Regional Center clients who are only receiving early intervention services under age 3 are not typically eligible for the full range of services available under the Lanterman Act, and are also not eligible to be enrolled on the HCBS-DD Medi-Cal waiver, which allows children to receive full-scope Medi-Cal without regard to their parents’ income. In order for a child under age 3 to access additional services and the Medi-Cal waiver, they need to be diagnosed with a qualifying developmental disability and demonstrate substantial functional limitations in at least three designated areas of development.
Eligibility under the Lanterman Act (as opposed to early intervention) is generally referred to as “Status 2.”
A child under age 3 must be enrolled as Status 2 to access the HCBS-DD waiver. Additionally, they need to have:
Because the criteria for eligibility are based on a child’s deficits relative to a typical child of the same age, and typically developing infants and toddlers are not generally capable of daily self-care and have limited self-direction, children under age 3 who qualify are most likely to have significant medical needs.
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 we suggest emphasizing the extent to which your child’s medical impairments require significant interventions on a regular basis.
Some service coordinators think that only children with severe health needs will qualify (e.g. the child needs to be medically complex and need nursing care). Get documentation from your doctor on how much support and intervention is required for your child. Some Undivided families have said that letters from specialists such as geneticists have helped document their child’s needs.
If your child is under age 3 and you want them to be evaluated under the Lanterman Act criteria, ask your Early Start service coordinator for your child to be switched to Status 2. This switch does not automatically imply waiver evaluation or eligibility, so be sure to request a waiver referral as well.
Some 3- and 4-year-olds who age out of early intervention services can receive provisional eligibility for Regional Center services under the Lanterman Act until they turn 5. This is not an extension of early intervention services but an expansion of access to services under the Lanterman Act. Children with provisional eligibility are coded as “Status U.”
Children across California receive early intervention services from Regional Centers if they have been diagnosed with or are at risk for developmental delays. Once a child turns 3, the child’s school district becomes responsible for providing special education services.
In the past, continued Regional Center eligibility was not available to children over age 3 without a formal diagnosis. However, some developmental disabilities are particularly challenging to diagnose in toddlers, and many children experienced a gap in crucial services because they aged out of early intervention before a firm diagnosis could be determined.
As of July 2021, Regional Center eligibility includes a provisional eligibility category for children ages 3 and 4 who do not meet the standard criteria but who still have a disability that is not solely physical in nature. These children are provisionally eligible for Regional Center services under the Lanterman Act if they have significant functional limitations in at least two of these areas:
self-direction
Children who are provisionally eligible will be reassessed 90 days prior to their fifth birthday to determine whether they will remain eligible at age 5.
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. 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.
If you disagree with your child’s provisional eligibility status, you can submit an appeal requesting that your child be assessed for full Lanterman Act eligibility. 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.
At this time, children who are provisionally eligible do not have access to the institutional deeming waiver.
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