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

(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.