Paying for RBS

1
Paying for RBS

• Developing a Functional Funding Model for a
  Comprehensive Intervention

2
The Four Questions

• What are you buying?
• What is it worth to you?
• What will you pay for it with?
• How will the payments be made?

3
What are you buying?

• Commodities (items)
• Bed days
• Rental assistance
• Parent training class
• Assessments
• Activities (time spent)
• Hours of therapy
• Monthly care coordination
• Hours of family finding

• Processes (performance)
• Resource management
• Family and youth involvement
• Planning
• Flexible service array
• Quality assurance
• Outcomes (results)
• Permanency
• Safety
• Well-being

4
What is it worth to you?

• Item based cost setting
• Set price by contractor estimate
• Set price by resource availability
• Package based cost setting
• Set price by actuarial review
• Set price by market custom
• Set price by available resources
• Negotiated rate
• Set price by civilized haggling

5
What are you using to pay for it?

• Tapping into multiple funding streams
• Child by child blending
• Addition of the eligibility specialist to team
• Program level blending
• Program level braiding
• Finding a primary stream or streams
• Creating a new stream
• New money
• Old money redirected

6
How is it being paid for?

• Invoice per item
• To a single source
• To multiple sources
• Invoice per package
• One for the entire package
• One for each subset in the package
• Upfront payment plus cost reimbursement
• Base payments plus cost reconciliation
• Incentivized payments
• The sooner it happens the more you make
• Payment per milestone
• The longer you take the less you make

7
An Emerging Question

• Can we create a prototype RCL alternative that is
  driven by quality points rather than quantity
  points?
• If there was an RCL RBS option what would it
  include and how would the assessment be
  conducted?
• Keeping in mind that federal AFDC-FC payments can
  only be claimed for the costs of board and care
• Would this alternative operate analogously to SB
  163?