Prior to age three, children across California can receive early intervention services from Regional Centers if they have been diagnosed with, or are at risk for, developmental delays or developmental disabilities. Early intervention for children under age three is mandated by Individuals with Disabilities Education Act (IDEA), the federal law governing special education. Many children receive occupational, physical, and speech therapy from the Regional Center during this time, along with other early intervention services.
Once a child turns three, the child’s school district of residence becomes responsible for providing special education services under IDEA. The transition progress begins several months before the child turns three, so that an Individualized Education Plan (IEP) is in place with the school district by the child’s third birthday (which is when Regional Center early intervention services end). To read more about the transition to special education, read our article, The Preschool Transition: Choosing a School and Preparing for Your First IEP.
Some children will be eligible for continued Regional Center services under the Lanterman Developmental Disabilities Act after they turn three years old, if they have been diagnosed with a developmental disability as defined by California law.
Who is eligible under the Lanterman Act?
To be eligible for Regional Center services after age three, a child must have a substantial disability that begins before age 18 and is expected to continue indefinitely. Eligible disabilities include cerebral palsy, epilepsy, autism, intellectual disability, and other conditions closely related to intellectual disability or that require similar treatment. However, a diagnosis alone is insufficient for eligibility; the child’s disability must be “substantial.” A “substantial” disability is one in which the person has impairments (defined in comparison to the expectations for a typical person of the same age) in at least three of the following areas: communication skills (receptive and expressive language), learning abilities, self-care, mobility, self-direction, independent living skills, and economic self-sufficiency.
During the transition process, the Regional Center will determine whether your child is eligible to remain a consumer under the Lanterman Act. If you disagree with the Regional Center’s determination, you have the right to file a request for a hearing to appeal their decision. See this article for more information on the appeal process.
If Regional Center determines that your child is not eligible for continued services under the Lanterman Act, ask whether your child can receive provisional eligibility status, which allows them to continue Regional Center services until age five. Undivided's Public Benefits Specialist, Lisa Concoff Kronbeck, says that if your child is switched to provisional eligibility status at age three or four, you should ask why they are not being switched to full eligibility under the Lanterman Act. She also wants parents to be aware that continued eligibility after age three is not the same as continuation of their existing services after age three.
For a list of questions you can discuss with your service coordinator during the Lanterman Act transition meeting to provide more clarity, see this document:
The scope of Regional Center services after age three is significantly different from what is provided through early intervention. Below is a summary of some of the services and resources that may be available via the Regional Center once a child has transitioned out of early intervention, depending on your child’s needs as outlined in the Individualized Program Plan (IPP). Each Regional Center is operated independently, and the type and extent of services vary from center to center, depending on the service and whether the Lanterman Act requires or merely allows each Regional Center to provide it. Every Regional Center has on its website a document that outlines the Purchase of Service (POS) Standards for each service that it provides. For specific information about your Regional Center, please consult their service standards guide.
Some things to keep in mind:
A Regional Center may consider funding for behavioral supports when a child’s behaviors pose a health or safety threat to themselves or others, when they jeopardize a child’s ability to be maintained in the least restrictive setting (e.g., the behaviors put a child at risk of institutionalization or preclude them from participating in typical day programs), and when they interfere with the acquisition of developmentally appropriate adaptive or functional skills that are “fundamental to the attainment of social inclusion and increased independence.”
The Regional Center may refer parents to community resources, fund educational sessions or workshops to aid parents in addressing their children’s behaviors at home, or fund in-home consultation with a credentialed behaviorist, who helps parents set up an individualized behavior intervention program to be implemented by the parent. Some Regional Centers offer a toilet-training program as one of their behavioral services. For children with higher behavioral needs, the Regional Center may fund in-home Applied Behavioral Analysis (ABA) services or other behavioral therapy programs, such as Floortime.
Per recent changes in the law, children who receive Medi-Cal through a managed care plan will receive ABA through Medi-Cal rather than the Regional Center.
A Regional Center may fund in-home respite services for the purpose of providing parents with relief from the ongoing care and supervision of their child with developmental disabilities. The number of respite hours provided is based largely on the extent of the child’s care needs, as well as extenuating family circumstances. Additional respite hours may be available on an emergency basis, e.g., due to a family health emergency or for parents to attend training or conferences related to the child’s disability.
Social skills therapy is “structured programming in either an individual or group format that primarily addresses significant deficits” in engagement and awareness of other people, play skills, social communication skills, and social interaction skills. Some Regional Centers will provide social skills classes if they are necessary to aid the consumer in meeting social goals articulated in the IPP.
Effective July 1, 2021, funding has been restored for social-recreational funding and camping services that help a Regional Center client meet goals articulated in the IPP.
Typically, for generic community programs such as dance classes, Scouts, community summer camps, etc., the cost of the program itself remains the parents’ responsibility, as it would for the parents of a typically developing child. When a child needs additional supports to participate in community group activities with non-disabled peers, Regional Centers may fund a variety of services to help them access those programs, including, among others, behavioral supports, a 1:1 for health or safety purposes, or a temporary inclusion aide who “works directly with the staff members, teaching them how to support the disabled individual and encourage others in the program to engage and accept the individual with disabilities.”
When a child is unable to participate in generic community activities, the Regional Center may fund social-recreational or camping programs with embedded disability supports, such as specialized dance classes, summer camps for children with disabilities, etc. Providers must complete the Regional Center vendorization process for the program to be funded. Regional Centers should also maintain a list of current vendors.
The Regional Center will only fund educational services for those ages 3 to 17 as a payor of last resort.
Regional Centers may be able to fund specialized child care services (sometimes referred to as day care, child care, or specialized supervision) for parents who work full-time or are enrolled in job training or education programs that will lead to employment and can only take place beyond the child’s school day. The child’s care and supervision needs must exceed that of a non-disabled child of the same age, such that they cannot participate in regular childcare resources in the community (such as day care centers, after-school programs, YMCA programs, and others). Child care is generally funded to the extent the cost exceeds childcare costs for a typical child; in other words, only the portion in excess of typical childcare costs will be funded.
Often, additional child care/specialized supervision/personal assistance funding may be available for older children and young adults, as their typically developing peers usually do not require 1:1 day care services.
Most of the time, incontinence supplies (diapers, moisture barrier creams, incontinence pads, etc.) for children over the age of three will be funded either by private insurance or by Medi-Cal. However, sometimes a child will be unable to use the brands provided by Medi-Cal due to allergic reactions or other sensitivities. In the event that Medi-Cal is unable to provide an acceptable alternate brand of diaper, the Regional Center may be able to fund the diapers even for a child covered by Medi-Cal, as long as adequate documentation is provided showing that the diapers are medically necessary (including the change in brand) and cannot be obtained from another funding source.
The same may be true of certain medical supplies and equipment that are medically necessary but cannot be funded by private insurance, Medi-Cal, or California Children’s Services. We are happy to provide more information about this service on request.
Planning for transition to adulthood begins at age 14 and is a collaborative effort between the IEP team, Regional Center, and other relevant agencies such as the Department of Rehabilitation where appropriate. The school district bears the primary responsibility for coordinating these services as long as the child is enrolled in special education, but Regional Center should be involved in some capacity, and the IPP should reflect transitional goals. Some Regional Centers will transfer consumers to a new service coordinator at age 14 if they have a separate department for transition-age children. Preparation for the transition to adulthood may involve aspects such as development of independent living skills, plans for where your child will live as an adult, preparation for work or training programs, and more.
Some Regional Centers may also provide family resource centers, support groups, IEP advocacy, and funding for educational training and conferences related to your child’s disability (typically only the registration fee is funded and not travel, food, or lodging). For specific information on what services may be available at your Regional Center, you should consult its standards guide.
When your child turns three years old, ask Regional Center about enrolling your child in Medi-Cal. Through California’s Medi-Cal institutional deeming waiver for individuals with developmental disabilities, many Regional Center clients are able to enroll in full-scope Medi-Cal (i.e., Medi-Cal that includes the full range of covered benefits and not just emergency services) without regard to parental income, so long as the child’s personal income and resource levels fall below program thresholds. For more information, please see this article about the Medi-Cal waiver.
Regional Center can also help with copayments in certain situations. Learn more here.
For a user-friendly but comprehensive discussion of consumers’ rights under the Lanterman Act, please take a look at Disability Rights California’s publication, “Rights Under the Lanterman Act.”
