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DDS Adult Long Term Residential (ALTR) Services 2021

The Department of Developmental Services (DDS), in collaboration with the Executive Office of Health and Human Services (EOHHS), reviewed the pricing methodology of Adult Long-Term Residential (ALTR) services and developed a new and simplified rate structure effective January 1, 2021.

The new ALTR rate structure transitions from the “per person, per day” to a “per site, per day” approach. Notably, the new ALTR rate structure:

  • Was developed in partnership with the EOHHS Workforce Initiative using Federal Bureau of Labor Statistics salary data to standardize staff salaries that are incorporated into the new ALTR rate models.
  • Prioritized Direct Care Support Professional staff salaries with a 6-11% increase (Note: Salaries are for modeling purposes only and private providers ultimately determine wages for position types).
  • Promotes rate standardization and administrative simplification across the ALTR system.
  • Reduces the number of available rates by approximately 50%, from 356 to 189.
  • Results in an overall 10+% rate increase to private providers operating Basic or Intermediate homes.

The DDS residential service system is one of the Department’s most important, complex, and resource-intensive rate-regulated services. In FY20, DDS expended nearly $2 billion on ALTR and Acquired Brain Injury (ABI) services and supports.

The community-based residential system (ALTR and ABI) is operated by approximately 100 private providers with over 2,200 group homes located throughout the Commonwealth. These group homes are ably staffed by approximately 15,000 Direct Care Support Professionals who serve nearly 8,000 individuals with intellectual and developmental disabilities or acquired brain injuries.

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