Proposition 56 Supplemental Payment for Intermediate Care Facilities for Developmentally Disabled
Overview
This program provides supplemental reimbursement for eligible Intermediate Care Facilities for the Developmentally Disabled (ICF/DD) facilities, including ICF/DD-Habilitative and ICF/DD-Nursing facilities services. The supplemental reimbursement is a fixed amount and provided in addition to the base per diem rates for these services.
Methodology
The supplemental payment amounts are fixed amounts that were calculated based on the difference between the RY 2008-09 frozen rate at the 65th percentile increased by 3.7%, and the 2017-18 unfrozen rate.
ICF/DD Supplemental Payment Per Diem Amounts
Facility Peer Group |
LTC Accommodation Code
(Regular Services) |
Behold Accommodation Code |
Supplemental Payment
Per Diem |
|---|
ICF/DD |
41 (1-59 beds) |
43 |
$15.47 |
ICF/DD |
41 (60+ beds) |
43 |
$0.00 |
ICF/DD-H |
61 (4-6 beds) |
63 |
$10.75 |
ICF/DD-H |
65 (7-15 beds) |
68 |
$0.00 |
ICF/DD-N |
62 (4-6 beds) |
64 |
$12.47 |
ICF/DD-N |
66 (7-15 beds) |
69 |
$22.30 |
Note that facilities in peer groups in which the unfrozen 2017-18 65th percentile rate is lower than the current reimbursement rate will not receive the supplemental payment. State-owned ICF/DD facilities are not eligible to receive the supplement payment.
The Centers for Medicare & Medicaid Services (CMS) approved State Plan Amendment 19-0022, which authorizes the continuation of this supplemental payment program for eligible services, effective August 1, 2019 through December 31, 2021.
1915(c) HCBS Waiver Rate Update
CMS approved an amendment to the 1915(c) Home and Community-Based Alternatives (HCBA) Waiver updating the reimbursement rates for the services identified below, effective July 1, 2018.
ICF DD-CNC Supplemental Payments
| Produce Code | Provider Type | Supplemental Amount |
| T2033 U8 (Non-Vent) | CLHF (59) | $35.58 |
| T2033 U9 (Vent) | CLHF (59) | $39.32 |
