FY22 First Steps Rate Study Services C2172

The following outlines the four phases of a rate study for the First Steps Program. The overall goal is to provide data to support potential updates to the current rate structure. In identifying rate study options, studies conducted in Indiana (2018), Tennessee (1996), and California (2019), as well as the previous study in Kentucky (2002) were reviewed. A summary of information gathered through these reports in provided in Appendix A. Study staff will participate in Lead Agency meetings to present data as needed to inform rate structure changes as requested. STUDY PHASE 1 – ADMINISTRATIVE DATA REVIEW Based on a review of available tots data, the first study would involve analysis of two years of administrative data (contract period: july 1, 2018 - june 30, 2020) to explore the degree to which service provision differs by provide type to allow for analysis of cost per service. This would include direct service time, general travel, and no-show impact for both offsite and onsite services. Changes in provider contracts effective july 1, 2020 will be taken into consideration. To conduct the exploratory study, copies of the current billing manual, current provider rate schedules, along with access to the following tots data fields would be required. Analysis is dependent on completeness and accuracy of data received. STUDY PHASE 2 – GEOGRAPHICAL INFORMATION SYSTEMS (GIS) In this study option, the overall goal would be to conduct a travel time study to determine impact of travel on direct service provision and service coordination. Based on a sample of providers and TOTS data, GIS technology would be used to determine and visualize time, service and travel patterns for a sample of providers and service coordinators across provider type and POE region across a three to six-month time period. Analysis of extraordinary travel and no-shows would be included to determine the impact on provider and rates. Provider base and service location data would be required to complete this phase, which would run concurrently with Study Phase 1. STUDY PHASE 3 – PROVIDER SURVEY In this study option, the overall goal would be to identify provider costs not captured via TOTS administrative data (e.g., preparation time, training) and would be based on findings and gaps identified in Study Phase 1 and 2. Based on findings, a web-based survey would be sent to providers to gather information. Specific survey items would be created in collaboration with the Lead Agency. STUDY PHASE 4 – STATE RATE SURVEY A comparison of rates with surrounding states would be completed via survey interview with state Part C administrators.