Regional Center Supports During COVID-19 School Closures

By Woodsmall Law Group on November 10, 2020

As uncertainty continues regarding the spread of the COVID-19 pandemic, we wanted to take a few moments to remind you of some helpful supports available from your regional center.  The law governing the regional centers – the Lanterman Act, provides robust protections for eligible children and adults.  This article provides guidance on your rights to potentially available services during this trying time.

UNDERSTANDING THE PAYOR OF LAST RESORT OBLIGATION

To understand how the regional center system works, you must first understand the concept of generic and natural resources.  Services and supports that are available to the public through publicly funded and private insurance(s) are called “generic resources.”  Generic service providers include CCS, Medi-Cal/CAL-OPTIMA, public school, insurance and other available resources must first be explored prior to seeking payment from the regional center. This does not include “natural supports”, meaning the types of supports that you receive from relatives, friends and others in the community.  However, to the extent that a regional center’s obligations under the Lanterman Act overlap with the obligations of a generic provider or where a generic agency is required to provide services but fails, falls short, or refuses to do so, such services must be provided by the regional center as the payor of last resort. If the regional center believes that the generic source has failed to meet its obligations, then it must provide the services, and it is authorized to pursue reimbursement under Welfare and Institutions Code section 4659.  Families should not be forced to pay privately for essential services.

If your child requires essential related services (such as behavior, speech, occupational therapy, etc.) during the school shutdown, consider requesting these services from the regional center.  Be sure to also request these services from other possible generic providers such as insurance, including Medi-Cal, as the regional center service coordinator will need to see that you have explored alternate options prior to authorizing additional services as Payor of Last Resort.

CHILD CARE SERVICES

Definition:  Child Care is defined as care and supervision for a child under the age of eighteen who is living at home and is unable to care for her/himself when both parents or the single parent is employed full time outside the home; and/or a parent whom is engaged in a full or part-time educational or vocational training program that will lead to full or part-time employment.

If you require child care support, for employment or educational purposes, during this temporary suspension of school services, you have the right to request assistance from your regional center.  Consult your regional center’s Purchase of Service guidelines to better understand how your service coordinator can assist you.

RESPITE

Definition:  Respite care is defined as the provision of intermittent temporary care to an individual(s) with developmental disabilities in order to relieve families of the constant responsibility of caring for a family member with a developmental disability. 

There is no single recipe for determining respite. Rather, it is an individualized determination based on the unique needs of the individual/family. One or more of the following factors may be considered by regional center staff when authorizing the service request to ensure that the person served and their family meets the criteria for respite and the level of care required.

1. The individual’s needs cannot be met by a baby-sitter/parent due to special circumstances, e.g. lack of available services, parent obligated to work out of home.
2. The individual requires care and supervision due to documented challenging behaviors.
3. The individual requires special care and supervision due to recently documented medical problems.
4. The individual requires care and assistance due to significant self-care deficits for his/her age, e.g., not toilet trained, inability to feed themselves.
5. Care is required due to a temporary family crisis.

HOW CAN I REQUEST ASSISTANCE FOR MY CHILD?

If you are facing a gap in essential services, consider the following steps:

1. Contact your generic service providers to determine available options. Most regional centers will request proof of your efforts.  It is helpful to have documents like an insurance denial letter.
2. Contact your regional center service coordinator and explain the gap in services
3. Consider the unique factors that justify your request such as your work obligations, effect on your child due to a gap in services; effect on siblings, etc. These factors may assist the regional center in devising an emergency plan for your family.

FINAL THOUGHTS

Regional Centers are natural allies for families coping with difficult and changing life circumstances. Work with the regional center team to secure necessary services. They are there to help you. Woodsmall Law Group will remain open during this difficult time to support our families and answer any questions that you may have. Stay safe and take care of each other. If you have any questions, contact our office at (626) 440-0028.

To access this and other articles online, please visit our website: www.woodsmalllawgroup.com.