actual, applicable costs.• CWAs must follow the guidelines detailed in the

Allowable Cost Policy Manual.• Costs reimbursed through an SSC rate must not be

duplicated in other reimbursement claims.• No administrative costs are allowed in the SSC rates.

https://www.dhs.wisconsin.gov/business/allow-cost-manual.htm


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Administrative Expenses

No administrative costs may be included in the SSC rates:• The federally matched SSC activities use Wisconsin’s

Federal Medicaid Assistance Percentage (FMAP), which will be 58.23% during CY 2016 until September 30, 2016.

• Administrative activities in support of Medicaid benefit activities are allowed a maximum federal match of 50%.

• Administrative costs must remain separate from the SSC rate to ensure an accurate federal funding claim.


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SSC Rate Certifications

• SSC rates will not be approved without a completed Section I certification.

• Only CWAs that have not transitioned to Family Care and IRIS may use Section II (COP SSC form only).

• CWAs that complete Section III (COP SSC form only) do not need to establish a 2016 COP SSC rate.

• CWAs without an established 2016 COP SSC rate will not be allowed to use COP funding for SSC activities, except as outlined in the Section III certification.


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Direct Billable Service Hours

Direct billable service hours represents the time spent directly benefiting a program client and will be submitted as service time for reimbursement.• Only include staff who are providing SSC services

directly to the client.• Only include time estimates that will be submitted as

service time.• Subtotal A should be a best-guess estimate of the

number of SSC hours reimbursed during CY 2016.


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Allocated Direct Service Time: Allowable Costs

Allocated direct service time refers to time spent that directly benefits the program client but is not submitted as service time. Examples of allocated direct service time include:• Submitting the client’s claim information to the Third

Party Administrator (TPA).• Preparing paperwork essential to the client’s service

plan.• Travel time (if not represented elsewhere).


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Allocated Direct Service Time: Unallowable Costs

Do not include staff and time that are allocated to the program but are not a direct benefit to the client. Common examples of inappropriate staff and time include:• Time that does not benefit a program client.• Meetings not focused on the program’s clients.• Accounting and human resources activities used by the

CLTS or COP programs.• High-level supervisory or executive staff.• Maintenance or janitorial time.


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Non-Salary Costs

Non-salary costs are essential overhead expenses that correspond directly to the benefit service provided. • All costs included must not be more appropriately

considered an administrative expense.• Allocated expenses must correspond specifically to SSC

benefit activities, not the program as a whole.• Be wary of indirect cost, Agency Management Support

and Overhead (AMSO), and other agency-wide allocation methods, as they may include costs not considered to be benefit expenses.


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Helpful SSC Metrics

Ratio of Non-Billable Direct Service Time to Billable Direct Service Time:• This ratio reflects how much time away from the client is

required to complete the benefit activity.• High ratios might indicate that the rate includes too many

allocated hours, too few direct billable hours, or unallowable allocated time.

• Low ratios might indicate that there are too many direct billable hours or too few allocated direct hours.


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Helpful SSC Metrics

Percentage of non-salary costs:• This percentage indicates how much of an SSC rate

does not derive from payroll.• High percentages might indicate an inappropriate

allocation methodology or the inclusion of costs that are administrative in nature.

• Low percentages might indicate that overhead costs are reimbursed through other methods or overhead costs are minimal for the CLTS SSC workers.


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Question and Answer

Please submit questions in the Adobe Connect chat box

or

ask questions through the conference call line.

You can send additional SSC rate questions to the DHS CLTS Fiscal team at [email protected].

mailto:[email protected]

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