Assembly Bill (AB) 4th Extraordinary, Chapter 9, Statutes of 2009, made changes to Welfare and Institutions Code (WIC) Section 4686 of the Lanterman Developmental Disabilities Services Act.
This statute expands the incidental medical services that may be performed by an in-home respite worker, who is not a licensed health care professional and who is trained by a licensed health care professional to perform these services for consumers of regional centers with stable conditions. These incidental medical services are restricted to gastrostomy, colostomy/ileostomy, and urinary catheter care.
3. Are agencies providing in-home respite incidental medical services vendored by DDS or regional centers?
The vendoring regional center is responsible for 1) ensuring that the applicant meets licensing and statutory or regulatory requirements for vendorization; 2) determining the appropriate vendor category for the service to be provided; and, 3) approving or disapproving vendorization based upon their review of the documentation submitted by the applicant.
If you are interested in becoming a vendor, please contact your local regional center. For vendorization questions, please visit the Vendorization, FAQs.
WIC Section 4686(f) states “The treating physician or surgeon shall give assurances to the regional center that the patient’s condition is stable prior to the regional center’s purchasing incidental medical services for the consumer through an appropriately trained respite worker.”
7. Do all in-home respite workers need to complete first aid and cardiopulmonary resuscitation (CPR) training?
Yes. WIC Section 4686(b) states “In order to be eligible to receive training for purposes of this section, an in-home respite worker shall submit to the trainer proof of successful completion of a first aid course and successful completion of a cardiopulmonary resuscitation course within the preceding year.”
8. Are guidelines/criteria available to assist service providers in developing training to in-home respite workers in the provision of incidental medical services?
11. Some service providers do not have a registered nurse on staff. Who pays for a registered nurse to provide training to staff?
14. Are service providers required to submit training curricula for all incidental medical services, even when they plan to provide only one or two incidental medical services?
Service providers who would like to provide in-home respite incidental medical services should send their proposals for DDS review/approval via email to ClinicalServices@dds.ca.gov or mail to:
Department of Developmental Services 1215 O Street (MS 7-10) Sacramento, CA 95814 Attn: Clinical Services
17. The gastrostomy services training protocol includes the administration of medication through the gastrostomy tube. Does this mean that trained in-home respite workers are permitted to administer oral medications?
18. Is there any reimbursement available to agencies to provide training to in-home respite workers?
19. Is the fifty-cent ($.50) per hour wage increase and eight-cent ($.08) per hour benefit increase based on the actual rate or the 4.25 percent (4.25%) reduced rate?
DDS has informed the regional centers of the new sub-codes for in-home respite incidental medical services training and the provision of these training services. Please discuss further billing questions with your regional center.
22. Are service providers allowed to bill the regional centers prior to providing in-home respite incidental medical services (as they may need to coordinate writing the plan, training staff, signing of the plan by a physician, etc)?
23. A restricted health care plan for the provision of incidental medical services is required under California Code of Regulations (CCR) Title 22. Is a restricted health care plan required for the provision of in-home respite incidental medical services under Title 17?
Last modified: December 6, 2022