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ICF/DD, ICF/DD-H, ICF/DD-N, and DD-CNC

Intermediate Care Facilities for Individuals with Developmental Disabilities (ICF/IID) are health facilities licensed by the Licensing and Certification Division of the California Department of Public Health (CDPH) to provide 24-hour-per-day residential services. There are four types of ICF/IID’s, which primarily provide services to regional center clients with developmental disabilities.

ICF/DD (Developmentally Disabled)

“Intermediate care facility/developmentally  disabled” is a facility that provides 24-hour personal care, habilitation, developmental, and supportive health services to developmentally disabled clients whose primary need is for developmental services and who have a recurring but intermittent need for skilled nursing services.

ICF/DD-H (Habilitative)

“Intermediate care facility/developmentally disabled-habilitative” is a facility with a capacity of 4 to 15 beds that provides 24-hour personal care, habilitation, developmental, and supportive health services to 15 or fewer developmentally disabled persons who have intermittent recurring needs for nursing services, but have been certified by a  physician and surgeon as not requiring availability of continuous skilled nursing care.

ICF/DD-N (Nursing)

“Intermediate care facility/developmentally  disabled-nursing” is a facility with a capacity of 4 to 15 beds that  provides 24-hour personal care, developmental services, and nursing supervision  for developmentally disabled persons who have intermittent recurring needs for  skilled nursing care but have been certified by a physician and surgeon as not  requiring continuous skilled nursing care. The facility shall serve medically  fragile persons who have developmental disabilities or demonstrate significant  developmental delay that may lead to a developmental disability if not treated.

Developmentally Disabled-Continuous Nursing Care (DD-CNC)

There is an additional facility type, the Developmentally Disabled – Continuous Nursing Care (DD-CNC). The DD-CNC Waiver program provides 24-hour continuous skilled nursing care in home and community-based residential settings to persons with developmental disabilities who are medically fragile.  Eligibility criteria requires that DD-CNC Waiver participants be Medi-Cal eligible, enrolled in, and certified by a Regional Center as having a developmental disability, exhibit medical necessity for 24-hour continuous skilled nursing care and free of any clinically active communicable disease.  Participants must also meet specific minimum medical criteria as described in the waiver. The program provides home and community-based services that assist Medi-Cal beneficiaries to live in the community and avoid institutionalization. The DD-CNC program is initially licensed as an ICF/DD-N type facility.  However, the license is suspended while the facility operates under a Waiver program. DD-CNC development is currently limited by a regional center’s assessed need for this program.

In addition to maintaining licensure through CDPH, ICF/DD, ICF/DD-H, ICF/DD-N, and DD-CNC type facilities must meet the standards and conditions specified in Title 42 Code of Federal Regulations as Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID).

Read more here.

Respite (In-Home) Services means intermittent or regularly scheduled temporary non-medical care and/or supervision provided in the person’s home from a respite vendor. In-Home Respite services are support services which typically include:

• Assisting family members to enable a person with developmental disabilities to stay at home;

• Providing appropriate care and supervision to protect that person’s safety in the absence of a family member(s);

• Relieving family members from the constantly demanding responsibility of providing care; and

• Attending to basic self-help needs and other activities that would ordinarily be performed by the family member.

Types of Respite Include:

1. Self Service Respite

2. Full Service Respite

3. Specialized Health Care Respite

4. Out of home Respite

Respite Fact Sheet

Respite Fact Sheet – Spanish

Note: Client must meet certain criteria in order to qualify for respite services, and should contact their service coordinator for additional information. Read more here.

Respite (Out-of-Home) Services are provided in licensed residential facilities.

Respite services are subject to Family Cost Participation Program (FCPP) criteria for children under 18 years old; learn more about FCPP here:  FCPP Frequently Asked Questions

“NEW” PROPOSED SERVICES (NPS) FOR EXISTING VENDORS

If you are an existing vendor and are interested in developing a “NEW” vendored service, your current vendorizations must be in good standing. To start to this process please complete a New Proposed Service (NPS ) form and list all active vendor numbers. You must also provide a brief description of your New Proposed Services and the programs expected outcomes. As an existing provider you are not required to submit references however, you are required to submit an updated resume reflecting your experience and education related to your New Proposed Service.

Requests will be reviewed every 2nd and 4th Friday of the month. Expect to hear back from the assigned Resource Developer within the next two (2) weeks via email or Sign Now.

VENDORIZATION CHANGES

All vendors are responsible for reporting any changes to an existing vendorization. Reportable changes to an existing vendorization may include but are not limited to the below. To report these changes please complete the Vendor Change Request form at Sign Now.

• Name
• Address and/or  License Site Location Change
• Ownership Change
• Program Design
• Program Closure

Vendorization changes can result in a vendor file review.  A vendor file review includes updating expired insurance policies, professional licenses, completing and submitting required vendor documents. NBRC will work closely with vendors on this process.

Requests will be reviewed every 2nd and 4th Friday of the month. Expect to hear back from the assigned Resource Developer within the next two (2) weeks via email or Sign Now.

EXPIRED VENDOR DOCUMENTS 

Documents such as insurance or professional license may be sent directly to vendor@nbrc.net  Please be sure to include the name of the vendored program and vendor number(s) associated with the attachments.

VACANCIES

Are you a service provider with vacancies in your program? Let us know! Email a completed vacancy form ( NBRC Vacancy Information) to  RESOURCES@nbrc.net

EBILLING

Are you  a Service Provider with questions about eBilling? Click on eBilling Instructions and Enrollment Instructions.

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Service Providers Independent Audits and Review

Section 4652.5 was added to the Welfare & Institutions Code on March 24, 2011, requiring specified vendors to contract with an independent accounting firm for an audit or review of their financial statements.

Under current law, service providers who are paid an amount more than or equal to $500,000 but less than $2 million in the vendor’s fiscal year from regional center payments shall be required to obtain an independent review conducted by a CPA firm. Providers that are paid by regional centers an amount equal to or more than $2 million shall obtain an independent audit of its financial statements. Vendors need to submit their audit/report to NBRC within nine (9) months of the end of their fiscal year.

Request for Exemption

Service providers may request a 2-year waiver for the next audited report/review if the independent CPA audit report or independent review show an unmodified opinion or if the report has no material findings that impact regional center services.

Please submit the Independent CPA audited report/review and the request for exemption letter to rates@nbrc.net

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Community Resource Development Plan FY 22/23 – NBRC’s Local Priorities

A Community Resource Development Plan (CRDP) is developed by each regional center in California with stakeholder input. This plan will be used to develop new resources for individuals with developmental

For FY 22/23, NBRC gathered stakeholder input via survey and determined the below local priorities for NBRC’s Community Resource Development Plan:

Target Population: 0-3yrs

*Infant Development Programs

*Speech

*Individualized/ Family Training

Target Population: 3-12yrs

*Behavior Therapeutic Services

*Intensive behavior services for children with Autism

*Socialization skills/ training program

Target Population: 13-18yrs

* Socialization skills/ training program

* Behavior Therapeutic Services

* Individualized/ Family Training

Target Population: 18-59
* Independent/ SLS
* Day Services with focus on employment
* Residential license facilities

Target Population:  60yrs ( +)
* Independent/ SLS
* HHA
* Residential license facilities

Last Year Survey Results
For FY 20/21, NBRC gathered stakeholder input via survey and determined the below local priorities for NBRC’s Community Resource Development Plan:

• Day/Employment Programs that focus on competitive integrated employment
• Behavior Therapy for children
• Social Training for teens
• Home Health Care Services for Seniors
• Affordable Housing
• Licensed Residential Homes
• Services that focus on Autism
• Services that focus on Substance Abuse

What are regional centers?

There are 21 regional centers in California, each one covering a specific geographical area. Regional centers are private, independent non-profit corporations contracted by the State of California through the Department of Developmental Services to coordinate lifelong services and supports for people with developmental disabilities and their families.  Regional centers also help support individuals with developmental disabilities and their families by identifying local resources and other community-based services that can address the individual’s identified support needs.

See how we are doing: https://nbrc.net/about-us/transparencyaccountability/

Who is eligible for services through the regional centers?

Regional centers are responsible for administering programs for the State of California, each of which has different eligibility requirements that have specific legal and clinical definitions.

• Lanterman Act:To be eligible for services and supports under California’s Lanterman Developmental Disabilities Services Act, adults and children aged 3 and older must have a developmental disability.
• Early Start services: Created by the Early Intervention Services Act, California’s Early Start program serves infants and young children under age three who are considered “high risk” for a developmental disability due to, for example, significant delay in one or more developmental areas or certain medical problems and complications.

What is a developmental disability?

A developmental disability is defined as a disability that is attributable to any of the following conditions:

• Intellectual Disability
• Cerebral Palsy
• Epilepsy
• Autism
• Disabling conditions found to be closely related to an  intellectual/cognitive disability or to require treatment similar to that required for individuals with intellectual disabilities

In addition to the above, the disability must:

• Originate before age 18
• Be likely to continue indefinitely
• Constitute a “substantial disability” for the individual as defined by Title 17, Section 54001 of the California Code of Regulations

What is the California Department of Developmental Services? 

The Department of Developmental Services (DDS) is a department within the California Health and Human Services Agency dedicated to providing services and supports to people with developmental disabilities. Each regional center operates under a Performance Contract (link to Performance Contract under Transparency) with DDS to meet both budgetary and service goals that are aligned with the Lanterman Act.

What is the Lanterman Act?

The landmark Lanterman Developmental Disabilities Services Act  was established over 40 years ago and created
the regional center system. The 21 regional centers that make up this system links those with developmental disabilities with services and supports they need to live safely and with dignity as valued members of their community.

What Can The Regional Center Do For Me?
The regional center helps identify, coordinate, and monitor the services that are needed for an individual to lead a more independent life because of a developmental disability. This is called case management or service coordination. A case manager or service coordinator is assigned to help every individual. He or she will assist in developing an Individual Program Plan (3 years old and above) that includes the identification of services needed, where those services are available what those services should consist of, and how those services should be monitored for progress.

Many online resources have information about autism. It can be difficult to determine which information is the the most helpful and from trusted sources. Below are links to state and national resources that many professionals in the field find useful

Autism Speaks: Autism Speaks has grown into the world’s leading autism science and advocacy organization, dedicated to funding research into the causes, prevention, treatments and a cure for autism; increasing awareness of autism spectrum disorders; and advocating for the needs of individuals with autism and their families.

For those who are newly diagnosed, the 100-Day Kit from Autism Speaks may be a very helpful resource. You can find it here. You will have to enter your email address and the kit will be emailed to you as a pdf file.

Effective July 1, 2012 Senate Bill 946 ensures that people with autism have treatments for behavioral health covered by their health insurance. This includes Applied Behavioral Analysis and other evidence-based therapies that are of medical necessity. Learn more through the California Department of Insurance.

Most health insurance providers and Regional Centers only support therapies for Autism Spectrum Disorder that use evidence-based practices. Evidence-based practices are focused interventions that produce specific behavioral and developmental outcomes and have been demonstrated as effective through applied research. Learn more about evidence-based practices at the California Autism Professional Training and Information Network.

The UC Davis MIND Institute in Sacramento, CA was founded in 1998 as a unique interdisciplinary research center where families, community leaders, researchers, clinicians and volunteers work together toward a common goal: researching causes, treatments and potential prevention of challenges associated with neurodevelopmental disabilities. The institute has major research efforts in autism, fragile X syndrome, chromosome 22q11.2 deletion syndrome, attention-deficit/hyperactivity disorder (ADHD) and Down syndrome. For more information about the institute, please visit mindinstitute.ucdavis.edu. If you would like to partner on research and share concerns and needs with the MIND Institute, please sign up for the Community Partner Registry here:  https://ucdavis.co1.qualtrics.com/jfe/form/SV_3OCeuR5wUR5syk6

National Autism Association: The mission of the National Autism Association is to respond to the most urgent needs of the autism community, providing real help and hope so that all affected can reach their full potential.

Social Security

Social Security Office Locations

A United States federal program of social insurance and benefits developed in 1935. The Social Security program’s benefits include retirement income, disability income, Medicare and Medicaid, and death and survivorship benefits. Social Security is one of the largest government programs in the world, paying out hundreds of billions of dollars per year.

Based on the year someone was born, retirement benefits may begin as early as age 62 and as late as age 67. The amount of income received is based on the average wages earned over the worker’s lifetime, with a maximum calculable amount of $102,000 as of 2008. Spouses are also eligible to receive Social Security benefits, even if they have limited or non-existent work histories.

Supplemental Security Income –SSI

Supplemental Security Income (SSI) is a Federal income supplement program funded by general tax revenues (not Social Security taxes):

CalFresh for SSI Recipients

 CLICK ABOVE LINK for information sheets in multiple languages

CalFresh, known federally as the Supplemental Nutrition Assistance Program (SNAP), provides monthly food benefits to certain individuals and families with low-income. The amount of benefits a household receives is based on household size, countable income, and monthly expenses, such as rent and utilities. The program provides the monthly benefits on an Electronic Benefit Transfer (EBT) card which may be used at grocery stores and farmers’ markets that accept EBT cards.

Benefits for Adults Disabled Before 22

An adult disabled before age 22 may be eligible for child’s benefits if a parent is deceased or starts receiving retirement or disability benefits. We consider this a “child’s” benefit because it is paid on a parent’s Social Security earnings record.

The “adult child”—including an adopted child, or, in some cases, a stepchild, grandchild, or step grandchild—must be unmarried, age 18 or older, and have a disability that started before age 22.

·Employment Support for Young People

A guide to benefits for children with disabilities.

MediCal

Medi-Cal is California’s Medicaid program. This is a public health insurance program which provides needed health care services for low-income individuals including families with children, seniors, persons with disabilities, foster care, pregnant women, and low income people with specific diseases such as tuberculosis, breast cancer or HIV/AIDS.  Medi-Cal is financed equally by the State and federal government.

Medicare

Medicare is for seniors and some individuals with developmental disabilities whose parents have retired, become disabled themselves, or who have deceased.  Learn about Medicare health plans, which provide Part A and Part B benefits to people with Medicare, and what Part D covers. The plans include Medicare Advantage, Medicare Medical Savings Account (MSA), and Medicare Cost plan. The Center for Benefits offers resources in English and Spanish to help navigate the complexities of these programs. Read more here.

Department of Developmental Services  DDS is the agency through which the State of California provides services and supports to individuals with developmental disabilities.

• Lanterman Act This is the California law that says people with developmental disabilities and their families have a right to get the services and supports they need to live like people who don’t have disabilities

• Early Start Families whose infants or toddlers have a developmental delay or disability or an established risk condition with a high probability of resulting in a delay may be eligible to receive an “Early Start” in California. Read more.

Consumer Corner

• Information about publications, resources, and much much more.

Family Cost Participation Program

• Established for the purpose of assessing a cost participation to parents of children who receive three specific regional center services: day care, respite, and/or camping.

Publications & Resources

Appeals, Complaints & Comments

• Click here to access a number of formal processes that have been established for handling appeals and complaints.

Association of Regional Center Agencies (ARCA)

• The Association of Regional Center Agencies (ARCA) represents the autonomous regional centers objective to support and advance the intent and mandate of the Lanterman Developmental Disabilities Services Act. As an advocate for the regional center system members, ARCA promotes the continuing entitlement of individuals with developmental disabilities to all services that enable full community inclusion.

California State Council on Developmental Disabilities

• Established by state and federal law as an independent state agency to ensure that people with developmental disabilities and their families receive the services and supports they need.

Americans with Disabilities Act (ADA)

• Prohibits discrimination against people with disabilities in employment, transportation, public accommodation, communications, and governmental activities. The ADA also establishes requirements for telecommunications relay services.

Employment

California Department of Rehabilitation

• works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living and equality for individuals with disabilities.

Employment Development Department- CalJobs

• the online resource to navigate California’s workforce services providing employment and labor market information for the state of California. The enhanced system allows users to easily search for jobs, build résumés, or access career resources

Disability Benefits 101

• tools and information on health coverage, benefits, and employment. You can plan ahead and learn how work and benefits go together