California Code of Regulations › Title 17 - Public Health › Division 2 - Health and Welfare Agency-Department of Developmental Services Regulations › Chapter 3 - Community Services › Subchapter 2 - Vendorization › Article 2 - Vendorization Process › Section 54302 - Definitions

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Except as
					 provided in subsection (b) below, the following definitions shall apply to the
					 language contained in Sections
					 54310 through
					 54390 of these regulations:
(1) "Accreditation" means a formal
					 determination and recognition by CARF that a Work Activity or Supported
					 Employment Program is in compliance with the service delivery standards CARF
					 has established for the program.
(2) "Activity Center" means a community-based
					 day program that serves adults who generally have acquired most basic self-care
					 skills, have some ability to interact with others, are able to make their needs
					 known, and respond to instructions. Activity center programs focus on the
					 development and maintenance of the functional skills required for
					 self-advocacy, community integration and employment;
(3) "Adult" means a person 18 years of age or
					 older;
(4) "Adult Day Health Care
					 Program" means an Adult Day Health Care Program as defined in Health and Safety
					 Code Section
					 1570.7(a);
(5) "Adult Day Programs" means those
					 community-based day programs defined in (a)(1), above and (a)(6), (11), (13),
					 (31), and (60) below;
(6) "Adult
					 Day Services" means the broad category of nonresidential services under which
					 adult day programs are categorized;
(7) "Adult Development Center" means a
					 community-based day program that serves adults who are in the process of
					 acquiring self-help skills. Individuals who attend adult development centers
					 generally need sustained support and direction in developing the ability to
					 interact with others, to make their needs known, and to respond to
					 instructions. Adult development center programs focus on the development and
					 maintenance of the functional skills required for self-advocacy, community
					 integration, employment, and self-care;
(8) "Age Appropriate" means the consideration
					 of the chronological age of the person in the use of activities, instructional
					 locations, and techniques;
(9)
					 "Applicant" means an individual, partnership, group, association, corporation,
					 nonprofit organization, institution, or entity, and the officers, directors,
					 boards of directors, owners, managing employees or agents thereof, that apply
					 to the regional center to become a vendor;
(10) "Authorized Agency Representative" means
					 a person authorized to act on behalf of either the Department or the regional
					 center, by law, by court order, or by a written statement signed by the
					 Director of the Department or the regional center director,
					 respectively;
(11) "Authorized
					 Consumer Representative" means the parent or guardian of a minor, conservator
					 of an adult, or person who is legally entitled to act on behalf of the
					 consumer;
(12) "Behavior Management
					 Program" means a community-based day program that serves adults with severe
					 behavior disorders and/or dual diagnosis who, because of their behavior
					 problems, are not eligible for or acceptable in any other community-based day
					 program;
(13) "CARF" means The
					 Rehabilitation Accreditation Commission, as referenced in Welfare and
					 Institutions Code, Section
					 4851.
(14) "Certification" means a certification
					 determination completed by the Department of Rehabilitation.
(15) "Child" means a person under the age of
					 18 years;
(16) "Community-based Day
					 Programs" means those programs which provide services to individuals on an
					 hourly or daily basis, but less than a 24-hour basis in the community rather
					 than at a developmental center. Only the following types of services are
					 community-based day programs: activity centers, adult development centers,
					 behavior management programs, independent living programs, infant developmental
					 programs and social recreation programs;
(17) "Community Integration" means presence,
					 participation and interaction in natural environments;
(18) "Congregate Living Health Facility"
					 means a Congregate Living Health Facility as defined in Health and Safety Code
					 Section
					 1250(i)(1);
(19) "Consumer" means an individual who has
					 been determined by a regional center to meet the eligibility criteria of the
					 Welfare and Institutions Code, Section
					 4512,
					 and of Title 17, Sections
					 54000,
					 54001 and
					 54010, and for whom the regional
					 center has accepted responsibility;
(20) "Controlling Agency" means any agency,
					 department, or commission that by statute requires standards to be met for the
					 issuance of a license, credential, registration, certificate or permit required
					 for the operation or provision of service;
(21) "Days" means calendar days unless
					 otherwise stated;
(22) "Department"
					 means the Department of Developmental Services;
(23) "Developmental Center" means any
					 institution referred to in the Welfare and Institutions Code, Section
					 4440.
					 Developmental Center is synonymous with state hospital;
(24) "DHS" means the Department of Health
					 Services;
(25) "DSS" means the
					 Department of Social Services;
(26)
					 "Direct Care Staff" means staff who personally provide direct services to
					 consumers. Personnel who are responsible for other staff functions may be
					 considered direct care staff only during that time when they are providing
					 direct services to consumers or are involved in program preparation
					 functions;
(27) "Direct Services"
					 means hands-on training provided by the vendor in accordance with the
					 requirements of the consumer's Individual Program Plan and the provisions of
					 Section 56720 of these
					 regulations;
(28) "Director" means
					 the Director of the Department of Developmental Services;
(29) "Family Member" means an individual who:
					 A) Has a developmentally disabled person residing with him or her; B) Is
					 responsible for the 24-hour care and supervision of the developmentally
					 disabled person; and C) Is not a licensed or certified resident care facility
					 or foster family home receiving funds from any public agency or regional center
					 for the care and supervision provided;
(30) "Functional Skills" means those skills
					 which enable an individual to communicate, interact with others and to perform
					 tasks which have practical utility and meaning at home, in the community or on
					 the job;
(31) "Generic Agency"
					 means any agency which has a legal responsibility to serve all members of the
					 general public and which is receiving public funds for providing such
					 services;
(32) "Generic Support(s)"
					 means voluntary service organizations, commercial businesses, non-profit
					 organizations, generic agencies, and similar entities in the community whose
					 services and products are regularly available to those members of the general
					 public needing them.
(33) "Group
					 Practice" means more than one individual which functions as a business entity
					 while providing services to individuals;
(34) "Habilitation Services" means
					 community-based services purchased or provided for adults with developmental
					 disabilities, including services provided under the Work Activity Program and
					 the Supported Employment Program, to prepare and maintain these adults at their
					 highest level of vocational functioning, or to prepare them for referral to
					 Vocational Rehabilitation services;
(35) "Independent Living Program" means a
					 community-based day program that provides to adult consumers the functional
					 skills training necessary to secure a self-sustaining, independent living
					 situation in the community and/or may provide the support necessary to maintain
					 those skills. Independent living programs focus on functional skills training
					 for adult consumers who generally have acquired basic self-help skills and who,
					 because of their physical disabilities, do not possess basic self-help skills,
					 but who employ and supervise aides to assist them in meeting their personal
					 needs;
(36) "Individual Program
					 Plan (IPP)" means a written plan that is developed by a regional center
					 interdisciplinary (ID) team, in accordance with the provisions of the Welfare
					 and Institutions Code, Sections
					 4646
					 and
					 4646.5;
(37) "Infant Development Program" means a
					 community-based day program defined in the Welfare and Institutions Code,
					 Section
					 4693;
(38) "In-home Respite Services" means
					 intermittent or regularly scheduled temporary non-medical care and supervision
					 provided in the consumer's own home and designed to do all of the following:
(A) Assist family members in maintaining the
					 consumer at home;
(B) Provide
					 appropriate care and supervision to protect the consumer's safety in the
					 absence of family members;
(C)
					 Relieve family members from the constantly demanding responsibility of caring
					 for a consumer; and
(D) Attend to
					 the consumer's basic self-help needs and other activities of daily living,
					 including interaction, socialization, and continuation of usual daily routines
					 which would ordinarily be performed by the family member;
(39) "Interdisciplinary (ID) Team" means the
					 group of persons convened in accordance with the Welfare and Institutions Code,
					 Section
					 4646,
					 for the purpose of preparing a consumer's IPP;
(40) "Intermediate Care Facility" means an
					 Intermediate Care Facility as defined in Health and Safety Code Section
					 1250(d);
(41) "Intermediate Care
					 Facility/Developmentally Disabled (ICF/DD)" means a licensed residential health
					 facility which provides care and support services to developmentally disabled
					 consumers whose primary need is for developmental services and who have a
					 recurring, but intermittent, need for skilled nursing services;
(42) "Intermediate Care
					 Facility/Developmentally Disabled-Habilitative (ICF/DD-H)" means a licensed
					 residential health facility which has as its primary purpose the furnishing of
					 24-hour personal care, developmental training, habilitative, and supportive
					 health services in a facility with 15 beds or less to residents with
					 developmental disabilities;
(43)
					 "Intermediate Care Facility/Developmentally Disabled-Nursing (ICF/DD-N)" means
					 a licensed residential health facility which has as its primary purpose the
					 furnishing of 24-hour nursing supervision, personal care, and training in
					 habilitative services in a facility with 4-15 beds to medically fragile
					 developmentally disabled consumers, or to consumers who demonstrate a
					 significant developmental delay that may lead to a developmental disability if
					 not treated. Such consumers must have been certified by a physician as not
					 requiring skilled nursing care;
(44) "Long-Term Health Care Facility" means
					 an Adult Day Health Care Program, a Congregate Living Health Facility, a
					 Skilled Nursing Facility (SNF), an Intermediate Care Facility (ICF), an
					 Intermediate Care Facility/Developmentally Disabled (ICF/DD), an Intermediate
					 Care Facility/Developmentally Disabled-Habilitative (ICF/DD-H), or an
					 Intermediate Care Facility/Developmentally Disabled-Nursing
					 (ICF/DD-N);
(45) "Management
					 Organization" means a separate and distinct corporation or entity which
					 operates two or more services;
(46)
					 "Mobility Training" means individually planned activities and instruction which
					 enable adults with developmental disabilities to utilize the most normalizing
					 independent transportation modes possible;
(47) "Natural Environment" means places and
					 social contexts commonly used by individuals without developmental
					 disabilities;
(48) "Natural
					 Supports" means, pursuant to Welfare and Institutions Code, Section
					 4512(e),
					 personal associations and relationships typically developed in the family and
					 community that enhance or maintain the quality and security of life for
					 people;
(49) "Nonresidential
					 Services" means all services provided by any vendor other than a residential
					 facility;
(50) "Nursing Facility"
					 means a licensed health facility or a distinct part of a hospital which
					 provides continuous skilled nursing and supportive care to patients whose
					 primary need is for availability of skilled nursing care on an extended basis.
					 It provides 24-hour inpatient care and, as a minimum, includes physician,
					 skilled nursing, dietary and pharmaceutical services, and an activity
					 program;
(51) "Program Preparation
					 Functions" means secondary activities performed by non-residential direct care
					 staff, such as preparation of lesson plans, completion of the necessary
					 documentation required by these regulations, preparation and clean-up of the
					 area where the direct service is provided to consumers, or involvement in other
					 duties such as staff meetings and parent conferences;
(52) "Purchase of Service Funds" means those
					 funds identified in the Budget Act for the purpose of purchasing services,
					 provided by vendors, for consumers;
(53) "Reasonably suspected" means an
					 objectively reasonable suspicion that a person would entertain, based upon
					 facts that could cause a reasonable person in a like position, drawing, when
					 appropriate, on his or her training and experience, to suspect abuse.
(54) "Regional Center" means a diagnostic,
					 counseling, and service coordination center for developmentally disabled
					 persons and their families which is established and operated pursuant to the
					 Welfare and Institutions Code, Sections
					 4620
					 through
					 4669,
					 by a private nonprofit community agency or corporation acting as a contracting
					 agency. As used in these regulations, any reference to the regional center
					 shall, by reference, be applicable to those agencies or persons with which the
					 regional center contracts to provide service coordination to consumers under
					 the provisions of the Welfare and institutions Code, Section
					 4648;
(55) "Residential Facility" means any
					 licensed community care facility as defined in Health and Safety Code Section
					 1502(a)(1), (4), (5)
					 or (6), or a licensed residential care
					 facility for the elderly as defined in Health and Safety Code Section
					 1569.2;
(56) "Self-Advocacy" means the awareness,
					 motivation and ability of an individual to represent and communicate his or her
					 own interests, to exercise personal choice, to exert control over his or her
					 environment, and to avoid exploitation and abuse;
(57) "Self-Care" means meeting one's physical
					 and personal needs, such as dressing, grooming and hygiene without dependence
					 on others or having the ability to direct others to meet those needs;
(58) "Service Catchment Area" means the
					 geographical area within which a regional center provides services specified in
					 its contract with the Department as required by the Welfare and Institutions
					 Code, Section
					 4640;
(59) "Service Code" means a number which is
					 assigned by the vendoring regional center to a vendor which indicates the type
					 of authorized service to be provided;
(60) "Service Contract" means an agreement
					 entered into between a regional center and a non-residential vendor which
					 specifies the level of payment and units of service to be used by the vendor to
					 charge and invoice the regional center for services provided to
					 consumers;
(61) "Service Design"
					 means a written description of the service delivery capabilities and
					 orientation developed, maintained, and implemented by a SLS vendor;
(62) "Services" means assistance provided,
					 and duties performed, by a vendor for a consumer;
(63) "Skilled Nursing Facility (SNF)" means a
					 Skilled Nursing Facility as defined in Health and Safety Code Section
					 1250(c);
(64) "Social Recreation Program" means a
					 community-based day program which provides community integration and
					 self-advocacy training as they relate to recreation and leisure
					 pursuits;
(65) "Special Incident
					 Report" is the documentation prepared by vendor staff or long-term health care
					 facility staff detailing a special incident and provided to the regional
					 center;
(66) "Staffing Ratio" or
					 "Staff-to-Consumer Ratio" means the numerical relation of the number of direct
					 care staff to the number of consumers;
(67) "Statewide Vendor Panel" means the
					 statewide listing of all vendors which contains information specified in
					 Section 54334 of these
					 regulations;
(68) "Subcode" means a
					 series of a maximum of five numbers and/or letters which is assigned by the
					 vendoring regional center to a vendor for billing purposes;
(69) "Supported Employment" means services
					 that are provided by a job coach in order to support and maintain an individual
					 with developmental disabilities in employment;
(70) "Supported Employment Program" means a
					 program that meets the requirements of the term supported employment , as
					 defined in this section, and of the terms, integrated work, supported
					 employment placement, allowable supported employment services, group services,
					 and individualized services as defined in Section
					 58801.
(71) "Supported Living Service(s) (SLS)"
					 means those services and supports referenced in Section
					 54349(a) through
					 (e), and specified as SLS service and support
					 components in Title 17, Section
					 58614, which are provided by a SLS
					 vendor, paid for by the regional center, and support consumers' efforts to:
(A) Live in their own homes, as defined in
					 Title 17, Section
					 58601(a)(3);
(B) Participate in community activities to
					 the extent appropriate to each consumer's interests and capacity; and
(C) Realize their individualized potential to
					 live lives that are integrated, productive, and normal;
(72) "Unit of Service" means the increment of
					 service provided to consumers which is used to charge and invoice the regional
					 center for services provided. The increment of service is specified as hours,
					 days, transportation mileage or any other increment of service agreed to by the
					 Department, regional center and the vendor;
(73) "User Regional Center" or "Utilizing
					 Regional Center" means any regional center which utilizes a service within the
					 vendoring regional center's catchment area;
(74) "Vendor" means an applicant which has
					 been given a vendor identification number and has completed the vendorization
					 process, and includes those specified in Section
					 54310(d) and
					 (e);
(75) "Vendor Application" or "Application
					 Packet" means the form, DS 1890 (7/2011), and the information specified in
					 Section 54310(a)(1) through
					 (10) of these regulations;
(76) "Vendor Identification Number" means the
					 unique number which is assigned to each vendor in order to establish a
					 recordkeeping and tracking system for regional centers' billing
					 purposes;
(77) "Vendoring Regional
					 Center" means the regional center in whose service catchment area the vendor is
					 located;
(78) "Vendorization" means
					 the process used to:
(A) Verify that an
					 applicant meets all of the requirements and standards pursuant to Section
					 54310 of these regulations prior
					 to the provision of services to consumers; and
(B) Assign vendor identification numbers,
					 service codes and subcodes, for the purpose of identifying vendor
					 expenditures;
(79)
					 "Voucher" means a written authorization issued by a regional center to a family
					 member or consumer to procure the service for which the voucher was issued and
					 which specifies the maximum reimbursement authorized by the regional
					 center.
(80) "Work Activity
					 Program" includes, but is not limited to, Work Activity centers or settings
					 that provide support to consumers engaged in paid work and have demonstrated
					 that the program is in compliance with Department of Rehabilitation
					 certification standards or are accredited by CARF;