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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 : Centre
\|Service Name / Level	\|Rate

Behavioral Supports-Level 1-Initial/Ongoing	$22.08 / 15 min.
CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:2 or 1:3	$6.98 / 15 min.
CPS Community 2:1	$24.62 / 15 min.
CPS Community 2:3	$10.43 / 15 min.
CPS Facility 1:1	$12.40 / 15 min.
CPS Facility 1:1 Enhanced	$17.27 / 15 min.
CPS Facility 1:1 Enhcd LPN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd RN	$17.27 / 15 min.
CPS Facility 1:11 to 1:15	$2.96 / 15 min.
CPS Facility 1:2 to 1:3	$6.84 / 15 min.
CPS Facility 1:4 to 1:6	$5.23 / 15 min.
CPS Facility 1:7 to 1:10	$3.18 / 15 min.
CPS Facility 2:1	$23.77 / 15 min.
CPS Facility 2:1 Enhcd	$28.65 / 15 min.
CPS Facility 2:1 Enhcd LPN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd RN	$28.65 / 15 min.
CPS:Community OnCall/Remote Support	$1.64 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$7.95 / 15 min.
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$317.80 / 1 Day
Small Group Employment (Base)-15 min	$2.30 / 15 min.
Small Group Employment (Level 1)-15 min	$3.54 / 15 min.
Transportation(Zone 1)-Trip	$33.83 / Trip
Transportation(Zone 2)-Trip	$60.91 / Trip
Transportation(Zone 3)-Trip	$69.19 / Trip

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

CPS Community 1:2 or 1:3	$6.98 / 15 min.
CPS Community 2:3	$10.43 / 15 min.
CPS Facility 1:1	$12.40 / 15 min.
CPS Facility 1:1 Enhanced	$17.27 / 15 min.
CPS Facility 1:1 Enhcd LPN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd RN	$17.27 / 15 min.
CPS Facility 1:11 to 1:15	$2.96 / 15 min.
CPS Facility 1:2 to 1:3	$6.84 / 15 min.
CPS Facility 1:4 to 1:6	$5.23 / 15 min.
CPS Facility 1:7 to 1:10	$3.18 / 15 min.
CPS Facility 2:1	$23.77 / 15 min.
CPS Facility 2:1 Enhcd	$28.65 / 15 min.
CPS Facility 2:1 Enhcd LPN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd RN	$28.65 / 15 min.
CPS:Community OnCall/Remote Support	$1.64 / 15 min.
Transportation(Zone 2)-Trip	$60.91 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$22.08 / 15 min.
CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:1 Enhcd LPN	$17.83 / 15 min.
CPS Community 1:2 or 1:3	$6.98 / 15 min.
CPS Community 2:1	$24.62 / 15 min.
CPS Community 2:3	$10.43 / 15 min.
CPS Facility 1:1	$12.40 / 15 min.
CPS Facility 1:1 Enhanced	$17.27 / 15 min.
CPS Facility 1:1 Enhcd LPN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd RN	$17.27 / 15 min.
CPS Facility 1:11 to 1:15	$2.96 / 15 min.
CPS Facility 1:2 to 1:3	$6.84 / 15 min.
CPS Facility 1:4 to 1:6	$5.23 / 15 min.
CPS Facility 1:7 to 1:10	$3.18 / 15 min.
CPS Facility 2:1	$23.77 / 15 min.
CPS Facility 2:1 Enhcd	$28.65 / 15 min.
CPS Facility 2:1 Enhcd LPN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd RN	$28.65 / 15 min.
CPS:Community OnCall/Remote Support	$1.64 / 15 min.
Companion Services (Level 1)	$4.42 / 15 min.
Companion Services (Level 2)	$7.71 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$10.28 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$19.83 / 15 min.
Life Sharing-1 Person-Elig-NG 1-by Relative >30Hrs	$171.35 / 1 Day
Life Sharing-1 per-Elig-NG 2-by Relative > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 per-Elig-NG 3-By Relative > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 per-Elig-NG 4-by Relative > 30 Hrs	$355.61 / 1 Day
Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 1-ByRelative> 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 2-By Relative>30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 3-By Relative>30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day
Life Sharing-2 person-Elig-NG 4-by Relative>30 Hrs	$237.16 / 1 Day
Res Hab-1 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-1 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-1 Person-NG 3-Elig	$924.89 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$746.22 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-3 Person-NG 1-Elig	$387.76 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$294.49 / 1 Day
Res Hab-3 Person-NG 2-Elig	$441.87 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$341.21 / 1 Day
Res Hab-3 Person-NG 3-Elig	$514.20 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$440.90 / 1 Day
Res Hab-3 Person-NG 4-Elig	$624.74 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$484.03 / 1 Day
Res Hab-Lic-1 Person-Inelig	$88.34 / 1 Day
Res Hab-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 1 Day
Respite-Base Out-of-Home 24 Hours (Level 1)-Day	Not Set
Respite-Life Sharing-Day (Level 2, 1:2)Out-of-Home	$139.56 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1)Out-of-Home	$245.13 / 1 Day
Respite-Life Sharing-Day (Level 4, 2:1)Out-of-Home	$490.11 / 1 Day
Respite-Life Sharing-Day(Lvl 3,1:1 Enh)Out-of-Home	$416.93 / 1 Day
Respite-Life Sharing-Day(Lvl 4,2:1 Enh)Out-of-Home	$661.90 / 1 Day
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$7.95 / 15 min.
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$317.80 / 1 Day
Small Group Employment (Base)-15 min	$2.30 / 15 min.
Small Group Employment (Level 1)-15 min	$3.54 / 15 min.
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.
Transportation(Zone 1)-Trip	$33.83 / Trip
Transportation(Zone 2)-Trip	$60.91 / Trip
Transportation(Zone 3)-Trip	$69.19 / Trip

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

CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:2 or 1:3	$6.98 / 15 min.
CPS Community 2:1	$24.62 / 15 min.
CPS Community 2:3	$10.43 / 15 min.
CPS Facility 1:1	$12.40 / 15 min.
CPS Facility 1:1 Enhanced	$17.27 / 15 min.
CPS Facility 1:1 Enhcd LPN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd RN	$17.27 / 15 min.
CPS Facility 1:11 to 1:15	$2.96 / 15 min.
CPS Facility 1:2 to 1:3	$6.84 / 15 min.
CPS Facility 1:4 to 1:6	$5.23 / 15 min.
CPS Facility 1:7 to 1:10	$3.18 / 15 min.
CPS Facility 2:1	$23.77 / 15 min.
CPS Facility 2:1 Enhcd	$28.65 / 15 min.
CPS Facility 2:1 Enhcd LPN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd RN	$28.65 / 15 min.
CPS:Community OnCall/Remote Support	$1.64 / 15 min.

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