Could California’s Self-Determination Program Flexibility Be at Risk? What Regional Center Families Need to Know

Families in California's Regional Center system could soon see changes in how services are approved and paid for, including in the Self-Determination Program (SDP). The Department of Developmental Services (DDS) has been directed by state law to create, for the first time, a statewide definition of what "cost-effective" means.

That may sound technical, but families and disability advocates are paying close attention because the definition could affect how Regional Centers decide what services they'll fund and, for people in SDP, how much they can pay providers.

The biggest question right now is what will happen to the flexibility that makes SDP work. No one knows the answer yet. DDS has released a draft definition and is asking for public feedback by July 31, 2026, before issuing the final policy later this summer. Find more information on giving feedback at the end.

DDS has proposed a new definition of cost-effective for Regional Center services. Under their proposal, “cost-effective” will be defined as meeting all the following criteria:

• Meets the individual’s needs
• Helps the individual achieve their Individual Program Plan (IPP) goals
• Does not replace generic services
• Is eligible for federal financial participation
• Is provided by a qualified provider
• Is provided at a reasonable rate

Individuals will still be able to choose who provides their services.

Community concerns to note: SDP rate caps?

DDS has to consult with community partners regarding their new definition of cost-effectiveness. On June 29, 2026, DDS held a series of webinars, facilitated by their contractor Mission Analytics Group, in which they presented their proposed definition and accepted comments in the Q&A. Questions and comments were answered only with appreciation, with no clarification over how the new definition might be interpreted by different Regional Centers or how it might be implemented.

Among concerns that the webinar lacked clarity, the biggest concern from attendees was that the definition of cost effectiveness being applied to the SDP program would remove the very flexibility that makes SDP a better way for many families to receive RC services. The cost effectiveness of SDP comes from having a limited budget for a spending plan. Adding an additional cost-effectiveness test to the spending plan could prevent families from accessing non-traditional services.

The DDS presentation gave us some indication of how this will work for SDP. The slideshow suggests that:

• Vendored services match the vendor’s program design, meaning vendors that are approved by the Regional Center for traditional services. A reasonable rate is the vendored rate. Regional Centers can take into account comparable services at rates set by other government departments.
• For services from local businesses or community resources, a reasonable rate is a rate not higher than what similar community providers charge.
• Rate adjustments can be explored to meet the unique needs of the individual

Most attendees interpreted this part of the definition to say that SDP participants would no longer be able to set their own rate for employees or services.

But there is so much that is not clear: who determines a rate adjustment based on unique needs? Is this going to require Regional Centers to approve these rate adjustments in the SDP spending plan? If a reasonable rate cannot be higher than what is offered by local businesses or community resources, how much will they take into account the effectiveness of those other low-rate services in terms of achieving IPP goals?

For example, if a provider recommends that a child will need 1:1 swimming lessons, are families going to be denied the rate for a 1:1 service because there is another swim program 20 miles away with a lower rate for group lessons, even if that other program regularly tells families that their services won’t work for kids like theirs? How will the comparison ensure that the service is substantially similar in the way it meets the child’s unique needs?

Disability advocates are less concerned about the phrase “cost-effective” itself. Their concern is how DDS will define it. They worry that if the definition focuses too heavily on standardized rates instead of whether a service actually helps someone meet their IPP goals, families could lose some of the flexibility that makes services effective, particularly in the Self-Determination Program.

Other concerns are “natural supports” and “generic resources,” and how the Regional Center will use them as the “cost-effective” method, with reference to the expectations of families and possible unpaid care. Not all adults with disabilities have families that provide care, and this could mean that those who do might have higher levels of expectations for unpaid care based on having access to their family for housing or levels of direct care. Let’s explore some of these terms:

“Generic services”

When Regional Center provides services, they first have to look for services that are provided to the general population, such as public school, health insurance, and other government services such as IHSS and the Department of Rehabilitation (DOR). They call these “generic services” - they can be free public goods, or they can have a cost that is usually borne by family members. For example, participating in a sports team is a cost that many families with typically developing children pay. This is termed “family responsibility.”

“Eligible for federal financial participation”

By this term, DDS means that they plan to take account of whether a service is reimbursable through federal Medicaid. Services that are not federally reimbursable might not be considered cost-effective under these rules, meaning Regional Center could choose not to purchase services that don’t meet the federal Medicaid requirements. Although independent facilitator services fall into this category, they are specifically protected under the Lanterman Act. Other services that fall into this category are possibly person-centered planning, legal and civil rights advocacy, and resource development.

“Qualified provider”

What makes a provider qualified? Many SDP families value staff and service providers with nontraditional qualifications. They might not have a college degree or a specialty certificate, but they have great experience and aptitude, especially with their client. They might be someone who just “gets” their client. For example, the provider might be an athlete or an artist with lots of experience but no formal training.

“Reasonable rates”

Under the proposed change, what does “reasonable rate” mean? For traditional services, the DDS definition proposes that Regional Centers use rates set by the DDS rate study or rates set in law. They can also use rates set by other government agencies or rates charged to the general public. If the Regional Center wants to pay a negotiated rate exceeding these methods, they have to seek approval from DDS.

For Self-Determination Program participants, the proposed definition offers a different solution to “reasonable rate." This proposed definition applies to all SDP services identified in the individual’s spending plan. That means we are not just talking about the rate that Regional Center uses to identify your budget but also the rate that you are able to pay your provider. In this way, the proposal endangers the flexibility that makes SDP such a success.

“Least restrictive”

The new definition curiously seems to leave out an important component of the existing definition. Many people in the disability community are concerned that the current proposal weakens existing protections that insist that Regional Centers cannot select the least costly provider if the service will then be delivered in a more restrictive setting. Given that the federal government can no longer be counted on to enforce this accessibility rule, advocates are concerned that DDS is not explicitly including a preference for services being provided in inclusive and natural environments.

The Lanterman Act is the California law that governs Regional Center services for individuals with intellectual and developmental disabilities. It sets out the requirements and begins with a definition of services and supports that Regional Centers can provide.

The act uses the term “cost-effective" over 20 times to describe how Regional Centers should determine which services to purchase for eligible individuals. For example, it says that Regional Centers need to consider “the needs and preferences of the consumer…the effectiveness of each option in meeting the goals stated in the individual program plan, and the cost-effectiveness of each option.” (California Welfare and Institutions Code § 4512(b))

Cost-effectiveness isn't the only consideration, but it is one of them. The Lanterman Act also requires that service decisions take into account the cost-effective use of public resources alongside individual needs, preferences, and goals.

Regional Center funds cannot be used to provide services that are the responsibility of other government agencies, such as public schools or IHSS provided by the county. Participants must use generic services first, including private medical insurance. Also, Regional Centers are not allowed to provide services that fall under normal family responsibility, out-of-state services, or experimental treatments.

Rates in traditional Regional Center services and SDP

In 2019, California ordered a statewide study to set clearer, more consistent payment rates for Regional Center services. The goal was to create published rates that reflect differences in cost of living and wages across the state. That study is now complete, and the rates are available online for Regional Centers to use.

When it comes to the Self-Determination Program (SDP), there is an important difference between the budget that Regional Centers provide for the individual's services and the rates that the individual pays their providers in their spending plan. For example, the Regional Center might provide 100 hours of respite at their published rate in the budget. The individual can currently instead pay their provider double that rate for 50 hours. In the pilot study for SDP, it was found that this accommodation is cost-effective because it allows individuals to choose the providers who work best for them, and in the long term, SDP participants used less public funding than traditional Regional Center participants.

Last year, the state government required DDS to develop a definition of "cost-effective" for all Regional Center services. This had been identified as a problem within the Lanterman Act as early as 2011 and is not necessarily only targeted at SDP. But many in the SDP community are concerned that the new definition of cost-effective that DDS is developing might not allow SDP participants the same flexibility in rates — and might not take into account the long-term cost-effectiveness of retaining long-term and well-trained staff.

What “cost-effective” and SDP flexibility means in practice

Iris Barker, Independent Facilitator, founder of Bridge Builders CA, and Undivided Self-Determination Consultant, gave us some examples of how the flexibility in SDP often makes services more effective in terms of furthering the goals identified in your child’s IPP.

Matching services to IPP goals

For example, if the child is taking a gymnastics class, the cheapest class in your community might not be a successful option, while a more expensive class might have well-trained staff members who take the time to ensure that the child with a developmental disability can be included. The definition of cost-effective should be tied to the IPP goals and take a long-term view. The cheaper class isn't cost-effective because it doesn't lead to progress on the IPP goals. Another example given was the distance that a family has to travel, particularly in rural areas. For example, if a family is forced to use providers 30 minutes away to be "cost-effective," that renders services practically inaccessible.

Barker gave us another example of a parent who might have a service in their budget based on the Regional Center rate study, but in their area, they cannot find highly qualified and experienced providers at that rate. The flexibility of the SDP spending plan allows participants to find staff with qualifications who can better address behavioral issues, and their training and experience are what make the service effective at meeting the IPP goals. This doesn't cost the state more because the overall cost is set by the budget, not the spending plan.

Participants are going to have to pay close attention to their IPP goals and how services are tied to them to ensure that effectiveness is tied to the real needs of the participant. Before going into SDP, many families experienced that the services provided by traditional Regional Center funding were not usable and therefore ineffective. We need to get that long-term, goal-oriented view of what is reasonable into our definition of cost-effective.

Long-term effectiveness

The logistics of the SDP plan itself often also get in the way of the most cost-effective purchase. You can’t just go into a big box store to purchase specialized equipment. In many cases, small local businesses such as day camps and music classes are being asked to write specialized invoices that don't require a credit card on file — AND, importantly, cannot require prepayment without a full refund if cancelled.

Let's say a family pays for a week of camp to secure a place and has to cancel last-minute due to illness; a small business would likely not be able to cope with that loss of revenue. Many local businesses cannot operate on those economics for the rest of the community — we are asking them to provide an additional service, and only premium services are likely able to comply with the DDS requirements. Often, the logistical requirements of the FMS paying providers based on Medicaid rules force families to choose a more expensive option.

True cost effectiveness has to be considered from a long-term viewpoint. The cheapest service sometimes ends up being more expensive in the end; hiring lower-cost, less experienced providers often leads to higher long-term costs due to service failure and the need for more frequent interventions. More importantly, the cheap service might end up not even being used. Many families have turned to SDP because they previously were not using their needed Regional Center services. They may have had respite hours but could never find a worker at the time needed, or their assigned worker did not know sign language or was not trained in AAC to communicate with the individual eligible for Regional Center services.

To be cost effective is not only to be the least expensive but also to be wholly effective. The experiment of SDP is to show that when individuals are driving their own spending, they can do so far more effectively, sometimes not choosing the least expensive, but the most effective — and in this way, SDP furthers the IPP goals with much greater impact than traditional Regional Center services. This view of cost-effectiveness needs to be tied back to IPP goals in order to measure effectiveness.

Right now, nothing has changed. DDS is still accepting feedback, and the final definition has not been released. But advocates are concerned because the proposal could:

• Make it harder to justify paying providers above Regional Center rates in SDP
• Reduce flexibility and quality when a more expensive provider is actually the one who helps someone meet their IPP goals
• Make Regional Centers rely more heavily on published rates instead of individual circumstances
• Create uncertainty about services that don't fit neatly into traditional funding rules

Last year, we reported that the 2025 Developmental Services Budget Trailer Bill, Assembly Bill 143 requires the Department of Developmental Services (DDS) to issue a written directive defining the term "cost-effective" for all programs with community input no later than August 1, 2026. That community input is happening now!

You can currently submit written input. The changes proposed must be presented on August 1, 2026. DDS has issued a survey to collect feedback, with responses due by July 31. But families are encouraged to submit their comments as soon as possible, so DDS has time to consider and incorporate that feedback into its final definition.

Chris Arroyo, deputy director of the State Council on Developmental Disabilities, tells Undivided, “This is an advocacy opportunity to impact the system. Cost-effectiveness is a decision that will impact both traditional services and SDP. Please utilize this opportunity to use your voice."

The directive could potentially change the way Regional Centers assess cost-effectiveness in determining which services to purchase for eligible individuals, so it's important to understand how this definition will be applied and what the impact could be.

DDS asked specifically for ideas for additional terms or definitions that would assist in making their definition of cost-effective clearer and more usable. Make sure you answer this survey by July 31, 2026, so that your voice can be heard.

The feedback survey allows plenty of opportunity for families to raise their voice and tell their story. We need to show how the flexibility of setting our own rates allows us to make our spending more effective at reaching our IPP goals. Please include your personal stories of how SDP flexibility in rate setting has allowed your Regional Center services to be far more effective based on your child’s IPP goals.

Start here: guiding questions for families in SDP

Families are encouraged to share concrete examples from their own experience. Have you experienced the effectiveness of SDP’s freedom to choose a different rate? Perhaps you paid staff a little more than the DDS respite rate because you wanted to ensure they stayed, or you chose a provider with more experience working with nonspeaking children? Did you find that the more expensive gym was the one that was willing to work with you to provide an invoice for your FMS without storing a credit card on file? In providing feedback to DDS, focus on examples that are strongly tied to meeting your child’s IPP goals.

To help families think through their public feedback to DDS, we’ve put together a few guiding questions below. These are meant to spark ideas and make it easier to reflect on your experience with Self-Determination Program (SDP) flexibility — especially where it has helped (or limited) your child’s ability to meet their IPP goals and unique needs.

As you read through, think about real-life examples: where flexibility made a meaningful difference, where it helped you find or keep the right support, or where cost rules got in the way of what was actually most effective for your child.

Think of an example:

• Have you experienced the effectiveness of SDP’s freedom to choose a different rate?

• Have you been able to find or retain staff in SDP by paying a higher rate than the one allocated in your budget (but for fewer hours)?

• Have you given trusted workers a small payrise?

• Have you found a provider who can work with your child but doesn't have qualifications?

• Have you found a respite or community integration provider who makes more than the DDS rate from babysitting?

• Have you had difficulty finding community businesses that will work with SDP—such as camps or gyms, for example, not having a credit card on file for monthly membership or not having a no-cancellation policy? Or needing an invoice?

• Has SDP enabled you to use services that are closer to your home or include kids without disabilities?

• Have you had trouble using generic or free services, such as IEP training from a PTI that isn't timely or focused on your IEP issue?

Focusing on your example:

• How did SDP’s flexibility allow you to further your kids’ IPP goals? How was the more costly service more effective?

• What specific words or phrases could DDS add to their definition of cost-effective that would give your confidence that it would result not in the cheapest services but the most effective services for the least cost?