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§ 57300. Rate-Setting Requirements Applicable to All Nonresidential Service Vendors.

17 CA ADC § 57300Barclays Official California Code of Regulations

Barclays California Code of Regulations
Title 17. Public Health
Division 2. Health and Welfare Agency--Department of Developmental Services Regulations
Chapter 3. Community Services
Subchapter 7. Nonresidential Service Vendor Rate-Setting Provisions
Article 2. General Provisions
17 CCR § 57300
§ 57300. Rate-Setting Requirements Applicable to All Nonresidential Service Vendors.
Currentness
(a) In order for the Department to establish a rate of reimbursement for nonresidential service vendors, each vendor shall:
(1) Be approved as a vendor by a regional center pursuant to Section 54322(d)(1);
(2) Submit complete and accurate information and documentation; and
(3) Comply, if applicable, with the submission requirements specified in:
(A) Sections 57422 through 57439 for community-based day programs; or
(B) Sections 58020 through 58039 for in-home respite service agencies.
(b) Vendors shall not charge regional centers more for services to consumers than they charge for comparable services to any other person served by the vendor, solely because the consumer is a person with a developmental disability whose services are publicly rather than privately funded.
(c) Regional centers shall not reimburse vendors:
(1) Unless they have a rate established pursuant to these regulations which is currently in effect; nor
(2) For services in an amount greater than the rate established pursuant to these regulations.
(d) For those vendors for whom the Department establishes a rate, once the vendor has received notice of the rate established by the Department, any regional center, or its designee, purchasing or intending to purchase services from the vendor may negotiate with the vendor the level of payment for services provided to its consumers for a specified period of time. The level of payment may be less than but shall not exceed the maximum reimbursement possible during the period specified, using the rate established by the Department and the units of service used by the vendor to charge and invoice the regional center for services provided to consumers as the basis for determining the maximum reimbursement possible.
(1) Each regional center and vendor shall mutually agree in writing upon the level of payment and the effective date for commencing and terminating payment at the agreed upon amount.
(2) Upon termination of the level of payment negotiated by a regional center and vendor, the vendor shall be reimbursed for services at the rate established by the Department.
(3) Within the limitations specified in this section, the level of payment negotiated by a regional center and vendor may be renegotiated.
(4) Each regional center shall provide the Department and vendor with a copy of the written agreement specifying the terms of the level of payment.
(e) If a vendor does not have a rate established by the Department, and if the SMA is not applicable to the service provided by the vendor, and if the vendor does not have an established usual and customary rate as defined in Section 57210(a)(19), the vendoring regional center shall negotiate with the vendor the level of payment for services provided to consumers for a specified period of time.
(1) Once the vendor has received written notice of vendorization and rate approval from the vendoring regional center, any regional center purchasing or intending to purchase services from the vendor may utilize the approved rate or negotiate with the vendor for a level of payment for a specified period of time.
(f) Rates of reimbursement established pursuant to the Schedule of Maximum Allowances (SMA) or the vendor's usual and customary rate or rates set by negotiation with a regional center in accordance with this section do not require approval by the Department.
(g) For nonresidential rate-setting purposes, a change in ownership, pursuant to Section 54330, will not result in a change in the vendor's rate if the staffing ratio and program activities, as identified in the program design, remain unchanged.

Credits

Note: Authority cited: Chapter 722, Statutes of 1992, Section 147; and Sections 4690, 4690.1, 4690.2, 4691, 4691.5 and 4791(i), Welfare and Institutions Code. Reference: Sections 4648(a), 4690, 4690.1, 4690.2, 4691, 4691.5 and 4791, Welfare and Institutions Code.
History
1. New section filed 6-26-90 as an emergency; operative 7-1-90 (Register 90, No. 36). A Certificate of Compliance must be transmitted to OAL by 10-29-90 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance as to 6-26-90 order transmitted to OAL 9-28-90 and filed 10-29-90 (Register 90, No. 46).
3. New subsections (d)-(d)(5) and amendment of Note filed 11-5-91 as an emergency; operative 11-5-91 (Register 92, No. 21). A Certificate of Compliance must be transmitted to OAL 3-4-92 or emergency language will be repealed by operation of law on the following day.
4. New subsections (d)-(d)(5) and amendment of Note refiled 3-4-92 as an emergency; operative 3-4-92 (Register 92, No. 25). A Certificate of Compliance must be transmitted to OAL 7-2-92 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 3-4-92 order including repealer of subsection (d)(5) and amendment of subsections (a)(1) and (a)(3)(B) transmitted to OAL 6-25-92 and filed 8-6-92 (Register 92, No. 33).
6. Amendment of section filed as an emergency 6-17-93; operative 6-17-93. Submitted to OAL for printing only pursuant to SB485 (Chapter 722, Statutes of 1992) Section 147(a) (Register 93, No. 26).
7. Certificate of Compliance as to 6-17-93 order transmitted to OAL 6-20-94 and filed 8-2-94 (Register 94, No. 31).
8. Change without regulatory effect amending subsections (a)(1), (b) and (d) filed 1-17-97 pursuant to section 100, title 1, California Code of Regulations (Register 97, No. 3).
9. Amendment of subsections (c)(1)-(d), new subsection (e)-(e)(1), subsection relettering and amendment of subsection (f) filed 4-25-2000; operative 5-25-2000 (Register 2000, No. 17).
This database is current through 5/10/24 Register 2024, No. 19.
Cal. Admin. Code tit. 17, § 57300, 17 CA ADC § 57300
End of Document