Rate Reform, QIP, and Provider Directory Updates

Good afternoon,

This bi-weekly email includes the latest updates and progress on developments for Rate Reform, the Quality Incentive Program (QIP), and the Provider Directory. Thank you to all regional center and service providers staff for your partnership in advancing these efforts. Please see the Need-to-Know section for the latest information and next steps.

What is Rate Reform?

In 2019, the California Legislature received a study of the rates for services provided for people with intellectual and developmental disabilities. This study looked at the amount paid for most services and in different areas of California, as well as the quality of those services. The study led to what is known as “Rate Reform”. Rate Reform has been implemented in phases, until its full implementation that will be effective January 1, 2025.

Rate Reform includes the Quality Incentive Program (QIP). Through QIP, providers can earn up to 10 percent of their rate based on the quality of the service(s) they provide. The QIP has several different measures, each related to different types of services. The following areas for QIP measures were determined through the QIP’s public workgroup process: Prevention and Wellness; Employment; Informed Choice and Satisfaction; Workforce Capacity; Early Intervention; and Service Access.

A new foundational measure, called the Provider Directory , has been added to the QIP. The Provider Directory will compile and provide accurate statewide information for the first time about service providers. Participation in the Provider Directory is the only QIP measure that will be used in 2024-25 and 2025-26 for establishing whether a provider will receive the 10 percent quality incentive portion of the rate model for their service(s). Other measures are planned to continue evolving toward individual-level outcome measures.

Need-to-Know

Rate Reform Update:

Over the coming weeks, the Department of Developmental Services (Department) will release a series of directives to regional centers to fully implement new rate models on January 1, 2025. These directives will include:

An overview of Rate Reform and detailed directives for individual service types
Information on the QIP’s Provider Directory measure for use in the new rate models
A description of roles and responsibilities for changes to services within Rate Reform
Guidance for special circumstances and exceptions

Service providers within Rate Reform already have received two rate adjustments based on the services currently being provided. In the coming months, regional center staff and service providers will need to reference the forthcoming directives to consider changes to some services covered by the rate study, including new definitions and provider requirements. Service providers either must align with these requirements or change to a service that best reflects the services being provided.

Quality Incentive Program (QIP) Update:

The Department continues to review and analyze data gathered through the current QIP measures. The Department also is working with providers and QIP focus groups to further develop longer-term quality measures.

At this time, there are eight QIP measures available that providers may participate in to earn incentives. These include the Provider Directory. More information about eligibility, measures and incentives can be found here: www.dds.ca.gov/rc/vendor-provider/quality-incentive-program.
The Provider Directory, which includes all vendored providers, is the sole QIP measure allowing providers to earn the quality incentive portion (up to ten percent) of their rate. DDS will rely on the Provider Directory information for administering future activities, including QIP quality measures and outcome payments, so it is important that all providers participate.

Provider Directory Update:

Data collection and cleanup efforts are underway, led by a third-party data management vendor, Protiviti.

Protiviti, the Department, and regional centers continue to outreach to service provider contact people. This outreach will continue during August for data collection, surveying, and cleanup activities.
Service providers who have not yet responded to this outreach should expect to be contacted via email or a phone call. There also is a self-service survey located on the Provider Directory website. Multiple contact attempts will be made so that all service providers can confirm their records and qualify for an incentive payment.
Learn more about the data cleanup, registration, and validation steps in the previous bi-weekly email on the Provider Directory website: www.dds.ca.gov/initiatives/provider-directory

Next Steps (Key take aways, action items, or important dates):

Rate Reform:

Regional center staff and providers should check the website for updated information on rate reform, directives, trainings, and office hours: www.dds.ca.gov/rc/vendor-provider/rate-study-implementation
Before December 31, 2024, regional centers will confirm provider vendorizations through the rate reform workbooks.
Final rates will be determined by the verification of completed activity in the Provider Directory.

QIP:

The next QIP workgroup meeting will be scheduled and held in late summer 2024. A registration link will be distributed and added to the DDS Stakeholder Events webpage later in August 2024.

Provider Directory:

Participation in the Provider Directory by October 31, 2024, is the only measure that will be for the quality incentive portion of the rate model’s full rate that starts on January 1, 2025. It will be the only measure for the 2025-26 fiscal year, as well. DDS will be sharing more guidance on the enrollment and validation process in the upcoming weeks.
DDS and Protiviti are reaching out to regional centers and service provider contacts for the data collection information.
A toolkit has been shared to support regional centers in outreach to service providers. It is available on the Provider Directory website.
After the initial data collection is validated, all providers are required to go into the online Provider Directory and update any information about their business. This applies to all providers of developmental disabilities services, regardless of whether the Rate Reform applies to that provider. Details about how to do this will be released in the coming weeks in a directive from the Department.

Questions:

Rate Reform Email: ratesquestions@dds.ca.gov

QIP Email: QIPquestions@dds.ca.gov

Provider Directory Email: providerdirectory@dds.ca.gov.