Paying for RBS

Developing a Functional Funding Model for a Comprehensive

Intervention

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?

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

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

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

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

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?