View Comments on ‘Participant Directed Services Regulations’

The reimbursement rate being suggested is still way too low. At our regional center, there is no FMS that would offer PDS Community Based Training Service (CBTS) because it was “not worth it for them to provide this service.”

We contacted all three of the vendored FMSs who provided PDS, (once we finally got approval for PDS CBTS ) and no FMS would provide it stating the current rate of $16.22 was not feasible for them to offer this service.

So I would highly recommend that the reimbursement rate for PDS CBTS be comparable to what the reimbursement rate is for a vendored service provider who is providing a Community Integration Training Program (055 service code). You will see in Attachment #1* that the definitions of what a 475 and 055 service code are, are very similar to each other. They both have similar goals of community integration leading towards community-based employment or volunteer opportunities so the reimbursement rates be similar.

Also, I would highly recommend that the process to receive PDS services is streamlined and a directive is given as to a time-line to be able to start to receive this service once it is requested by the consumer (and family if applicable).

My son and I had tried for almost a year to get PDS Personal Assistance (PA). We initially requested it in April of 2020 and didn’t receive it until February of 2021.

We initially requested PDS CBTS in August of 2020 and didn’t receive approval for PDS CBTS until June 2021.

We initially requested PDS Transportation in May of 2021 to transport Johnny to and from his community based activities and we STILL have not received it and are waiting on approval.

Receiving services from regional centers that are become part of a consumer’s IPP should not take this long.

Our RC has a long list of requirements that they are asking for but they don’t let us know what those requirements are all at once. They keep adding things on that they need, which prolongs the process to get PDS.

For example, they wanted the community based locations my son was going to, and the mileage to and from those locations. So we provided that to them and now they are “requesting a map” of the locations.

Receiving PDS should not be so difficult for consumers and families to request and receive.

So if you can please add in the revised regulations a timeline to receive approval for PDS, once it is requested AND what the required documents are, so consumers and families know ahead of time, they can be prepared with those when they request PDS. This would be extremely helpful and make the process a lot quicker and easier for consumers and families.

Many times, the reason consumers and families request PDS is because they are not able to get the service under the traditional service delivery vendored model. Which means they have gone without a service they need.

The reason we requested PDS Community Based Training Service through our regional center because there was no quality vendored day program that would accept my son. We were told, this was based on the level of support needs that my son had which included needing 1:1 direct support to assist with personal care (toileting) and a few other minimal behavioral support needs (ex. possible elopement issues at times when out in the community).

This has been the case for many other regional center consumers we know personally, who require assistant using the restroom, and/or are wheelchair users and/or may have behavioral support needs. Vendored Day Programs can pick and choose which consumers they accept into their programs, (which one can argue is against the ADA because vendored service providers receive State and Federal funding through the regional centers.) I mention this because THIS is the reason, PDS Community Based Training Services are so important to many including those with more significant level of support needs which are often under served consumers with unmet needs.

If we don’t offer this service, we are denying consumers a chance to be integrated and included in their communities which is what the HCBS CMS Final Rule is all about.

So please consider making the reimbursement rate somewhat comparable to what a vendored 055 service provider receives.

Lastly I would recommend that you amend this part of PDS CBTS below in RED:

(A) A regional center shall classify a vendor as a Participant-Directed Community-Based Training Service for Adults if the vendor:

1. Is an adult consumer, family member, or conservator;

2. Is not the direct provider of the community-based training service for adults. A parent or conservator shall not be the direct support worker employed by the community-based training vendor; and

The reason being is because often times when you have higher level of support needs, it is very difficult to find quality support staff that can be with consumers out in the community. I completely understand that DDS wants to ensure a parent or conservator isn’t taking advantage of this funding and not providing the service needed but you can put stipulations on it and require proof of what community based locations/activities the parent is assisting the consumer at. For example, proof of a class at community college or proof of enrollment in an acting class, etc.

So the parent/conservator has accountability to show what sort of CBTS they are providing to their adult consumer. As a child, it makes sense to not offer this but when a consumer becomes an adult, we want to create every opportunity we can to give consumers a chance to be out in their community. And if the parent needs to support them in the community that means that they have to take time away from their job. Allowing this as an option, would support the consumer and family to be included in their communities.

Thank you for your support for PDS and expanding it to include PA, ILS and SLS. Also thank you for your time and consideration to our suggestions. I am happy to discuss this more with whomever may be interested.

My son and I are grateful for PDS and having PDS PA helped A LOT throughout this pandemic.

Have a safe and meaningful holiday filled with laughter and love.

With gratitude,
Christina Cannarella and Johnny Hatch

ARCA appreciates the opportunity to comment on the emergency regulations proposed by the Department of Developmental Services (DDS) related to participant directed services. ARCA acknowledges the work of DDS in developing comprehensive regulations that allows for the greatest level of flexibility in meeting the needs of consumers and their families. Please see the attached document for ARCA's comments. Best!

I support making the temporary Participant Directed Services during Covid a permanent benefit. My autistic adult daughter has not used these services yet as she is either not ready or we do not need them yet. However, in the future these services will certainly be needed. To have them as a permanently available supported service will be extremely important. Thank you. Diane Walker, Grass Valley (Nevada County)