January 11, 2019
In alignment with the key principles of the Self-Determination Program (SDP), participants have the authority to control a certain amount of money to purchase needed services and supports. This amount of money is called an individual budget. The purpose of this correspondence is to provide the requirements for determining the amount of the individual budget and how this amount can be used. Applicable excerpts from the Welfare & Institutions (W&I) Code are enclosed (See Enclosure 1).
Definition of Terms
The following terms are used in this correspondence:
- Individual budget – This is the total amount of regional center funds available to the SDP participant each year.
- Spending plan – This plan details how the available funds will be used to purchase services and supports necessary to implement the Individual Program Plan (IPP).
Determining the individual budget amount
The individual budget amount is determined in one of the following ways.
- For participants who currently receive regional center services – The individual budget amount is based on the prior 12 months of all regional center expenditures used to purchase services in the This amount shall be calculated with the most recent 12 months of data.
This amount can be adjusted only if both of the following occur:
- The IPP team determines an adjustment to this amount is necessary due to a change in the participant’s needs, circumstances or resources, or the team identifies prior needs or resources unaddressed in the IPP that would have resulted in an increase or decrease in the amount of regional center expenditures. Examples of when an adjustment to the individual budget amount may be necessary include, but are not limited to, recent/pending change in living situation; services received previously that are no longer needed; services included in the IPP were not used due to illness or lack of provider availability, thus no costs were incurred.
- The regional center certifies the expenditures used to calculate the individual budget amount, including any adjustments, would have occurred regardless of the individual’s participation in the SDP.
2. For participants who are either newly eligible for regional center services or who do not have 12 months of regional center purchases
The individual budget amount is calculated based on the following:
- As required by W&I Code section 4646, the IPP team identifies the services and supports needed by the participant.
- The regional center calculates the annual cost of providing the needed services and supports. This is done by using the average cost paid for each of the identified services and supports and how often the IPP team determines each service or support is The average cost may be adjusted if the regional center determines the participant has unique needs that result in a higher or lower cost. Unique needs may include, but are not limited to, language preference, support for behavioral/medical needs and location of available services.
- The regional center certifies the individual budget amount would have been expended regardless of the individual’s participation in the SDP.
The individual budget amount shall not be increased to fund either the independent facilitator or financial management services (FMS). The individual budget amount is calculated no more than once every 12 months unless, as described above, an adjustment is necessary due to a change in an individual’s needs, circumstances, or resources and the regional center certifies the expenditures would have occurred regardless of the individual’s participation in the SDP.
Spending plan
The IPP team must use a person-centered planning process to develop the IPP which identifies the type and amount of all the needed services and supports to achieve the planned outcomes and ensure the participant’s health and safety. After the individual budget amount is determined, the participant must develop a plan to use the available funds to meet their goals and objectives as outlined in their IPP. The spending plan must be attached to the IPP.
The spending plan must identify the cost of each service and support that will be purchased with regional center funds. This includes the cost for FMS, which is a required service for all SDP participants. Participants may require support from others, such as the independent facilitator, to negotiate with providers to determine the cost for each service.
In addition to wages, costs for employee benefits and payroll taxes must be included when determining the cost of each service. The total spending plan amount cannot exceed the individual budget amount.
SDP funds can only be used for services that:
- have been approved by the federal Centers for Medicare and Medicaid Services; and,
- are not available through other funding sources (e.g., Medi-Cal, In-Home Supportive Services, schools, etc.).
Spending plan changes
Each service in the spending plan falls into one of three larger budget categories (see Enclosure 2 for the list of services and budget categories as of January 2019). A participant may annually transfer up to 10 percent of the funds originally in any budget category to another budget category or categories without approval from the regional center or IPP team. Transfers exceeding 10 percent of the budget category require approval/agreement from the regional center or IPP team.
If there are questions about this information, or to request technical assistance, please send an email to [email protected].
Sincerely,
Original signed by:
JIM KNIGHT
Assistant Deputy Director Community Services Division
This DDS directive may be available in other languages. Here is a link to the DDS website.
