Print out the entire Chapter 4 from here.Please Note:
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This document is only current up to the day it was printed.
Printed on: 09/28/2022
Please always refer to the online version for the most current up-to-date information.
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Chapter 4: Individual Program Plans
(4.1) What is an Individual Program Plan (IPP)?
The IPP is a document with services and supports you need and want to reach your goals for your life. It says who will provide services and supports. The IPP is a contract: once you and the regional center agree on what is in the IPP, the regional center must do what it says.[[“While it is true that regional centers have ‘wide discretion’ in determining how to implement the IPP, they have no discretion at all in determining whether to implement it; they must do so [referring to Section 4648].” Association for Retarded Citizens-California v. Department of Developmental Services (1985) 38 Cal.3d 384, 390.]] Both you (or parent or representative) and the regional center must sign the IPP before the services you have agreed to may start.[[Section 4646(i).]] You can only get the services in your IPP. To get a new or different service, you must change your IPP, usually with another IPP meeting. The IPP says your needs, preferences, choices, goals and objectives, and the services and supports you need to reach those goals. The IPP focuses on you and, where appropriate, your family. Your IPP should help you stay in your community and enjoy as independent, productive, and normal life as possible.[[Section 4646.]]
Your IPP should include:
- Information about your strengths, choices, and needs.[[Section 4646.5(a)(1).]]
- The specific services and supports you need and choose to lead a more independent and productive life.[[Sections 4501 and 4502(a).]]
- The specific services you need to meet your individual needs.[[“The [Lanterman] Act clearly contemplates that the services to be provided each client will be selected ‘on an individual basis.’” Williams v. Macomber (1991) 226 Cal.App.3d 225, 232.]]
- A list of the services and supports you need, who will provide them, and when they will start.[[Section 4646.5(a)(5).]]
Your IPP must say if regional center will provide, supervise, or pay for your services, or if it will be another agency. It must be clear in your IPP who is responsible for providing or paying for each service.[[“The services and supports the regional center agrees to provide to its clients should be set forth in unambiguous language. [Just saying] that the regional center will ‘request’ funding is ambiguous because it is unclear whether the agency is agreeing to provide the services… or is only agreeing to request them.” In the Matter of T.S. v. Golden Gate Regional Center, Office of Administrative Hearings (OAH) Case Numbers 2003020153 and N2003010267.]]
Our Supplements can help you plan for your IPP: Supplement I (IPP Meeting Planner); Supplement J (Use Your IPP to Plan for Community Activities); and Supplement K (Get Ready for Your Child’s IPP or IFSP Meeting).
(4.2) What is a “person-centered” IPP meeting?
It is where the IPP meeting is focused on you! Your IPP should meet your needs and show your choices and preferences. This is called “person-centered.”[[Title 17, Cal. Code Regs., section 56076(e)(9).]]
Person-centered planning is an approach to working toward the future you want for yourself.[[Section 4646(a).]] It gives you a way to say:
- Where you want to live and work
- Who you want to live with
- How and with whom you want to spend your time
- How you want to arrange other important parts of your life[[Sections 4501 and 4502(b)(10).]]
You must participate in making your IPP with your planning team so you get the services and supports you need to achieve your goals and dreams.[[Sections 4646(a)(b) and (d) and 4512(j).]] It is an ongoing process, not just one meeting. And it’s all about YOU and your goals.
(4.3) What if I do not understand what people are saying at my IPP meeting?
Everyone at the meeting should speak in a way you understand. If someone uses a word or phrase you do not understand, ask them to explain it. If you or your family do not speak English well, ask for an interpreter. You can also ask that your IPP be translated into your native language.[[Section 4646(j).]]
The IPP meeting is your chance to talk about what is important to you. It’s important to communicate the things you need from the regional center and other agencies, such as Medi-Cal and IHSS, and from your family, friends, and service providers.
(4.4) Where can I learn more about how to get ready for my IPP meeting?
(4.5) Why is the IPP so important?
The IPP is important because it authorizes your services and supports. The IPP is like a contract between you and the regional center. It is an agreement to provide services and supports.[[“The rights of developmentally disabled persons and the obligations of the state toward them are implemented through individual program plans (IPPs) which regional centers must develop for each client.” Clemente v. Amundson, 60 Cal.App.4th 1094 (1998).]] If there is a service or support you need and want, including a service from another agency, you must ask that it be written in the IPP.
Whenever you need services and supports, ask your regional center for an IPP meeting. Every service or support should be listed, including services from a “generic agency.”[[Section 4646.5(a)(5). A generic agency provides services and benefits to people generally whether or not they are regional center clients. Section 4644(b). Examples of generic agencies and services are the Medi-Cal or Medicare programs for health care, California Children’s Services (CCS) for health care related to a physical disability, school districts for services provided through a special education program, Social Security Administration for SSI or Social Security Disability benefits.]]
- If a service is listed in your IPP, the regional center must either provide it or help you get (or keep getting) it somewhere else.[[Section 4648.]]
- If a service is NOT in your IPP, the regional center does not have to give it to you or help you get it from another agency.
(4.6) Who makes the IPP?
The planning team makes your IPP. The planning team includes:
- Your parents if you are a minor child
- Your conservator or authorized representative, if you have one and you are an adult
- One or more people from the regional center, including your service coordinator
- Anyone you invite, such as a service provider.[[Section 4512(j). If you live in a Developmental Center, staff from the Developmental Center will also be at the meeting. Section 4418.3(c)]]
The IPP meeting should be cooperative. Your team works together to find ways for you to achieve your goals and dreams. You get to say what your hopes, dreams, and challenges are. And the regional center brings its experience and knowledge of the services and supports available to help you.
(4.7) Can I ask someone to help me in my IPP meeting or can someone be appointed to help me?
Yes. If you are an adult and do not already have a conservator appointed by a court, you may tell the planning team you want to name someone to help you at the IPP meeting and to develop your IPP.
Sometimes, the regional office of the State Council on Developmental Disabilities (used to be called Area Board) can appoint an authorized representative to speak for you. The authorized representative will help you express your needs and choices and make decisions.[[Section 4541(a)(1).]]
If you cannot ask for yourself, someone may ask for you. You may ask for a particular person to be appointed, such as a family member or friend. Your decision about who should be your representative and if you need a representative must be honored.[[Section 4541(a)(2).]] If you do not ask for a particular person, the State Council can appoint a family member or a volunteer if they have one available. State Council must have representatives available for you if you live in a developmental center.[[Section 4541(a)(3).]] See Chapter 5 for more information about the State Council on Developmental Disabilities
(4.8) I want someone to be at my IPP meeting, but they cannot come in person. Can they participate by phone?
Yes, your neighbor, or anyone else you choose, can participate by phone. Ask the regional center to make sure there is a telephone with a “speaker” so everyone can hear each other. Ask your service coordinator to send your neighbor your last IPP and any recent changes along with any other papers, such as evaluation reports, needed for the IPP meeting.
When you call your service coordinator, you can say, “I want my neighbor, Mrs. Hill, to be at the meeting. She works and cannot be there in person. Please send her my last IPP and a copy of the reports you are bringing to the meeting so she can participate by phone.”
In fact, the whole IPP meeting can be held by remote electronic communication (such as by telephone or Zoom) if you request it. This right to request your IPP meeting be held by telephone or virtual platform will last until June 30, 2022.[[Section 4646(g).]]
(4.9) What does it mean to “identify and build circles of support”?
A “circle of support” is your family, friends and other people in your life who volunteer to meet with you regularly. Their goal is to listen to you, share their experiences, and help you become independent and involved with your community. Solving problems is easier if you know you have the support and assistance of neighbors and friends. A circle of support is one of several “natural supports” that the regional center can help you start.[[Section 4512(f).]]
Natural supports are people who are part of your community. They are your family, neighbors, co-workers, friends, fellow students, and members of organizations, clubs, and civic organizations you associate with or belong to.[[Section 4512(e).]]
The regional center cannot make your natural supports help you. And, they cannot stop or deny a service because a natural support could help you, unless that person agrees to help you.
(4.10) Sometimes I misplace things that are sent to me. Will the regional center send notices to someone else too?
You can ask your regional center service coordinator to:
- Send notices about IPP meetings – and any other notices about your services – to you and someone you want to help you, including a family member, advocate, or friend.[[Section 4646(e).]]
- Call you about IPP meetings. If you also want a written notice, ask them to send all IPP meeting notices to you and someone else.
(4.11) Where will the IPP meeting be?
Your IPP can be any place that is easy for you to get to. It should be at a time convenient for you.[[Section 4646(a).]] Often, the meeting takes place where you live. Sometimes the IPP meeting takes place at a day program or at your regional center.
(4.12) The regional center just told me I am eligible for regional center services. When do I get my first IPP?
Your written IPP must be done within 60 days after your initial intake and assessment.[[Section 4646(c).]] So, you will have your IPP meeting and your IPP document in 60 days. Sometimes – especially with your first IPP – you may need more than one meeting. A follow-up meeting must be held within 15 days, unless you agree to a later date.[[Section 4646(h).]]
If you have not heard from the regional center about your IPP meeting date within 2-3 weeks of becoming a regional center client, call the regional center and ask when the IPP meeting will be held. You can ask to speak with the regional center person who helped you during the intake process or ask who your service coordinator is.
(4.13) How often are IPP meetings required?
Your IPP must be reviewed and modified at least once every 3 years. You may have it reviewed or modified more often. You can change your IPP as your needs and goals change.[[Section 4646.5(b).]] If you receive services through the Medi-Cal Home and Community-Based Waiver,[[For more information about the Medi-Cal Home and Community-Based Waiver, see Chapter 11.]] or if you live in a group home, Intermediate Care Facility (ICF/DD), or developmental center,[[For more information about Intermediate Care Facilities, see Chapter 7.]] you must have an IPP meeting every year to review your IPP. You and someone you choose have the right to receive written notice of all IPP meetings and any changes in services or appeals.[[Section 4646(e).]]
(4.14) Can I ask for an IPP meeting at any time to change my supports?
Yes. You can have an IPP meeting whenever you think you need one because you want to change your services and supports. The meeting must take place within 30 days of your request to review your IPP.[[Section 4646.5(b).]]
(4.15) Can I get an emergency IPP meeting?
Yes. You can request an emergency IPP meeting if you need to talk about staying in the place you live or if your health and safety is at issue. If you request it for these reasons, the regional center must hold the IPP meeting within 7 days. For all other reasons you request an IPP meeting, the regional center must hold it within 30 days.
(4.16) How can I participate in my IPP if I do not talk?
There are many ways of communicating. People can give and get information without speaking. People may use signs or communication devices, others can point, some can nod or blink “yes” or “no.” People who cannot say “yes-no” can still communicate about what they like and do not like. They may show what they like by being relaxed, smiling, making happy or contented sounds. They may show what they do not like by being tense, agitated, crying, or other signs of distress such as an increase in seizures.
Because the IPP is person-centered, others may need to prepare extra well before the meeting to make sure you can participate and the IPP will reflect your choices. You have the right to facilitation if those services will help you participate in your IPP meeting.[[Section 4646(b) and (j)(1).]] Facilitation means you can have information in a way you understand. You can have special equipment or an assistant so you can understand information and make decisions and choices that affect your life.[[Section 4512(g).]] If you have trouble communicating, it is important to have people there who know you well and know your likes and dislikes. They can help make sure that what is written in the IPP is what you want.
(4.17) What if I am worried about keeping track of everything that happens at my IPP meeting?
Here are things you can do to keep track of what happens:
- Bring someone with you to help take notes and help you follow what is going on.
- Prepare before the meeting (See IPP Meeting Planner in
- Ask the regional center to bring an easel with large sheets of paper, markers, and masking tape. Ask someone to write notes on the large sheets of paper and tape the sheets of paper to the wall so everyone can see the notes of the meeting.
- If you have assessments or reports that will help you get the services you are requesting, bring copies to your meeting.
Also, at the end of the meeting, the regional center must give you a list of services and supports you both agreed to in the meeting.[[Section 4646(g)]] The list must say:
- when services may start,
- how often you will have the services and how long they will last, and
- the provider of services (if known).
You or your representative would need to sign the list of agreed-upon services and supports before they start. The regional center needs to give you these either in writing or electronically. The list must also be in your native language. If you disagree with services at the IPP meeting, you can delay getting the list of supports and services until you agree. The regional center must hold another IPP meeting within 15 days (or later, if you want), to reach a final agreement. At that time, the regional center has to give you a list of supports and services in your native language.[[Section 4646(h)]]
(4.18) What if I do not speak English?
Good communication is essential. If you do not speak English, have trouble understanding English, or feel more comfortable speaking in a different language, tell the regional center as soon as possible. They must provide an interpreter. You can have an interpreter at every meeting, if you need one. You can also bring along a friend or family member who speaks English to help you. But, the regional center cannot make you bring a friend to be your interpreter.
The law gives you the right to:
- Get translations of your IPP and other documents, and
- Have an interpreter for meetings or phone conversations.[[Sections 4502.1 and 4646(h)&(j).]]
If your regional center will not translate documents or give you an interpreter, call Disability Rights California or OCRA for help.
(4.19) Can I record my IPP meeting?
Yes. You, or your representative, can make a sound recording of your IPP meeting. But you must tell the regional center at least 24 hours before the meeting. You must also bring your own recorder. The regional center does not have to give you recording equipment.[[Section 4646.6.]]
(4.20) Can the regional center record my IPP meeting?
Maybe. If you decide to record the meeting, the regional center may also make their own recording of the meeting. If the regional center wants to record your IPP meeting but you disagree, you have the right to say you will not go to the meeting if they are recording. If you tell them you object, they are not allowed to record the meeting.[[Section 4646.6.]]
(4.21) What happens at an IPP meeting?
It depends on the type of IPP meeting. It could be the first IPP meeting, a meeting to review the IPP and your progress, or a special meeting to change the IPP between regular meetings. No matter the type of meeting, most start by reviewing information. Assessment information is helpful:
- to develop an IPP or to review progress toward your goals,
- to decide whether to add or change services to help you reach your goals, and
- to include new goals because you have reached those that are in your current IPP.
After assessments, the team may discuss what goals should be in your IPP. Next, talk about services and supports to help you to reach your new or revised goals. The discussion should include agreeing on the services you need, how often you will get them, and when they will start. The discussion must also say who is responsible to provide those services. The provider may be the regional center or a provider the regional center pays. Or it may be another local, state, or federal program or agency that is responsible. The regional center’s role would then be to make sure you start getting the services from that other program or agency.[[Sections 4646 and 4646.5.]]
IPP development for children involves respect for the decision-making authority of the family, meeting the evolving needs of the entire family, building on the family’s strengths, and respecting their cultural preferences, values, and lifestyle.[[Sections 4646.5(a)(1)&(3) and 4685(b).]]
(4.22) Can a regional center decide it needs an assessment before writing my IPP?
Yes. If you need and want certain kinds of services or supports, formal assessments may be done before the meeting or between meetings. Assessments could be done if you need:
- behavior management services,
- occupational and/or physical therapy, or
- supported living.
An assessment must be done by someone who is qualified. Whenever possible, it should take place in the natural environment. It must involve taking information from you, your family, your friends, your providers, and your advocates and other representatives. And it must be sensitive to your and your family’s lifestyle and cultural background.[[Section 4646.5(a)(1).]]
(4.23) What if the person from the regional center says they do not have the authority to decide?
The law says there must be someone at your IPP meeting who can make decisions on behalf of the regional center. Decisions about your services and supports must be made by someone at the meeting.[[Section 4646(d)&(g).]] That person may be the service coordinator, a supervisor, or other administrator. You may speak directly with the people from the regional center who decide about your services.
If the “decision-maker” is not present at your initial IPP meeting, the law allows the regional center to have the decision-maker come to a second meeting within 15 days (unless you or your representative agree to a longer time).[[Section 4646(h).]]
If a regional center says that a Purchase of Service (POS) or other committee must make final decisions about services and supports before they will agree to put them in your IPP, you can object. Don’tagree to an IPP that just “recommends funding,” saying a regional center committee must make the final decision. Final decisions from the regional center on your IPP should be made at the first meeting, or by the end of the second meeting, if there is one.
Tell your service coordinator before the IPP meeting what you want to discuss in the planning team meeting. That way, the people from the regional center will know what decisions need to be made at the meeting, and the person who can make decisions on those services can be there.
(4.24) What if I need more than one meeting to develop my IPP?
If you have complex needs or need an assessment about your services and supports, you may need more than one IPP meeting. You and the regional center can meet as often as you need to write your IPP.
(4.25) What should be written in the IPP?
The IPP must contain:
- Your goals and objectives. Your goals must be based on your needs, preferences, and life choices. Your objectives are time-limited steps to reaching your goals and meeting your needs. Your objectives must be written so your progress on the objectives under each goal can be measured. Objectives can also monitor whether you are getting the services in your IPP.
- A list of the types and amounts of all services and supports you need to reach your objectives and goals. This includes services the regional center will provide or pay for and those that will come from other agencies or resources. The description of services and supports must include the date they will start and a timeline for anything needed before they start.
- A schedule for review and evaluation of your IPP. This helps track that you are getting the IPP services, meeting your objectives on time, and you and your family are satisfied with your IPP and how it is being carried out.[[Section 4646.5(a)(2)(5)&(8).]]
(4.26) What sorts of goals and objectives should an IPP contain?
Goals and objectives should set out many possible ways for you to:
- Make friends and relationships with peers;
- Have a job, live in the community, go to school, and do things you enjoy;
- Make decisions about where, with whom, and how you want to live;
- Be a part of your community like joining a recreation group, a People First chapter, or a local committee;
- Learn skills like handling your money, cooking, and using the bus; or
- Get the help you and your family need, such as respite, day care, and behavior services.
(4.27) How should the IPP be written to ensure I keep getting services and supports I need?
The IPP should state the information from assessments and from you, your family, and friends about how your disability affects you. This means talking about how well you do independently, productively, and living like people your age who do not have disabilities.[[Section 4501, paragraph four.]] A good description and a list of clear and measurable objectives and goals will decide the kinds and amounts of services and supports you need. It also helps if the regional center wants to reduce or terminate your services. If you continue to have the same problems functioning in the areas covered by your IPP goals, it will be harder to say the services must end. But, it may be good to discuss changing services. The law requires your IPP to say how often your team will review the IPP. This is to see if you can reach your objectives and goals, so you can change or increase services if needed.
A complete and detailed IPP makes sure everyone understands what services and supports you are entitled to get and should be getting.
(4.28) What is the difference between a “goal” and an “objective?”
Your IPP must have a statement of your goals and the specific objectives for addressing your goals.[[Section 4646.5(a)(2).]]
A goal is a broad statement about where you would like to get to in your life. You do not need IPP goals for things you already have or can do. IPP goals are based on your needs. The focus of IPP goals should be on the areas of life where you have trouble. IPP goals should also be based on your preferences and life choices. You may have goals for where you want to live, what activities you want to do, or what kind of job you would like.[[Section 4502(b)(10). ]] A goal can be something in your life you want to change. If you do not have a job but want to have one, your goal may be, “I will get a job.” A goal may be something in your life that you would like to continue. If you are a student and want to continue learning, your goal may be, “I will continue to take classes.”
Objectives are specific and time-limited activities that help you reach your goals.[[Section 4646.5(a)(2). ]] Objectives must be written in your IPP to measure your progress or monitor your services. Objectives keep you and the regional center accountable toward your goals. If your goal is to get a job in your neighborhood, one of your objectives can be: “Every week, I will complete and submit three job applications at nearby businesses.” Your second objective toward your goal of getting a job might be to make follow up calls to each employer. Because they are specific and measurable, objectives hold you and your support person accountable. If you and your support person have not completed the job applications or made the follow-up calls, your objectives in the area of employment were not met. Your goal of getting a job may also not be achieved.
Your goals and objectives should maximize chances to develop relationships and be part of community life in areas such as housing, work, school, and leisure.[[Section 4646.5(a)(2) ]]
(4.29) How do I decide which services or supports to ask for in my IPP to meet my objectives and achieve my goals?
Under the Lanterman Act, “services and supports for people with developmental disabilities” is broad. It includes services and supports to lessen the effects of your developmental disability and help you achieve and maintain an independent, productive, and normal life.[[Sections 4501 and 4512(b).]]
Look at what you (and your family, if appropriate) want and need. The IPP can help you choose services and supports you need and prefer. Services must be cost-effective, which means that they must meet your needs. But, if two service providers can meet your needs, the regional center may use the one that costs the least.[[Section 4648(a)(6).]] All of the services and supports you will receive must be listed in your IPP.
Here are examples of services:
- Assessment Services
- Habilitation and training
- Treatment and therapy intervention
- Preventative Services
- An array of different living arrangements
- Community Integration
- Employment/Day Programs
- Counseling services
- Family Support Services
- Relationship services and supports
- Emergency and crisis services
- Specialized Equipment
- Transportation Services
- Interpreter/Translator Services
The list has ideas about what kinds of things are available. It does not include all services, but is a good starting point. the much longer list of services in the law is not an exhaustive list. So, if there is a service not listed in the law, but you think you need it order to achieve your IPP goals, the regional center must consider it.
There may be different services that can get the same result, so do not worry about labels. Think about what results you want from a service or support. To prepare for an IPP meeting, list your likes and dislikes, wants and needs. Then list the services you think will help you meet your needs. If assessment reports are helpful to you in identifying your needs or suggesting IPP goals or services, mention those during the meeting. If you have thought about what you need and want, and some IPP goals, write a letter to your service coordinator before your IPP meeting and tell them what goals and services you believe should be in your IPP. That way, the regional center will be more prepared to discuss these specifics during your meeting.
For services if you want to live with family, see Chapter 6. For services to support you in different living arrangements, see Chapter 7. For work, day, and leisure supports and services, see Chapter 9.
(4.30) Can I get special equipment or assistive technology through
Maybe. Talk about your need for the special equipment or assistive technology you need at your IPP meeting. The regional center might first help you get equipment you need from a generic agency, such as:
- California Children’s Services,
- private insurance, or
- California Department of Rehabilitation.[[Sections 4659(a) and 4648(a)(8).]]
If you are enrolled in a special education program, the regional center may refer you to your school district for specialized equipment or assistive technology. The school district might provide this if you need the same equipment for your education, and if the school district allows you to take the items home. But, if what you need for your education is different than what you need at home or the community, or if the school district will not let you take it home, the referral to your school district will not fulfill this need.
If there will be a delay, the regional center may pay for the special equipment or assistive technology in the meantime.[[In one case, a California Superior Court upheld an administrative hearing decision ordering the regional center to provide educational services during a dispute with the school district. T.S. v. North Los Angeles County Regional Center, OAH Case No. L-2002070084, upheld in T.S. v. Clifford Allenby et al., Los Angeles Superior Ct. Case No. BS 079835.]] If there is no other generic agency that can pay for it, and a service, equipment, or technology is necessary to carrying out your IPP, the regional center must use its resources to provide it.
Make sure your IPP includes timelines and identifies who will help you get assistive technology or equipment from another agency or program responsible for it.
(4.31) Does the IPP include information about my health and health
Yes. The IPP team, with your consent, may review your general health status at the IPP meeting.[[Section 4646.5(a)(6).]] This review can include medical, dental, and mental health needs. It can also include a discussion of your medications, side effects, and the date of the last medications review. If there are any concerns, you should be referred to the regional center’s clinical staff or your treating physician. Service coordinators must document your health status and any referrals in your record.
(4.32) What kinds of special equipment or assistive technology can I get?
Special equipment and assistive technology include:
- communication devices,
- hospital beds,
- ramps to get in and out of your home,
- special hinges to make doors wider for a wheelchair,
- computers, and
- other devices and technology to help you lead a more normal and productive life.
For more information about special equipment and assistive technology, visit Assistive Technology and Medical Equipment in Disability Rights California’s website Resources section.
(4.33) Can the regional center pay for medical or dental services under any circumstances?
There are a few situations in which the regional center can pay for these services:
- When Medi-Cal and insurance coverage is denied and the regional center believes an appeal of the denial will not succeed;
- While Medi-Cal or insurance coverage is being pursued, and there has been no denial yet;
- While an appeal to Medi-Cal or insurance of a coverage denial is pending and there is no final decision yet; and
- When Medi-Cal or insurance coverage is granted but has not started yet.[[Section 4659(d).]]
(4.34) Can a regional center refuse to write a service or support into my IPP based on its own Purchase-of-Service policy?
The Lanterman Act says every person with a developmental disability, should get individualized services and supports to live the most independent and productive life they can.[[Sections 4501, 4502, 4646(b), 4646.5(a)(1).]] A regional center may not apply general policies that prevent you from getting services based on what you want and need.[[See Williams v. Macomber, 226 Cal.App.3d 225 (1990) in which a California Appellate Court ruled that the denial of home day-care services on the basis of a general policy of denying such services to minors with working parents violates the Lanterman Act’s requirement that services to be provided for each consumer must be selected “on an individual basis.” The Court said that “the Regional Center’s reliance on a fixed policy is inconsistent with the Act’s stated purpose of providing services ‘sufficiently complete to meet the needs of each person with developmental disabilities’ [referring to section 4501].” Williams, 226 Cal.App.3d 225, 232.]]
Each regional center does, however, have its own policies, which are used as guidelines for purchasing services and supports for consumers. These Purchase-of-Service (POS) policies usually explain requirements for getting a service and sometimes set limits on the amount or frequency of the service. Policies vary from regional center to regional center. DDS must review all regional center POS policies to make sure they comply with the Lanterman Act before the policies can start.[[Section 4434(d).]]
The amount and type of services you get must be decided at your individual IPP meeting. So, POS policies cannot prevent you from getting services or set strict limits on the amount of a service you show you need to address your IPP goals and objectives. Every POS policy must have an exception for individual circumstances. Unfortunately, regional centers do not always make this clear. If your regional center service coordinator tells you the support you want is beyond what the regional center provides under its POS policy, ask for a copy of the policy and for the exception to the policy. You can appeal if you believe you need particular services or supports from the regional center despite the POS policy.
For example, a regional center policy that limits independent living skills (ILS) training to two years violates the law that says regional centers must provide services based on your individual needs. A policy with these limits cannot be used to deny ILS training if you can show you need more than two years to achieve your goals. For the same reason, a policy that does not allow the purchase of in-home nursing respite for any child who uses a respirator would violate the law if the child’s IPP goal is to live at home and they need in-home nursing respite to make that possible.
Some regional centers have mostly fair POS policies. Others do not. The decision about what services or supports you need must be made in the IPP process and must be based on your individual needs.[[Section 4646(a)&(b).]] If you are denied a service because of a POS policy that sets unfair limits, you can file an appeal. You can also file a complaint to challenge the policy itself as having an illegal cap on services. For more information on appeals and “Section 4731 Complaints,” see Chapter 10.
(4.35) Can a regional center refuse to provide a service or support because it does not have enough money?
Funds are always limited, but a regional center must base its decisions about services and supports on your choices and needs. The California Supreme Court says the Lanterman Act gives people with developmental disabilities the services and supports they choose and need to lead more independent and productive lives. If it has any funds to purchase services, the regional center must provide services and supports based on your individual needs and preferences made through the IPP process. The Court has ruled regional centers have wide discretion in how to implement an IPP. But, they have no discretion about whether to implement it. They must do what your IPP says.[[Association for Retarded Citizens v. DDS, 38 Cal.3d 384 (1985).]] Request a fair hearing if the regional center denies or reduces your services or supports because of lack of money.
If the regional center says it cannot provide (or must stop or cut back) a service in your IPP because of a lack of money, you must get proper written notice. The regional center must also notify DDS in writing within 30 days of the date it notified you. The regional center must describe the service and the expected cost. The regional center must request that DDS provide the regional center, within 30 days, with enough money to cover the cost to the end of the fiscal year.[[Section 4710(c)&(d).]]
(4.36) What is “cost-effectiveness” and how does it affect the IPP process?
Parts of the Lanterman Act say regional center services must be cost-effective in achieving your goals and implementing your IPP.[[Sections 4512(b), 4646(a), 4648(a)(6), 4651(a), and 4685(c)(3).]] This means the regional center must fund services and supports that get the best results for the money spent.[[Title 17, Cal. Code Regs., section 58501(a)(6).]] The regional center can consider cost when choosing among providers who deliver the same services of similar quality. But, it cannot make cost the only factor for whether to provide a needed service to you. The regional center cannot deny a type of service because they think it is not cost-effective. For example, if your IPP goal is to live in your own home with support, the regional center cannotdeny supported living services because you could live in a group home more cheaply. Group home living contradicts your goal of living in your own home.Cost-effective service does not mean least expensive outcome to the regional center. But, in this example, if two supported living services providers could support you in your own home, and one of them charges less, the regional center can use the least costly provider.[[Section 4648(a)(6).]]
(4.37) Should the IPP say if the regional center will help me get services from another agency?
Even if a service need will be met by another source, such as a generic resource, it must still be listed in the IPP.[[Section 4646.5(a)(5).]] And, the IPP must describe the actions needed for generic services to start.[[Section 4646.5(a)(5). ]] If you would have trouble applying to the generic resource for their services, then the actions needed for services to start may include helping you apply. If you do not need help applying, but the generic resource denies your application, the actions needed may have to include advocacy services from the regional center.[[Section 4648(b).]] Regional centers should not just refer you to generic agencies to get IPP-listed services without making sure the needed services are available and provided. The regional center should also make sure that no gaps occur in the services you need.[[The Lanterman Act provides: “[t]he complexities of providing services and supports to persons with developmental disabilities requires the coordination of services of many state departments and community agencies to ensure that no gaps occur in communication or provision of services and supports.” Section 4501.]]
If another agency refuses to pay for a service or support you need right away (and it would otherwise be a regional center responsibility), the regional center must pay for it until the responsible party agrees to pay.[[Once services and supports are identified in the IPP, the regional center must secure the needed services and supports. See Sections 4648(a) and 4640.7 and Association for Retarded Citizens v. DDS (1985) 38 Cal.3d 384, at 388 and 390. Securing IPP services is done through purchasing or by obtaining services from generic agencies or other resources. Section 4647(a). If services needed immediately cannot be obtained immediately from generic or other resources, the regional center must purchase them.]] So, the IPP should say whether the regional center will help you get the service you need from another agency, and if the regional center will provide it right away if the other resource is not.
(4.38) What happens to my IPP if I move to an area with a different regional center?
The law says if you have been found eligible for services by a regional center, you are eligible for services by any other regional center if you move somewhere in the state. The new regional center can only say no if they do a comprehensive reassessment which finds that the original regional center was clearly wrong.[[Section 4643.5(a)&(b).]]
And, your new regional center must follow the IPP developed at your old regional center, if the services are available, until you have a new IPP.[[Section 4643.5(c).]] If any IPP services are not available in the new regional center’s area, the regional center must set up an IPP meeting within 30 days and provide alternative services that best meet your needs in the meantime.[[Section 4643.5(c). ]]
DDS made guidelines for regional centers to make your transition to a new regional center smooth. The guidelines also make sure there are no delays or gaps in your services and supports and include a process for resolving disagreements.[[Section 4643.5(c). ]] For more information about transferring from one regional center to another, see Supplement G.
(4.39) Do I have the same rights at all meetings with the regional center that I have at an IPP meeting?
In Disability Rights California’s opinion, yes. Regional centers sometimes hold “ID team meetings,” “informal IPPs,” or “annual reviews” that the regional center may not consider IPP meetings. Sometimes the regional center will say that agreements reached at these meetings are not formal agreements and do not have to be followed. Any meeting where regional center staff meets with you and your family to discuss services and supports is actually an IPP meeting. This means a decision-maker must be present, the agreements you make must be followed, and you must be able to sign the IPP or IPP amendment that results.
Read Supplement H at the end of this book to make sure your rights are protected at all meetings.
(4.40) Is the IPP process different if I live in a Developmental Center?
No. IPP requirements are the same no matter where you live. But, if you live in a Developmental Center (DC), it is the DC staff, rather than regional center staff, who will coordinate the planning team process.
Even if you live in a DC, the regional center must continue to participate in the IPP process. Planning teams must include one or more regional center representatives.[[Section 4512(j).]] Regional center staff are important because they know the services and supports for you to move back to the community. The Lanterman Act notes the importance of coordinating with regional centers, and regional resource development projects, to transition people to the community.[[Section 4418.3.]] If a regional center person is not at your meeting, ask that they participate, preferably in person, at all of your planning team meetings.
(4.41) What if the planning team cannot agree on my IPP?
If the planning team is cannot agree on the services and supports that will be in your IPP after one or more meetings, or if you get no answer to your request for services, ask for a fair hearing. See Chapter 10 about the fair hearing procedures of the Lanterman Act.
(4.42) Why should I sign my IPP?
You or your representative must sign the IPP so it can go into effect.[[Section 4646(i).]] If you agree on some things but not others, write down which things you agree on and which you don’t. Then sign the IPP so the agreed-upon services can begin, but write near your signature that you are signing only as to the things you and the regional center have agreed on. You can appeal disagreements through the fair hearing procedure. The things you do agree on should go into effect by the date you decided at the meeting.
(4.43) What if I disagree with one part or a few parts of the IPP?
If you and the regional do not agree on all parts of the IPP, like goals, objectives, services, or who is responsible for providing services, the regional center must send you a written notice within 5 business days after the meeting.[[Section 4710(b).]] If the regional center wants to change or end a service you are already getting, it must tell you in writing 30 days ahead of the change or cut-off.[[Section 4710(a).]] The notice must include the action the regional center wants to take, the reason, the effective date, the law supporting the action, and how to appeal, including referrals for advocacy help.[[Section 4701.]] See Chapter 10 on Disputes and Appeals.
(4.44) Can the regional center change my IPP without my permission and without giving me prior notice?
Without your permission, the regional center cannot reduce, terminate, or change a service in the IPP. But, if you do agree to a change, the regional center would not have to send you notice before the action goes into effect.[[Section 4710(a).]] A regional center would also not have to send you notice before reducing, terminating, or changing an IPP service if the regional center has decided that the action is necessary for your health and safety. But, the regional center must still send you notice of the action within ten days after the reduction, termination, or change to your services happens.[[Section 4710(f).]]
(4.45) If I appeal a regional center’s decision to reduce, change, or stop an IPP service, what happens to that service during my appeal?
You must file your appeal within 10 days from the date you get the notice in the mail for the service to be provided until the appeal is decided.[[Sections 4701(n) and 4715(a).]] This is called “Aid Paid Pending.” If you do not email your appeal, your appeal date will be the postmark date on your appeal letter. You always have 30 days after the regional center gives you notice of a reduction, termination, or change to appeal that proposed change. But, to have a service continue until your appeal is decided, you must act more quickly and appeal within 10 days of receiving the regional center’s notice.[[Section 4710.5(a).]]
(4.46) Does the regional center have to make my IPP work?
The regional center must do things to make your IPP work, including:
- Getting the services and supports identified in your IPP. This is true if the services come from the regional center, or someone paid by the regional center to provide them, or the services are provided by generic agencies or natural supports. (Be specific about what services and supports you want and need.)[[Sections 4648(a) and 4646.5(a)(5).]]
- Advocating for your legal, civil, and service rights to make sure you get the services listed in your IPP.[[Sections 4648(b) and 4512(b).]] (See Question 47.)
- Identifying and building a Circle of Support for you.[[Section 4648(c).]]
- Ensuring the quality of the services you receive.[[Section 4648(d).]]
- Developing new programs, if what you need does not exist or is not
available now.[[Section 4648(e).]]
(4.47) How does the regional center make sure I get the services and supports in my IPP?
Once you and the regional center agree on the services and supports you need, the regional center must get them for you. It can do that in many ways, including:
Get Services from Generic Agencies
The regional center can help you get services from another agency that provides services to the public, such as school, Medi-Cal or IHSS. These are called “generic agencies.”[[Section 4647(a). A “generic agency” is a government agency that has a legal responsibility to serve all members of the general public and is receiving public funds to do so. Title 17, Cal. Code Regs., section 54302(a)(31).]] If a generic agency can provide a service you need, regional centers must help you get that service from that agency before they pay for the service.[[Sections 4648(a)(8), 4659.7, and 4646.5(a)(5).]] This is a good idea, but in practice it can cause problems. Sometimes the regional center tells you to go to a generic agency without making sure the needed services are available or they will meet your needs. The regional center is responsible for advocating for you to make sure the services you are eligible for from another agency are actually provided.[[Section 4648(b).]]
Purchase Services and Supports from Service Providers (Vendors)
The regional center can purchase services for you directly from a service provider. The regional center can go to a service provider, an agency, or a person it already has an agreement with, or it can contract separately with a new agency or person.[[Section 4648(a)(3).]] The regional center must find providers who can meet your needs.
Provide You with Vouchers
The regional center can provide you with a “voucher” for the services or equipment you need.[[Section 4648(a)(4).]] Vouchers are like payment coupons. The voucher lets you (or your family, where appropriate) select who will do the service.[[Section 4512(i).]] The regional center still has to make sure the service or item is available.
Develop Services If They Do Not Exist
When good quality services are not available or need to be expanded, a regional center can find a person or an agency by “Request for Proposal” (RFP) or other means.[[Section 4648(e)(1).]]
Request Funds from the State
Regional centers can request money from the Program Development Fund or the community placement plan to reimburse the start-up costs needed to start a new program or services and supports that you need.[[Section 4648(e)(2).]]
Use Creative/Innovative Means
Regional centers can use creative and innovative service delivery models, including asking about natural supports, such as willing friends or relatives of the consumer.[[Section 4648(e)(3). ]]
Provide Direct Treatment and Supports in an Emergency Situation
Generally, regional centers cannot provide direct treatment and therapeutic services. Instead, they have to use appropriate public and private community agencies. But in an emergency, regional centers can provide direct treatment and therapeutic services.[[Section 4648(f).]]
DDS Can Provide Services Directly
To meet your IPP goals in rare situations “where there are identified gaps in the system of services and supports or where there are identified consumers for whom no provider will provide services and supports contained in his or her individual program plan,” DDS may provide services and supports directly.[[Section 4648(g).]]
(4.48) What do I need to know about vouchers?
Vouchers are one way of getting services. They are “coupons” from the regional center that allow you to pay someone to provide a service for you. There are vouchers for things such as respite, transportation services, day care, in-home nursing, and diapers.
The advantage of vouchers is:
You can use them to purchase services from any person or organization you choose and avoid agency waiting lists.
The disadvantage of vouchers is:
They make you responsible for finding a service provider.
Also, by using a voucher, you may be establishing an “employer-employee” relationship between you and the person hired to provide the service. As an employer, you must follow both state and federal laws about hiring, firing, reporting wages, withholding income and payroll taxes, and workers’ compensation. The regional center should provide technical assistance, guidance, and training to help you meet those requirements.[[Title 17, Cal. Code Regs., section 54355.]] The important thing is that the regional center cannot make you use vouchers instead of one of the other ways of securing services for you. This is particularly true if, because of your disability, you cannot manage the extra work required.
(4.49) Can I choose who will provide my services and supports?
You have an important voice in choosing your service provider, but it is not up to you alone. In deciding on a service provider, the planning team, including you and your family or advocate, must consider:
- The provider’s ability to provide quality services that will help you carry out your IPP.
- The provider’s success in helping you achieve your IPP objectives.
- If the provider must be licensed, whether the provider has that license.
- If comparable services (of equal or better quality) are available at less cost from another provider.
- The provider that is your or your family’s choice.[[§ 4648(a)(6).]]
You must be satisfied with a provider’s performance. Services cannot continue unless you and your family are satisfied and agree the services have been provided as required and you have made reasonable progress on your IPP objectives as a result.[[§ 4648(a)(7).]]
The regional center may not force you to accept a provider simply because it is cheaper. It must consider all the above factors. But, you do not have a right to any provider you choose if others are available who can provide similar and equally good services at a lower cost.
(4.50) How can the regional center advocate for me to get services from other agencies?
You may be entitled to services from a variety of agencies and programs. Some examples are:
- Appropriate special education services from your local public school
- Equipment and services from Medi-Cal, California Children’s Services (CCS), or private health insurance
- Supplemental Security Income (SSI)
- The right kinds and amounts of In-Home Supportive Services (IHSS)
If you are having trouble getting the services and benefits you need, the regional center must advocate for you. Your service coordinator (or someone else selected by the regional center) might help by going with you to your IEP meeting at the school. They might help you calculate how many IHSS hours you need by figuring out how much time it takes to do different tasks at home. The regional center could also help you at an administrative hearing with one of these agencies.[[Section 4648(b)(1)&(2). Some regional centers hire attorneys to represent consumers in certain circumstances.]]
Regional centers must have a staff person (or contract with someone) with expertise in the areas of criminal justice, special education, family support, affordable housing, community integration, and quality assurance. Regional centers must also hire a “consumer advocate” who is a person with a developmental disability.[[Section 4640.6(g).]] You should be able to go to any of these people to get help advocating in these areas.
If the regional center cannot or will not help, file an appeal and ask the judge to order the regional center to provide advocacy help to you. See Chapter 10 for more information about appeals.
(4.51) What if the regional center agrees to a service, but there is no provider available?
Sometimes your planning team will agree that you need a service, but there is no provider available. This can be a serious problem. Although it may be hard for the regional center, they must still use every possible means to fulfill your IPP.[[Assoc. for Retarded Citizens-Calif. v. Dept. of Developmental Services, 38 Cal.3d 384, 388 (1985).]] Regional centers have no choice about whether to carry out your IPP, but they do have choices about how they do so. The regional center can look at these options:
- They can ask existing providers if they will provide the service you need, even if it differs from the services they usually provide.
- They can contract with different agencies to provide the services you need.
- They can send a “Request for Proposals” (RFP) to the provider organizations in the area to see if an agency will develop new services.
- They can see if a provider from a different area will come into your area and provide services for you.
- They can ask for funds from DDS to initiate and develop a new program of services and supports.[[Section 4648(e).]]
See Question 47 for the different ways regional centers can make sure you get the services and supports that are written in your IPP. Regional centers are expected to have services available in the community where you live. But, it may take time to develop the services. Sometimes, no provider will develop the service in your area.
The regional center may ask if you will move to a different area where there is a provider of the services you need. That is often a very difficult thing to do. Sometimes this happens if you need a group home and there isn’t one available in your area. Regional centers may do a “statewide search” for available placements and may find a place for you in another area of the state.
If the regional center says it does not have a particular service or support you need and want (and it is not available from a “generic” source) or the regional center will not provide it, you can appeal. (See Chapter 10.) But first consider the regional center’s reason for denying your request and see if there are alternatives you can agree to.
(4.52) If I am in the Self-Determination Program, do I still go through the IPP process and have a written IPP?
Yes. The Self-Determination Program (SDP) is another way to get your regional center services that gives you more freedom, control, and responsibility. But, you still go through the IPP process and have a written IPP with the regional center. The IPP team (which you are a part of) determines your Individual Budget. You then use your Individual Budget to buy your own services and supports that are in your IPP. [[Section 4685.8(d)(3)(C)]] You have all of the same appeal rights as the traditional regional center system if you disagree with your IPP or a regional center decision.