Cal. Code Regs. Tit. 17, § 54355 - Vouchers

(a) A regional center may offer vouchers to family members or adult consumers to allow the families and consumers to procure their own diaper/nutritional supplements, day care, nursing, respite, and/or transportation services. When vouchers are issued they shall:

(1) Be used in lieu of, and shall not exceed the cost of services the regional center would otherwise provide; and

(2) Be issued only for services which are unavailable from generic agencies.

(b) The regional center shall provide prospective voucher recipients with information to assist them in determining liabilities they may incur by participating in a voucher program. Information provided shall include, but need not be limited to:

(1) Identification of the following areas of potential impact:

(A) Impact of vouchers on Supplemental Security Income (SSI) and/or other benefits;

(B) Voucher recipient's status as an employer and employer responsibilities;

(C) Impact of vouchers on personal taxes;

(D) Potential increase in insurance needs; and

(E) Voucher recipient's responsibility for worker's compensation; and

(F) Voucher recipient's responsibility to withhold and pay the appropriate Federal, State and local taxes; and

(2) Identification of the appropriate agency(ies), including the Internal Revenue Service and the Employment Development Department, which the voucher recipient may contact to obtain information and/or technical assistance regarding the areas of potential impact specified in (1)(A) through (F) above.

(3) The requirement to maintain records for at least 5 years, pursuant to Section 50604(d)(3)(A) through (E), as applicable.

(4) The requirement to submit to the regional center on form DS 1811, Respite Services Billing Form (7/04) data as specified in (A) through (O) below with billings/invoices for the billing period:

(A) Name and Unique Client Identifier (UCI) number of consumer receiving respite service;

(B) Vendored family member name;

(C) Vendor number;

(D) Vendor address;

(E) Vendor phone number;

(F) Date of service;

(G) Address where respite services were provided;

(H) Start and end times of service provided;

(I) Number of hours respite worker worked;

(J) Amount billed to the regional center;

(K) Name of respite worker, agency or facility used;

(L) Respite worker's social security number or any document pursuant to Section 50604(d)(3), if individual worker is used;

(M) Respite worker's address, if individual worker is used;

(N) Respite worker's phone number, if individual worker is used; and

(O) Respite worker's signature, if individual worker is used.

(5) The requirement of the vendored family member to sign, with original signature, and date Form DS 1811 (8/04), which includes a certification that the information provided on the form is true and correct, and that the person signing the form is the only person who employed, supervised, and assigned duties to the respite worker(s) listed on the form, in addition to having read and followed all respite service program requirements and the terms and conditions pursuant to Title 17, Sections 50604(a), 50604(d), 54326(a)(10), 54355(b)(1) through (3), 54355(g)(4)(B), 54355(g)(4)(C)1. and 54355(g)(4)(C)2.

(c) If a family member or adult consumer accepts a voucher to procure their own service, the regional center shall assist the consumer or family member, as appropriate, in identifying providers of services and supports.

(d) Voucher recipients shall be legally responsible for the selection and supervision of the services provided under any voucher issued pursuant to this section. It is the responsibility of the voucher recipient to ensure that the requirements specified in (g)(1) through (5) below for the actual provider of the vouchered service are met by the individual/entity selected to provide the service.

(e) If a family member or adult consumer accepts a voucher to procure their own service, as listed in (a) above, the regional center shall vendor either:

(1) The vouchered family member or adult consumer pursuant to (g) below; or

(2) The provider of the vouchered service pursuant to Section 54342.

The regional center shall not vendor the voucher recipient and the voucher service provider for the same service.

(f) Family members or adult consumers to whom the voucher is issued shall only be vendored as the provider of the service for which the voucher is issued if specifically authorized pursuant to (g)(1) through (5) below.

(g) If the vouchered family member or adult consumer is to be vendored to procure their own service, the family member or adult consumer shall meet the specified criteria and be vendored pursuant to the following:

(1) Day Care -- Family Member -- Service Code 405.

(A) A regional center shall classify a vendor as day care - family member if the vendor:

1. Is a family member;

2. Is not the direct provider of the day care service; and

3. Selects the day care service for the consumer from:

a. An individual who possesses the skill, training, or education necessary to provide the day care service; or

b. An agency that meets the criteria specified in Section 54342(a)(4)(A)1. and 2., or (a)(15)(A), (B), or (C).

(B) Vouchers for day care for children shall only be issued by regional centers for day care costs and/or hours exceeding the cost of providing day care services provided to a child without disabilities. The regional center may pay in excess of this amount when a family can demonstrate a financial need and when doing so will enable the children to remain in the family home.

(2) Diaper and Nutritional Supplements -- Family Member -- Service Code 410.

(A) A regional center shall classify a vendor as diaper and nutritional supplements -- family member if the vendor is a family member who is authorized by the regional center to directly purchase diapers and/or nutritional supplements for a consumer in the family member's home.

(B) Vouchers for diapers shall only be issued for the procurement of diapers for children three years of age or older. A regional center may purchase diapers for children under three years of age when a family can demonstrate a financial need and when doing so will enable the child to remain in the family home.

(3) Nursing Service -- Family Member -- Service Code 415.

(A) A regional center shall classify a vendor as nursing service - family member if the vendor:

1. Is a family member; and

2. Selects, assigns, and monitors an individual who provides nursing services for a consumer.

(B) The family member may be the direct provider of the nursing service if the service is not intended to provide respite to the family member.

(C) The individual or family member who provides the nursing service shall possess the qualifications specified in Section 54342(a)(46), (51), or (66).

(4) Respite Service -- Family Member -- Service Code 420. A regional center shall classify a vendor as respite service - family member if the vendor:

(A) Is a family member;

(B) Is not the direct provider of the respite service; and

(C) Selects the respite service for the consumer from:

1. An individual who:

a. Is at least 18 years of age. Individuals currently providing in-home respite service shall have 90 days from the effective date of these regulations to comply; and

b. Possesses the skill, training, or education necessary to provide the respite service. The vendored family member shall be responsible for ensuring that the individual selected to provide the respite service will possess the skill, training, or education necessary to provide the respite service.

In addition, the vendored family member is responsible for ensuring that the person providing respite care is familiar with the consumer's daily routines and needs, and is trained in any specialized supports necessary for the consumer. To the extent that these specialized support needs require additional training or certification in such things as First Aid, Cardiopulmonary Resuscitation (CPR), etc., these needs and requirements will be included as part of the description of respite care needs in the consumer's Individual Program Plan (IPP) or Individualized Family Service Plan (IFSP); or

2. An agency that meets the criteria specified in Section 54342(a)(38); or

3. For out-of-home respite services, a facility which meets the standards specified in Section 54342(a)(58) or (72). A relative who provides out-of-home respite in the relative's own house is exempt from licensure pursuant to Title 22, California Code of Regulations, Section 80007.

(5) Transportation -- Family Member -- Service Code 425.

(A) A regional center shall classify a vendor as transportation - family member if the vendor secures the transportation to and/or from authorized services identified in the consumer's IPP and the vendor:

1. Is a family member or adult consumer. The family member or adult consumer may either provide the transportation service or secure an individual to provide the transportation services identified in the consumer's IPP;

(B) The individual who is actually providing the transportation service shall:

1. Possess a driver's license which is valid in California; and

2. Have evidence of maintenance of adequate insurance coverage pursuant to Welfare and Institutions Code, Section 4648.3.

(C) Vouchers for transportation shall only be issued by regional centers to cover transportation costs which exceed the transportation costs that the family member would incur for a minor child without disabilities. The regional center may pay in excess of this amount when a family can demonstrate a financial need and when doing so will enable the consumer to remain in the family home.

(h) The voucher recipient shall maintain records of services provided to the consumer pursuant to Section 54326(a)(4).

(i) Effective October 1, 2011, for the services in (g)(1), (3), (4), and (5) above, when funded with federal financial participation through Medicaid programs, the consumers and family members of consumers shall:

(1) Be vendored for the services pursuant to California Code of Regulations, Title 17, Section 58886; or

(2) Use another vendored service provider.

Notes

Cal. Code Regs. Tit. 17, § 54355

1. New section filed 6-20-94 as an emergency; operative 6-20-94. Submitted to OAL for printing only pursuant to Chapter 722, Statutes of 1992, Section 147 (Register 94, No. 25).
2. Certificate of Compliance as to 6-20-94 order, including amendment of section, transmitted to OAL 2-20-96 and filed 3-29-96 (Register 96, No. 13).
3. Change without regulatory effect amending section filed 1-17-97 pursuant to section 100, title 1, California Code of Regulations (Register 97, No. 3).
4. Redesignation of subsections (b)1.-2. to (b)(1)-(2) and amendment of newly designated subsection (b)(2) and subsections (e) and (e)(2) filed 4-25-2000; operative 5-25-2000 (Register 2000, No. 17).
5. Change without regulatory effect amending subsections (g)(1)(A)3.b., (g)(3)(C) and (g)(4)(C)1.-3. filed 1-14-2003 pursuant to section 100, title 1, California Code of Regulations (Register 2003, No. 3).
6. Amendment of section and NOTE filed 8-27-2004 as an emergency; operative 8-27-2004 (Register 2004, No. 35). A Certificate of Compliance must be transmitted to OAL by 12-27-2004 or emergency language will be repealed by operation of law on the following day.
7. Amendment of section and NOTE refiled 12-22-2004 as an emergency; operative 12-22-2004 (Register 2004, No. 52). A Certificate of Compliance must be transmitted to OAL by 4-21-2005 or emergency language will be repealed by operation of law on the following day.
8. Certificate of Compliance as to 12-22-2004 order, including further amendment of subsections (b)(4) and (b)(4)(L), transmitted to OAL 4-19-2005 and filed 5-18-2005 (Register 2005, No. 20).
9. Change without regulatory effect amending subsection (g)(4)(C)3. filed 11-10-2005 pursuant to section 100, title 1, California Code of Regulations (Register 2005, No. 45).
10. Change without regulatory effect amending subsection (g)(3)(C) filed 4-21-2008 pursuant to section 100, title 1, California Code of Regulations (Register 2008, No. 17).
11. New subsections (i)-(i)(2) and amendment of NOTE filed 8-29-2011 as a deemed emergency pursuant to Welfare and Institutions Code section 4648.12; operative 8-29-2011 (Register 2011, No. 35). A Certificate of Compliance must be transmitted to OAL within 18 months or emergency language will be repealed by operation of law on the following day.
12. Certificate of Compliance as to 8-29-2011 order transmitted to OAL 1-25-2013 and filed 3-11-2013 (Register 2013, No. 11).

Note: Authority cited: Sections 4405, 4648(a) and 4648.12(c)(1)(B), Welfare and Institutions Code; and Section 11152, Government Code. Reference: Sections 4631, 4648(a) and 4648.12(c), Welfare and Institutions Code.

1. New section filed 6-20-94 as an emergency; operative 6-20-94. Submitted to OAL for printing only pursuant to Chapter 722, Statutes of 1992, Section 147 (Register 94, No. 25).
2. Certificate of Compliance as to 6-20-94 order, including amendment of section, transmitted to OAL 2-20-96 and filed 3-29-96 (Register 96, No. 13).
3. Change without regulatory effect amending section filed 1-17-97 pursuant to section 100, title 1, California Code of Regulations (Register 97, No. 3).
4. Redesignation of subsections (b)1.-2. to (b)(1)-(2) and amendment of newly designated subsection (b)(2) and subsections (e) and (e)(2) filed 4-25-2000; operative 5-25-2000 (Register 2000, No. 17).
5. Change without regulatory effect amending subsections (g)(1)(A)3.b., (g)(3)(C) and (g)(4)(C)1.-3. filed 1-14-2003 pursuant to section 100, title 1, California Code of Regulations (Register 2003, No. 3).
6. Amendment of section and Note filed 8-27-2004 as an emergency; operative 8-27-2004 (Register 2004, No. 35). A Certificate of Compliance must be transmitted to OAL by 12-27-2004 or emergency language will be repealed by operation of law on the following day.
7. Amendment of section and Note refiled 12-22-2004 as an emergency; operative 12-22-2004 (Register 2004, No. 52). A Certificate of Compliance must be transmitted to OAL by 4-21-2005 or emergency language will be repealed by operation of law on the following day.
8. Certificate of Compliance as to 12-22-2004 order, including further amendment of subsections (b)(4) and (b)(4)(L), transmitted to OAL 4-19-2005 and filed 5-18-2005 (Register 2005, No. 20).
9. Change without regulatory effect amending subsection (g)(4)(C)3. filed 11-10-2005 pursuant to section 100, title 1, California Code of Regulations (Register 2005, No. 45).
10. Change without regulatory effect amending subsection (g)(3)(C) filed 4-21-2008 pursuant to section 100, title 1, California Code of Regulations (Register 2008, No. 17).
11. New subsections (i)-(i)(2) and amendment of Note filed 8-29-2011 as a deemed emergency pursuant to Welfare and Institutions Code section 4648.12; operative 8-29-2011 (Register 2011, No. 35). A Certificate of Compliance must be transmitted to OAL within 18 months or emergency language will be repealed by operation of law on the following day.
12. Certificate of Compliance as to 8-29-2011 order transmitted to OAL 1-25-2013 and filed 3-11-2013 (Register 2013, No. 11).