Cal. Code Regs. tit. 22 § 51510.1

Current through Register 2024 Notice Reg. No. 45, November 8, 2024

Section 51510.1 - Intermediate Care Services for the Developmentally Disabled

(a) Each provider of intermediate care services for the developmentally disabled shall furnish all equipment, drugs, services and supplies necessary to provide intermediate care services for the developmentally disabled except as provided in subsection (b). Such equipment, drugs, supplies, and services are, at a minimum, those which are required by law, including those required by federal Medicaid regulations and state licensing regulations.

(b) Not included in the payment rate and to be billed separately by the provider thereof, subject to the utilization controls and limitations of Medi-Cal regulations covering such services and supplies, are as follows:

(1) Allied health services ordered by the attending physician.

(2) Alternating pressure mattresses/pads with motor.

(3) Atmospheric oxygen concentrators and enrichers and accessories.

(4) Blood, plasma and substitutes.

(5) Dental services.

(6) Durable medical equipment as specified in Section 51321(g).

(7) Insulin.

(8) Intermittent positive pressure breathing equipment.

(9) Intravenous trays, tubing and blood infusion sets.

(10) Laboratory services.

(11) Legend drugs.

(12) Liquid oxygen system.

(13) MacLaren or Pogon Buggy.

(14) Medical supplies as specified in the list established by the Department.

(15) Nasal cannula.

(16) Osteogenesis stimulator device.

(17) Oxygen (except emergency).

(18) Parts and labor for repairs of durable medical equipment if originally separately payable or owned by the beneficiary.

(19) Physician services.

(20) Portable aspirator.

(21) Portable gas oxygen system and accessories.

(22) Precontoured structures (VASCO-PASS, cut out foam).

(23) Prescribed prosthetic and orthotic devices for exclusive use of patient.

(24) Reagent testing sets.

(25) Therapeutic air/fluid support systems/beds.

(26) Traction equipment and accessories.

(27) Variable height beds.

(28) X-rays.

(c) Not included in the payment rate nor in the Medi-Cal schedule of benefits are costs for personal items of beneficiaries such as cosmetics, tobacco products and accessories, dry cleaning, beauty shop services (other than shaves or shampoos performed by the facility staff as part of patient care and periodic trims) and television rental.

(d) Skilled nursing facilities and intermediate care facilities with the licensed bed capacities shown below meeting the standards and criteria established for intermediate care facility services for the developmentally disabled, as defined in Sections 76301 through 76413, Article 3, Chapter 8, Division 5, Title 22, California Code of Regulations, shall be entitled to payment according to the following daily rates. Payment for service includes the Quality Assurance Fee pursuant to Health and Safety Code Section 1324.2.

Total Licensed Beds
Effective Rate Year	1-59	60+	60+ w/Distinct Part
2004-05	$143.95	$123.87	$123.87
2005-06	$158.58	$134.46	$134.46
2006-07	$158.58	$147.03	$147.03

(1) Reduced for leave of absence for all patients receiving intermediate care facility services for the developmentally disabled in accordance with Section 51535.

(2) Reduced for bed hold for acute hospitalization for all patients receiving intermediate care facility services for the developmentally disabled in accordance with Section 51535.1.

(e) Effective October 1, 1990, state operated facilities shall be entitled to payment for services at actual allowable cost.

(f) For purposes of this section, the rate year is August 1st through July 31st.

Cal. Code Regs. Tit. 22, § 51510.1

1. Amendment filed 8-7-89 as an emergency; operative 8-7-89 (Register 89, No. 32). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 12-5-89. For prior history, see Register 89, No. 1.
2. Certificate of Compliance transmitted to OAL 12-1-89 and filed 1-2-90 (Register 90, No. 2).
3. Amendment filed 12-10-90 as an emergency; operative 12-10-90 (Register 91, No. 6). A Certificate of Compliance must be transmitted to OAL by 4-9-91 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 12-10-90 order including amendment of subsection (a) transmitted to OAL 4-8-91 and filed 5-8-91 (Register 91, No. 24).
5. Amendment of subsections (d), (f) and NOTE filed 8-12-91 as an emergency; operative 8-12-91 (Register 92, No. 6). A Certificate of Compliance must be transmitted to OAL 12-10-91 or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance, including editorial correction of table in subsection (f), as to 8-12-91 order transmitted to OAL 12-9-91 and filed 1-2-92 (Register 92, No. 18).
7. Amendment of subsections (d) and (f) and NOTE filed 12-3-92 as an emergency; operative 12-3-92 (Register 92, No. 49). A Certificate of Compliance must be transmitted to OAL 4-2-93 or emergency language will be repealed by operation of law on the following day.
8. Certificate of Compliance as to 12-3-92 order transmitted to OAL 4-2-93 and filed 5-14-93 (Register 93, No. 20).
9. Amendment of subsections (d) and (f) and NOTE filed 8-24-93 as an emergency; operative 8-24-93 (Register 93, No. 35). A Certificate of Compliance must be transmitted to OAL by 12-22-93 or emergency language will be repealed by operation of law on the following day.
10. Amendment of subsections (d) and (f) and NOTE refiled 12-20-93 as an emergency; operative 12-20-93 (Register 93, No. 52). A Certificate of Compliance must be transmitted to OAL by 4-21-94 or emergency language will be repealed by operation of law on the following day.
11. Certificate of Compliance as to 12-20-93 order transmitted to OAL 3-22-94 and filed 4-28-94 (Register 94, No. 17).
12. Amendment of subsections (d) and (f) and NOTE filed 8-31-94 as an emergency; operative 8-31-94 (Register 94, No. 35). A Certificate of Compliance must be transmitted to OAL by 12-29-94 or emergency language will be repealed by operation of law on the following day.
13. Amendment of subsections (d) and (f) and NOTE refiled 1-3-95 as an emergency; operative 1-3-95 (Register 95, No. 1). A Certificate of Compliance must be transmitted to OAL 5-3-95 or emergency language will be repealed by operation of law on the following day.
14. Certificate of Compliance as to 1-3-95 order transmitted to OAL 4-27-95 and filed 6-9-95 (Register 95, No. 23).
15. Amendment of subsections (d) and (f) and NOTE filed 9-19-96 as an emergency; operative 9-19-96 (Register 96, No. 38). A Certificate of Compliance must be transmitted to OAL by 1-17-97 or emergency language will be repealed by operation of law on the following day.
16. Certificate of Compliance as to 9-19-96 order transmitted to OAL 1-17-97 and filed 3-3-97 (Register 97, No. 10).
17. Amendment of subsections (d) and (f) filed 5-15-97 as an emergency; operative 5-15-97 (Register 97, No. 20). A Certificate of Compliance must be transmitted to OAL by 9-12-97 or emergency language will be repealed by operation of law on the following day.
18. Certificate of Compliance as to 5-15-97 order transmitted to OAL 9-10-97 and filed 9-30-97 (Register 97, No. 40).
19. Amendment of subsections (d) and (f) and amendment of NOTE filed 12-31-97 as an emergency; operative 12-31-97 (Register 98, No. 1). A Certificate of Compliance must be transmitted to OAL by 4-30-98 or emergency language will be repealed by operation of law on the following day.
20. Editorial correction of HISTORY 19 (Register 98, No. 24).
21. Certificate of Compliance as to 12-31-97 order transmitted to OAL 4-27-98 and filed 6-9-98 (Register 98, No. 24).
22. Amendment of subsection (d) and NOTE filed 10-29-98 as an emergency; operative 10-29-98 (Register 98, No. 44). A Certificate of Compliance must be transmitted to OAL by 2-26-99 or emergency language will be repealed by operation of law on the following day.
23. Certificate of Compliance as to 10-29-98 order transmitted to OAL 2-26-99 and filed 4-8-99 (Register 99, No. 15).
24. Amendment of subsection (d) and NOTE filed 11-3-99 as an emergency; operative 11-3-99 (Register 99, No. 45). A Certificate of Compliance must be transmitted to OAL by 3-2-2000 or emergency language will be repealed by operation of law on the following day.
25. Certificate of Compliance as to 11-3-99 order transmitted to OAL 3-1-2000 and filed 4-6-2000 (Register 2000, No. 14).
26. Amendment of subsection (d) filed 6-29-2000 as an emergency; operative 7-1-2000 (Register 2000, No. 26). A Certificate of Compliance must be transmitted to OAL by 10-30-2000 or emergency language will be repealed by operation of law on the following day.
27. Certificate of Compliance as to 6-29-2000 order transmitted to OAL 9-29-2000 and filed 11-1-2000 (Register 2000, No. 44).
28. Amendment of subsection (d) and NOTE filed 11-17-2000 as an emergency; operative 11-17-2000 (Register 2000, No. 46). A Certificate of Compliance must be transmitted to OAL by 3-19-2001 or emergency language will be repealed by operation of law on the following day.
29. Certificate of Compliance as to 11-17-2000 order transmitted to OAL 3-8-2001 and filed 4-19-2001 (Register 2001, No. 16).
30. Amendment of subsection (d) and amendment of NOTE filed 1-27-2003 as an emergency; operative 8-1-2001 pursuant to Statutes of 2002, Chapter 16, Items 4260-101-0001 and 4260-101-0890 (Register 2003, No. 5). A Certificate of Compliance must be transmitted to OAL by 5-27-2003 or emergency language will be repealed by operation of law on the following day.
31. Amendment of subsection (d) and amendment of NOTE refiled 5-22-2003 as an emergency; operative 5-22-2003 (Register 2003, No. 21). A Certificate of Compliance must be transmitted to OAL by 9-19-2003 or emergency language will be repealed by operation of law on the following day.
32. Editorial correction of HISTORY 31 (Register 2003, No. 25).
33. Certificate of Compliance as to 5-22-2003 order transmitted to OAL 9-18-2003 and filed 10-16-2003 (Register 2003, No. 42).
34. Amendment of subsection (d) and amendment of NOTE filed 8-24-2005 as a deemed emergency pursuant to Welfare and Institutions Code section 14105(a); operative 8-24-2005 for dates of service 8-1-2002 through 7-31-2003 pursuant to Statutes of 2002, Chapter 379, Items 4260-101-0001 and 4260-101-0890 (Register 2005, No. 34). A Certificate of Compliance must be transmitted to OAL by 12-23-2005 or emergency language will be repealed by operation of law on the following day.
35. Certificate of Compliance as to 8-24-2005 order transmitted to OAL 12-22-2005 and filed 1-23-2006 (Register 2006, No. 4).
36. Change without regulatory effect amending subsections (b)(6), (b)(14) and (d)(1)-(2) and amending NOTE filed 1-26-2009 pursuant to section 100, title 1, California Code of Regulations (Register 2009, No. 5).
37. Amendment of subsection (d), repealer and new subsection (e) and amendment of NOTE filed 6-24-2010 as an emergency; operative 6-24-2010 (Register 2010, No. 26). A Certificate of Compliance must be transmitted to OAL by 12-21-2010 or emergency language will be repealed by operation of law on the following day.
38. Certificate of Compliance as to 6-24-2010 order transmitted to OAL 11-29-2010 and filed 1-10-2011 (Register 2011, No. 2).
39. Amendment of subsection (d), new subsection (e), subsection relettering and amendment of NOTE filed 12-24-2013 as an emergency; operative 12-24-2013 (Register 2013, No. 52). A Certificate of Compliance must be transmitted to OAL by 6-23-2014 or emergency language will be repealed by operation of law on the following day.
40. Certificate of Compliance as to 12-24-2013 order transmitted to OAL 4-15-2014 and filed 5-22-2014 (Register 2014, No. 21).

Note: Authority cited: Section 20, Health and Safety Code; and Sections 10725, 14105, 14108, 14110.6, 14110.7 and 14124.5, Welfare and Institutions Code. Reference: Sections 14087.3, 14108, 14109.5, 14110.4, 14110.6, 14110.7 and 14123, Welfare and Institutions Code; Sections 1250, 1324, 1324.2, 1324.4, 1324.8, 1324.10 and 1324.12, Health and Safety Code; Statutes of 2004, Chapter 208, Items 4260-101-0001 and 4260-101-0890; Statutes of 2005, Chapter 38, Items 4260-101-0001 and 4260-101-0890; and Statutes of 2006, Chapter 48, Items 4260-101-0001 and 4260-101-0890.

1. Amendment filed 8-7-89 as an emergency; operative 8-7-89 (Register 89, No. 32). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 12-5-89. For prior history, see Register 89, No. 1.
2. Certificate of Compliance transmitted to OAL 12-1-89 and filed 1-2-90 (Register 90, No. 2).
3. Amendment filed 12-10-90 as an emergency; operative 12-10-90 (Register 91, No. 6). A Certificate of Compliance must be transmitted to OAL by 4-9-91 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 12-10-90 order including amendment of subsection (a) transmitted to OAL 4-8-91 and filed 5-8-91 (Register 91, No. 24).
5. Amendment of subsections (d), (f) and Note filed 8-12-91 as an emergency; operative 8-12-91 (Register 92, No. 6). A Certificate of Compliance must be transmitted to OAL 12-10-91 or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance, including editorial correction of table in subsection (f), as to 8-12-91 order transmitted to OAL 12-9-91 and filed 1-2-92 (Register 92, No. 18).
7. Amendment of subsections (d) and (f) and Note filed 12-3-92 as an emergency; operative 12-3-92 (Register 92, No. 49). A Certificate of Compliance must be transmitted to OAL 4-2-93 or emergency language will be repealed by operation of law on the following day.
8. Certificate of Compliance as to 12-3-92 order transmitted to OAL 4-2-93 and filed 5-14-93 (Register 93, No. 20).
9. Amendment of subsections (d) and (f) and Note filed 8-24-93 as an emergency; operative 8-24-93 (Register 93, No. 35). A Certificate of Compliance must be transmitted to OAL by 12-22-93 or emergency language will be repealed by operation of law on the following day.
10. Amendment of subsections (d) and (f) and Note refiled 12-20-93 as an emergency; operative 12-20-93 (Register 93, No. 52). A Certificate of Compliance must be transmitted to OAL by 4-21-94 or emergency language will be repealed by operation of law on the following day.
11. Certificate of Compliance as to 12-20-93 order transmitted to OAL 3-22-94 and filed 4-28-94 (Register 94, No. 17).
12. Amendment of subsections (d) and (f) and Note filed 8-31-94 as an emergency; operative 8-31-94 (Register 94, No. 35). A Certificate of Compliance must be transmitted to OAL by 12-29-94 or emergency language will be repealed by operation of law on the following day.
13. Amendment of subsections (d) and (f) and Note refiled 1-3-95 as an emergency; operative 1-3-95 (Register 95, No. 1). A Certificate of Compliance must be transmitted to OAL 5-3-95 or emergency language will be repealed by operation of law on the following day.
14. Certificate of Compliance as to 1-3-95 order transmitted to OAL 4-27-95 and filed 6-9-95 (Register 95, No. 23).
15. Amendment of subsections (d) and (f) and Note filed 9-19-96 as an emergency; operative 9-19-96 (Register 96, No. 38). A Certificate of Compliance must be transmitted to OAL by 1-17-97 or emergency language will be repealed by operation of law on the following day.
16. Certificate of Compliance as to 9-19-96 order transmitted to OAL 1-17-97 and filed 3-3-97 (Register 97, No. 10).
17. Amendment of subsections (d) and (f) filed 5-15-97 as an emergency; operative 5-15-97 (Register 97, No. 20). A Certificate of Compliance must be transmitted to OAL by 9-12-97 or emergency language will be repealed by operation of law on the following day.
18. Certificate of Compliance as to 5-15-97 order transmitted to OAL 9-10-97 and filed 9-30-97 (Register 97, No. 40).
19. Amendment of subsections (d) and (f) and amendment of Note filed 12-31-97 as an emergency; operative 12-31-97 (Register 98, No. 1). A Certificate of Compliance must be transmitted to OAL by 4-30-98 or emergency language will be repealed by operation of law on the following day.
20. Editorial correction of History 19 (Register 98, No. 24).
21. Certificate of Compliance as to 12-31-97 order transmitted to OAL 4-27-98 and filed 6-9-98 (Register 98, No. 24).
22. Amendment of subsection (d) and Note filed 10-29-98 as an emergency; operative 10-29-98 (Register 98, No. 44). A Certificate of Compliance must be transmitted to OAL by 2-26-99 or emergency language will be repealed by operation of law on the following day.
23. Certificate of Compliance as to 10-29-98 order transmitted to OAL 2-26-99 and filed 4-8-99 (Register 99, No. 15).
24. Amendment of subsection (d) and Note filed 11-3-99 as an emergency; operative 11-3-99 (Register 99, No. 45). A Certificate of Compliance must be transmitted to OAL by 3-2-2000 or emergency language will be repealed by operation of law on the following day.
25. Certificate of Compliance as to 11-3-99 order transmitted to OAL 3-1-2000 and filed 4-6-2000 (Register 2000, No. 14).
26. Amendment of subsection (d) filed 6-29-2000 as an emergency; operative 7-1-2000 (Register 2000, No. 26). A Certificate of Compliance must be transmitted to OAL by 10-30-2000 or emergency language will be repealed by operation of law on the following day.
27. Certificate of Compliance as to 6-29-2000 order transmitted to OAL 9-29-2000 and filed 11-1-2000 (Register 2000, No. 44).
28. Amendment of subsection (d) and Note filed 11-17-2000 as an emergency; operative 11-17-2000 (Register 2000, No. 46). A Certificate of Compliance must be transmitted to OAL by 3-19-2001 or emergency language will be repealed by operation of law on the following day.
29. Certificate of Compliance as to 11-17-2000 order transmitted to OAL 3-8-2001 and filed 4-19-2001 (Register 2001, No. 16).
30. Amendment of subsection (d) and amendment of Note filed 1-27-2003 as an emergency; operative 8-1-2001 pursuant to Statutes of 2002, Chapter 16, Items 4260-101-0001 and 4260-101-0890 (Register 2003, No. 5). A Certificate of Compliance must be transmitted to OAL by 5-27-2003 or emergency language will be repealed by operation of law on the following day.
31. Amendment of subsection (d) and amendment of Note refiled 5-22-2003 as an emergency; operative 5-22-2003 (Register 2003, No. 21). A Certificate of Compliance must be transmitted to OAL by 9-19-2003 or emergency language will be repealed by operation of law on the following day.
32. Editorial correction of History 31 (Register 2003, No. 25).
33. Certificate of Compliance as to 5-22-2003 order transmitted to OAL 9-18-2003 and filed 10-16-2003 (Register 2003, No. 42).
34. Amendment of subsection (d) and amendment of Note filed 8-24-2005 as a deemed emergency pursuant to Welfare and Institutions Code section 14105(a); operative 8-24-2005 for dates of service 8-1-2002 through 7-31-2003 pursuant to Statutes of 2002, Chapter 379, Items 4260-101-0001 and 4260-101-0890 (Register 2005, No. 34). A Certificate of Compliance must be transmitted to OAL by 12-23-2005 or emergency language will be repealed by operation of law on the following day.
35. Certificate of Compliance as to 8-24-2005 order transmitted to OAL 12-22-2005 and filed 1-23-2006 (Register 2006, No. 4).
36. Change without regulatory effect amending subsections (b)(6), (b)(14) and (d)(1)-(2) and amending Note filed 1-26-2009 pursuant to section 100, title 1, California Code of Regulations (Register 2009, No. 5).
37. Amendment of subsection (d), repealer and new subsection (e) and amendment of Note filed 6-24-2010 as an emergency; operative 6-24-2010 (Register 2010, No. 26). A Certificate of Compliance must be transmitted to OAL by 12-21-2010 or emergency language will be repealed by operation of law on the following day.
38. Certificate of Compliance as to 6-24-2010 order transmitted to OAL 11-29-2010 and filed 1-10-2011 (Register 2011, No. 2).
39. Amendment of subsection (d), new subsection (e), subsection relettering and amendment of Note filed 12-24-2013 as an emergency; operative 12-24-2013 (Register 2013, No. 52). A Certificate of Compliance must be transmitted to OAL by 6-23-2014 or emergency language will be repealed by operation of law on the following day.
40. Certificate of Compliance as to 12-24-2013 order transmitted to OAL 4-15-2014 and filed 5/22/2014 (Register 2014, No. 21).