Brian Capra Public Counsel 213 3852977 ext 249 bcaprapubliccounselorg Lisa Winebarger Alliance for Childrens Rights 213 3686010 ext 126 lwinebargerkidsallianceorg ID: 652712
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Regional Center Services
Brian Capra Public Counsel (213) 385-2977, ext. 249 bcapra@publiccounsel.org Lisa WinebargerAlliance for Children’s Rights(213) 368-6010, ext. 126l.winebarger@kids-alliance.org CASA Volunteers Presentation – July 13, 2017 Slide2
What are Regional Centers?Slide3
LA County Regional CentersSlide4
What Programs Does the Regional Center Administer?Slide5
What is Early Start? Slide6
Why is Early Start So Important for Kids in the Dependency System? Slide7
Who Qualifies for Early Start Services?Slide8
How to Identify Developmental DelaysSlide9
Early Start Referral ProcessSlide10
Early Start Referral Timeline Slide11
Education Rights Holders (ERH) & Developmental Services Decision-makers
(DSDM)Slide12
What Is an Individualized Family Service Plan (IFSP)? Slide13
What does an IFSP include ?Slide14
IFSP ServicesSlide15
The Lanterman Act
Establishes the Regional Center system.Gives individuals with developmental disabilities the right to specialized services and supports that will allow them to live a more normal, independent and productive life.Consumers have the right to decide what kinds of supports they want and need. They have the right to make choices about their own lives.Slide16
What Is a Developmental Disability?
Intellectual Disability (formerly Mental Retardation),Autism,Cerebral Palsy,Epilepsy, orThe “Fifth Category”A disabling condition found similar to mental retardation or requires treatment similar to that required for persons with mental retardationWhich…Slide17
What Is a Developmental Disability?
(continued)Is expected to continue indefinitely,Originates before age of 18, andConstitutes a “substantial disability.” Does not include conditions which are “solely” physical, learning disabling, or psychiatric in nature.Slide18
Substantial Disability
Significant functional limitations in three or more of the following areas:Self-Care,Receptive and Expressive Language,Learning,Mobility,Self-Direction,Capacity for Independent Living, and Economic Self-Sufficiency.Slide19
Application Process
Contact the appropriate regional center (RC).RC will need consent from parent or developmental services decision-makerGet minute order or JV-535 if neededRegional center determines if assessments are needed with 15 working days.Regional center conducts assessments.Under Lanterman Act: RC generally has 120 days to complete assessments BUT 60 days if 120 day timeline could cause significant further delay in development, risk to health & safety, or result in a more restrictive placement. Slide20
Individual Program Plan (IPP)
Contract between consumer and the RC must list all of the services and supports needed to be purchased or secured by the RC.Must be held within 60 days of establishing eligibility. Held every 3 years, but IPP reviews are done annually. Can request an IPP meeting at any time and must be held within 30 days.Must be a person-centered plan (consider the needs & preferences of the consumer/family, effectiveness, cost-effectiveness)Must be done in the native language of the consumer and family.RCs must provide translated copy of plan into threshold language w/in 45 days of request.RC must track & report to DDS the number of instances translated IPP was requested in non-threshold
language if not provided within 60 days of request.Slide21
Examples of Regional Center Services for Children & Youth through the IPP
Behavior training and behavior modification programsSpecial training for parentsAdaptive equipment such as wheelchairs, hospital beds, etc. Community integration servicesAdvocacy assistanceCounselingDay ProgramsWork Services ProgramsEmergency and crisis intervention
Infant stimulation programs and other early intervention programsRespite (in-home or out-of-home) for caregiversSocial skills training
Specialized medical and dental care
Transportation services necessary to ensure delivery of services
Independent Living Skills ServicesSlide22
Restrictions on Certain Services
Respite Limits – but not for long!!!Non-Medical Therapies, Social Recreational Services & Camping SuspendedNo “Experimental Treatments”Behavior Intervention RequirementsRequired use of Medi-Cal/Private InsuranceTransportation RequirementsRequirement to Access Certain Services through School for Youth 18-21Slide23
Is there a Charge for Regional Center Services?
24-hour out of home care for minors – WIC 4782Day care – WIC 4685 (c)(6)Diapers – WIC 4685 (c)(7)Family Cost Participation Program (FCPP): Share of cost for day care, respite, & camping for children between ages 0 and 17. Medi-Cal children exempt – WIC 4783Annual Family Program Fee: Depending on income and household size, $150 or $200 fee. Medi-Cal children exempt. FCPP interplay. – WIC 4785Any other co-payment scheme violates the Lanterman Act - Clemente v. Amundson, 60 Cal.App.4th 1094 (1998)Slide24
What are Purchase of Service Guidelines?
Help determine the types and amounts of services regional centers will fundExplain requirements for receiving servicesVary from regional center to regional centerDDS must approve POS policies – WIC § 4434(d)POS policies cannot violate the Lanterman Act entitlement to necessary services and supports Williams v. Macomber, 226 Cal.App.3d 225 (1990)POS are now required to be posted online, along with other key RC information, under WIC § 4629.5Slide25
What is a Generic Agency?
Any agency receiving public funds with legal responsibility to serve all members of the general public - 17 CCR § 54302(a)(31).RC is the “payor of last resort”—but, RC is also the generic Targeted Case Management provider’RC must “gap-fund” IPP services if necessary to implement the IPP Behavioral Health Treatment ServicesNew Early Start law effective
1/1/18Slide26
Fair And Equal Access
Los Angeles Times article, 12/13/11:http://www.latimes.com/news/local/autism/la-me-autism-day-two-html,0,3900437.htmlstorySenate Select Committee on Autism & Related Disorders, Equity Hearing, 4/30/12:http://autism.senate.ca.gov/informationalhearingsSenate Human Services Oversight Hearing, 3/14/17:http://shum.senate.ca.gov/content/hearingsSlide27
Cultural and Linguistic Competency
AB 1472 (2012): Enacted WIC 4519.5 (disparities data collection)SB 555 (2013): RCs must communicate w/ family in native language during planning process; family can request translated copy of plan. SB 1093 (2014): Requires greater transparency/accountability and data reporting by RCs to ensure more effective participation by diverse communities with developmental disabilities; ILS change.SB 82
(2015): RCs must provide translated copy of plan into threshold language w/in 45 days of request.
RC must track/report number of instances translated IPP was requested in
non-threshold
language if not provided within 60 days of request.
Stakeholder data review & report to Legislature in 2016-2017.
Contracts with RCs must now measure progress in reducing disparities and improving equity in purchase of services expenditures.
AB 1610 (Ridley-Thomas, Current Legislative Proposal –
died
But - MCO Tax Revenue, Budget & AB 959 (Holden) still activeSlide28
Public Counsel Disparity Report
http://www.publiccounsel.org/home#panel-28 of the 11 RCs with higher-than average percentages of Hispanic and Black/African-American consumers had lower-than-average per capita authorizations. DDS’ current method of allocating funding among the RCs perpetuates funding disparities.The data is not being compiled and reported in a uniform manner and many of the RCs’ data reports are incomplete, inaccurate, and inaccessible to the public.Slide29
Public Counsel Disparity Report
Significant disparities across RCs for minority children. (e.g., for Spanish–speaking children living in their homes ages 3-21 in 2015-2016, highest per capita authorizations were at Redwood Coast Regional Center ($16,801), while lowest per capita authorizations were at Central Valley Regional Center, ($2,690).Significant disparities between children of different ethnicities and languages within individual RCs. (e.g., at North Bay Regional Center in Fiscal Year 2015-2016, Black/African American children 0-2 living at home had per capita authorizations of $4,165; White children 0-2 living at home had $7,999 in per capita authorizations. Slide30
AB 1089 (2014): RC Transition Procedures for Foster Children
Transfers of court-involved children between RCsOnce RC is notified of child’s move to another RC catchment area by child welfare agency or attorney, the sending RC must get services in place in new location within 30 days of notificationThe sending RC must report to the court if services not in place within 30 days, and continue to report every 30 days until all services are securedCase management transfers from sending RC to receiving RC after services are securedSlide31
SB 1048 (2012): Joinder
Authorizes the court, at any time after a petition has been filed, to: Join in a juvenile court proceeding any agency that the court determines has failed to meet a legal obligation to provide services to a child who is the subject of a dependency proceeding, a minor who is the subject of a delinquency proceeding, a nonminor person over whom the juvenile court has retained dependency or delinquency jurisdiction, or a nonminor dependent, as defined.Definition of “Agency”
Any governmental agency or any private service provider or individual
that receives
federal, state, or local governmental
funding or reimbursement
for providing services.Slide32
Remaining In Foster Care
Common misconception that Non-Minor Dependents (NMDs) receiving Regional Center services or SSI are NOT eligible for extended foster care (EFC) after age 18.They are! EFC intended to be as inclusive as possible. Statutory guidance:WIC 11403(b) Participation Criteria #5 for eligibility: medical exception (state policy specifies RC & SSI).WIC 303: NMD who is incapable of making an informed agreement does not need to sign the mutual agreement. WIC 13754: NMD right to receive SSI and be their own rep payee, if appropriate.
Los Angeles County MOU between DCFS & RCsSlide33
Emerging Issues Involving Youth with Disabilities In Extended Foster Care
Capacity IssuesSupported Decisionmaking vs. ConservatorshipsPlacement IssuesResources: e.g., SCI Rates, ILP, RC, Special Ed., Dept. of Rehab., SSI, DAC, CAPI, IHSS, CCS, Katie A., etc.
EthicsSlide34
I.T. v. Los Angeles County, et al.
Highlights of Settlement2010 Settlement: Our investigation showed that youth with DD are often in danger in juvenile hall and are detained 6 to18 months longer than others because of the lack of available community placements.
WHO?Youth with or
suspected of
having a DD
Btw May 2012-June
2014,
there were 270
unique
youth
Approx.
30-50 youth at any
given time in Juvenile
Hall
)
Approx.
50-75
youth at
any
given time in Juvenile Field or PlacementSlide35
I.T. v. Los Angeles County, et al.
Highlights of Settlement (continued)WHAT?L.A. County Department of Probation Directives No. 1379 and 1382: set policy and expectations for Detention, Field,
and Placement staff for all probationers with an identified
DD or suspected
of having
a DD.
WHERE/WHEN?
Minors under
Probation’s jurisdiction (e.g. detained in juvenile hall, in suitable placement, or
in home
of
parent or relative).
WHY?
To ensure that youth with or suspected of having
DD have
adequate
care, protection
from
harm,
and
reasonable modifications
to their treatment under federal and state law.Slide36
I.T. v. Los Angeles County, et al.
Highlights of Settlement (continued)HOW?While detained:Identification/screening; referral to regional center (if not yet a client)Providing information to caregivers re: RCs and appeals processReferral for special education
services (if not yet participating)
Monitoring
by Developmentally Disabled Minors Coordinator (
DDMC)
Special Housing; Integrated
Habilitative
Treatment Plan (
IHTP); Social
, Recreational,
Pre-Vocational/Vocational Skills; Discharge Planning
In Suitable
Placement and Field:
Monitoring by Developmentally Disabled Placement Coordinator (DDPC
)
or Developmentally
Disabled Field Services Coordinator (DDFSC),
Referral
to RC (if not yet a
client); request
IPP meeting for current consumers; provide
info
to caregivers; attend IHTP meetings; review and implement Discharge Plan,
provide Transitioning services. Slide37
Resolving Disputes With the Regional Center
Options include:Filing for Fair HearingClaimant can participate in an Informal Meeting with the RC first to try to resolveParties may also participate in Mediation to try to resolveFiling a Complaint4731 Complaints & Early Start ComplaintsSlide38
Important Timelines
RC has 15 calendar days to decide to whether to include a service in the IPP after the request has been made.If the RC decides to deny, it has 5 working days to send a NOA advising the consumer of its decision.The regional center must give you notice at least 30 days before it changes the services in your IPP.Unless change is necessary to protect health and safety—in which case, NOA must be sent no later than 10 days after the change was made. Slide39
What can you do if the regional center denies eligibility or services?
Right to the Fair Hearing process, but the request must be made within 30 calendar days of receiving the Notice of Action (NOA).“Aid Paid Pending”For reduction or cancellation of services, you must appeal within 10 calendar days of receiving the NOA for services to continue during the appeal.The right to Aid Paid Pending is automatic in Early Start.Slide40
What is the Dual Agency Rate?
Enhanced rate for a dual agency child (certain children in foster care, KinGAP, or adoptive placement who are also eligible for regional center services).Children with “inactive” RC cases are still eligible – ACL 16-54Slide41
Dual Agency Rate
Dual Agency children under 3 in Early Start receive $1,041 – COLA effective 7/1/17 will raise Dual Agency children under 3 with a developmental disability receive $2,328 - COLA effective 7/1/17 will raise Dual Agency children over 3 w/o extraordinary needs receive $2,328 - COLA effective 7/1/17 will raise Dual agency children over 3 may also be eligible for a Supplement to the Dual Agency RateSlide42
Supplement to the Dual Agency Rate
Supplement of up to $1000 for Dual Agency children over age 3 w/ extraordinary needsAvailable in increments of $250, $500, $750, or $1,000Available if there is there is a severe deficit in self-care, severe impairment in physical coordination or mobility, a severe medical condition, and/or severely disruptive or self-injurious behaviorBased on severity of condition and combination of multiple conditionsSlide43
How to Request the Supplement
Caregiver can make a verbal and/or written request to the social workerReferral can also be made by regional centerSocial worker can and should identify children on their caseload who may qualify for the supplementThe county has an ongoing duty to inform caregivers of the Dual Agency Rate and Supplement and how to request the SupplementCASA can request the Supplement on behalf of the family. Make sure to request any applicable retroactive payments of the Supplement in your request.Slide44
County Process to Determine Eligibility for Dual Agency Rate & Supplement
DCFS has 90 days from the date of the request or referral from regional center. Info & verification from RC preferred not essential – ACL 17-67The caregiver must be informed through a Notice of Action if Supplement is denied or dissatisfied with the amount of the Supplement if approved. Must file for Fair Hearing within 90 days of the Notice of Action.DCFS policy on Dual Agency Rates:http://file.lacounty.gov/dcfs/cms1_172272.pdfSlide45
DCFS Regional Center Support
RC Contact, Services, Case Management, Referral, Consent, Eligibility, etc.Payment IssuesDual Agency/SupplementSpecial Payment/Placement and SSIPlacement AssistanceTransition Age PlanningRC Case TransfersSend an E-Mail to:regionalcentersupport@dcfs.lacounty.gov Slide46
Advocacy Resources
DISABILITY RIGHTS CALIFORNIA350 South Bixel Street, Suite 290 Los Angeles, CA 90017Ph: (213) 213 - 8000 Fax: (213) 213 - 8001OFFICE OF CLIENTS’ RIGHTS ADVOCACY
East LA Regional Center – Jackie Dai and Lucy Garcia: (626) 576-4437
Harbor Regional Center –
Marsha
Johnson and Cynthia
Salomon
: (562) 623-9911
Lanterman
Regional Center – Hannah
Liddell
and Ada
Hamer
: (213) 213-8180
North LA County Regional Center – Bebo
Saab
San Gab/Pomona Regional Center - Aimee Delgado
South Central Los Angeles Regional Center –
Perla
Muizar
and
Carlos Mora (323
) 292-9907
Westside Regional Center – Debra Marcia and Luisa Delgadillo: (310) 846-4949Slide47
Advocacy Resources (continued)
For dependency- & delinquency-linked children (including out of home or adoptive) ages 0-21 years: Public Counsel at (213) 385-2977.For dependency-linked children, including out of home, ages 0-3 (Early Start cases): The Alliance for Children’s Rights at (213) 368-6010.State Council on Developmental Disabilities, Los Angeles Office (formerly Area Board 10), (818) 543-4631Slide48
Thank you!
Brian Capra Public Counsel (213) 385-2977 bcapra@publiccounsel.org Lisa WinebargerAlliance for Children’s Rights(213) 368-6010, ext. 126l.winebarger@kids-alliance.org