Chapter DCF 52

DCF 52.63(3) (3) Enforcement action. The department may order any sanction or impose any penalty on a licensee in accordance with s. 48.685, 48.715 or 48.76, Stats.

DCF 52.63 History History: Cr. Register, February, 2000, No. 530, eff. 9-1-00.

subch. IX of ch. DCF 52 Subchapter IX — Rate Regulation

DCF 52.64 DCF 52.64 Rate determination.

DCF 52.64(1) (1) The department shall determine the maximum per client rate that each residential care center program may charge for costs associated with room, board, administration, service provision, and oversight of residents in the residential care center program based on the following:

DCF 52.64(1)(a) (a) A maximum per client rate determined by the department that no residential care center may exceed.

DCF 52.64(1)(b) (b) A per client rate that the department determines is appropriate for each residential care center program based on the reasonable and necessary costs of the services provided by that residential care center.

DCF 52.64(2) (2) A residential care center shall charge all Wisconsin public purchasers the same rate for the same services.

DCF 52.64 Note Note: A residential care center may have multiple programs within the center and may charge a different rate for each program.

DCF 52.64 History History: EmR1106: emerg. cr., eff. 9-16-11; CR 11-026: cr. Register December 2011 No. 672, eff. 1-1-12; CR 14-054: am. (1) (intro.) Register April 2015 No. 712, eff. 5-1-15.

DCF 52.65 DCF 52.65 Allowable costs. In determining rates under this subchapter, the department may consider costs incurred for any purpose that is allowable under all of the following:

DCF 52.65(1) (1) Applicable federal regulations, including 2 CFR Part 200, 45 CFR Part 75, and 48 CFR Part 31, except as provided in sub. (2).

DCF 52.65(2) (2) Reserves or profit as allowed under the following:

DCF 52.65(2)(a) (a) For nonprofit corporations, reserves allowed under s. 49.34 (5m) (b) 1., Stats.

DCF 52.65(2)(b) (b) For proprietary residential care centers, profit allowed on an annual basis is the smaller amount determined under the following 2 methods of calculating profit:

DCF 52.65(2)(b)1. 1. The equity method is the sum of 7.5 percent of allowable operating costs plus 15 percent of average net equity for the year. In this subdivision, “average net equity” means the average cost of equipment, buildings, land, and fixed equipment minus the average accumulated depreciation and average long term liabilities for the year.

DCF 52.65(2)(b)2. 2. The expenses method is 10 percent of allowable operating costs for the year.

DCF 52.65 Note Note: Further explanation is available in the department’s Allowable Cost Policy Manual, which is available in the Partner Resources/Grants and Contract Administration section of the department’s website at http://dcf.wisconsin.gov.

DCF 52.65 History History: EmR1106: emerg. cr., eff. 9-16-11; CR 11-026: cr. Register December 2011 No. 672, eff. 1-1-12; CR 20-003: am. (1), (2) (a) Register July 2020 No. 775, eff. 8-1-20.

DCF 52.66 DCF 52.66 Rate methodology.

DCF 52.66(1) (1) Cost and service information. Each year no later than July 1, a licensee shall submit the following information to the department:

DCF 52.66(1)(a) (a) A cost and service report in which the licensee reports the residential care center’s costs, types of services provided, and number of children served in the previous year. The report shall be submitted on a department-prescribed form.

DCF 52.66 Note Note: The cost and service report form is available at https://dcf.wisconsin.gov/ratereg.

DCF 52.66(1)(b) (b) The residential care center’s most recent audit report under s. DCF 52.11 (6) (a).

DCF 52.66(2) (2) Maximum allowable rate. Each year no later than September 1, the department shall notify licensees of the per client rate that no residential care center may exceed for services provided in the following calendar year.

DCF 52.66(3) (3) Proposed rates.

DCF 52.66(3)(a) (a) Each year no later than October 1, a licensee shall submit to the department a proposed rate for the following calendar year for each residential care center program that the licensee operates. The licensee shall submit the proposed rate on a department-prescribed form.

DCF 52.66(3)(b) (b) A licensee may request an exception to the department’s maximum rate under sub. (2) if the licensee provides a specialized service or specialized programming to a specific population of children. The exception request shall explain the benefits of the service or programming and why the licensee cannot provide the service or programming within the maximum rate. The exception request shall be made on the rate request form.

DCF 52.66 Note Note: The rate request form is available at https://dcf.wisconsin.gov/ratereg.

DCF 52.66(4) (4) Review of a proposed rate. In reviewing a proposed rate submitted by a licensee under sub. (3), the department shall consider all of the following:

DCF 52.66(4)(a) (a) Whether the proposed rate exceeds the maximum rate determined by the department under sub. (2).

DCF 52.66(4)(b) (b) The residential care center’s most recent cost and service report under sub. (1) (a).

DCF 52.66(4)(c) (c) The residential care center’s most recent audit report under sub. (1) (b).

DCF 52.66(4)(d) (d) Whether the residential care center’s reported costs are within a range of similar costs reported by other residential care centers for similar items and services.

DCF 52.66(4)(e) (e) The residential care center’s per client rate in previous years.

DCF 52.66(4)(f) (f) Changes in the consumer price index for all urban consumers, U.S. city average, as determined by the U.S. department of labor, for the 12 months ending on June 30 of the year in which the proposed rate is submitted.

DCF 52.66(4)(g) (g) Changes in the consumer price index for all urban consumers, U.S. city average, for the medical care group, as determined by the U.S. department of labor, for the 12 months ending on June 30 of the year in which the proposed rate is submitted.

DCF 52.66(4)(h) (h) Changes in the allowable costs of residential care centers based on current actual cost data or documented projections of costs.

DCF 52.66(4)(i) (i) Changes in program utilization that affect the per client rate.

DCF 52.66(4)(j) (j) Changes in the department’s expectations relating to service delivery.

DCF 52.66(4)(k) (k) Changes in service delivery proposed by a residential care center and agreed to by the department.

DCF 52.66(4)(L) (L) The loss of any source of revenue that had been used to pay expenses, resulting in a lower per client rate for services.

DCF 52.66(4)(m) (m) Whether the residential care center is accredited by a national accrediting body that has developed child welfare standards.

DCF 52.66(4)(n) (n) Changes in any state or federal laws, rules, or regulations that result in any change in the cost of providing services, including any changes in the minimum wage, as defined in s. 49.141 (1) (g), Stats.

DCF 52.66(4)(o) (o) Competitive factors.

DCF 52.66(4)(p) (p) The availability of funding to pay for the services to be provided under the proposed rate.

DCF 52.66(5) (5) Rate approval.

DCF 52.66(5)(a) (a) Each year no later than November 1, the department shall notify each licensee that submitted all information as required under subs. (1) and (3) of the maximum approved per client rate for the residential care center’s program for the following year.

DCF 52.66 Note Note: The notification will be sent to the electronic mail address that the licensee has provided to the department.

DCF 52.66(5)(b) (b) If the department determines that a proposed rate submitted under sub. (3) is appropriate based on the factors in sub. (4), the department shall approve the proposed rate.

DCF 52.66(5)(c) (c) If the department determines that a proposed rate submitted under sub. (3) is not appropriate based on the factors in sub. (4), the department shall negotiate with a licensee to determine an agreed to rate. The department’s approved rate under par. (a) following negotiations shall be based on the factors in sub. (4) and additional relevant information presented during negotiations.

DCF 52.66(5)(d) (d) The department may grant a licensee’s request for an exception to the department’s maximum rate under sub. (3) (b) if the department determines that the licensee has shown by clear and convincing evidence that the licensee’s costs are reasonable and necessary given the costs and benefits of the licensee’s specialized service or specialized programming.

DCF 52.66(6) (6) Noncompliance. If a licensee does not submit all information as required under subs. (1) and (3), the department may impose sanctions and penalties under s. DCF 52.62 (5) and s. 48.715, Stats., including license revocation.

DCF 52.66 History History: EmR1106: emerg. cr., eff. 9-16-11; CR 11-026: cr. Register December 2011 No. 672, eff. 1-1-12.

DCF 52.67 DCF 52.67 Rate resolution.

DCF 52.67(1) (1) Mediation.

DCF 52.67(1)(a) (a) If a licensee has negotiated with the department under s. DCF 52.66 (5) (c) and does not agree to the department’s approved rate under s. DCF 52.66 (5) (a), the licensee may request that the department and the licensee engage in mediation. A licensee shall send a request for mediation within 5 business days after the date of the notice in s. DCF 52.66 (5) (a). The request shall be sent by electronic mail to an address specified by the department.

DCF 52.67 Note Note: Requests for mediation should be sent to [e-mail].

DCF 52.67(1)(b) (b) The department shall notify the licensee of the date of the mediation no later than 10 working days after receiving the request under par. (a).

DCF 52.67(1)(c) (c) The issues discussed in the mediation shall be limited to the factors in s. DCF 52.66 (4).

DCF 52.67(2) (2) Order a rate. If after mediation a rate is not agreed to, the department shall order a rate after considering the factors in s. DCF 52.66 (4) and relevant information presented during negotiation and mediation.

DCF 52.67(3) (3) Contested rate.

DCF 52.67(3)(a) (a) A licensee may appeal the rate ordered by the department under sub. (2) as a contested case under ch. 227, Stats. A request for hearing may be submitted to the division of hearing and appeals within 30 days after the date of the order.

DCF 52.67 Note Note: Requests for hearing may be sent to the Division of Hearings and Appeals, PO Box 7875, Madison, WI 53707.

DCF 52.67(3)(b) (b) The basis for a request for hearing shall be limited to the factors in s. DCF 52.66 (4).

DCF 52.67(3)(c) (c) The division of hearings and appeals shall notify the parties in writing at least 10 days before the hearing of the date, time, and location of the hearing and the procedures to be followed.

DCF 52.67 History History: EmR1106: emerg. cr., eff. 9-16-11; CR 11-026: cr. Register December 2011 No. 672, eff. 1-1-12.

DCF 52.68 DCF 52.68 Extraordinary payments.

DCF 52.68(1) (1) A licensee may request that a Wisconsin public purchaser pay an extraordinary payment in addition to the rate established under ss. DCF 52.64 to 52.67 for a specific child in care.

DCF 52.68(2) (2) A licensee may request and a Wisconsin public purchaser may approve a child-specific extraordinary payment if all of the following conditions are met:

DCF 52.68(2)(a) (a) The child has service needs that are not accounted for in the maximum per client rate for the residential care center program as determined under s. DCF 52.66 (5) or 52.67, as applicable.

DCF 52.68(2)(b) (b) The child’s service needs are not paid for by another source.

DCF 52.68(2)(c) (c) The extraordinary payment will be used to cover expenses that are an allowable cost under s. DCF 52.65.

DCF 52.68(3) (3) A licensee shall submit a request for an extraordinary payment to the Wisconsin public purchaser on a form prescribed by the department. The request shall be dated and signed and include all of the following:

DCF 52.68(3)(a) (a) Name of the residential care center program, licensee, and any authorized representative.

DCF 52.68(3)(b) (b) Name of the child for whom an extraordinary payment is being requested.

DCF 52.68(3)(c) (c) Amount of the extraordinary payment requested and time period that the extraordinary payment would cover.

DCF 52.68(3)(d) (d) A rationale for the request that includes all of the following:

DCF 52.68(3)(d)1. 1. An explanation of the child’s service needs.

DCF 52.68(3)(d)2. 2. The amount of money that the residential care center program is currently spending to address the child’s needs.

DCF 52.68(3)(d)3. 3. Any services that are not being provided due to economic constraints.

DCF 52.68(3)(d)4. 4. Documentation of the need for additional services by a person with expertise in the child’s type of needs.

DCF 52.68(3)(d)5. 5. How additional dollars would be allocated and the means by which additional services would be provided.

DCF 52.68 Note Note: A extraordinary payment request form is available at https://dcf.wisconsin.gov/ratereg.

DCF 52.68(4) (4) The Wisconsin public purchaser shall approve or deny the request or recommend an alternative to meet the child’s needs and shall notify the licensee of the determination within 10 working days after receipt of the request form. The Wisconsin public purchaser shall send a copy of the licensee’s request, the signed and dated determination, and the justification for the determination to the department within 20 days of the approval or non-approval of the request.

DCF 52.68 Note Note: Required information should be sent to Department of Children and Families, Division of Safety and Permanence, Extraordinary Payments Panel, 201 W. Washington Avenue, P.O. Box 8916, Madison WI 53708-8916.

DCF 52.68(5) (5) A licensee may not appeal the denial of a request for an extraordinary payment under this section.

DCF 52.68 History History: EmR1106: emerg. cr., eff. 9-16-11; CR 11-026: cr. Register December 2011 No. 672, eff. 1-1-12.

DCF 52.69 DCF 52.69 Advisory committee. The department shall convene the rate regulation advisory committee under s. 49.343 (5), Stats., at regular intervals to consult with the department on items in s. 49.343 (5) (a) to (c), Stats.