Cal. Code Regs. Tit. 17, § 58886 - General Requirements for Participant-Directed Services

(a) Effective October 1, 2011, for consumers and family members of consumers receiving the services in California Code of Regulations, Title 17, Section 54355(g) (1), (3), (4), and (5), when these services are funded with federal financial participation through Medicaid programs, the regional center may offer Participant-Directed Services to allow the adult consumer and/or family member to procure their own community-based training service, day care, nursing, respite, and/or transportation services. Effective September 16, 2022, personal assistance, independent living services, and supported employment are included in the list of Participant-Directed Services.
(b) When an adult consumer or family member makes the decision to use Participant-Directed Services the regional center shall:
(1) Provide information regarding their responsibilities and functions as either the Employer or Co-Employer;
(2) Provide information about the requirements regarding the use of a FMS Co-Employer or FMS F/EA;
(3) Assist the adult consumer or family member to identify and choose an FMS Co-Employer or FMS F/EA as follows:
(A) An adult consumer or family member who chooses to be the Employer as described in Section 58884(a)(3) shall make use of a FMS F/EA vendor pursuant to Section 58884(a)(5);
(B) An adult consumer or family member who chooses to be a Co-Employer as described in Section 58884(a)(2) shall make use of a FMS Co-Employer pursuant to Section 58884(a)(4); and
(C) Neither the adult consumer nor the family member shall be the FMS Co-Employer nor the FMS F/EA.
(4) Vendor the adult consumer or family member acting as Employer or Co-Employer for one or more Participant-Directed Services pursuant to (c), and a family member of more than one consumer shall only be vendored once.
(c) The Employer or Co-Employer duties and authority over workers include, but are not limited to, the following:
(1) Recruits workers;
(2) Verifies worker qualifications;
(3) Specifies additional worker qualifications based on consumer needs and preferences;
(4) Determines worker duties;
(5) Schedules workers;
(6) Orients and instructs workers in duties;
(7) Supervises workers;
(8) Evaluates worker performance; and
(9) Verifies time worked by employees and approves time sheets.
(d) The Employer or Co-Employer has the following additional responsibilities:
(1) The adult consumer or family member in the capacity as an Employer pursuant to (b)(3)(A) above has independent authority to:
(A) Hire workers; and
(B) Terminate workers.
(2) The adult consumer or family member in the capacity as Co-Employer pursuant to (b)(3)(B) above has authority to make recommendations to the FMS Co-Employer for hiring and terminating workers.
(e) The regional center shall vendor the Employer and Co-Employer in accordance with vendor requirements contained in California Code of Regulations, Title 17, Sections 54310 and 54326, in addition to the following requirements:
(1) Participant-Directed Day Care Service -- Family Member -- Service Code 455.
(A) A regional center shall classify a vendor as Participant-Directed Day Care Service -- 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 California Code of Regulations, Title 17, Section 54342(a)(4) or (a)(15)(A), (B), or (C).
(B) Participant-directed day care services for children shall only be authorized 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) Participant-Directed Nursing Service -- Family Member -- Service Code 460.
(A) A regional center shall classify a vendor as a Participant-Directed 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 California Code of Regulations, Title 17, Section 54342(a)(46), (51), or (66).
(3) Participant-Directed Respite Service -- Family Member -- Service Code 465.
(A) A regional center shall classify a vendor as Participant-Directed Respite Service -- Family Member if the vendor:
1. Is a family member;
2. Is not the direct provider of the respite service; and
3. Selects the respite service for the consumer from an individual who is at least 18 years of age and 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 IPP or IFSP; or
4. An agency that meets the criteria specified in California Code of Regulations, Title 17, Section 54342(a)(39); or
5. For out-of-home respite services, a facility which meets the standards specified in California Code of Regulations, Title 17, 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.
(4) Participant-Directed Transportation -- Family Member -- Service Code 470.
(A) A regional center shall classify a vendor as Participant-Directed 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) Participant-Directed Transportation shall only be authorized 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.
(5) Participant-Directed Community-Based Training Service for Adults -- Service Code 475, as established in Welfare and Institutions Code Section 4688.21(c)(1) through (12) is an adult day program service that assists the adult consumer in the development of skills required for community integrated employment and/or participation in volunteer activities and to secure employment and/or volunteer positions or pursue secondary education.
(A) A regional center shall classify a vendor as a Participant-Directed Community-Based Training Service for Adults if the vendor:
1. Is an adult consumer, family member, or conservator;
2. Is not the direct provider of the community-based training service for adults. A parent or conservator shall not be the direct support worker employed by the community-based training vendor; and
3. Selects the community-based training service for adults from an individual who is at least 18 years of age and possesses the skill, training, or experience necessary to provide the community-based training service for adults in accordance with the IPP. If the selected individual is required to transport the consumer, meets the requirements in (e)(4)(B) above.
(B) The Participant-Directed Community-Based Training Service for Adults shall be provided in natural environments in the community, separate from the consumer's residence.
(6) Participant-Directed Personal Assistance--Service Code 456 is a Personal Assistance service that assists the consumer with personal assistance and support to help the consumer be successful in their own home and in the community.
(A) A regional center shall classify a vendor as a Participant-Directed Personal Assistance Service if the vendor:
1. Is an adult consumer, family member, or conservator;
2. Selects an individual who is at least 18 years of age;
3. Ensures that the individual selected will possess the skill, training, or education necessary to provide the service in accordance with the IPP; and
4. Ensures that the individual is familiar with the consumer's daily routines and needs and is trained in any specialized supports necessary for the consumer.
(7) Participant-Directed Independent Living Services--Service Code 457 is an independent living service that assists the adult consumer in the development or maintaining of skills required for living independently in the community.
(A) A regional center shall classify a vendor as a Participant-Directed Independent Living service for Adults if the vendor:
1. Is an adult consumer, family member, or conservator;
2. Selects an individual who is at least 18 years of age;
3. Ensures that the individual will possess the skill, training, or education necessary to provide the service in accordance with the IPP; and
4. Ensures that the individual is familiar with the consumer's daily routines and needs and is trained in any specialized supports necessary for the consumer.
(8) Participant-Directed Supported Employment--Service Code 458 is a service that is provided in order to support a consumer in obtaining and maintaining competitive integrated employment, or self-employment. This may include developing a plan for employment by assessing the consumer's strengths, weaknesses, skills, and desires for employment.
(A) A regional center shall classify a vendor as a Participant-Directed Supported Employment provider if the vendor:
1. Is an adult consumer, family member, or conservator;
2. Selects an individual who is at least 18 years of age;
3. Ensures that the individual selected will possess the skill, training, or education necessary to provide the service in accordance with the IPP; and
4. Ensures that the person providing supported employment is familiar with the consumer's daily routines and needs and is trained in any specialized supports necessary for the consumer.
(f) By September 30, 2011, adult consumers or family members vendored pursuant to California Code of Regulations, Title 17, Section 54355(g)(1), (3), (4) and (5) who choose to be an Employer or Co-Employer are not required to be re-vendored. The regional center shall:
(1) Ensure that the adult consumer or family member continues to meet vendor requirements in accordance with (b), (c), (d) and (e) above;
(2) Provide the adult consumer or family member with information regarding the requirements to use an FMS Co-Employer and/or FMS F/EA pursuant to (b) above when these services are funded with federal financial participation through Medicaid and about the requirements for the applicable Participant-Directed Services, pursuant to (e) above;
(3) Assist the adult consumer or family member to identify and choose an appropriate FMS Co-Employer or FMS F/EA pursuant to (b) above;
(4) Assign the applicable Participant-Directed Service code pursuant to (e) above, with services to be effective no sooner than October 1, 2011; and
(5) Continue to pay the existing rate of the voucher service(s) for the corresponding participant-directed services as described in (e) above.

Notes

Cal. Code Regs. Tit. 17, § 58886
1. Adoption of article 2 (sections 58886-58887) and subsection (e)(5) filed 8-29-2011 as a deemed emergency pursuant to Welfare and Institutions Code section 4688.21; operative 8-29-2011 (Register 2011, No. 35). A Certificate of Compliance must be transmitted to OAL within 24 months or emergency language will be repealed by operation of law on the following day.
2. Adoption of subsections (a)-(e)(4)(C) and (f)-(f)(5) 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.
3. Certificate of Compliance as to 8-29-2011 orders transmitted to OAL 1-25-2013 and filed 3-11-2013 (Register 2013, No. 11).
4. Amendment of subsection (a) and new subsections (e)(6)-(e)(8)(A)4. filed 9-15-2022; operative 9-16-2022 pursuant to Government Code section 11343.4(b)(3) (Register 2022, No. 37).

Note: Authority cited: Sections 4405, 4648(a), 4648.12(c)(1)(B) and 4688.21(d), Welfare and Institutions Code; and Section 11152, Government Code. Reference: Sections 4631, 4648(a), 4648.12(c) and 4688.21, Welfare and Institutions Code.

1. Adoption of article 2 (sections 58886-58887) and subsection (e)(5) filed 8-29-2011 as a deemed emergency pursuant to Welfare and Institutions Code section 4688.21; operative 8-29-2011 (Register 2011, No. 35). A Certificate of Compliance must be transmitted to OAL within 24 months or emergency language will be repealed by operation of law on the following day.
2. Adoption of subsections (a)-(e)(4)(C) and (f)-(f)(5) 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.
3. Certificate of Compliance as to 8-29-2011 orders transmitted to OAL 1-25-2013 and filed 3-11-2013 (Register 2013, No. 11).
4. Amendment of subsection (a) and new subsections (e)(6)-(e)(8)(A)4. filed 9-15-2022; operative 9/16/2022 pursuant to Government Code section 11343.4(b)(3) (Register 2022, No. 37).

State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.


No prior version found.