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Provider Demographic Information - FUTURES COMMUNITY SUPPORT SERVICES INC

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	FUTURES COMMUNITY SUPPORT SERVICES INC
Address:	23 MAIN ST TOWANDA, PA 18848-1803
Phone:	(570) 265-3800
Fax:	(570) 265-8271
E-mail:	rrickert@fcssonline.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


Type:	Regional/Field Office	Counties Served:
Name:	FUTURES COMMUNITY SUPPORT SERVICES
Address:	23 Main Street towanda, PA 18848-1803
Phone:	(570) 265-3800

Type:	Regional/Field Office			Counties Served:
Name:	FUTURES COMMUNITY SUPPORT SERVICES
Address:	23 MAIN ST TOWANDA, PA 18848-1803
Phone:	(570) 265-3800

Type:	Regional/Field Office	Counties Served:	Bradford, Sullivan
Name:	FUTURES COMMUNITY SUPPORT SERVICES
Address:	23 MAIN ST TOWANDA, PA 18848-1803
Phone:	(570) 265-3800

Type:	Regional/Field Office			Counties Served:
Name:	Futures Community Support Services
Address:	23 MAIN ST TOWANDA, PA 18848-1803
Phone:	(570) 265-3800

Type:	Regional/Field Office	Counties Served:
Name:	Futures Community Support Services Inc
Address:	23 MAIN ST TOWANDA, PA 18848-1803
Phone:	(570) 265-3800

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PROVIDER SERVICES AND RATES Supporting line for group header


County : Bradford/Sullivan
\|Service Name / Level	\|Rate

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
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: Community OnCall/Remote Support	$1.77 / 15 min.
Chore, Permanent - 1 Hour	$24.55 / 1 hr.
Chore, Temporary - 1 Hour	$24.55 / 1 hr.
Companion Services (Basic Staff Support)	$3.45 / 15 min.
Companion Services (Level 1)	$4.77 / 15 min.
Companion Services (Level 2)	$8.33 / 15 min.
Family Aide (Base) - 15 Minutes	Not Set
Family Aide (Level 1) - 15 Minutes	Not Set
Family Aide (Level 2) - 15 Minutes	Not Set
Family Aide (Level 3 Enh)-15 Mins-TE	Not Set
Family Aide (Level 3)-15 Mins	Not Set
Homemaker, Permanent - 1 Hour	$24.55 / 1 hr.
Homemaker, Temporary - 1 Hour	$24.55 / 1 hr.
Housing Transition/Tenancy Sustaining services	$21.86 / 15 min.
In-Home & Commnty Supprts (Basic)	$4.42 / 15 min.
In-Home & Commnty Supprts (Lvl 1)	$6.22 / 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-Elig-Unlic < 30 Hrs	$156.49 / 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	$181.63 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$216.55 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$296.35 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$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 per-Elig-Unlic < 30 Hrs	$111.44 / 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	$128.04 / 1 Day
Life Sharing-2 person-NG 2 > 30 Hrs WithDay	$153.53 / 1 Day
Life Sharing-2 person-NG 3 > 30 Hrs WithDay	$208.88 / 1 Day
Life Sharing-2 person-NG 4 > 30 Hrs WithDay	$251.39 / 1 Day
Life Sharing-2 person-NG5 > 30 Hrs WithDay	$251.39 / 1 Day
Life Sharing-Med. Complex-1 Person-By Relative-NG4	$462.10 / 1 Day
Life Sharing-Med. Complex-1 Person-By Relative-NG5	$462.10 / 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-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-4 Person-NG 1-Elig-w/Day Supports	$245.99 / 1 Day
Res Hab-4 Person-NG 2-Elig-w/Day Supports	$284.31 / 1 Day
Res Hab-4 Person-NG 3-Elig-w/Day Supports	$362.42 / 1 Day
Res Hab-4 Person-NG 4-Elig-w/Day Supports	$398.69 / 1 Day
Res Hab-4 Person-NG5-Elig-w/Day Supports	$642.84 / 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
Res Hab-Lic-4 Person-Elig-NG 1	$322.49 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 2	$367.82 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 3	$425.56 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 4	$510.56 / 1 Day
Res Hab-Lic-4 Person-Elig-NG5	$766.28 / 1 Day
Res Hab-Lic-4 Person-Inelig	$27.15 / 1 Day
Respite, Base-Emerg Licen 6400 24 Hrs Basic-U2	Not Set
Respite, Base-Emerg Licen 6400 24 Hrs Lvl 1-U2	Not Set
Respite, Base-Emerg Licen 6400 24 Hrs Lvl 2-U2	Not Set
Respite-Base Out-of-Home 24 Hours (Basic)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 1)-Day	$317.80 - $355.94 / 1 Day
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3)	Not Set
Respite-Lic-Day-1 person-NG 3	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 4	$987.25 / 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 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-4 person-NG 1	$295.27 / 1 Day
Respite-Lic-Day-4 person-NG 1-Emergency	$295.27 / 1 Day
Respite-Lic-Day-4 person-NG 2	$333.59 / 1 Day
Respite-Lic-Day-4 person-NG 2-Emergency	$333.59 / 1 Day
Respite-Lic-Day-4 person-NG 3	$411.70 / 1 Day
Respite-Lic-Day-4 person-NG 3-Emergency	$411.70 / 1 Day
Respite-Lic-Day-4 person-NG 4	$447.97 / 1 Day
Respite-Lic-Day-4 person-NG 4-Emergency	$447.97 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 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-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) Out-of-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)Out-of-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$8.59 / 15 min.
Respite-Unlic-Day (Basic 1:4) Out-of-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) Out-of-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.
Supported Living-1 Person-NG1	$160.19 / 1 Day
Supported Living-1 Person-NG2	$268.46 / 1 Day
Supported Living-1 Person-NG3	$428.64 / 1 Day
Supported Living-1 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day

County : Lackawanna/Susquehanna
\|Service Name / Level	\|Rate

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-4 Person-NG 3-Elig-w/Day Supports	$362.42 / 1 Day
Res Hab-4 Person-NG 4-Elig-w/Day Supports	$398.69 / 1 Day
Res Hab-Lic-3 Person-Inelig	$35.47 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 1	$322.49 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 2	$367.82 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 3	$425.56 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 4	$510.56 / 1 Day
Res Hab-Lic-4 Person-Inelig	$27.15 / 1 Day
Res Hab-Lic-5-8 Person-Inelig	$18.93 / 1 Day

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

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-3 Person-Inelig	$35.47 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 4	$510.56 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.

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

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-Med. Complex-1 Person-By Relative-NG4	$462.10 / 1 Day
Life Sharing-Med. Complex-1 Person-By Relative-NG5	$462.10 / 1 Day

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Life Sharing (Base Only)	Not Set
Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$181.63 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$216.55 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$296.35 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$376.95 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs WithOut	$182.70 / 1 Day
Life Sharing-2 person-NG 1 > 30 Hrs WithDay	$128.04 / 1 Day
Life Sharing-2 person-NG 2 > 30 Hrs WithDay	$153.53 / 1 Day
Life Sharing-2 person-NG 3 > 30 Hrs WithDay	$208.88 / 1 Day
Life Sharing-2 person-NG 4 > 30 Hrs WithDay	$251.39 / 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-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-4 Person-NG 4-Elig-w/Day Supports	$398.69 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Res Hab-Lic-3 Person-Inelig	$35.47 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 4	$510.56 / 1 Day
Res Hab-Lic-4 Person-Inelig	$27.15 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

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