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Provider Demographic Information - CLINTON COUNTY COMMUNITY CONNECTIONS INC

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	CLINTON COUNTY COMMUNITY CONNECTIONS INC
Address:	10 N WASHINGTON ST LOCK HAVEN, PA 17745-3550
Phone:	(570) 748-9006
E-mail:	smoore@ccccservices.org
Web Site:	N/A

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PROVIDER CERTIFICATION INFORMATION Supporting line for group header

Click here to view Provider Certification Information

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PROVIDER'S PARENT/ REGIONAL OFFICE Supporting line for group header

No parent or regional addresses are listed for this provider.

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PROVIDER SERVICES AND RATES Supporting line for group header


County : Carbon/Monroe/Pike
\|Service Name / Level	\|Rate

Res Hab-1 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-1 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-1 Person-NG 3-Elig	$980.38 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$790.99 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,185.86 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$871.56 / 1 Day
Res Hab-2 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-2 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-Lic-1 Person-Inelig	$93.64 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

County : Centre
\|Service Name / Level	\|Rate

CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
Life Sharing-1 Person-Elig-NG 1-by Relative >30Hrs	$181.63 / 1 Day
Life Sharing-1 Person-NG1-Relative >30Hrs WithOut	$200.90 / 1 Day
Life Sharing-1 per-Elig-NG 2-by Relative > 30 Hrs	$216.55 / 1 Day
Life Sharing-1 per-Elig-NG 3-By Relative > 30 Hrs	$296.35 / 1 Day
Life Sharing-1 per-Elig-NG 4-by Relative > 30 Hrs	$376.95 / 1 Day
Life Sharing-1 per-NG2-Relative >30Hrs WithOut	$230.47 / 1 Day
Life Sharing-1 per-NG3-Relative >30Hrs WithOut	$325.99 / 1 Day
Life Sharing-1 per-NG4-Relative > 30 Hrs WithOut	$414.65 / 1 Day
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$8.59 / 15 min.
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day
Small Group Employment (Base)-15 min	$2.48 / 15 min.
Small Group Employment (Level 1)-15 min	$3.82 / 15 min.
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

County : Columbia/Montour/Snyder/Union
\|Service Name / Level	\|Rate

CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.

County : Lancaster
\|Service Name / Level	\|Rate

CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
Transportation(Zone 2)-Trip	$65.78 / Trip

County : Lycoming/Clinton
\|Service Name / Level	\|Rate

CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:1 Enhcd LPN	$19.26 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
Companion Services (Level 1)	$4.77 / 15 min.
Companion Services (Level 2)	$8.33 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
Life Sharing-1 Person-Elig-NG 1-by Relative >30Hrs	$181.63 / 1 Day
Life Sharing-1 Person-NG1-Relative >30Hrs WithOut	$200.90 / 1 Day
Life Sharing-1 per-Elig-NG 2-by Relative > 30 Hrs	$216.55 / 1 Day
Life Sharing-1 per-Elig-NG 3-By Relative > 30 Hrs	$296.35 / 1 Day
Life Sharing-1 per-Elig-NG 4-by Relative > 30 Hrs	$376.95 / 1 Day
Life Sharing-1 per-Elig-NG5-by Relative > 30 Hrs	$376.95 / 1 Day
Life Sharing-1 per-NG2-Relative >30Hrs WithOut	$230.47 / 1 Day
Life Sharing-1 per-NG3-Relative >30Hrs WithOut	$325.99 / 1 Day
Life Sharing-1 per-NG4-Relative > 30 Hrs WithOut	$414.65 / 1 Day
Life Sharing-1 per-NG5-Relative > 30 Hrs WithOut	$414.65 / 1 Day
Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 - $181.63 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 - $216.55 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 - $296.35 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 - $376.95 / 1 Day
Life Sharing-1 person-Elig-NG5 > 30 Hrs	$376.95 / 1 Day
Life Sharing-1 person-NG1 > 30 Hrs WithOut	$200.90 / 1 Day
Life Sharing-1 person-NG2 > 30 Hrs WithOut	$230.47 / 1 Day
Life Sharing-1 person-NG3 > 30 Hrs WithOut	$325.99 / 1 Day
Life Sharing-1 person-NG4 > 30 Hrs WithOut	$414.65 / 1 Day
Life Sharing-1 person-NG5 > 30 Hrs WithOut	$414.65 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs WithOut	$160.45 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs WithOut	$182.70 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs WithOut	$230.61 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs WithOut	$271.93 / 1 Day
Life Sharing-2 person-Elig-NG5 > 30 Hrs WithOut	$271.93 / 1 Day
Life Sharing-2 person-NG 1 > 30 Hrs WithDay	$120.79 - $128.04 / 1 Day
Life Sharing-2 person-NG 2 > 30 Hrs WithDay	$144.84 - $153.53 / 1 Day
Life Sharing-2 person-NG 3 > 30 Hrs WithDay	$197.06 - $208.88 / 1 Day
Life Sharing-2 person-NG 4 > 30 Hrs WithDay	$237.16 - $251.39 / 1 Day
Life Sharing-2 person-NG1-Relative> 30 Hrs WithDay	$128.04 / 1 Day
Life Sharing-2 person-NG2-Relative>30 Hrs WithDay	$153.53 / 1 Day
Life Sharing-2 person-NG3-Relative>30 Hrs WithDay	$208.88 / 1 Day
Life Sharing-2 person-NG4-Relative>30 Hrs WithDay	$251.39 / 1 Day
Life Sharing-2 person-NG5 > 30 Hrs WithDay	$251.39 / 1 Day
Life Sharing-2 person-NG5-Relative>30 Hrs WithDay	$251.39 / 1 Day
Res Hab-1 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-1 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-1 Person-NG 3-Elig	$980.38 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$790.99 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,185.86 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$871.56 / 1 Day
Res Hab-1 Person-NG5-Elig	$1,754.51 / 1 Day
Res Hab-1 Person-NG5-Elig-w/Day Supports	$1,341.85 / 1 Day
Res Hab-2 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-2 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-Lic-1 Person-Inelig	$93.64 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Res Hab-Lic-3 Person-Inelig	$35.47 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2)Out-of-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1)Out-of-Home	$343.22 / 1 Day
Respite-Life Sharing-Day (Level 4, 2:1)Out-of-Home	$681.46 / 1 Day
Respite-Life Sharing-Day(Lvl 3,1:1 Enh)Out-of-Home	$531.24 / 1 Day
Respite-Life Sharing-Day(Lvl 4,2:1 Enh)Out-of-Home	$869.48 / 1 Day
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$8.59 / 15 min.
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day
Small Group Employment (Base)-15 min	$2.48 / 15 min.
Small Group Employment (Level 1)-15 min	$3.82 / 15 min.
Supplemental Habilitation 1:1 - 15 min	$5.77 - $6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 - $12.22 / 15 min.
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

County : Northumberland
\|Service Name / Level	\|Rate

CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.

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