Breaking Down the Spending Plan

A spending plan can look like a wall of codes and dollar amounts. It is simpler than it looks. Every line answers four questions: what kind of service, which service code, who may provide it, and how much money for the year. Once you can read one line, you can read the whole plan and predict what will be paid, to whom, and when.

What one line contains

In California's Self-Determination Program (SDP), the spending plan is attached to your Individual Program Plan (IPP) and shows how your individual budget will be used. The Department of Developmental Services (DDS) requires it to list services, how often they occur and what they cost, sorted into uniform budget categories. Each line carries:

• A budget category. The DDS category the service belongs to.
• A service code. The regional center's code for that type of service. The code, not the provider's name, is what the Financial Management Service (FMS) pays against.
• A provider type and qualifications. Whether the service will come from an caregiver you hire, a vendored agency, or another provider, and what qualifications they need. This is required even if you have not chosen the person yet.
• An annual amount. Your approved budget for that service for the year.

The total of all lines cannot exceed your individual budget. The regional center reviews the plan for federal eligibility, generic-resource rules, provider qualifications and your choices before it is approved. How do spending plans work covers that review.

Reading a line as hours

The annual amount is the least useful number on the page until you divide it. Take a line for service code 310, Independent Living Skills Training, at $12,000 a year. That is $1,000 a month.

If you hire a caregiver at $20 an hour in the Co-Employer model, the line is charged wages plus employer burden. Burden is the employer's share of Social Security and Medicare, unemployment insurance, the Employment Training Tax, workers' compensation and paid sick leave. At Sentinel Four it runs about 21% in the Co-Employer model, so a $20 wage costs about $24 an hour all-in. $1,000 a month divided by about $24 an hour is roughly 41 hours a month, or a little under 10 hours a week.

Two things follow. First, if you plan to schedule 15 hours a week, that line will run out around mid-year. Second, if a minimum wage increase raises the rate, the same line buys fewer hours. That is why DDS allows a budget to be adjusted when costs change. Our employer burden article has the full percentage breakdown, and changing your spending plan mid-year explains how to move money between lines.

How a line becomes a payment

For an caregiver you hire. The caregiver clocks in and out of each shift in the AxisCare app, which satisfies the Electronic Visit Verification (EVV) requirement. Hours are grouped Monday through Sunday. Sentinel Four calculates wages, withholds taxes, adds the employer burden, and pays the caregiver on a Monday. Wages plus burden are recorded against the line for that service.

For a vendor. The vendor sends an invoice, through our portal or by email, showing the participant, the dates of service and the type of service. We validate it against your service codes, rates, dates and regional center authorizations, check for duplicates, and pay by ACH or check on a predictable cycle. The vendor gets a remittance notice; the amount is recorded against the line.

Every month. You get an expenditure report for each line: what was allocated, what was spent in the last 30 days and what remains. The same balances are in your portal at any time.

What a line cannot pay for

Some costs are paid outside the individual budget and should not appear as spending plan lines: the FMS itself (the regional center pays for it since July 1, 2022), insurance co-pays and deductibles, rent, SSI and SSP, and a few program-specific payments. Some things cannot be bought with SDP funds at all: services available from a generic agency such as IHSS, Medi-Cal or a school district, and anything not federally eligible under the SDP waiver. A legally responsible person, typically a parent of a minor or a spouse, cannot be paid for services they would normally provide. What an SDP budget can and cannot pay for has the details; check with your regional center on your own situation.

How Sentinel Four handles this

• Your signed and approved spending plan needs to reach us by the 10th of the month before your start date. During onboarding, your case manager maps each line to its service code and loads the lines and balances into your portal.
• Caregivers are set up in ADP and paid weekly on Mondays. Vendors complete a W-9 and vendor agreement at onboarding and are paid by ACH or check.
• Before any payment goes out, we confirm the service code matches an approved line and that enough remains on it.
• Your portal shows each line, what has been charged to it and the remaining balance, so you can do the hours math above at any point in the year. Our budget management page describes the reports.