Program Issues, Contract Requirements or Payments Contact Tina Bumgarner

1. 2009 IV-E Foster Care Cost Report Training Program Issues, Contract Requirements or Payments Contact Tina Bumgarner Tina.Bumgarner@ncmail.net (704) 462-2686 Cost Report & Time Study questions Contact Mike Thompson Mike.Thompson@ncmail.net (919) 855-3684

2. Medicaid Services Medicaid services reporting questions Contact Christal Kelly Christal.Kelly@ncmail.net (919) 855-4218 NC Department of Health and Human Services Division of Medical Assistance 2501 Mail Service Center Raleigh, NC 27699-2501

3. Agenda • Rate Setting Process • Cost report package • Foster Care definitions • Relationship between the Time Study and the Cost Report • Daily Supervision vs Foster Care Activities/Social Service • Tips

4. Rate Setting Process • Agencies must qualify through the Division of Social Services • Agencies submit their Audit, Cost Report and Time Study to Office of the Controller • Cost Report and Time Study are reviewed by Office of the Controller

5. Cost Report Package In order to obtain a foster care rate, an agency must submit the following no later than the due date (March 16, 2009) Residential Treatment and Foster Care Cost Report Documentation of Child Care days Financial Audit Time Study participation Supplemental Schedules/Reports Agencies should perform a self check on the cost report using the: Rate Review Work Sheet

6. Cost Report Basics • Cost report is based on the audit • Total expense on Schedule C must match audit • The expense for each program in the audit should match that program on the cost report • Admin should be reported in the admin column, unless it is allocated in the audit • Child care days must be separated by service

7. Audit Requirements • Audits must show both revenues and expenditures. • Revenues must be broken out by fund type. • Expenditures must show a separation between administrative costs and program costs. • Administrative costs must also delineate between management and fund-raising costs. • Program costs must be delineated by type as well as identify specific allowable foster care costs within each type.

8. Terms for Cost Reporting • Therapeutic vs. treatment or Foster Care? • Medical necessity and Medicaid authorization for mental health service

9. Terms for Cost Reporting • Foster Care Maintenance Payment Payment to cover the cost of, and the cost of providing: • Clothing • Food • Shelter • Daily Supervision • School supplies • Personal Incidentals • Liability Insurance • Travel to the child’s home for visitation • Includes reasonable administration and operation for institutional care

10. Non-Allowable Costs: Items Not Covered by IV-E Funding • Medical and social services treatment or services • Educational expenses other than school supplies • Expenses not directly related to providing room, board, supervision and necessary administration, such as swimming pools, gymnasiums, chapels/churches, housing other than the residential facilities occupied by the children in care. • Gifts • Food served at banquets, or training • Recreation other than the occasional expense allowed in Personal Incidentals

11. Recreation is NOT an allowable item of expense, except where it clearly substitutes for daily supervision – CWPM 8.3B.1 (1)d. A child’s personal incidentals can include the reasonable and occasional cost of such items as tickets or other admission fees for sporting, entertainment or cultural events or dues for clubs. – CWPM 8.3B.1 (2)

12. Successful Time Study Participation Communication is key Only time performing FC/SS activities is reported on time study All time performing as FC/SS is reported on time study Ensure participants have the definitions

13. Daily Supervision vs FCA/SS • Daily supervision – performing routine day-to-day care and supervision of children. • Foster Care Activities/Social Services – performing activities described in the Foster Care Service Definitions, such as case management, referral to services, etc.

14. Daily Supervision NOT reported on the Time Study Expense is reported on lines 14-16 of the Cost Report FCA/SS IS reported on the Time Study Expense is reported on lines 18-20 of the Cost Report Daily Supervision vs FCA/SS

15. Time Study - General Instructions • Required by federal regulations • To document allowable activities for inclusion in the rates • Participation is based onactivities, not title or position. • Use DSS Definitions of Foster Care Activities

16. Time Study - General Instructions • Agency staff will collect the reports, verify that all entries are complete and Program Codes are correct. • Agencies are requested to submit the completed time sheets to the Controller’s Office, to be received by March 16, 2009. • Retain a copy of the daily work sheets for your files and audit purposes and mail (paper originals) or email (Excel) sheets to: • DHHS FC Rate Setting • Office of the Controller • 2019 Mail Service Center • Raleigh, North Carolina 27699-2019 • mike.thompson@ncmail.net

17. Time Study - Specific Instructions Agency Totals Worksheet • Agency ID - Changed to DSS Agency ID; auto fill • Agency Name - Dropdown list • Service Type - Residential or Family Foster Placement

18. Time Study - Specific Instructions Employee Worksheets • Agency ID and Name – from Agency Totals Worksheet • Employee Last & First Name – text • Line Number - Pre-printed • Date - Enter the numeric date. Excel is limited to numbers 1-31, dropdown list • Minutes - Enter in 15 or multiples of 15. Excel limited to multiples of 15 from 15 – 720. • Description of Activity -Enter category from Foster Care Activities Definitions; dropdown list • Service and Program Codes – Entered automatically based on Description of Activity

19. Allocation of Program Code A It is used to allow for the inclusion of time/expense allocated to social service activities not detailed in O or Z such as expense for absences due to sickness or vacation. The Time sheets have been modified to capture this information. For example: Allowed Non-allowed Absences Total % Minutes A Day Z O A 1 employee went home sick 120 15 345 480 2 240 240 The remainder of this employee’s time was spent in task not expensed (allocated) to social service activities. 3 360 120 480 End of Month Total720 135 345 120 A Allocation%84.210526% 15.7894737% 100. % A Minutes Allocated290.52632 54.4737 345 End of Month Total1010.5263 189.474 1200

20. Time Study - General Instructions • Use DSS Definitions of Foster Care Activities • Agency staff will collect the reports, verify that all entries are complete and Program Codes are correct. • Submit the completed time study workbook to the Controller’s Office, to be received by March 16, 2009. • Retain a copy of the time study workbook for your files and audit purposes • Tip - Participants can combine minutes of the same activity performed on a single day.

21. Tips • Please do not send hardcopies of anything submitted electronically • Please submit everything that you can electronically • Be sure to include any supplemental schedules used to complete the report • If your agency does not provide any of the treatment services that must be reported on Schedule C-1, use the smaller cost report • If “Other Programs” tie in total from the audit to the cost report, the total of “Other Programs” can be entered on line 88

22. All information, forms and schedules for completing the Residential Treatment and Foster Care Cost Report are available athttp://www.ncdhhs.gov/control/ under Program Specific Information for: Look for Residential Treatment and Foster Care in the list to link to pertinent information.

23. Questions