441—152.3 (234) Determination of rates. Rates for foster group care services effective on or after November 1, 2006, shall be based on the historical payment rate negotiated between the provider and the department and shall be calculated based on rule 441—156.9(234).
	 152.3(1) Negotiation of rates. Rates for foster group care services effective on or after November 1, 2006, must be established in accordance with this subrule, except as provided in subrule 152.3(4).
	  a.   	 All historical rate negotiations made under the former rehabilitative treatment and supportive services program on or after February 1, 1998, remain true and valid.
	  b.   	 The scope of negotiations is limited solely to the rate to be paid for each service.
	  c.   	 No other items, such as, but not limited to, changes in staff qualifications, service definition, required components, allowable costs or any licensing or other contractual requirements, shall be the subject of negotiations or be used as a basis for changing rates.
	  d.   	 The service area manager of the host area is responsible for the negotiation of rates for each provider whose contract for foster group care services is administered by the host area, regardless of where the services are provided. Only the service area manager of the host area may approve the rates negotiated for a provider, except as provided in subrule 152.3(4).
	 (1) 	 The service area manager of the host area shall take into consideration the other service areas served by a provider when negotiating a rate for a service provided in multiple service areas.
	 (2) 	 When a service is provided only in a nonhost area, the two service area managers shall determine which one will negotiate the rate for that service.
	  e.   	 The service area manager of the host area and the provider are mutually responsible for initiating the rate negotiation process. Negotiations may be conducted in a manner acceptable to both parties, but shall be conducted face to face upon the request of either party.
	  f.   	 At the initiation of the rate negotiation process, the provider must disclose all relevant subcontractual and related-party relationships involved in the provision of foster group care services.
	  g.   	 Negotiated rates shall not exceed any rate ceiling established or authorized by the legislature.
	  h.   	 Once a negotiated rate is established, it shall not be changed or renegotiated, except in the following circumstances:
	 (1) 	 Rates may be changed when funds are appropriated for an across-the-board increase.
	 (2) 	 Rates may be changed by mandated across-the-board decreases.
	 152.3(2) New service. When a prospective provider contracts to provide a foster group care service or an existing provider adds a new foster group care service on or after November 1, 2006, the rate for the new service shall be established based on a payment rate negotiated with the provider.
	  a.   	 The starting point for negotiated rates shall be the weighted average for each service as of July 1, 1997, as previously established in accordance with 441—subrule 185.109(1), in effect at that time, and further calculated based on rule 441—156.9(234). These rates shall become the established weighted average rates for each service code as described in 441—Chapter 156 and in the appendices of the foster group care contract.
	 (1) 	 The rate for community-level group care child welfare service is $8.43 per unit of service.
	 (2) 	 The rate for community-level group care maintenance is $50.16 per unit of service.
	 (3) 	 The rate for comprehensive-level group care child welfare service is $10.13 per unit of service.
	 (4) 	 The rate for comprehensive-level group care maintenance is $60.31 per unit of service.
	 (5) 	 The rate for enhanced comprehensive-level group care child welfare service is $13.36 per unit of service.
	 (6) 	 The rate for enhanced comprehensive-level group care maintenance is $79.55 per unit of service.
	  b.   	 In the event the department and a new provider or an existing provider adding a new foster group care service are unable to reach agreement on a rate for a service within 60 days of initiating rate negotiations, a rate resolution process may be used. If no rate is agreed upon within 60 days of initiation of a rate resolution process, no rate shall be established and the services in question shall not be part of any approved contract for foster group care services.
	 152.3(3) Interruptions in a program.
	  a.   	 The rate for a new provider shall remain the same as the rate established for the former provider if:
	 (1) 	 A provider assumes the delivery of a program from a related-party provider, or
	 (2) 	 The difference between the former provider and the new provider is a change in name or a change in the legal form of ownership (i.e., a change from partnership to corporation).
	  b.   	 If a provider ceases to contract for and provide a foster group care service on or before October 31, 2006, and before the calculation of new rates according to rule 441—156.9(234), the rate in effect when the contract ceased shall be used to calculate the new rates to be used as the starting point in negotiations.
	  c.   	 If a provider ceases to contract for and provide a foster group care service after a rate has been established in accordance with rule 441—156.9(234) and then decides to again contract for and provide the foster group care service, the rate shall be established at the rate in effect when the service was interrupted.
	 152.3(4) Exception to rate policy. When a provider not located in Iowa has been granted an exception to these rules based upon another state’s requirement that its providers be paid the same rate they are paid for clients from that state, the exception shall continue in effect as written for the life of the contract.
	 152.3(5) Across-the-board cuts. Payment under the contract may be subject to across-the-board cuts pursuant to Iowa Code section 8.31.
[ARC 7741B, IAB 5/6/09, effective 7/1/09]