Behavior Services Providers

Effective July 1, 2011, the Lanterman Act (Welfare and Institutions code 4686.31) requires any vendor who provides Behavioral Services as specified in Title 17 of the California Code of Regulations to submit a completed verification form to the regional center for services provided to consumers under the age of 18 years who reside in the family home.  The Department is required to post a form which can be used for this purpose.  DDS has developed a new form (DS 5862) containing all the information the vendor is required to report.  This form, along with instructions, is located on the DDS home page http://www.dds.ca.gov/Forms/docs/DS5862.pdf 

The form is available in English, Spanish, Tagalog, Russian, Chinese, and Vietnamese. 

The vendor must submit the completed verifications to the regional center with the invoices for the services provided. If the parents or legally appointed guardians of a minor consumer do not submit a verification of services to the vendor, the vendor shall contact the regional center. 

Vendors in the following service codes must submit completed verification forms to the regional center: 

612-Behavior Analyst

613-Associate Behavior Analyst

615-Behavior Management Assistant

616-Behavior Technician-Paraprofessional

620-Behavior Management Consultant

625-Counseling Services

680-Tutor

017-Crisis Team-Evaluation and Behavioral Intervention Training

025-Tutor Services – Group

048-Client/Parent Support Behavior Intervention Training

077-Parent-Coordinated Home Based Behavior Intervention Program for Autistic Children.