Finance Systems
Building a systemic approach to financing a statewide system of services is a complex process that includes the identification, understanding, and full utilization of all existing funding resources. The following are examples of ways that states have been successful at forming a framework for a financing system that is based upon a common vision of a community-based, family-centered, and culturally competent foundation of services and supports to meet individual needs.
Framework
A Framework for Developing and Sustaining a Part C Finance System
(2007) 
(PDF: 173kb) summarizes the fiscal challenges that this legislation
presents and proposes a framework for analyzing, adjusting, and maintaining a flexible and self-regulating finance
system to support Part C early intervention services for infants and toddlers and their families. The framework design
features four phases of work to help agencies understand the issues and make informed decisions for on-going
development and support of a Part C finance system.
Medicaid Waiver
A Medicaid waiver is when the Federal Government allows or grants States permission to waive certain Federal
requirements in order to operate a specific kind of program. In general, Federal law allows States to enact two
types of Medicaid waivers – Program waivers and research and demonstration waivers.
- Maryland - House Bill 99
(PDF: 1,110kb) - Services for autistic children and
seriously emotionally disturbed individuals
- Montana -§1915(c) HCB Waiver designed to serve young children aged 15 months through seven years who are diagnosed with Autism Spectrum Disorder and who have deficits in adaptive behaviors (downloaded 6/24/10)
- North Dakota
(PDF: 1,198kb) waiver for case management, homemaker service,
personal care, respite care, habilitation.
- Pennsylvania
(PDF: 420kb)
- CMS Waiver to provide community habilitation, respite, service management, transportation, therapy and visiting nurses, permanency planning service, and physical adaptations.
- Texas - EPSDT Developmental Rehabilitation Services include diagnostic, evaluative and consultative services for the purposes of identifying or determining the nature and extent of, and rehabilitating an individual's medical or other health-related condition.
- Wisconsin
(PDF: 2,058kb) - Payment by Medicaid for eligible children
when use of private insurance is denied by the parent.
Centralized Billing and Reimbursement Systems
Centralized billing and reimbursement systems allow for a centralized pooling of funds to maximize utilization of
multiple fund sources and lowers distribution cost, and eliminates distribution formulas and other grant
contracting difficulties.
- Illinois - Early Intervention - Central Billing Office (CBO)
- Indiana - Overview of the Central Reimbursement Office (CRO)
- Kentucky's Central Billing and Information System - KY provides an electronic billing system for early intervention providers through the data system, TOTS. The system bills Medicaid on behalf of the providers and plans are underway to add an insurance billing feature to the system.
Financial Case Management
As states become increasingly invested in assisting families in all aspects of accessing the system of services,
more states are finding that financial case management is key to successfully paying for a given type or category
of services.
- Indiana's Financial Case Management Tool
(PDF: 116kb)