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Self-Determination Program - Frequently Asked Questions
Q. What is the Self-Determination Program?
A. The Self-Determination Program allows participants the opportunity to have more control in developing their service plans and selecting service providers to better meet their needs.
Q. When does the Self-Determination Program start; can I enroll now?
A. The program will start once it is approved for federal funding. The Department worked with stakeholders to draft a Home and Community-Based Services Waiver application that was submitted for approval to the Centers for Medicare and Medicaid Services on December 31, 2014. Upon approval of the Waiver application, the Self-Determination Program will be implemented for up to 2,500 participants during the first three years. After this three year phase-in period, the program will be available to all consumers.
Q. How can I keep updated on the progress of the Self-Determination Program?
A. Updates will be posted as they become available on the Self-Determination website. If you want to be notified when updates are made, send us an email and ask to be included on the update notification list.
Q. How can someone learn more about the Self-Determination Program?
A. Interested participants, families, or others are encouraged to visit the Self-Determination Program website to find out more information about Self-Determination. The site will be updated as more information is available.
Criminal Background Checks
Q. Who is required to get a background check? Will parents and family members need one also?
A. A criminal background check is required for people providing direct personal care. If family members provide direct personal care, they must obtain background checks and receive clearance.
Financial Management Services
Q. What are Financial Management Services?
A. Financial Management Services help participants manage their individual budgets by paying bills and managing the payroll for support workers.
Q. In the co-employer model, is it possible for the person receiving services and their family to be part of the interview process and/or pick the interview questions?
A. Yes. The participant and any person selected and directed by the participant can be as involved as they choose to be.
Q. Who can be a Financial Management Services Provider?
A. Any entity or person, except a relative or legal guardian, chosen by the participant and meets the qualifications may be a Financial Management Services provider.
Q. As a Self-Determination Program participant, would I pay my providers directly and get reimbursed by the Financial Management Services entity, or would I submit the expenses to the Financial Management Services entity for payment to my providers?
A. Neither. The Financial Management Services Provider will pay providers directly.
Q. For individuals needing 24-hour supportive services, is overtime pay applicable whether the co-employment model or fiscal employer agent is selected?
A. Each participant will need to work with their Financial Management Services Provider to determine when overtime pay is required.
Q. What type of certification or licensure should individuals request from independent facilitators?
A. An independent facilitator is required to receive training in the principles of self-determination, the person-centered planning process, and the other responsibilities consistent with coordination of services for consumers' individual program plans.
Q. What if I need help locating services and supports but choose not to work with an independent facilitator?
A. If a participant chooses not to use the services of an independent facilitator, he/she may choose to use a regional center service coordinator to provide the services and functions of the independent facilitator.
Q. Who pays the cost of the independent facilitator and how much does that typically cost?
A. The cost of the independent facilitator is paid through the participant's individual budget and can be negotiated with the facilitator.
Q. What is an individual budget?
A. It is the amount of money a Self-Determination Program participant has available to purchase needed services and supports.
Q. How does the individual budget amount get determined?
A. The individual budget is determined by the individual program plan team, and is based upon the amount of purchase of service funds used by the individual in the most recent 12-months. This amount can be adjusted, up or down, if the individual program plan team determines that the individual's needs, circumstances, or resources have changed. Additionally, the individual program plan team may adjust the budget to support any prior needs or resources that were not addressed in the individual program plan.
Q. How does the individual budget amount get determined for an individual, who is either new to the regional center, or does not have a 12-month history of purchase of service costs?
A. For these individuals, the individual budget amount is determined by the individual program plan team, and is based upon the average purchase of service cost of services and supports, paid by the regional center, that are identified in the individual's individual program plan. The average cost may be adjusted, up or down, by the regional center, if needed to meet the individual's unique needs.
Q. Are there restrictions on what the individual budget can be used for?
A. Yes, a participant can only purchase services and supports as described in the Self-Determination Program Waiver and in the individual program plan. Services funded through other sources (e.g., Medi-Cal, schools) cannot be purchased with Self-Determination Program funds.
Q. Is the Self-Determination Program budget and In-Home Supportive Services [budget] different?
A. Yes. In-Home Supportive Services is a generic resource and is not included or paid for through the Self-Determination Program.
Q. In reality is the program decreasing your budget?
A. The individual budget is determined by the individual program plan team, and is based upon the amount of purchase of service funds used by the individual in the most recent 12-months with the ability to adjust if circumstances require it. The Self-Determination Program expands the options available to a participant; your budget is the same as it would be if you were obtaining services through your Regional Center.
Q. Can I use my budget to pay for recreation activities?
A. The Self-Determination Program allows you to purchase social recreation activities.
Q. What is an unmet need? How do I get that included in my budget?
A. An unmet need is a service identified as needed and not yet provided. You may be able to include services in your budget by adding them to your individual program plan.
Q. What if participants are happy with their current service delivery program and do not wish to enroll in the Self-Determination Program?
A. Enrollment in the Self-Determination Program is completely voluntary. Just like any other program offered under the Lanterman Developmental Disabilities Services Act in California, an individual chooses what is best for him or her. An individual may choose to participate in, and may choose to leave, the Self-Determination Program at any time.
Q. How much responsibility will participants or their family have if they choose to participate in the Self-Determination Program?
A. The participant will need to develop a person-centered plan and select individuals or members from their planning team to help implement the plan. The participant will also need to choose a Financial Management Services entity that will work with him or her to monitor an individual budget.
Q. If I choose to participate in the Self-Determination Program, will I still have the same rights?
A. Yes, participants enrolled in the Self-Determination Program will have the same rights established under the traditional service model (e.g. appeals, eligibility determinations, and all other rights associated with the individual program plan process).
Q. What criteria will the regional center use to select participants?
A. The process for selecting and enrolling the 2,500 participants in the first three years is described on the Self-Determination Program web page.
Q. Who is eligible for the Self-Determination Program?
A. An individual must meet the following eligibility requirements:
- Has a developmental disability and currently receives services from a regional center or is a new consumer of a regional center;
- Agrees to specific terms and conditions, which include but are not limited to, participation in an orientation for the Self-Determination Program, working with a Financial Management Services entity, and managing the Self-Determination Program services within an individual budget amount;
- An individual who lives in a licensed long-term health care facility (i.e., a Skilled Nursing Facility or Intermediate Care Facility) is not eligible to participate in the Self-Determination Program. If someone lives in one of these facilities and is interested in the Self-Determination Program, he or she can request that the regional center provide person-centered planning services in order to make arrangements for transition to the Self-Determination Program, provided that he or she is reasonably expected to transition to the community within 90 days.
Q. The Self-Determination Program website has links to a list of proposed services and definitions. Will the individual regional centers be allowed to interpret those differently?
A. The listed services are those that have been proposed in the Self-Determination Program Waiver application. Also included with each service is a description of qualifications for each service provider. This is all subject to approval by the Centers for Medicare & Medicaid Services.
Q. Can a consumer request a camp or trip through an organization that is not familiar to the regional center?
A. Other than Financial Management Services, providers of services in the waiver do not have to be vendored through the regional center.