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 54326 - General Requirements for Vendors and Regional Centers

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) All vendors shall:
(1) Be prohibited from transferring
					 vendorization of their service to another person or entity;
(2) Provide access to regional center and/or
					 Department staff, on an announced or unannounced basis, for the purposes
					 specified in the Welfare and Institutions Code, Section
					 4648.1;
(3) Maintain records of services provided to
					 consumers in sufficient detail to verify delivery of the units of service
					 billed:
(A) Such records shall be maintained
					 for a minimum of five years from the date of final payment for the State fiscal
					 year in which services were rendered or until audit findings have been
					 resolved, whichever is longer. This requirement may be satisfied by retaining
					 an electronic record of the information in the record, if the record reflects
					 accurately the information set forth in the record at the time it was first
					 generated in its final form as an electronic record or otherwise, and the
					 electronic record remains accessible for later reference.
(B) Records must include for each consumer
					 the information specified in Section
					 50604(d)(3)(A), (B), (C), (D), (E) or
					 (F), as applicable.
(C) Data, as specified in Section
					 50604(d)(3)(A), (B), (C), (D), (E) or
					 (F), as applicable, for the billing period
					 shall be submitted to the regional center with the
					 billings/invoices.
(4)
					 Make available any books and records pertaining to the vendored service,
					 including those of the management organization and disclosure information
					 required in Section
					 54311, if applicable, for audit,
					 inspection or authorized agency representatives. This shall also include only
					 those portions of any personnel records that are necessary to ensure staff
					 qualifications comply with the requirements contained in Section
					 56724, and Section
					 56770 or
					 56792 of these regulations, if
					 applicable, in order to comply with the monitoring of program standards
					 pursuant to the Welfare and Institutions Code, Section
					 4691(f);
(5) Utilize and be bound by Title 17,
					 Sections 50700 through
					 50767, and the Welfare and
					 Institutions Code, Section
					 4648.2,
					 should the vendor elect to appeal any audit findings;
(6) Comply with the provisions contained in
					 the Fair Labor Standards Act (29 U.S.C., Sections 201 through
					 219);
(7) Not discriminate in the provision of
					 services to consumers on the basis of race, religion, age, disability, sex, or
					 national origin of the consumer, or his/her parents, guardian, or
					 conservator;
(8) Be vendored
					 separately for each type of service provided, as specified in Sections
					 54342 through
					 54356 of these regulations unless
					 the regional center waives separate vendorization pursuant to Section
					 54342(a)(37) or
					 54342(a)(78)(A);
(9) Provide certification consistent with the
					 Public Contract Code, Sections
					 10410
					 and
					 10411,
					 that the vendor and the agents or employees of the vendor, in the performance
					 of the contracts, are independent contractors and are not officers or employees
					 of the State of California;
(10)
					 Bill only for services which are actually provided to consumers and which have
					 been authorized by the referring regional center. When the vendor is receiving
					 payment for a consumer from the Department of Rehabilitation and/or the
					 Department of Health Services for a portion of the program day, and the
					 vendor's rate of reimbursement is based on costs reported pursuant to Section
					 57422(c)(2), the
					 vendor shall only bill the prorate share of the daily rate.
(11) Not bill for consumer absences for
					 nonresidential services. The Department shall authorize payment for absences
					 which are the direct result of situations and/or occurrences for which a State
					 of Emergency has been declared by the Governor. If payment for absences due to
					 a State of Emergency is authorized by the Department, the vendor shall bill
					 only for absences in excess of the average number of absences experienced by
					 the vendor during the 12-month period prior to the month in which the disaster
					 occurred;
(12) Agree to accept the
					 rate established, revised or adjusted by the Department as payment in full for
					 all authorized services provided to consumers and not bill the consumer nor the
					 consumer's family, conservator, guardian or authorized consumer representative
					 for a supplemental amount regardless of the cost of providing the authorized
					 service. This shall not preclude the vendor from billing the consumer or
					 consumer's family for services provided which were authorized by the consumer
					 or family and which were not authorized by the regional center;
(13) Comply with all applicable staffing
					 ratio requirements;
(14) Be
					 prohibited from being vendored by more than one regional center for the same
					 service at the same location; and
(15) Comply with conflict of interest
					 requirements as determined by the criteria established by Title 17, Sections
					 54500 through
					 54525 and the Welfare and
					 Institutions Code, Sections
					 4626
					 through
					 4628.
(16) Sign the Home and Community-Based
					 Services Provider Agreement (6/99), if applicable pursuant to Section
					 54310. If the Home and
					 Community-Based Services Provider Agreement (6/99) is required and has not been
					 signed, the regional center shall:
(A) For
					 new applicants requesting vendorization, deny vendorization pursuant to Section
					 54322(c);
					 or
(B) For existing vendors, notify
					 in writing, the vendor and utilizing regional center(s), if any, that the
					 signed Home and Community-Based Services Provider Agreement (6/99) is required
					 and that payment of the vendor's rate will be suspended, the effective date of
					 the suspension, and that payment shall remain suspended until the signed Home
					 and Community-Based Services Provider Agreement (6/99), is received.
(1) The effective date for suspension of
					 payment of the vendor's rate shall be 15 days from the date of the letter
					 notifying the vendor that payment will be suspended.
(2) If the signed Home and Community-Based
					 Services Provider Agreement (6/99), is submitted within the time specified, no
					 further action will be taken.
(3)
					 If the Home and Community-Based Services Provider Agreement (6/99), is
					 submitted after the date when payment of the vendor's rate has been suspended,
					 the vendoring regional center shall notify the vendor and utilizing regional
					 center(s) that payment of the vendor's rate is reinstated as of the date
					 payment was suspended.
(17) Notify the vendoring regional center of
					 any additions or changes in the information disclosed on the DS 1891 (7/2011)
					 and submit the information pursuant to requirements of Section
					 54311(c).
(18) Notify the vendoring regional center of:
(A) Any conviction for any felony or
					 misdemeanor, within the previous ten years, involving fraud or abuse in any
					 government program, or related to neglect or abuse of an elder or dependent
					 adult or child, or in connection with the interference with, or obstruction of,
					 any investigation into health care related fraud or abuse, or that has been
					 found liable, within the previous ten years, in any civil proceeding for fraud
					 or abuse in any government program;
(B) Any settlement in lieu of conviction
					 involving fraud or abuse in any government program within the previous ten
					 years; or
(C) Any loss of license,
					 certificate or credential, or failure to maintain any valid licenses,
					 certificates or credentials required for the performance or operation of the
					 vendored service.