Joint Initiative from EOHHS and DCYF: Children's Services Rate Setting

EOHHS and DCYF are partnering on an initiative to establish a uniform rate setting approach to congregate care and home- and community-based services offered through the DCYF system of care. The initiative is intended to follow three tenets: 

  • Promote broad access to services,
  • Provider high-quality care, and
  • Ensure the long-term sustainability of services.

The overall goal of the project is to create better alignment between Medicaid and DCYF by transitioning individually contracted rates for DCYF services to uniform service standards by state fiscal year 2025 (July 1, 2025). This initiative is intended to support the provision of high-quality care, promote broad access to services, and ensure the long-term sustainability of congregate care and home- and community-based services for children, youth and families served by DCYF and youth and families seeking behavioral health services. The specific goals of the project are detailed below.

Goal Details
Uniform Service Standards Combine comparable contracted services under common, functional service definitions with defined eligibility rules (e.g., medical necessity standards for Medicaid-eligible services)
Rational Payments Develop a standardized framework for rate methodologies supporting common-sense relationships among service rates (i.e., rates reflect resource intensity including skill/cost of providers and time requirements)
Alignment with Medicaid Ensure service definitions and payment methodologies align with Medicaid requirements, and align DCYF services rates with rates for comparable services, where possible
Transparency Rating assumptions are clear, supported by data, and can support indexed updates in future years; rating framework is understood by stakeholders and captures their input
Stakeholder Engagement Solicit input on how services are provided today and identify areas for improvement, foster trust and collaboration with stakeholders throughout the process 
Prioritize Prevention Identify and prioritize services that prevent movement to higher levels of care and that support children’s individual needs in the least restrictive environment

Direct billing for all Medicaid-eligible DCYF services will begin July 1, 2025. All activities listed below are working towards that date.

Rate setting project timeline

Stakeholder engagement is a key component of the RI Children Services Rate Setting project. It is pivotal to gather input from a variety of sources on service definitions, service delivery costs, and payment rate development. Below outlines a variety of ways EOHHS and DCYF plans to engage with stakeholders. 

  • Ongoing throughout entirety of project: Project specific mailbox at OHHS.RIChildServices@ohhs.ri.gov
  • August 2024: All Provider Kickoff Meeting (hosted August 29, 2024)
  • September 2024: Provider Survey (closed October 7, 2024)
    • Series of three office hours were held to support providers 
    • 1:1 technical assistance meeting upon request 
    • Use of project specific mailbox where providers could ask technical questions and get responses 
  • October-November 2024: Congregate Care and Home and Community Based Workgroups 
  • Winter 2025: All Provider Draft Rate Meeting 

Throughout this project, there will be a series of All Provider meetings. The first one was held on August 29, 2024. Please click below to see material presented during the call. 

All Provider Kickoff meeting deck

Final Rate Report 

This item is forthcoming

FAQs

Frequently asked questions will be collected throughout the project. The FAQ document will be updated on a rolling basis. Please see FAQs to date below.  

Contact us

If you have any questions, concerns, or feedback, please contact us OHHS.RIChildServices@ohhs.ri.gov.