(a) Within five days of receipt of the rate adjustment request from the vendor, the Department shall send a written notification to the vendoring regional center which shall indicate that the Department has received the rate adjustment request from the vendor.
(b) Within 30 days from the date of the Department's written notification pursuant to (a), the vendoring regional center shall:
(1) Review all information submitted by the vendor to determine if it complete and complies with the requirements of sections 57920 and 57922; and
(2) Notify the Department in writing, with a copy to the vendor, of the vendoring regional center's recommendation, including supporting rationale for their recommendation. The vendoring regional center's supporting rationale shall include:
(A) The specific regulatory basis for the request;
(B) A statement that the circumstances necessitating the request have been verified by the regional center; and
(C) Other documents which support the regional center's recommendation.
(c) If the vendoring regional center does not notify the Department of the results of its review and recommendation pursuant to (b), the Department shall proceed with its review procedures pursuant to (d) through (g).
(d) Within 50 days of receipt of the rate adjustment request from the vendor, the Department shall review the request to determine if it is complete and complies with the requirements of sections 57920 and 57922.
(1) If the vendor's rate adjustment request is complete and complies with the requirements of sections 57920 and 57922, the Department shall approve the vendor's rate adjustment request within 60 days of receipt of the request. However, requests for anticipated program changes shall only be approved contingent upon funds being available pursuant to section 57920(d).
(2) If the vendor's rate adjustment request is not complete or does not comply with the requirements of sections 57920 and 57922, the Department shall make a written request to the vendor for additional information, as required, and send a copy of the request to the vendoring regional center. The vendor shall submit the required additional information to the Department within 15 days from receipt of the written request.
(A) If the vendor fails to submit the required additional information within 15 days, the Department shall deny the vendor's rate adjustment request.
(B) If the vendor submits the required additional information within the 15 days and it is complete and complies with the requirements of sections 57920 and 57922, the Department shall approve the vendor's rate adjustment request within 60 days of receipt of the required additional information. However, requests for anticipated program changes shall only be approved contingent upon funds being available pursuant to section 57920(d).
(C) If the vendor submits the required additional information within 15 days and it is not complete and does not comply with the requirements of sections 57920 and, 57922, the Department shall deny the vendor's rate adjustment request.
(e) The Department shall notify, in writing, the vendor, the vendoring regional center, and utilizing regional center(s), if any, of the following:
(1) The decision to approve or deny the vendor's rate adjustment request pursuant to (d). Notification shall be as follows:
(A) Within,the time specified in (d)(1) if the vendor's rate adjustment request, when initially received by the Department, is complete and complies with sections 57920 and 57922;
(B) Within 15 days from the date any required additional information from the vendor is due, if the vendor fails to submit the required additional information within the time specified in (d)(2)(A);
(C) Within the time specified in (d)(2)(B) if the vendor submits the required additional information within 15 days and it is complete and complies with sections 57920 and 57922; or
(D) Within 60 days of receipt of any required additional information which is not complete and does not comply with sections 57920 and 57922, as specified in (d)(2)(C).
(2) The availability of funds in the Budget Act, to fund previously approved anticipated program changes pursuant to section 57920(d). The notification shall be by September 1.
(f) The effective date for all approved rate adjustments due to anticipated program changes, pursuant to section 57920(b), shall be September 1 of the subsequent fiscal year, or later, depending upon when the cost relating to the change actually occurs.
(g) The effective date for all approved rate adjustments due to unanticipated program changes pursuant to section 57920(c) shall be the date the community-based day program began incurring the additional cost.
Credits
Note: Authority cited: Section 4691, Welfare and Institutions Code. Reference: Section 4691, 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).
This database is current through 5/10/24 Register 2024, No. 19.
