(a) Community Crisis Home Facility Component -- Service Code 902.
(1) A Community Crisis Home administrator shall complete one Department form DS 6023 (Rev 9/2021) entitled “Rate Development -- Facility Costs” for the facility.
(A) The administrator shall submit a completed Department form DS 6023 to the regional center for review, negotiation and written approval as part of the initial contract execution pursuant to Section 59014.
(B) The regional center shall review the facility rate as part of the contract renewal pursuant to Section 59014, and the administrator shall submit an updated Department form DS 6023 to the regional center for review and written approval. Any change to the facility rate shall become effective on the first day of the month following approval.
(2) The rate of payment for the Community Crisis Home facility component may not exceed the maximum rate of reimbursement as determined by use of the DS 6023 and as specified below:
(A) The monthly rate of reimbursement to any Community Crisis Home for the facility component may not exceed the rate limit determined by the Department by use of the DS 6023.
(B) The monthly rate of reimbursement and rate limit is subject to the appropriation of funds pursuant to the Budget Act of each fiscal year.
(3) Facility rate payment.
(A) The monthly facility rate is prorated by the licensed capacity of the facility. Portions not funded by a consumer placement are paid through the contract.
(B) Beginning with the initial consumer placement, the facility rate is paid based on the licensed capacity of the facility:
1. Despite temporary consumer absences or vacancies.
2. With vacancies funded through the contract.
3. At six months from the initial placement in the facility, and at each subsequent 30 days, the vendor and regional center shall meet to determine if the portion of the facility rate funded through the contract due to the unfilled beds will continue.
(C) At 60 days of temporary vacancy, and at each subsequent 30 days, the vendor and regional center shall meet to determine if the portion of the facility rate funded through the contract due to the temporary vacancy will continue. For purposes of this section, “temporary vacancy” means a vacancy of 60 days or fewer.
(b) Community Crisis Home Individualized Services and Supports Component -- Service Code 903.
(1) A Community Crisis Home shall complete one Department form DS 6024 (Rev 9/2021) entitled “Rate Development -- Individual Costs Associated with Residency” for each consumer to establish the consumer's individual monthly rate while placed at the facility.
(A) The administrator shall submit the completed Department form DS 6024 to the regional center for review and written approval prior to or upon a consumer's admission to the Community Crisis Home.
(B) A consumer's Individual Behavior Supports Team shall review the consumer's individualized services and supports rate within 30 days of initial placement, and at least every six months thereafter, and submit an updated completed Department form DS 6024 to the regional center within 30 days, for review and written approval.
(2) The rate of payment for the Community Crisis Home Individualized services and supports Component may not exceed the maximum rate of reimbursement as specified below:
(A) The monthly rate of reimbursement to any Community Crisis Home for any consumer's individualized services and supports may not exceed the rate limit determined by the Department by use of the DS 6024.
(B) The monthly rate of reimbursement and rate limit is subject to the appropriation of funds pursuant to the Budget Act of each fiscal year.
(3) Individualized services and supports rate payment:
(A) The established individualized services and supports rate may be paid by the regional center for the full month when the consumer is temporarily absent from the facility 14 days or less per month.
(B) When the consumer's temporary absence is due to the need for inpatient care in a health facility, as defined in subsection (a), (b), or (c) of Section 1250 of the Health and Safety Code, the regional center may continue to pay the established individualized services and supports rate until the Individual Behavior Supports Team has determined that the consumer will not return to the facility. Individualized services and supports funded by a regional center during a consumer's absence from the facility must be approved by the regional center director and may only be approved in 14-day increments. The facility shall continue to provide direct supervision and special services as needed during a consumer's temporary absence to continue to receive payment of the individualized services and supports rate.
(C) The established individualized services and supports rate is prorated for a partial month of service in all other cases by dividing the established rate by 30.44, then multiplying the quotient by the number of days the consumer resided in the facility.
(D) If the consumer resides at a Community Crisis Home licensed as an adult residential facility beyond 18 months or at a Community Crisis Home licensed as a group home beyond 12 months, any additional day(s) must be approved by the Department and reviewed monthly thereafter.
(c) Community Crisis Home Transition Component -- Service Code 899.
(1) The Individual Behavior Supports Team shall complete one Department form DS 6028 (New 10/2016) entitled “Community Crisis Home -- Rate Development Individual Costs Associated With Transition” for each vendor supporting a consumer in transition to establish the consumer's daily transition rate for that vendor.
(A) The transition rate is used to fund additional services and supports for the consumer during times of transition into or out of the Community Crisis Home.
1. Transition funding shall only be used for staff training, cross-training or needs specifically related to the consumer's transition process.
2. Transition funding is time limited, as determined by the consumer's Individual Behavior Supports Team.
3. The transition rate shall not be utilized for services and supports already billed at the individual rate during placement at the Community Crisis Home, or for services and supports provided as part of the rate during placement at the previous or future residential arrangement.
4. Transition funding shall not be used for facility expenses.
(B) The administrator shall submit the completed Department form DS 6028 to the regional center for review and written approval.
(C) A consumer's Individual Behavior Supports Team shall review the consumer's transition rate at least monthly and submit an updated completed Department form DS 6028 to the regional center within 10 days for review and written approval.
(2) The rate of payment for the Community Crisis Home Transition Component may not exceed the maximum rate of reimbursement as specified below:
(A) The daily rate of reimbursement to any vendor for any consumer's transition costs may not exceed the rate limit determined by the Department by use of the DS 6028.
(B) The daily rate of reimbursement and rate limit is subject to the appropriation of funds pursuant to the Budget Act of each fiscal year.
(3) Transition rate payment:
(A) The transition rate is paid for services and supports needed to support a consumer during times of transition, outside of those needed services and supports identified in the consumer's individual monthly rate developed in subsection (b)(1).
(B) The transition rate shall be paid only for actual days of service.
(C) The payment of the transition rate is dependent on the regional center prior authorization. Retroactive authorizations shall not be allowed.
(d) Administrative costs may not exceed 15% pursuant to Section 4629.7 of the Welfare and Institutions Code.
(e) The regional center will submit all rate documents to the Department after approval.
(f) Department forms DS 6023 Rate Development -- Facility Costs (Rev 9/2021), DS 6024 Rate Development -- Individual Costs Associated with Residency (Rev 9/2021) and DS 6028 Community Crisis Home -- Rate Development Individual Costs Associated with Transition (New 10/2016) are hereby incorporated by reference.
Credits
Note: Authority cited: Sections 4698 and 4698.1, Welfare and Institutions Code. Reference: Sections 4698 and 4698.1, Welfare and Institutions Code.
History
1. New article 11 (section 59022) and section filed 3-20-2017 as an emergency; operative 3-20-2017 (Register 2017, No. 12). Pursuant to Welfare and Institutions Code section 4698.1(b), a Certificate of Compliance must be transmitted to OAL by 3-19-2019 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance as to 3-20-2017 order, including amendment of section, transmitted to OAL 2-8-2019 and filed 3-25-2019; amendments operative 3-25-2019 pursuant to Government Code section 11343.4(b)(3) (Register 2019, No. 13).
3. Amendment of various Department forms (incorporated by reference) and amendment of subsections (a)(1), (b)(1), (b)(3)(D) and (f) filed 6-25-2021 as a deemed emergency; operative 6-25-2021 (Register 2021, No. 26). Pursuant to Welfare and Institutions Code section 4698.1(b), a Certificate of Compliance must be transmitted to OAL by 6-25-2023 or emergency language will be repealed by operation of law on the following day.
4. Amendment of various Department forms (incorporated by reference) and amendment of subsections (a)(1), (b)(1), (b)(3)(D) and (f) refiled 4-25-2022 as a deemed emergency; operative 4-25-2022 (Register 2022, No. 17). Pursuant to Welfare and Institutions Code section 4698.1(b), a Certificate of Compliance must be transmitted to OAL by 6-25-2023 or emergency language will be repealed by operation of law on the following day.
5. Amendment of various Department forms (incorporated by reference) and amendment of subsections (a)(1), (b)(1), (b)(3)(D) and (f) refiled 7-25-2022 as a deemed emergency; operative 7-25-2022 (Register 2022, No. 30). Pursuant to Welfare and Institutions Code section 4698.1(b), a Certificate of Compliance must be transmitted to OAL by 6-25-2023 or emergency language will be repealed by operation of law on the following day.
6. Updating certificate of compliance information in History 3, 4 and 5.
7. Certificate of Compliance as to 7-25-2022 order, including amendment of section, transmitted to OAL 5-30-2023 and filed 7-12-2023; amendments effective 7-12-2023 pursuant to Government Code section 11343.4(b)(3) (Register 2023, No. 28).
This database is current through 5/10/24 Register 2024, No. 19.
