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Guide to Becoming A Service Provider
All people or agencies interested in providing services to people served by California Regional Centers must complete an application and approval process, also known as vendorization. An approval of a service provider application by a Regional Center certifies that the individual or agency meets the minimum standards to provide services to developmentally disabled individuals of any Regional Center in California. Minimum service provider standards are set by the State Department of Developmental Services (DDS) and described in California Code of Regulations Title 17: Click link here. Each Regional Center is responsible for a defined geographic area. Regional Centers may approve only those service provider applicants whose business addresses are within that Regional Center’s assigned service area.
Who to Contact to Discuss Vendorization
Prospective service providers whose business address is within the San Andreas Regional Center (SARC) service area (Santa Clara, San Benito, Santa Cruz and Monterey Counties), must determine what service type they are planning on providing through review of this SARC webpage and the DDS website as well as research of applicable statutes and regulations and must select a service to apply for based on their experience and expertise. Prospective service providers may initiate their service inquiry with SARC through the inquiry form link at the bottom of this page. SARC's Community Services team will respond within 2 business days.
Vendor Application Process
Once the need for a service has been defined, the prospective service provider will be sent forms, questionnaires, and/or worksheets to complete. Depending on the service type, there may be additional licensing, certification and program design requirements which must be met before an application is accepted. Depending on the service type, providers may be required to participate in orientations hosted by SARC. Depending on the service type, SARC may conduct a pre-interview to determine qualifying experience. SARC requires that all prospective residential and day program service providers obtain necessary licenses before submitting a vendor application packet. The general vendorization requirements for all service categories are specified in Title 17, Sections 54300 – 54390: Click link here.
Once the application packet is submitted with all supporting documents, it will be reviewed for completeness, compliance with Title 17, and compliance with the Home and Community Based Services Final Rule. If the information provided is complete and compliant, SARC will schedule an interview with the primary person for that vendored service; e.g. Administrator or Director. The interview will assist in determining that the person has the necessary experience and skills to provide quality services. SARC reserves the right to interview any provider who is establishing a new service, including providers with existing program.
San Andreas has 45 days from receipt of the completed application, and/or successful interview, to approve the vendorization or provide feedback on items that require correction or revision. If approved, SARC issues a Service Provider Approval Letter that contains the provider’s assigned vendor number, approved service code, agreed rate of reimbursement and effective date. If the application is denied, the applicant will receive a letter stating the reasons for the denial and will be informed of the appeal rights, in accordance with Title 17.
The service provider’s rate of reimbursement is determined according to the service category, as specified in Title 17. There are several types of rate methodology structures. They include:
- Median Rate – in which the rate is mutually agreed upon by the Regional Center and the service provider without exceeding DDS’s median rate limits for SARC;
- Cost Statement - in which the rate is established by the CA Department of Developmental Services and is determined by a formula based upon the service provider’s program, allowable cost, client attendance and income: Click link here.
- Adjusted Rate Model (ARM Level) - rates for residential services licensed by the Community Care Licensing division of the CA Department of Social Services. These rates are set by the CA Department of Development Services: Click link here.
- Schedule of Maximum Allowable Rates (SMA) – in which the SMA rate, as established by the Department of Health Services for services reimbursable under the Medi-Cal program, is applied;
Legal Relationship between SARC and Providers
San Andreas Regional Center contracts with service providers. Service providers are not employees of SARC or DDS. Service providers are responsible for complying with all State and Federal employment and tax laws. Vendorization is non-transferable. Title 17 prohibits service providers from transferring vendorization of their service to another person or entity. The service provider must notify SARC at least 30 days prior to any change in ownership, Administrator or Program Director, location or in the required license, certificate, registration, credential or permit. New Administrators or Program Directors will be required to submit all mandated credentials and paperwork to demonstrate compliance with regulatory requirements and, as deemed necessary, to participate in an interview with appropriate SARC staff to confirm competency in the designated service.
Completing the service provider application process, does not guarantee nor imply that the service provider will receive client referrals. Approval of a service provider application simply means that the service provider is eligible to provide the selected service for individuals served by the Regional Center at the approved/designated rate of reimbursement.
Separate Service Applications
Service provider approval is also not a blanket process applied to all of the services provided by an applicant. Each service must be approved separately. For example, if a service provider offers residential services as well as out of home respite services, each of these services must undergo the application process and obtain approval, separately.
Change in Ownership
When a change of ownership occurs, the new owner must meet the requirements for vendorization, including all licensing/registration/certification requirements for the service being provided. Service providers must notify the vendoring Regional Center and all user Centers in writing at least 60 days before discontinuing service or making modifications to the program design or service curriculum.
Vendorization may be terminated by the Regional Center if the service provider is in violation of regulations or statute.
A service provider or an applicant has the right to appeal denial of vendorization, termination of vendorization or failure of SARC to comply with regulations in accordance with Title 17, Sections 54380 – 54390. You may review Title 17 California Code of Regulations here. You may review the Lanterman Act, Welfare & Institutions Code here.
GENERAL SERVICE PROVIDER REQUIREMENTS
In addition to the requirements specified above, all service providers are required to comply with the following requirements:
Documentation & Reporting
- Be prohibited from being vendored by more than one Regional Center for the same service at the same location.
- Comply with conflict of interest requirements as determined by the criteria established by Title 17, Sections 54500 through 54535 (Click link here) and the WIC Sections 4626 through 4628 (Click link here).
- Sign Form DS 1896, Home and Community Based-Services Provider Agreement.
- Report all Special Incidents as specified in Title 17, Section 54327, to the vendoring Regional Center and the Regional Center which provides case management services, as applicable.
- Submit a complete DS 1891 every 2 years and notify SARC of any additions or changes in the information disclosed on the DS 1891 (7/2011) and submit the information pursuant to requirements of Title 17, Section 54311(c) (Click link here).
- Maintain a written description of its organizational structure and operations at the service provider’s business office in accordance with Title 17, Section 54326(b).
- Maintain all insurance requirements as outlined by SARC and annually submit an updated Certificate of Insurance to SARC for its records. Click here for insurance requirements.
- When all payments service provider cumulatively receives from SARC and other regional centers during each annual period of July 1 through June 30 equals or exceeds $500,000, service provider is required by WIC, Section 4652.5 to engage an independent Certified Public Accountant at the service provider’s cost to complete an independent audit or review of financial statements (Click link here).
- Promote the rights of the individuals served by the Regional Center and only deny rights in accordance with Title 17, Sections 50500 through 50540 (Click link here).
- Adopt written internal policies and procedures to resolve grievances of the individuals served by the Regional Center pursuant to WIC Section 4705.
Billing & Rates
- Bill only for services which are actually provided to the individuals served by SARC and which have been authorized by the referring Regional Center.
- Not bill for absences of the individuals served by SARC for any nonresidential services.
- Agree to accept the rate established, revised or adjusted by DDS as payment in full for all authorized services provided to the individuals served by SARC and not bill the individual nor the family, conservator, guardian or authorized representative for a supplemental amount regardless of the cost of providing the authorized service.
- Comply with all applicable staffing ratio requirements.
Records & Monitoring
- Provide access to SARC and DDS staff on an announced or unannounced basis, for the purpose of monitoring services and supports purchased by SARC. SARC staff shall have access to the provider’s grounds, buildings and service program, and to all related records, including books, computerized data, accounting records and related documentation.
- Maintain records of services provided to the individuals served by SARC in sufficient detail to verify delivery of the units of service billed. Such records shall be maintained for a minimum of five years from the date of origination or until audit findings have been resolved, whichever is longer. Records must be specific to the date, actual service time, location, nature of services provided, units of service provided and name of the persons served. Attendance data, as specified above, for the billing period shall be submitted to SARC with the billings/invoices.
- Make available any books and records pertaining to the vendored service, including those of the management organization, 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 Title 17, Section 56724 and Section 56770 or 56792, as applicable, in order to comply with the monitoring of program standards pursuant to the Welfare and Institutions Code (WIC), Section 4691(f).
- Utilize and be bound by Title 17, Sections 50700 through 50767, and WIC Section 4648.2, should the service provider elect to appeal any audit findings.
- Maintain and keep confidential all information of the individuals served by the Regional Center and utilize such information only as necessary to provide safe and effective services in accordance with the W&I Code, Sections 4515 – 4518 and the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
- Comply with the provisions contained in the Fair Labor Standards Act http://www.dol.gov/whd/flsa/and the California State Labor Code http://www.ca.gov/Work/LawsAndRegs.html.
- Not discriminate in the provision of services to the individuals served by SARC on the basis of race, religion, age, disability, sex, sexuality, gender identity, language, culture, or national origin of the individual or members of their circle of support..
- Provide certification consistent with the Public Contract Code, Sections 10410 and 10411, that the service provider and the agents or employees of the service provider, in the performance of the contracts, are independent contractors and are not officers or employees of the State of California.
To inquire with our Community Services department about becoming a service provider, complete an inquiry form here.