What if someone tells me on the phone that my child won’t qualify for Regional Center services?
If a staff member tells you over the phone to try applying later or says that your child is probably ineligible, don’t be discouraged from applying. If you believe your child meets the eligibility criteria, go ahead and submit your application. This establishes a paper trail for your application and starts the timeline for the assessment process.
How long is the Regional Center assessment process supposed to take?
When you initially apply for Regional Center services on your child's behalf, the Regional Center has 60-120 days from your initial application to complete assessments and determine whether your child is eligible (or 45 days for children under age 3). Note that the 120-day deadline is calendar days, not business days.
Unfortunately, we have heard from Undivided families that delays are common. If the 120-day deadline has passed and the Regional Center has still not completed your child's assessment, you can file a citizen complaint.
What does “self-direction” mean for Regional Center eligibility?
In order to qualify for Regional Center services, a child needs to have “significant functional limitations” in three or more of the following areas (as compared to their typically developed peers of the same age):
Functional limitations in self-direction can include pragmatic/social issues, meltdowns or sensory overloads, self-control, dysregulation, and executive functioning.
Can my child get the Medi-Cal waiver under age 3?
Because early intervention services use a different stream of funding and are based on different eligibility criteria, parents will often be told that children cannot be enrolled in the waiver program until age 3. This is incorrect. However, children under age 3 must have significant medical concerns as well as a diagnosed developmental disability that will continue to qualify them for Regional Center eligibility after age 3.
In the past, the waiver was more vague about what medical criteria might apply, and parents have reported a variety of conditions being considered as qualifying, including heart defects, tube-feeding, oxygen, nebulizer treatments, monitoring placement of hearing aids and glasses, giving medications, and more. The current waiver document only specifies that the support needs must be moderate or severe, so when you request the waiver from your service coordinator, we suggest documenting the extent to which your child’s medical impairments require significant interventions on a regular basis. For more information, see our article about Status 2.
Do I need to wait a certain amount of time before re-applying if my child was denied?
If your child was denied eligibility for Regional Center services, you can reapply later. However, you generally cannot apply again with the same set of evidence; circumstances should have changed if you want Regional Center to reconsider your child's eligibility.
For example, if your child didn’t qualify the first time because they didn’t have a diagnosis and now they do, that could be a reason to re-apply. If your child had a diagnosis but didn’t have enough areas of substantial disability as a small child, but the gap has increased between them and their typically developing peers, or they’re old enough for the Regional Center to consider economic self-sufficiency and capacity for independent living, those might also be reasons to re-apply.
It's especially important to show new evidence if you're applying again after you were denied an earlier appeal. You have to show that things have changed, and you’re not trying to relitigate the same issues.
What if my service coordinator won’t return my calls or emails?
If your Regional Center service coordinator hasn't been returning your emails or calls in a reasonable amount of time, the next step is to contact their supervisor. There is no rule about what a "reasonable amount of time" is, but if you haven't heard back in a few weeks, you should follow up.
If you don’t know who your service coordinator’s supervisor is, call your Regional Center and ask for the officer of the day, who should be able to tell you your coordinator's supervisor. You may be transferred or given the phone number. Make sure you write down who you spoke to and when. Call your coordinator's supervisor directly and let them know what is happening. Tell them that you are not getting a response and ask for the best way to get an answer.
You also have the option of reaching out to your county's Office of Clients Rights Advocacy (OCRA) (find the contact person for your county here). They are there to advocate for Regional Center clients when these kinds of things happen.
If you have been waiting for months, you can file a Section 4731 complaint.
Lisa Carey, Undivided Navigator and Education Advocate, recommends requesting an IPP meeting every time you need something. When a family requests an IPP meeting, the service coordinator must have one within 30 days. Any request in the meeting must have a response within 15 days. For example, you could write your service coordinator an email like this: "We are requesting you fund specialized supervision. Please provide a date for an IPP meeting. If you are able to resolve this request prior to the meeting, I will be happy to rescind my IPP request or cancel the meeting."
Do I need to save emails from my service coordinator?
We recommend getting everything documented in writing when you communicate with your Regional Center service coordinator or other staff. Note that some Regional Centers use secure email systems that delete all correspondence within a certain amount of time to protect client privacy, such as every 30 days. You may want to print out the emails or turn them into PDFs and save them just in case. Be sure to save your sent emails too if you’re using the secure system to send responses. You can upload documents to your Undivided binder, which is HIPAA compliant and available to help you organize your document storage.
What do I do if I disagree with something in my child’s IPP?
If you disagree with something in the IPP during the IPP meeting, you should note your disagreement during the meeting or sign it in agreement with some parts and disagreement with other parts. If the IPP is already signed and you disagree with something in it, you can call an IPP meeting to update it.
What should I do if Regional Center is taking a long time to reimburse me?
If you are a parent vendor for your child's Regional Center services and you're waiting on reimbursement, there is no strict timeline on reimbursement, but unfortunately it's not uncommon to wait a year or more. If you have been waiting a long time, even after escalating to your service coordinator's supervisor, you can file a 4731 complaint. Note that you need to have it in writing that you're providing the service and that the Regional Center authorized the service and stated an intent to reimburse you.
How can I get Regional Center funding for a specific therapy?
Regional Center is always the payor of last resort, meaning you have to try every other resource available to you first. If you have private insurance and/or Medi-Cal, try to get them to cover the therapy first. If they won't, get a written denial that you can show to Regional Center.
You also need to show that the therapy is medically necessary for your child, so ask your child's doctor for documentation. Finally, you need to show that the therapy will support one of your child's IPP goals. It's not a guarantee that Regional Center will agree to fund the service, but providing as much documentation as you can will help support your request.
Concoff Kronbeck recommends that parents look at their Regional Center’s purchase of service standards to get a sense of when the center is willing to fund the service, which can help you understand how best to structure your request. The provider will need to be vendored with your Regional Center (for families in the Self-Determination Program, this is not required). If you find a provider that is vendored with a different Regional Center, you can ask the service coordinator to request the vendor file for courtesy vendorization.
What should I do if I disagree with a Regional Center assessment?
If you disagree with the results of a Regional Center assessment, you can try to get an independent evaluation done (and see if insurance can cover it). Regional Center is not obligated to perform another evaluation simply because you request it. You can also appeal a decision that Regional Center makes due to the assessment results.
What can I do if Regional Center says no to my request but won't give me an NOA?
You should receive a written Notice of Action (NOA) from the Regional Center informing you of the decision to deny or reduce services. If your service coordinator tells you that a service is unavailable, ask for a written denial. (They should provide it within five days.) If the service coordinator refuses to provide you with a written denial upon request, you can still file for a hearing, and write on the form that the Regional Center refused to provide you with a written denial.
How do I request that my child’s services continue while I appeal a denial?
The paperwork notifying you of the denial may have instructions for how you can request that your child's benefits or services continue at the same level until the appeal is resolved. This is called "aid paid pending appeal." There may be a box to check, or you may need to request "aid paid pending appeal" on your appeal form. Note that you typically have a shorter window of time to submit your appeal if you want to continue receiving benefits during the appeal process — 30 days instead of 60 days. Our step-by-step guide to Regional Center appeals can walk you through each part of the appeal process.
How do I appeal my child’s provisional eligibility status to have full eligibility?
Even if your child has a qualifying diagnosis, you need to establish that your child has "significant functional limitations" in at least three of the designated developmental areas. Concoff Kronbeck recommends submitting assessments from the health care providers who are in the best position to establish your child's disability in the specific domains they treat, e.g. a speech evaluation to address deficits in receptive and expressive communication, or OT and/or behavioral assessment to address self-care, adaptive skills, and self-direction. You can learn more about Regional Center provisional eligibility in this article.
Do you have a question about Regional Center services? Come to Undivided member office hours with Concoff Kronbeck to get answers! You’ll find the dates for upcoming office hours in the Events section of your account. You can also ask your Navigator if you’re working with a Navigator.
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