AFH-SPECIFIC NEEDS CONTRACT AND EXCEPTIONAL RATES Clause Samples
The "AFH-Specific Needs Contract and Exceptional Rates" clause establishes the terms under which additional funding or special contractual arrangements are provided for individuals in Adult Family Homes (AFH) who have unique care requirements. This clause typically outlines the criteria for determining when a resident's needs exceed standard care provisions, such as requiring specialized medical equipment, behavioral supports, or one-on-one supervision, and specifies the process for requesting and approving higher reimbursement rates. Its core function is to ensure that providers are adequately compensated for delivering enhanced services, thereby supporting the placement and care of individuals with exceptional needs who might otherwise be difficult to serve.
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AFH-SPECIFIC NEEDS CONTRACT AND EXCEPTIONAL RATES. Specific Needs Contract and Exceptional Rates are outside of the standardized APD- AFH rate structure and have their own distinct rate schedule defined below. Some of the specific needs covered under these contracts include: Ventilator Dependent, Neurological/Neuro-gerontologic, Brain Injury, Behavioral Needs, Bariatric, Complex ADL, Enhanced Care Outreach Services, and Cognitive/Memory Care. Rate Per Month
AFH-SPECIFIC NEEDS CONTRACT AND EXCEPTIONAL RATES. Specific Needs Contract and Exceptional Rates are outside of the standardized APD- AFH rate structure and have their own distinct rate schedule defined below. Some of the specific needs covered under these contracts include: Ventilator Dependent, Neurological/Neuro-gerontologic, Brain Injury, Behavioral Needs, Bariatric, Complex ADL, Enhanced Care Outreach Services, and Cognitive/Memory Care. Target Population Effective February 1, 2016 Effective February 1, 2017 ECOS (currently $2,435) $2,575 $2,640 Basic $5,747 $5,890 Advanced $6,568 $6,732 Ventilator $8,200 $8,418 Complex $8,435 $8,646 No later than April 1, 2016 the State agrees to convene a meeting with the Union and ventilator home providers to explore the possibility of establishing an “Advanced” ventilator home. The Specific Needs such as memory care, bariatric care, brain injuries, complex medical, complex ADL or neurological conditions may fall into the Basic, Advanced or Complex rate categories, depending on care and staffing needs of the Individuals served under that contract. AFHs receiving AFH Specific Needs Contract must comply with the contracted Statement of Work. Rates will only be provided for Individuals living in the AFH who meet the service and eligibility criteria specified in the Statement of Work and approved by APD Central Office. Specific Needs Contracts will require additional staffing, services and ongoing documentation of compliance with the Statement of Work as defined by the State.
AFH-SPECIFIC NEEDS CONTRACT AND EXCEPTIONAL RATES. Specific Needs Contract and Exceptional Rates are outside of the standardized APD- AFH rate structure and have their own distinct rate schedule defined below. Some of the specific needs covered under these contracts include: Ventilator Dependent, Neurological/Neuro-gerontologic, Brain Injury, Behavioral Needs, Bariatric, Complex ADL, Enhanced Care Outreach Services, and Cognitive/Memory Care. Target Population Effective January 1, 2020 Effective July 1, 2020 ECOS (currently $2,435) $3,095 $3,250 Basic $6,907 $7,252 Advanced $7,894 $8,289 Ventilator $9,869 $10,362 Complex $10,138 $10,645 The Specific Needs such as memory care, bariatric care, brain injuries, complex medical, complex ADL or neurological conditions may fall into the Basic, Advanced or Complex rate categories, depending on care and staffing needs of the Individuals served under that contract. AFHs receiving AFH Specific Needs Contracts must comply with the contracted Statement of Work. Rates will only be provided for Individuals living in the AFH who meet the service and eligibility criteria specified in the Statement of Work and approved by APD Central Office. Specific Needs Contracts will require additional staffing, services and ongoing documentation of compliance with the Statement of Work as defined by the State. Specific Needs Provider Compliance Process: By July 1, 2020 the State shall develop a checklist of items that will be reviewed during the routine Contract Compliance Process. Providers shall be notified thirty (30) days in advance of an upcoming compliance process. Providers shall have fifteen (15) business days from initial notification of the compliance process to provide requested documentation. By July 1, 2020 the State shall provide Specific Need Providers access to example forms for use in the SNP homes. If the requirements of the Specific Needs Contracts are not met, Specific Needs Contract may be terminated. Before Specific Needs Contracts are terminated, Providers will have the opportunity to come into compliance with the contract unless the contract violation possesses an imminent risk to the Individual/s in the AFH, as determined by the State. Providers will have no more than sixty (60) days to come into compliance before termination of the Specific Needs Contract. For multiple related occurrences of intentional non-compliance the State may terminate the contract as specified in the Specific Needs Contract. Appropriate transition plans including necessary funding throu...