Pennsylvania Code & Bulletin

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 53 Pa.B. 6142 (September 30, 2023).

55 Pa. Code § 6100.711. Fee for the ineligible portion of residential service.


§ 6100.711. Fee for the ineligible portion of residential service.

 (a)  The Department will establish a fee for the ineligible portion of payment for residential services.

 (b)  The fee in subsection (a) will be based on the factors in subsection (c) using a market-based approach so that payments are consistent with efficiency, economy and quality of care and sufficient to enlist enough providers so that services are available to at least the extent that such services are available to the general population in the geographic area.

 (c)  In establishing the fee in subsection (a), the Department will examine and use data relating to the following factors:

   (1)  Occupancy. Occupancy is the cost related to occupying a space, including rent, taxes, insurance, depreciation and amortization expenses.

   (2)  Meals for staff persons.

   (3)  Custodial and maintenance expenses.

   (4)  Geographic costs based on the location where the service is delivered.

   (5)  Other factors that impact costs.

 (d)  The Department will update the data used in subsection (c) at least every 3 years.

 (e)  The Department will publish a description of its fee setting methodology used in subsection (b) as a notice in the Pennsylvania Bulletin for public review and comment. The description will include a discussion of the use of the factors in subsection (c) to establish the fee; a discussion of the data and data sources used; and the fee.

 (f)  The Department will make available to the public a summary of the public comments received in response to the notice in subsection (e) and the Department’s response to the public comments.

Cross References

   This section cited in 55 Pa. Code §  6100.802 (relating to support coordination, targeted support management and base-funding support coordination); and 55 Pa. Code §  6100.803 (relating to organized health care delivery system).

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