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Cost Plan Budget Rebasing Explained (my understanding) News update Home
REBASING EFFECTIVE 11-23-09..
Basically the legislature passed a law (see below law)
last session that in essence said that the current cost plan budget
expenditures (7-1-08 to 6-30-09) cannot be greater than 105% of last years
budget expenditures (7-1-07 to 6-30-08). But if your current budget
expenditures are no more than 105% of last years budget, then no change is
necessary. “If an individual was not served for the entire previous state fiscal year
or there was any single change in the cost plan amount of more than 5 percent
during the previous state fiscal year, the agency shall set the cost plan amount
at an estimated annualized expenditure amount plus 5 percent.”
So if your last years budget expenditures were say $30,000 but this years approved budget is $35,000, then you will need to reduce your annualized amount down to $31,500 which is 105% of last years budget. This means cutting out $3,500 in this example. Just like in the tier budget cap adjustments, the consumer and possibly family or guardian need to determine what service(s) to reduce. The support coordinator will assist and can even recommend what to reduce but the decision is the consumer / guardian’s.
After reviewing the Notice of Hearing Rights, you may wish to file the Request for Hearing Form if you disagree with the new rebased budget. APD is asking that an amendment to reduce to new rebased budget still be filed but will not be implemented unless you have an unfavorable hearing decision. Rebasing process goes forward even if you have a pending hearing for the tier you were placed in by APD. Support coordinators are being required to turn in rebase budget reductions to APD by 12-8-09 with effective date of 1-1-10.
APD states: "During the 2009 legislative session, the legislature mandated rebasing of cost plans on an annual basis. §393.0661 (3) (f) 11(6) was amended to exempt from rebasing all individuals who have had a significant life change resulting in a cost plan change of five per cent or more. Therefore, no one whose tier was changed with a greater than 5% change in approved cost plan amount will have his or her cost plan rebased. Additionally, any individual who experienced an interruption in a waiver-funded service or services during FY0809 lasting18 days or more will not have their cost plan rebased."
§393.0661 (3) (f) 11(6) : (2009) (6) Effective January 1, 2010, and except as otherwise provided in this section, a client served by the home and community-based services waiver or the family and supported living waiver funded through the agency shall have his or her cost plan adjusted to reflect the amount of expenditures for the previous state fiscal year plus 5 percent if such amount is less than the client's existing cost plan. The agency shall use actual paid claims for services provided during the previous fiscal year that are submitted by October 31 to calculate the revised cost plan amount. If the client was not served for the entire previous state fiscal year or there was any single change in the cost plan amount of more than 5 percent during the previous state fiscal year, the agency shall set the cost plan amount at an estimated annualized expenditure amount plus 5 percent. The agency shall estimate the annualized expenditure amount by calculating the average of monthly expenditures, beginning in the fourth month after the client enrolled, interrupted services are resumed, or the cost plan was changed by more than 5 percent and ending on August 31, 2009, and multiplying the average by 12. In order to determine whether a client was not served for the entire year, the agency shall include any interruption of a waiver-funded service or services lasting at least 18 days. If at least 3 months of actual expenditure data are not available to estimate annualized expenditures, the agency may not rebase a cost plan pursuant to this subsection. The agency may not rebase the cost plan of any client who experiences a significant change in recipient condition or circumstance which results in a change of more than 5 percent to his or her cost plan between July 1 and the date that a rebased cost plan would take effect pursuant to this subsection.