Header:
CALIFORNIA CODE OF REGULATIONS
TITLE 17. PUBLIC HEALTH
DIVISION 2. HEALTH AND WELFARE AGENCY--DEPARTMENT OF DEVELOPMENTAL SERVICES REGULATIONS
CHAPTER 3. COMMUNITY SERVICES
SUBCHAPTER 21. HABILITATION SERVICES PROGRAM
ARTICLE 8. RATESE
Date:
08/31/2009
Document:
17 CCR 58876 (2011)
ยง 58876. Rate Adjustment and Rate Revision Provisions
(a) The Department shall adjust base rates following the addition of any State-approved COLA's except as provided in Section 58876(g)(7) and 58876(p).
(b) The Department shall make rate adjustments only before the payment year begins and make them effective July 1 of the payment year, except in cases of occupancy adjustments due to disasters such as earthquakes, floods, and fires pursuant to Section 58877.
(c) If the basis for the adjustment will not take effect until after the beginning of the payment year, the Department shall prorate the adjustment over the entire payment year effective July 1.
(d) In all cases the vendor shall actually incur the cost to be eligible for a rate adjustment.
(e) Documentation submitted by a vendor as the basis for an adjustment shall be subject to Departmental review and Departmental and/or regional center audit, as well as to all policies and procedures pertaining to such reviews and audits.
(f) No rate adjustment shall result in a rate exceeding the approved maximum daily rate for the vendor based on vendor grouping pursuant to section 58873(a) through (h).
(g) The Department shall take into account, as a basis for a rate adjustment, increases in occupancy cost (limited to rent, lease, mortgage interest, and building depreciation) from the historical period to the payment period, only if all of the following apply:
(1) The increase in rent, lease, mortgage interest, and/or building depreciation for the payment year exceeds the corresponding cost(s) in the historical period;
(2) The increased cost:
(A) Resulted in needed and more normalized or improved services to consumers and was approved in writing by the Department before it was incurred; or
(B) Was unavoidable, such as loss of lease or disaster, and the replacement vendor site, or portion thereof, was obtained at a cost consistent with the average cost paid for buildings in the area; or
(3) The vendor submits the request for adjustment in writing prior to July 1 of the payment year, except in cases of disasters such as earthquakes, floods, and fires, and in the form required by the Department;
(4) The vendor shall complete a Request for Rate Adjustment B Occupancy on a form specified by the Department and submit it to the Department with a copy to the vendoring regional center prior to July 1 of the payment year for which the adjustment is being requested, except in the case of disaster when the form shall be submitted before new occupancy commitments are made;
(5) If the cost increase meets all of the requirements specified in (g)(1) through (3) above, the Department shall deduct that amount from the historical period cost, and use the difference to compute the rate adjustment;
(6) If space utilization differs from that of the historical period, the vendor shall submit a Space Utilization Report, Form DS 1950 (3/05) Tab B, as a basis for distribution of the increased costs. If there is no change, the costs shall be distributed as in the historical period;
(7) The Department shall use all historical consumer data to calculate the adjustment for the payment year. However, because costs are payment year costs, no COLA increases shall be applied in the year of the adjustment.
(h) The Department shall make rate adjustments for staffing for the following reasons:
(1) If a vendor's Work Activity Program staff-to-consumer ratio in the historical period falls below the staffing level as defined here and the vendor elects to hire staff to attain this staffing level;
(A) The staffing level the Department will use as a basis for rate adjustments shall be applied to all consumers and staff in the combined programs offered by the Work Activity Program and is as follows:
(i) For direct service staff, three staff positions for the first ten consumers, and one additional staff position for each additional ten consumers;
(ii) These positions include the executive director, rehabilitation counselor, and all staff positions whose function is primarily to provide direct service to consumers including, but not limited to, supervision, training, and; education;
(iii) The position(s) of executive director and/or rehabilitation counselor may be combined;
(B) For administrative support staff, one staff position to provide clerical support and one staff position to provide fiscal support.
(i) If the functions of the administrative support staff above are included in the duties of staff defined as service delivery staff, the position(s) shall be calculated on a pro rata basis between direct service and administrative support;
(ii) If the vendor's Work Activity Program staffing level is not maintained following payment of a rate adjustment for that purpose, no future adjustments shall be approved for this reason; and/or
(iii) If the vendor incurs a loss of subsidized staff, from the historical period, causing the staff-to-consumer ratio to fall below the staffing level above, and hires or retains staff to attain or maintain this staffing level;
(iv) If the vendor cannot confirm the loss of subsidized staff prior to the deadline for submission of a request for rate adjustment, the vendor shall obtain information from the source of subsidy, and on the basis of that information, submit a request if there is likelihood that substantial subsidy will be lost.
(i) The adjustment, if approved, shall be based on the information as known, and if the subsidy is not reduced, the adjustment, in full or in part, will be rescinded retroactively.
(j) In all cases, the vendor shall supply written documentation verifying the hiring or retention of the staff including the salary and fringe benefits to be paid to such staff.
(k) The vendor shall complete a Request for Rate Adjustment B Staffing on a form specified by the Department and submit it to the Department with a copy to the vendoring regional center prior to July 1 of any future payment years for which the adjustment is being requested.
(l) Following the request for a rate adjustment by the vendor, the Department shall review the data submitted on the Staff Survey Report(s), Form DS 1950 (3/05) Tab A, the Consumer Survey Report(s), Forms DS 1950 (3/05) Tab G for the historical period to determine if the vendor met the staffing level as defined in this Section during the historical period, or if the loss of subsidized staff caused it to fall below that level for that period.
(m) If the vendor did not meet the staffing level as defined in this Section, the Department shall prorate the annual salary and fringe benefits to staff to be hired, or retained, based on the date hiring or retention is to occur.
(n) The Department shall enter the cost in (d) above on the Rate Computation Sheet, Form DS 1950 (3/05) Tab H and distribute it based on the Staff Survey Report, Form DS 1950 (3/05) Tab A.
(o) The Department shall complete the rate calculation using all client data from the historical period.
(p) The Department shall add no COLA increases in the year of the adjustment because costs used in calculating the rate adjustment are for current payment year costs.
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