Chapter 1: The Lanterman Act

(1.1) What is the Lanterman Act?

The Lanterman Act is the California law that gives people with developmental disabilities the right to services and supports they need to live independent and normal lives. The Act is in California Welfare and Institutions Code, section 4500-4906. Whenever you see the word “section(s)” in this manual or footnotes, with no other information, it is referring to section(s) of the Lanterman Act. For section 4512(a), it means information comes from the Lanterman Act, Welfare and Institutions Code Section 4512, subsection (a). To read the Lanterman Act, click here. 

The Act says it is important for each person to get the services and supports that meet their needs and choices.[[ Sections 4501, 4512(b). ]] The Act recognizes that people with developmental disabilities may need help to live full, productive lives. 

The Legislature said:

“An array of services and supports should be established which is sufficiently complete to meet the needs and choices of each person with developmental disabilities, regardless of age or degree of disability, and at each stage of life, and to support their integration into the mainstream life of the community.” [[ Section 4501.]]

(1.2) What has the California Supreme Court said about the Lanterman Act?

There is a case from 1985 called, “Association for Retarded Citizens-California (ARC) v. Department of Developmental Services (DDS).”[[38 Cal.3d 384 (1985).]] In that case, the California Supreme Court explained the purposes of the Lanterman Act and how the state must help people with developmental disabilities.

The Court said the Lanterman Act required the state to provide a “pattern of facilities and services sufficiently complete to meet the needs of each person with developmental disabilities, regardless of age or degree of [disability], and at each stage of life.”

These required services include:

• Identifying people with developmental disabilities,
• Assessing their needs, and
• Selecting and providing services to meet each person’s individual needs.

The Court also explained that the purpose of the law is to:

• Lower the number of people with developmental disabilities living in institutions and being removed from their family and community, and
• Allow people with developmental disabilities to have the same kind of lives as people of the same age without disabilities, and to lead more independent and productive lives in the community.

The Lanterman Act says the “State of California accepts a responsibility for its developmentally disabled citizens and an obligation to them which it must discharge.”[[Section 4501.]] It says people “with developmental disabilities have the same legal rights and responsibilities [as those] guaranteed all other individuals by the Federal Constitution and laws and the Constitution and laws of the State of California.” [[Section 4502.]] It also gives people with developmental disabilities certain legal rights, including the right to treatment and habilitation at state expense.

(1.3) How does the Lanterman Act serve and protect the rights of people with developmental disabilities?

It says people with developmental disabilities have the same rights as other Californians.[[Section 4502(a).]]

It also guarantees other rights, including the right to:

• make choices in your own life,[[Section 4502.1.]]
• have information you can understand to help you make decisions,[[Section 4502.1. ]]
• receive services and supports in the least restrictive way to help you make the most of your potential.[[Section 4502(b)(1).]]

In the Act, the Legislature decided services people with developmental disabilities need are special and unique. It says they cannot be provided well by state government agencies, so private, nonprofit community agencies should provide these services.[[Section 4620(b).]] The Act created a system of 21 private, nonprofit regional centers throughout California. Each regional center is the local agency that makes sure people with developmental disabilities living in that regional center’s area of responsibility get the services and supports they need. The Act also requires the California Department of Developmental Services (DDS) to monitor the regional centers to make sure they are carrying out the Act in each area of California.[[Section 4620 and 4434(a) to (c).]]

The Act requires the regional center to develop an Individual Program Plan (IPP) based on your needs.[[Section 4646.]] The IPP lists the services and supports you and the regional center agree you need and choose. The regional center pays for some IPP services. The regional center will assign you a service coordinator. This person will help you get the services listed on your IPP. The law gives you ways to enforce your rights, including your right to the services and supports you need and choose. When you ask the regional center to pay for something, such as more respite hours, you are actually asking the regional center to change your IPP to include the new hours. If the regional center denies your request and you think the regional center is wrong, you can appeal that decision. The appeal process starts when you ask for a fair hearing.[[Section 4710 and following.]]

Another way to enforce your rights is through the complaint process. This is sometimes called a Section 4731 Complaint.[[A “Section 4731 Complaint” is named after the section in the Lanterman Act where information regarding the complaint process is located.]] You can file a complaint if you think the regional center or an agency paid by the regional center violated your rights. For example, if you ask for an IPP meeting and the regional center refuses to schedule one, you can file a complaint.

You can use independent advocacy services for advice or help. These agencies can help you understand and enforce your rights:

• Office of Clients’ Rights Advocacy (OCRA):
  • Northern California 1-800-390-7032 (TTY 877-669-6023)
  • Southern California 1-866-833-6712 (TTY 877-669-6023)
• Disability Rights California:
  1-800-776-5746

(1.4) How does the Lanterman Act define “services and supports” for people with developmental disabilities?

“Services and supports” means the help you choose and need for your developmental disability to live a full, productive life in the community. Services and supports can help you learn new skills, improve your functioning, and help you lead an independent and normal life.[[Section 4512(b).]] For example, you may need occupational therapy to help you swallow so you can be less dependent on your feeding tube. Or, you may need training to use the local bus system.

The regional centers and other agencies provide services and support based on your IPP. Regional centers pay for some services and help you get some from other agencies. Even if a service or support is not specifically listed in the Lanterman Act, you can get it if you prove you need it.

(1.5) Who can receive services and supports under the Lanterman Act?

Four groups of people can get services under the Lanterman Act:

1. People who meet the Lanterman Act definition of developmental disability.[[Section 4512(a) and (l).]] These are people who have a substantial disability because of their cerebral palsy, epilepsy, autism, mental retardation, and other conditions closely related to mental retardation or that require similar treatment. A “substantial disability” is discussed at length in Chapter Two of this manual.
2. People who are at high risk of parenting a baby with a developmental disability. Parents and infants in this group may receive assessment services and preventive services.[[Sections 4642 and 4644.]]
3. Infants under age 3 and at high risk of becoming developmentally disabled. Parents and infants in this group may receive assessment services and preventive services. [[Sections 4642 and 4644. ]]
4. Children who are age 3 or 4 and may be “provisionally eligible.” This means they don’t qualify as having a “developmental disability.” But, with provisional eligibility, they can get full regional center services while they are 3- and 4-years-old. [[Sec. 4512(a)(2)]] See Chapter Two for more on regional center eligibility.

People in the second and third categories above may receive assessment services and preventive services.

(1.6) What is my point of contact in my community to get services and supports?

The regional center is the contact in your community to get services and supports you want and need. With your help, the regional center develops an IPP for you and pays for some of the services in your IPP.

Every regional center client gets a service coordinator, also called a case manager or social worker. Your service coordinator helps you get the services listed in your IPP, including services from other agencies, like Medi-Cal or the school district. If any of the services listed in your IPP are not available anywhere else, the regional center will pay for the services.

There are 21 regional centers in California. Each serves a different area of the state. To find the regional center for your area of the state, click here. The Department of Developmental Services, called DDS, monitors the regional centers and makes sure they implement the Lanterman Act.[[Sections 4416, 4434.]]

DDS is a state agency. Regional centers are private, non-profit agencies under contract with DDS. Regional centers provide some services to people with developmental disabilities, and they arrange for others to provide services. DDS does not provide services directly.[[ARC v. DDS (1985) 38 Cal.3d 384, 388-389 (citations and footnotes omitted).]]

The Legislature says that DDS “has jurisdiction over the treatment of the laws relating to the care, custody, and treatment of developmentally disabled persons."[[Section 4011.]] Regional centers provide persons with developmental disabilities “access to the facilities and services best suited to them through their lifetime."[[Section 4620(a).]]

(1.7) What other agencies provide services and supports?

DDS pays for most services and supports through contracts with regional centers. 

Sometimes other agencies pay for the services and support instead of the regional center. Under the Lanterman Act, services provided by other agencies are “generic” resources or services. “Generic services are those available to the public through publicly-funded agencies.[[Section 4648(a)(8).]] You may need the regional center to coordinate services or advocate to help you get generic services from agencies like:

• School districts
• Department of Rehabilitation
• Medi-Cal or Medicare
• California Children’s Services (CCS)
• In-Home Supportive Services (IHSS) and other agencies 

“Natural” supports are the free help you get from family, friends, neighbors, and others in your community.[[Section 4512(e).]] Services paid for by the regional center – like independent living or supported living services – can help you develop, strengthen, or expand your natural supports.

(1.8) Does anyone make sure that services and supports people need are available to them in their communities?

Every five years, the State Council on Developmental Disabilities does a “needs assessment” which looks at the kinds and amounts of services and supports needed, but not currently available. The needs assessment must report on the need for new or better community services and supports. The assessment must look at how any gaps in available services affect consumers in certain groups. The groups include people with a certain disability, age, ethnicity, challenge, or area. It must also highlight alternative and innovative service delivery models to address consumer needs. The needs assessment must be updated every year.[[Section 4677.]]

The State Council’s needs assessment is based on information provided by all regional centers. It may also include information from:

• Public hearings
• National Core Indicators assessments (required under Section 4571)[[A Quality Assurance System has been developed to collect information regarding consumer and family satisfaction, provision of services, and personal outcomes. DDS awarded this contract to the Human Services Research Institute (HSRI). HSRI administers the National Core Indicators (NCI) assessment to regional center consumers. This helps compare California services information to information collected in other states.]]
• Regional center reports on alternative service delivery submitted to DDS as required by Section 4669.2(c)
• Reports from regional centers on types and amounts of services and supports needed, but not available (required by Section 4677(b)(1))
• Annual reports on self-directed services (required by Section 4685.7(v))

These assessments and reports are included in the Council’s state plan and sent to DDS and the Legislature. The Council consults with DDS and recommends funding to the Department of Finance. The funding is for the Governor's Budget for program development based on the assessment.[[Section 4677(b)(6).]] These documents are available to the public. A special fund (the Developmental Disabilities Program Development Fund), provides resources to start new programs and expand or convert existing programs.[[*Section 4677.]] Money for the fund comes from fees collected from families whose children are placed outside the home.[[Section 4784.]] The fund supports programs that have integrated services for where people live, work, play, learn, socialize, and volunteer. These activities should increase the self-determination and independence of persons with developmental disabilities.[[Section 4677(a).]] This follows the approved priorities for program development in the Council’s State Plan.

(1.9) Where can I find out about services for infants and toddlers under three years old?

Most services for children under age three are covered by Part C of the federal Individuals with Disabilities Education Act (IDEA).[[20 U.S.C. Section 1431 and following.]] This manual does not cover Part C services. For information on Part C services, see Chapter 12 of Special Education Rights and Responsibilities by clicking here.

(1.10) Are services and supports for children over age two (age three and older) different than for adults with developmental disabilities?

The list of services and supports for persons with developmental disabilities applies to children and adults.[[Section 4512(b).]] However, certain services are mainly used by children and not adults, and others are used only by adults. Special education students age 3-22 are eligible for school district services to help their developmental disability. They get most services through school until they leave the school system. However, children and young adults who are enrolled in special education programs, and their families, can get services from the regional center. They can get case coordination services, services they need when they are at home (like respite or day care), and other services that they cannot get from school or Medi-Cal. Special education services are considered generic services which a regional center must use first before using its own resources to provide the same services.

If you are an adult, and able to get certain services in your IPP from the Department of Rehabilitation or Medi-Cal, the regional center should help you get those services from them.

(1.11) What services and supports are available through Medi-Cal?

Medi-Cal pays for health care services for low-income people and people with disabilities. Many regional center consumers are eligible for Medi-Cal. The Medi-Cal program must follow federal and state laws and regulations.

If you are a Medi-Cal beneficiary, Medi-Cal likely pays for part of your regional center services, equipment, and case management. You may not know Medi-Cal is paying, because it still goes through the regional center.

If your IPP includes services or equipment not usually covered by Medi-Cal, such as respite care or supported living services, Medi-Cal may pay for them through a Home and Community-Based Services Waiver. Waiver services are services that Medi-Cal normally only provides to people who live in facilities and not to people who live in their own homes. The waiver waives the requirement that only people who live in facilities can get these services.

Some regional center consumers can receive Medi-Cal services through the Developmental Disability Home and Community-Based Services Waiver, or “DD Waiver.” These are some (not all) services available through this waiver:

1. Case Management
2. Homemaker
3. Home Health Aide Services
4. Respite Care
5. Habilitation
6. Environmental Accessibility Adaptations
7. Skilled Nursing
8. Transportation
9. Specialized Medical Equipment and Supplies
10. Chore Services
11. Personal Emergency Response Systems (PERS)
12. Family Training
13. Adult Residential Care
14. Other waiver services which are cost-effective and necessary to prevent institutionalization:
    • Vehicle Adaptations
    • Crisis intervention
    • Mobile Crisis Intervention
    • Crisis Intervention Facility Services
    • Nutritional Consultation
    • Behavior Intervention Services including the development, analysis and tracking of programs
    • Specialized Therapeutic Services

Not all regional center consumers or regional center services are covered by Medi-Cal. Some regional center consumers are not eligible for Medi-Cal because of their income, immigration status, or some other reason. Your IPP should list all services you need, even if the regional center does not pay for them. If Medi-Cal or school pays for your services, they should still be listed in your IPP. But changes in the Lanterman Act have said regional centers can reduce or stop some services. If you are on the DD Waiver and your regional center tries to reduce or stop a service approved and listed in your IPP, contact Disability Rights California.

(1.12) Do I have to be a U.S. citizen to get Medi-Cal services?

You do not have to be a U.S. citizen to get Medi-Cal. Many immigrants are eligible for “full-scope” Medi-Cal, which is all the services Medi-Cal usually covers. Some immigrants are not eligible for full-scope Medi-Cal, but could get limited Medi-Cal, such as emergency medical, pregnancy, and some nursing facility services. If you get regional center services but not Medi-Cal, the regional center must pay for services and equipment you need in your IPP, but which you cannot get from Medi-Cal.

(1.13) Does the Regional Center have any residency requirements?

Your immigration status does not matter for regional center eligibility. But the Lanterman Act says you have to be a California resident.((California Government Code section 244 lists rules to consider in determining where your residence is located.)) In general, you are a California resident if you live in California and plan to stay. You can only live in one place at a time. It is okay if you leave California for a short time, as long as you plan to return. For an unmarried child under 18, the residence is normally the same as his or her parents’ home.

If you are in California on a temporary visa, it is hard to prove you are a California resident. The temporary visa says you are in the country temporarily and not permanently. The regional centers may believe you if you say you plan to stay here with a temporary visa. Talk to an immigration attorney before you do this. It could affect your immigration status.

(1.14) Is information about me kept confidential by the regional center?

All regional center information and records about you are confidential.[[Section 4514.]] Before anyone can see your information, the regional center needs permission from you, your conservator, or someone you say represents you. If you are under 18, your parent or legal guardian must give permission. There are only a few exceptions to this rule. Courts and law enforcement agencies can see your records in certain situations. Licensing investigators can see your records if they need them to make sure health facilities and community care facilities are providing good care.[[Section 4514(a)-(p).]] You have the right to review and copy records in your regional center file.[[Sections 4725 and 4726.]] If you ask to see your file, the regional center has three business days to show you your file.[[Section 4728.]] You also can give someone else permission to see your file.

(1.15) Are there any income limitations to be eligible for Regional Center services or costs for these services?

The regional center gives you the services and supports you need because of your developmental disability. Your income does not matter. The Lanterman Act does not say you have to pay for services and supports in your IPP. But, in some situations, the Lanterman Act requires families to pay for some services in a child’s IPP.