Rates for Certain Youth and Young Adult Support Services

Final Adoption Date Published in Mass. Register: December 5, 2025

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 427.00: RATES FOR CERTAIN YOUTH AND YOUNG ADULT SUPPORT SERVICES

Section

427.01: General Provisions 427.02: Definitions 427.03: Rate Provisions 427.04: Filing and Reporting Requirements 427.05: Severability

427.01: General Provisions

(1) Scope. .00 governs the payment rates for certain youth and young adult support services purchased by a governmental unit, including the Department of Children and Families, the Department of Mental Health, and the Department of Public Health.

(2) Applicable Dates of Service. Rates contained in .00 apply for dates of service provided on or after July 1, 2025.

(3) Disclaimer of Authorization of Services. .00 is neither authorization for nor approval of the services for which rates are determined pursuant to .00. Governmental units that purchase the services described in .00 are responsible for the definition, authorization, and approval of services extended to clients.

(4) Administrative Bulletins. EOHHS may issue administrative bulletins to clarify its policy on substantive provisions of .00.

427.02: Definitions

As used in .00, unless the context requires otherwise, terms have the meanings in .02.

Alternative School Engagement (ASE). Supports the delivery of alternative school programming in non-traditional school settings.

Alternative to Lock-up Program. This program provides non-secure alternatives to lock-up for juveniles in police custody to comply with federal and state regulations regarding the placement of juveniles in their custody for either status or non-violent delinquent offenses.

Client. An individual that receives certain youth and young adult support services purchased by a governmental unit.

Conflict of Interest Services. The provision of case management services to families in need of protective services when a potential conflict of interest may exist with the Department of Children and Families.

Contact Hour. An hour spent engaging with young people in Teen Pregnancy Prevention Youth Development activities.

1

Final Adoption Date Published in Mass. Register: December 5, 2025

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR CERTAIN YOUTH AND YOUNG ADULT SUPPORT SERVICES

Cost Report. The document used to report costs and other financial and statistical data. The Uniform Financial Statements and Independent Auditor's Report (UFR) is used when required.

Curriculum Hour. An hour spent delivering Teen Pregnancy Prevention evidence-based or evidence- informed sexuality programming to young people in a school setting or outside a school setting.

EOHHS. The Executive Office of Health and Human Services established under M.G.L. c. 6A.

Extraordinary Circumstances/Flex Funding. A method whereby, subject to availability, a purchasing governmental unit may provide resource allocations to a client and/or provider across the state. Flexible funding may be provided through a number of means including, but not limited to, reimbursement to client for specific support services or funds directed to a qualified provider for extraordinary circumstances.

Governmental Unit. The Commonwealth, any board, commission, department, division, or agency of the Commonwealth and any political subdivision of the Commonwealth.

Individual Consideration (IC). Payment rates for certain services are designated as individual consideration (IC). Where IC rates are designated, the purchasing governmental unit will determine the appropriate payment as the actual cost of the item or service as evidenced by invoice, published tuition amount, or other price reasonably obtained by a competitive market for the product or service.

Parent/Caregiver Engagement. Supports the involvement of parents/caregivers into ASE programming with workshops for parents prior to, during, and sometimes after programming to answer parent questions about curriculum content and programming.

Provider. Any individual, group, partnership, trust, corporation, or other legal entity that offers services for purchase by a governmental unit and that meets the conditions of purchase or licensure that have been or may be adopted by a purchasing governmental unit.

Reporting Year. The provider's fiscal year for which costs incurred are reported to the Operational Services Division on the Uniform Financial Statements and Independent Auditor's Report (UFR).

Teen Pregnancy Prevention Program. The teen pregnancy prevention programs deliver evidence- based or evidence-informed sexuality education programming to youth and young adults, with fidelity to the original program model. All teen pregnancy prevention programs use a positive youth development model that focuses on youth assets; some programs may choose to add additional positive youth development activities. Teen pregnancy prevention programs may be delivered in a virtual setting, school setting, or outside of the school setting.

Teen Pregnancy Prevention Partnership Development. Partnership development services focus on developing and maintaining relationships with community-based organizations and schools to support the delivery of Adolescent Sexuality Educational services including, but not limited to, coalition meetings and local advisory meetings focused on adolescents.

2

Final Adoption Date Published in Mass. Register: December 5, 2025

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR CERTAIN YOUTH AND YOUNG ADULT SUPPORT SERVICES

Teen Pregnancy Prevention Youth Development. The Teen Pregnancy Prevention Youth Development model focuses on young people as resources and emphasizes caring relationships between youth and trustworthy adults. Youth development activities can enhance the success of adolescent sexuality education curriculum delivery by supporting the growth and development of the whole young person. Youth development may include, but is not limited to, the following strategies, delivered in addition to teen pregnancy prevention curricula: peer leadership models, youth summits/retreats, education/employment supports, and youth advisory councils.

Therapeutic Day Services. Therapeutic Day Services are voluntary, structured, therapeutic group programs for children and/or adolescents who have serious emotional disturbance or mental illness. Therapeutic Day Services are available to children and adolescents who require interventions beyond what the school, family, and traditional outpatient or recreational services can provide.

Young Parents Support (YPS) Program. YPS provides intensive counseling, case management, and other services to parents at the highest risk of abuse or neglect. Young Parents Support program supports clients 14 through 23 years old who are typically referred to the program because they are not eligible for other teen parent programs. YPS enables their clients to meet their responsibilities as parents, students, and employees.

427.03: Rate Provisions

(1) Services Included in the Rate. The approved rate includes payment for all care and services that are part of the program of services of an eligible provider, as explicitly set forth in the terms of the purchase agreement between the eligible provider and the purchasing governmental unit(s).

(2) Reimbursement as Full Payment. Each eligible provider must, as a condition of acceptance of payment made by any purchasing governmental units for services rendered, accept the approved program rate as full payment and discharge of all obligations for the services rendered. Payment from any other source will be used to offset the amount of the purchasing governmental unit's obligation for services rendered to the publicly assisted client.

(3) Payment Limitations. No purchasing governmental unit may pay less than or more than the approved program rate.

(4) Administrative Adjustment for Extraordinary Circumstances. A method whereby, subject to availability of funds, a purchasing governmental unit may provide additional resource allocations to a qualified provider in response to unusual and unforeseen circumstances that substantially increase the cost of service delivery in ways not contemplated in the development of current rates. It must be demonstrated that such cost increases gravely threaten the stability of service provision such that client or consumer access to necessary services is at risk. The purchasing governmental unit will evaluate the need for the administrative adjustment, determine whether funding is available, and convey that information to EOHHS for review to determine the amount of any adjustment.

(5) Approved Rates. The approved rate is the lower of the provider’s charge or amount accepted as payment from another payer or the rate listed in .03.

3

Final Adoption Date Published in Mass. Register: December 5, 2025

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR CERTAIN YOUTH AND YOUNG ADULT SUPPORT SERVICES

Service Model Unit of Service Rate A Month $13,981 Alternative to Lock-up Program B Month $24,117 C Month $30,759 1 Family Month $1,380 Conflict of Interest Services 5 Families Month $6,868 Extraordinary Circumstances/Flex Funding N/A N/A IC In school Curriculum Hour $422.64 Teen Pregnancy Prevention Program Outside school Curriculum Hour $528.31 Remote Add-on Hour $105.66 Alternative School Engagement N/A Hour $493.07 Parent/Caregiver Engagement N/A Hour $67.54 Peer Leadership & Youth Development N/A Contact Hour $316.98 Partnership Development N/A Hour $59.71 Model 1 Month $35,713 Model 2 Month $30,554 Model 3A Month $33,048 Therapeutic Day Services Model 3B Month $44,792 Model 4A Month $25,797 Model 4B Month $48,551 A Month $9,953 Young Parent Support Program (YPS) B Month $19,906 YPS Specialty Direct Care III Add-on (.5 A Month $3,023 FTE) YPS Specialty Direct Care III Add-on (1 B Month $6,045 FTE)

Add-on Staff for Teen Pregnancy Prevention Program Title Unit of Service Rate Direct Care Hourly $26.83 Direct Care III Hourly $34.88

Add-on Staff for Therapeutic Day Services Title Unit of Service .25 FTE .5 FTE .75 FTE 1 FTE Clinical (LICSW) Monthly $2,248 $4,497 $6,745 $8,994 Peer/Direct Care Monthly $1,163 $2,325 $3,488 $4,650 Direct Care III Monthly $1,511 $3,023 $4,534 $6,045

4

Final Adoption Date Published in Mass. Register: December 5, 2025

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR CERTAIN YOUTH AND YOUNG ADULT SUPPORT SERVICES

427.04: Filing and Reporting Requirements

(1) General Provisions. (a) Accurate Data. All reports, schedules, additional information, books, and records that are filed or made available to EOHHS must be certified under pains and penalties of perjury as true, correct, and accurate by the executive director or chief financial officer of the provider. (b) Examination of Records. Each provider must make available to EOHHS or the purchasing governmental unit upon request all records relating to its reported costs, including costs of any entity related by common ownership or control.

(2) Required Reports. Each provider must file (a) an annual Uniform Financial Statements and Independent Auditor's Report completed in accordance with the filing requirements of 808 CMR 1.00: Compliance, Reporting and Auditing for Human and Social Services; (b) any cost report supplemental schedule as issued by EOHHS; and (c) any additional information requested by EOHHS within 21 days of a written request.

(3) Penalty for Noncompliance. The purchasing governmental unit may impose a penalty in the amount of up to 15% of its payments to any provider that fails to submit required information. The purchasing governmental unit will notify the provider in advance of its intention to impose a penalty under .04(3).

427.05: Severability

The provisions of .00 are severable. If any provision of .00 or application of any provision to an applicable individual, entity, or circumstance is held invalid or unconstitutional, that holding will not be construed to affect the validity or constitutionality of any remaining provisions of .00 or application of those provisions to applicable individuals, entities, or circumstances.

REGULATORY AUTHORITY

.00: M.G.L. c. 118E.

5