Assist families with Medicaid enrollment and insurance billing within 10 working days

Work with families referred to them to set them up with Medicaid within 10 working days of the first face-to-face meeting with the caregiver; inquire about private insurance within 10 working days; bill private insurance and Medicaid when eligible.

In‑office reimbursement and limited virtual delivery

With CPSS and CFSD Liaison approval, a model intervention may be reimbursed at the in‑office matrix fee schedule if fidelity requirements are maintained. Virtual platforms are permitted only for family visitation on a case‑by‑case basis for extraordinary circumstances.

Payment catalog (matrix fee schedule)

Matrix payment fee schedule and catalog (MATRIX PAYMENT FEE SCHEDULE AND CATALOG) are used to define rates and service entries in this Exhibit.

Provide clinician services in the family's home when specified

Certain clinician‑delivered services must be provided in the family's home as noted for specific programs (e.g., clinician items indicating 'Service from Clinician must be provided in the family's home').

Home delivery required for specified clinician services

Note: clinician services identified in the matrix must be delivered in the family’s home when the program entry specifies in‑home clinician delivery.

Set families up with Medicaid within 10 working days

Work with families referred to them to set them up with Medicaid within 10 working days of the first face‑to‑face meeting with the caregiver.

Billable no‑shows at Exhibit rate

No‑Shows may be billed at the rate specified in this Exhibit (No‑Show/Cancellation payment provisions apply).

Parenting class definitions and no‑show billing (Exhibit H)

Contractor will define parenting class content, fidelity, and requirements in Exhibit H; no‑shows for parenting classes can be billed at the rate laid out in this Exhibit.

Preapproval required for co‑parenting courses (Exhibit H)

Co‑Parenting courses must be preapproved by the Department; the contractor will define the course model and fidelity requirements in Exhibit H.

Billable activities for SafeCare Coach

SafeCare Coach billable time includes pre‑session calls, prep calls with home visitors, review of uploaded sessions, prep for coaching calls, coaching calls, check‑ins with the SafeCare Program Manager, monthly progress logs, and participation in monthly group calls.

• Review uploaded session and provide feedback within 3 business days
• Bill prep and coaching activities (pre‑session, prep call, coaching call, check‑ins, logs)

SafeCare Coach certification and duties

To function as a SafeCare Coach, attend the home visitor workshop and become certified as a home visitor; attend a one‑day coach workshop; complete required role‑plays and quizzes; be provisionally certified and demonstrate proficiency to reach full certification; retain home visitor certification and maintain caseload expectations.

• Attend home visitor workshop and obtain home visitor certification
• Attend one‑day coach workshop and complete role‑plays/quizzes
• Demonstrate proficiency in fidelity monitoring to reach full certification

SafeCare Trainer certification and responsibilities

SafeCare Trainers must complete full certification in SafeCare home visiting and coaching, attend a two‑day trainer workshop, complete required role‑plays and quizzes, be provisionally certified and then demonstrate proficiency to reach full trainer certification; trainers may provide up to three trainings per year as identified by the State.

• Complete full SafeCare home visiting and coaching certification
• Attend two‑day trainer workshop and complete role‑plays/quizzes
• Demonstrate proficiency to reach full trainer certification

Contact NWIC for Wraparound implementation support

Contact the National Wraparound Implementation Center (NWIC) for pre‑implementation materials and implementation support; NWIC provides assessment, tailored implementation plans, workforce development, accountability measures, and technology‑enabled supports.

• Use NWIC resources (assessment, implementation plans, workforce development, virtual supports)

Department approval and required training for Visitation Assessment

Visitation Assessment must be provided and approved by the Department; providers administering the Visitation Assessment must be trained in its administration.

Preapproval required for specified surveys

Adverse Childhood Experience Survey, Healthy Families Parenting Inventory, and Protective Factor Survey must be preapproved by the Department before administration.

Documentation steps required for no‑show/cancellation payment

For no‑show/cancellation payments, the contractor must email CPS and CPSS and follow documentation procedures; if a Resource Family cancels with less than 48 hours' notice, offer virtual service and document refusal.

• Email CPS and CPSS when appointment is cancelled or missed
• Offer virtual service to Resource Family and document if refused

One‑time $21.80 no‑show/cancellation payment

Contractor may receive a one‑time $21.80 payment per family when a scheduled appointment is cancelled or no‑showed if the Exhibit requirements are met.

• $21.80 one‑time charge per family

Email CPS/CPSS (and FRS Supervisor when applicable) for cancelled/missed appointments

Contractor must email CPS and CPSS (and Family Resource Specialist Supervisor when applicable) regarding cancelled or missed appointments.

Offer virtual delivery on late cancellations/no‑shows and document refusal

If a family cancels with less than 48 hours' notice or no‑shows, the contractor must offer the service via a virtual platform and document if the family declines.

Make multi‑modal engagement attempts after missed/cancelled appointments

Contractor must attempt to engage clients by contacting the family using every known form of contact (phone numbers — call/text, email) and send a letter to parents at all known addresses outlining missed services and how to set up the next appointment.

• Contact all known phone numbers (call and text)
• Email all known addresses
• Send outreach letter to parents at all known addresses

CC CPS worker on outreach letter to parents

The outreach letter to parents sent after missed appointments must be cc'd to the CPS worker.

Medicaid setup within 10 working days and notification duties

Work with families referred to them to set them up with Medicaid within 10 working days of the first face‑to‑face meeting with the caregiver, and notify CPS/CPSS regarding cancelled or missed scheduled appointments.

Limit: one no‑show payment per scheduled service

No‑show payment can only be assessed once per scheduled service.

Offer virtual option and notify CPS/CPSS/FRS Supervisor on missed appointments

When appointments are cancelled or missed, contractor must offer virtual service and document if the family declines; email CPS, CPSS, and Family Resource Specialist Supervisor about the cancelled/missed appointment.

No‑show billing limits (per service and monthly cap)

No‑show payment can only be assessed once per scheduled service; contractor may bill up to three times per month per family for parent's no‑shows or cancellations (monthly cap referenced repeatedly).

• No‑show billed only once per scheduled service
• Maximum three no‑show/cancellation billings per family per month

Required client engagement steps after missed/cancelled appointments

Contractor must contact the family by phone/text/email using every known contact and send a letter to all known addresses outlining missed services and how to re‑engage; the letter must be cc'd to the CPS worker.

Actions required on cancellations with less than 48 hours' notice and no‑shows

For short‑notice cancellations (<48 hours) and no‑shows, the contractor will email CPS and CPSS; offer virtual service and document denial if refused; and perform the engagement steps (multi‑modal contact and mailed letter cc'd to CPS).

• Email CPS and CPSS about the cancelled/missed appointment
• Offer virtual service and document refusal
• Perform multi‑modal outreach and send cc'd letter

Billing limits and scheduling suspension after repeated no‑shows

No‑show payment can only be assessed once per scheduled service; contractor may bill up to three times per month per family for parent no‑shows; after three consecutive no‑shows, the contractor will not schedule future appointments until a CPS‑family meeting occurs.

• One no‑show payment per scheduled service
• Max three billings per family per month
• Suspend scheduling after 3 consecutive no‑shows until CPS‑family meeting

Required actions after parent cancellation or no‑show

If the scheduled appointment is cancelled by a parent with less than 48 hours' notice or the parent no‑shows: offer virtual service and document if denied; contact the family using all known methods; send a letter to parents at all known addresses outlining missed services and how to re‑engage (letter must be cc'd to CPS); and email CPS and CPSS regarding the cancelled/missed appointment.

• Offer virtual service and document refusal
• Contact family via phone/text/email
• Send outreach letter to parents (cc CPS)
• Email CPS and CPSS

Actions required after Resource Family cancellation

If a Resource Family cancels with less than 48 hours' notice, offer the service via a virtual platform and document refusal if applicable; email CPS, CPSS, and Family Resource Specialist Supervisor about the cancelled/missed appointment.

• Offer virtual service and document denial
• Email CPS, CPSS, and FRS Supervisor

Suspend scheduling after 3 consecutive no‑shows until CPS‑family meeting

After three consecutive no‑shows the Contractor will not schedule future appointments with the family until a meeting with CPS and the family occurs to create a 30‑day plan; the CPS worker is responsible for setting up that meeting.

Billing limits for no‑shows and late cancellations

No‑show payment can only be assessed once per scheduled service; contractor can bill up to three times per month per family for parent no‑shows or cancellations.

No‑show billing frequency and monthly cap

Contractor may assess a no‑show payment only once per scheduled service; contractor can bill up to three times per month per family for a parent's no‑shows or cancellations.

Scheduling suspension after repeated no‑shows (3 consecutive)

After three consecutive no‑shows, the Contractor will not schedule future appointments with the family until a CPS‑family meeting occurs to engage and make a 30‑day plan; CPS is responsible for scheduling that meeting.

Offer virtual delivery on late cancellations/no‑shows and document refusals

If an appointment is cancelled with less than 48 hours' notice or the parent no‑shows, the contractor must offer virtual delivery and document if the virtual service is denied.

Mandatory notifications and cc'd correspondence on missed/cancelled appointments

Contractor must email CPS, CPSS, and Family Resource Specialist Supervisor regarding cancelled or missed appointments; outreach letters to parents must be cc'd to the CPS worker.

Client engagement requirements after missed appointments (multi‑modal outreach)

After a missed appointment, make every effort to contact the family by call/text to all known phone numbers and by email, and send a mailed outreach letter to all known addresses outlining missed services and next steps.

Email notifications for cancelled or missed appointments

Contractor will email CPS, CPSS, and Family Resource Specialist Supervisor when a scheduled appointment is cancelled or missed.

Offer virtual service and document denial on late cancellations/no‑shows

Contractor will offer to provide the service through a virtual platform when an appointment is cancelled with less than 48 hours' notice or the parent no‑shows, and must document if the family denies the virtual service.

Required client engagement and mailed outreach (cc CPS)

Contractor will attempt contact via all known methods (phone/text/email) and send a letter to all known addresses (which must be cc'd to the CPS worker) outlining missed services and how to re‑engage.

Suspend future scheduling after 3 consecutive no‑shows until CPS meeting

After three consecutive no‑shows, the Contractor will not schedule future appointments with the family until a CPS‑family meeting occurs to develop a 30‑day plan; CPS is responsible for setting up the meeting.

Monthly cap: maximum three no‑show/cancellation billings per family

Contractor can bill a maximum of three times per month per family for parent no‑shows or cancellations.

Required provider actions on cancellation or no‑show

Offer the virtual service option when an appointment is cancelled with less than 48 hours' notice or the family no‑shows and document if the family denies the virtual option; email CPS/CPSS (and FRS Supervisor when specified) and send outreach letter cc'd to CPS; contact the family by all known methods.

• Offer virtual option and document refusal
• Email CPS/CPSS/(FRS Supervisor when applicable)
• Send outreach letter to parents cc'd to CPS
• Contact family by phone/text/email

Do not schedule after 3 consecutive no‑shows until CPS‑family meeting

After three consecutive no‑shows the Contractor will not schedule future appointments with the family until a meeting with CPS and the family occurs; the CPS worker is responsible for setting that meeting.

Billing limits for no‑shows and late cancellations (per service and monthly cap)

No‑show payment can only be assessed once per scheduled service; contractor may bill up to three times per month per family for parent's no‑shows or cancellations provided documentation and outreach requirements are met.

• One no‑show payment per scheduled service
• Maximum three no‑show/cancellation billings per family per month