Cal. Code Regs. tit. 17 § 57210

Current through Register 2025 Notice Reg. No. 2, January 10, 2025

Section 57210 - Additional Terms Defined

(a) As used in Sections 57300 through 57948, the following words and phrases have the following meanings:

(1) "Allowable Range" means the distance from the lower limit to the upper limit in a distribution of amounts among like programs determined pursuant to Step four, Section 57513;

(2) "Cost-of-Living Adjustment" or "COLA" means an amount of funds appropriated in the Budget Act for increases in rates established by the Department which is representative of an overall increase in the cost of providing services to consumers;

(3) "Direct Service Hours" means the number of hours during which direct services are provided to consumers by direct care staff to meet the objectives of the program design pursuant to Section 56712 or 56762 and, for vendors reimbursed for absences pursuant to Section 54326(a)(11), the number of direct service hours for which reimbursement was received shall also be included;

(4) "Fiscal Year" means the 12-month period which begins July 1 of one calendar year and ends June 30 the following calendar year;

(5) "Gap" means the difference between the amount determined for each vendor in Step five, Section 57514(a)(1) and the amount determined for each vendor in Step two, Section 57511(a)(1) based upon allowable cost and consumer attendance reported to the Department;

(6) "Gap Funding" means an amount of funds appropriated in the Budget Act pursuant to Section 57820;

(7) "Like Programs" means programs that are assigned the same service code and have the same approved staffing ratios;

(8) "Level of Payment" means the total amount which a regional center reimburses a vendor for services provided to its consumers;

(9) "Lower Limit" means the lowest amount allowed in the distribution of amounts among like programs, without an increase in the amount pursuant to Step six, Section 57515;

(10) "Permanent Payment Rate" means a rate established by the Department subsequent to the effective date of Sections 57200 through 57948, which is based upon each vendor's program, allowable cost, consumer attendance, vendor income, and as applicable, regional center payment information;

(11) "Profit", for profit organizations, or "Surplus", for not-for-profit organizations, means the amount remaining after all allowable costs related to services for consumers are deducted from a vendor's reimbursement received for those consumers;

(12) "Public Agency" means federal, state, and local government, including school districts, colleges and/or universities supported by public funds;

(13) "Regional Center Payments" means the total amount of income which the vendor received from the vendoring regional center and/or utilizing regional center(s), if any, for services provided to consumers;

(14) "Schedule of Maximum Allowances (SMA)" means the schedule of the maximum allowable rate for the service provided as established by the Department of Health Services (DHS) for services reimbursable under the Medi-Cal program. If the vendor's usual and customary rate is less than the maximum rate allowed pursuant to the SMA, the regional center shall pay the vendor's usual and customary rate.

(15) "Staff Relief Time" means time worked by substitute staff for direct care staff who are absent because of vacation, illness, staff training, jury duty, military leave or administrative leave;

(16) "Straight-line Depreciation" means a depreciation method where the cost of property or equipment is deductible in equal annual amounts over the estimated useful life of the property or equipment;

(17) "Temporary Payment Rate" means a rate established by the Department subsequent to the effective date of Sections 57200 through 57948, for vendors who do not have an actual cost history which the Department can use to establish a permanent payment rate;

(18) "Upper Limit" means the highest amount allowed in the distribution of amounts among like programs, without a decrease in the amount pursuant to Step six, Section 57515;

(19) "Usual and Customary Rate" means the rate which is regularly charged by a vendor for a service that is used by both regional center consumers and/or their families and where at least 30% of the recipients of the given service are not regional center consumers or their families. If more than one rate is charged for a given service, the rate determined to be the usual and customary rate for a regional center consumer and/or family shall not exceed whichever rate is regularly charged to members of the general public who are seeking the service for an individual with a developmental disability who is not a regional center consumer, and any difference between the two rates must be for extra services provided and not imposed as a surcharge to cover the cost of measures necessary for the vendor to achieve compliance with the Americans With Disabilities Act. New programs applying for vendorization shall provide a written declaration to the vendoring regional center that it is their intent to comply with this subsection, and will be allowed up to 12 months to achieve compliance. The vendoring regional center may audit a vendor's records to determine compliance with this subsection and, if the vendor is found not to be in compliance, shall revoke the vendor's usual and customary rate and negotiate a rate pursuant to Section 57300; and

(20) "Vendor Income" means all income received from any public agency, with the exception of the Department, regional centers, or the Department of Rehabilitation and/or the Department of Health Services if the vendor reported costs pursuant to Section 57422(c)(2), for services to consumers pursuant to Section 57438.

Cal. Code Regs. Tit. 17, § 57210

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 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 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 new subsection (a)(21) and subsection renumbering 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. Amendment of subsection (a)(21) filed 4-22-94; operative 4-22-94. Submitted to OAL for printing only (Register 94, No. 16).
8. Amendment of subsection (a)(3) 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).
9. Certificate of Compliance as to 6-17-93 order transmitted to OAL 6-20-94 and filed 8-2-94 (Register 94, No. 31).
10. Certificate of Compliance as to 6-20-94 order transmitted to OAL 2-20-96 and filed 3-29-96 (Register 96, No. 13).
11. Change without regulatory effect amending section filed 1-17-97 pursuant to section 100, title 1, California Code of Regulations (Register 97, No. 3).
12. Amendment of subsection (a)(3) and (a)(19) filed 4-25-2000; operative 5-25-2000 (Register 2000, No. 17).
13. Change without regulatory effect amending subsection (a)(3) filed 1-14-2003 pursuant to section 100, title 1, California Code of Regulations (Register 2003, No. 3).

Note: Authority cited: Chapter 722, Statutes of 1992, Section 147; and Sections 4691, 4691.5 and 4791(i), Welfare and Institutions Code. Reference: Sections 4691, 4691.5 and 4791, Welfare and Institutions Code.