Cal. Code Regs. Tit. 17, § 56718 - Consumer Placement and Funding Termination Procedures

(a) Funding of a consumer's placement in a vendor's program shall be terminated when one or more of the following occur:

(1) The regional center issues a written determination stating that continued participation jeopardized the consumer's health and safety;

(2) The consumer or authorized consumer representative makes a written or oral request to the regional center to discontinue participation or the consumer can no longer attend the program due to an unanticipated change in residence;

(3) The ID Team has determined through a consumer evaluation that the vendor's program no longer meets the consumer's needs;

(4) The vendor determines that its program may no longer meet the consumer's needs; or

(5) The consumer, or authorized consumer representative acting on behalf of the consumer, consents to an alternate placement identified by the ID Team as being able to meet the consumer's needs and as being more cost effective. The alternate placement shall be considered more cost effective if the combined cost of the alternate placement and the cost of transporting the consumer to and from the alternate placement is less than the combined cost of the consumer's current placement and the cost of transporting the consumer to and from the current placement.

(b) When a determination is made pursuant to (a)(1), (3), (4) or (5) above, the basis for the determination shall be documented in writing in the consumer's case file by the regional center for (a)(1) and/or (3) and/or (5) and by the vendor for (a)(4). The regional center shall also include written documentation in the consumer's file that the consumer or authorized consumer representative has been informed of the fair hearing rights pursuant to Welfare and Institutions Code, Sections 4701, 4705 and 4710 when the determination is made pursuant to (a)(1), (3) or (5) above.

(c) When the regional center or the vendor proposes to terminate the consumer's placement in the vendor's program, other than in accordance with (a)(1) or (a)(2) above, the initiating party shall notify the other party and the consumer in writing at least 30 days prior to the proposed termination date. Such notice shall include a written statement of reasons for the termination. If the regional center terminates the placement prior to the end of the 30 day notice period, except as specified in (a)(1) and (a)(2) above, the vendor shall be paid for those days of program services during that 30 days period for which the consumer would have been authorized to receive services as identified in the IPP. Funding shall not continue under either of the following circumstances:

(1) There is agreement between the regional center, vendor, and the consumer or authorized consumer representative for an earlier termination date. In this instance, funding shall be provided through the date the consumer leaves the program.

(2) The consumer's vacated place in the program has been filled by another consumer. In this instance, funding for the consumer who is no longer in the program shall cease on the date the substitute consumer begins attending.

(d) When the conditions specified in (a)(1) above exist, termination shall be immediate and no further payment shall be made, except as specified in (e) below.

(e) When the conditions specified in (a)(1), (a)(3) or (a)(5) above exist, termination of funding shall not be made if the consumer files a fair hearing request pursuant to Welfare and Institutions Code, Sections 4700 through 4730.

(f) When the conditions specified in (a)(2) above exist, funding shall terminate immediately upon the consumer's nonparticipation. The regional center shall notify the vendor in writing of the reason that the consumer no longer wishes to participate in the program. Such notification shall be made within 10 days of the date the regional center is notified by the consumer or authorized consumer representative.

(g) A vendor may exclude a consumer from participation in the program during periods when the vendor determines that the consumer is a threat to the health and safety of other individuals in the program. Such exclusion shall be followed by a meeting scheduled by the vendor within three working days to include the consumer program coordinator, the consumer and authorized consumer representative to discuss the basis of the exclusion and any program changes that may be required. The provisions of this paragraph shall not apply to exclusions that are made in accordance with a prior written agreement with the regional center pertaining to the individual consumer.

Notes

Cal. Code Regs. Tit. 17, § 56718

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. Amendment of subsection (a)(4) and NOTE and new subsection (a)(5) 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. Amendment of subsection (a)(4) and NOTE and new subsection (a)(5) 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 amendment of subsections (a)(5), (b) and (e) 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 section heading and section filed 1-17-97 pursuant to section 100, title 1, California Code of Regulations (Register 97, No. 3).

Note: Authority cited: Section 4691, Welfare and Institutions Code. Reference: Sections 4648, 4648.1, 4691, and 4700 through 4730, Welfare and Institutions Code.

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. Amendment of subsection (a)(4) and Note and new subsection (a)(5) 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. Amendment of subsection (a)(4) and Note and new subsection (a)(5) 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 amendment of subsections (a)(5), (b) and (e) 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 section heading and section filed 1-17-97 pursuant to section 100, title 1, California Code of Regulations (Register 97, No. 3).