ACCESSING ASSISTIVE TECHNOLOGY Chapter 4 Regional Centers From a 13-Chapter Manual Available by Chapter and in Manual Form First Edition, 1995 (Rev. 8/96) Written by: Protection and Advocacy, Inc. (PAI) - Copyright © 1995 by PAI Prepared with funding provided through California Assistive Technology Project supported by funds from the National Institute of Disability and Rehabilitation Research (NIDRR), U.S. Dept. of Education, Grant #H224A30008-94. These materials are based on the laws and court decisions in effect at the time of publication. Federal and state law can change at any time. If there is any question about the continued validity of any information in this manual, contact PAI or a legal resource in your community. Protection and Advocacy, Inc. (PAI), is a private, nonprofit organization that protects the legal, civil and service rights of Californians who have disabilities. PAI provides a variety of advocacy services, including information and referral, technical assistance, and direct representation. For information or assistance with an immediate problem, call: PAI Toll Free/TDD: (800) 776-5746 - e-mail: firstname.lastname@example.org 8:30 AM to 5:00 PM - Monday through Friday Central Office: 100 Howe Ave., Suite 235-N, Sacramento, CA 95825, Legal Unit - (916) 488-9950, Administrative - (916) 488-9955 Southern California Area Office: 3580 Wilsure Blvd., Suite 902, Los Angeles, CA 90010, Tel. - (213) 427-8747 San Francisco Bay Area Office: 449 - 15th Street, Suite 401, Oakland, CA 94612, Tel. - (510) 839-0811 PAI receives funding under the Developmentally Disabled Assistance and Bill of Rights Act, the Protection and Advocacy for Mentally Ill Individuals Act, the Protection and Advocacy for Individual Rights Act, and the Technology-Related Assistance for Individuals with Disabilities Act. Any opinions, findings, recommendations or conclusions expressed in this publication are those of the authors and do not necessarily reflect the views of the organizations which fund PAI. ACCESSING ASSISTIVE TECHNOLOGY Chapter 4 REGIONAL CENTERS Table of Contents Question 1. What are regional centers? 2. What is a developmental disability? 3. What is assistive technology under the Lanterman Act? 4. Does a person with a developmental disability have a right to receive assistive technology? 5. How can a client get assistive technology through the regional center? 6. Who is eligible for regional center services? 7. What is the application process for regional center services? 8. What are the procedures for assessment? 9. What happens after the regional center finds a person eligible for regional center services? 10. What is an Individual Program Plan (IPP)? 11. What is the IPP assessment process? 12. How do regional centers secure the services and supports a client needs? 13. Where must the regional center provide assistive technology for its clients? 14. What kinds of services and supports are regional center clients entitled to receive? 15. What types of assistive technology can the regional center provide in order to help children with developmental disabilities live at home? 16. What types of assistive technology are available through the regional center as family supports for adults with developmental disabilities? 17. Can the regional center provide assistive technology to help adults with developmental disabilities live in their own homes? 18. Who has the responsibility for providing and maintaining assistive technology for regional center clients? 19. Who pays for the services and supports listed in the IPP? 20. Can a regional center refuse to provide equipment because it does not have enough money? 21. Who owns adaptive equipment purchased by the regional center? 22. What happens if a client disagrees with a regional center decision? 23. How can a client find out if the regional center intends to deny eligibility, or change, discontinue or reduce services? 24. Who can appeal the regional center's decision? 25. What are the timelines for appealing a decision of the regional center? 26. What are the steps in the appeal process? 27. After the state hearing, what happens? 28. What if a client believes a regional center or state developmental center has denied or violated any rights? Attachment - State Regional Center Listings ACCESSING ASSISTIVE TECHNOLOGY Chapter 4 REGIONAL CENTERS 1. What are regional centers? Regional centers are nonprofit corporations that contract with the State Department of Developmental Services (DDS) to provide assessment and case management for people with developmental disabilities. They also purchase necessary services and equipment based upon a client's individual needs. There are 21 regional centers throughout California, each serving a specified geographical area. The law that established regional centers and authorizes services for people with developmental disabilities is called the Lanterman Act and is found in the California Welfare and Institutions Code beginning with Section 4500. 2. What is a developmental disability? Developmental disabilities, for purposes of regional center eligibility,(1) include: mental retardation; cerebral palsy; epilepsy; autism; and other disabling conditions which are related to mental retardation or require treatment similar to treatment required for mentally retarded individuals. The condition must begin before the person is 18 years old, be likely to continue indefinitely, and constitute a substantial disability. Developmental disabilities do not include handicapping conditions that are "solely physical in nature." Welf. & Inst. § 4512(a). 3. What is assistive technology under the Lanterman Act? Under the Lanterman Act, the terms adaptive equipment and supplies and transportation servicesencompass available assistive technology. Assistive technology is part of the services and supports used to alleviate a developmental disability or help in the social, personal, physical, or economic habilitation or rehabilitation of a person with a developmental disability. Welf. & Inst. § 4512. The Lanterman Act specifies "wheelchairs, hospital beds, communication devices, and other necessary appliances and supplies" but does not give a complete list of assistive technology that regional centers can be asked to provide. Regional centers are responsible for ensuring that clients receive assistive technology that enables them to meet the goals of the Act and of their own individual program plans. 4. Does a person with a developmental disability have a right to receive assistive technology? Yes. A person with a developmental disability who is a client of a regional center has the right to receive services and supports, such as assistive technology, in the least restrictive environment. These supports should foster the person's developmental potential and be directed toward achieving the most independent, productive, and normal life possible. Welf. & Inst. § 4502. 5. How can a client get assistive technology through the regional center? Individuals who are not regional center clients must apply for eligibility to the regional center. The regional center does assessments to determine the nature of their disabilities. Once an individual becomes a regional center client, the regional center, the client and/or the client's representative develop an Individual Program Plan (IPP), which describes the client's goals and objectives, and the services and supports necessary to achieve them. The IPP should list any assistive technology needed. 6. Who is eligible for regional center services? Regional centers must serve people with developmental disabilities, individuals at high risk of giving birth to a child with a developmental disability, and infants at high risk of becoming developmentally disabled.(2) Individuals do not need to be U.S. citizens to receive regional center services. They only need to live in California to qualify. 7. What is the application process for regional center services? To start the process, a person with a disability (or an advocate or parent) may write to the regional center, telephone, or visit the center. Within 15 working days after the request for services, the regional center must complete an initial intake. During initial intake, the regional center will give information and advice on its services and the services of other agencies. 8. What are the procedures for assessment? A regional center staff person asks questions at initial intake to determine the nature of the applicant's disability. Welf. & Inst. § 4643. In addition, the regional center will conduct an assessment in which qualified professionals collect information and conduct evaluations, as necessary to determine the nature of the disability. A decision on whether or not assessments will be authorized is also made during initial intake. Welf. & Inst. § 4642. Ordinarily, assessments must take place within 120 days after the initial intake. However, this period must be reduced to 60 days if any delay would: expose the person to unnecessary risk to health and safety; result in serious delay in mental or physical development; or put the applicant at imminent risk of placement in a more restrictive environment.(3) After the assessment is finished, the regional center decides whether the person is eligible for services. If the regional center determines that the applicant is not eligible, the applicant may request a fair hearing to challenge the decision. (See questions 22-28 on complaint procedures). 9. What happens after the regional center finds a person eligible for regional center services? If a person is found eligible for services, the regional center is responsible for developing an Individual Program Plan (IPP) within 60 days after completing an assessment. Welf. & Inst. § 4646(c). The regional center must then ensure that the individual receives the services and supports listed in the IPP. 10. What is an Individual Program Plan (IPP)? An Individual Program Plan (IPP) is a written document which describes a client's goals and objectives, and the services and supports necessary to meet them. For every eligible person, the regional center must develop an IPP based on individual goals and objectives. Welf. & Inst. §§ 4646-4646.5. 11. What is the IPP assessment process? The IPP process starts with gathering information and conducting an assessment. Welf. & Inst. § 4646.5(a)(1). The purpose of the assessment is to determine a client's life goals, capabilities and strengths, preferences, barriers, and concerns or problems. It should consider any assistive technology needs the client may have. The assessment process must reflect awareness of, and sensitivity to, the lifestyle and cultural background of the client and (when appropriate) the family. If the client is a child, the process should include a review of the child's strengths, preferences and needs, and those of the family as a whole. The IPP is developed jointly by the service coordinator(4), the person with developmental disabilities and, where appropriate, the person's parents, legal guardian or conservator. Others may participate in developing the IPP if the client or (when appropriate) the parent, legal guardian, or conservator invites them to do so. The IPP developers must review the IPP as often as necessary, based on the client's progress or changing needs, but no less than once every three years. If the client or (when appropriate) the parent, legal guardian, or conservator, requests an IPP review, a review meeting must take place within 30 days. Welf. & Inst. § 4646.5(b). 12. How do regional centers secure the services and supports a client needs? The regional center must obtain the services necessary to carry out the objectives stated in the client's IPP. It must give highest preference to services and supports that: allow children to live with their families; allow adults to live as independently as possible in the community; and allow all people with developmental disabilities to positively and meaningfully interact with people who do not have disabilities. The regional center may secure the services a client needs either by helping to obtain the services from another agency (such as a public school, California Children's Services, Medi-Cal, etc.) or by purchasing the services from vendors. A provider cannot continue to furnish services unless the client or (when appropriate) the parent, guardian, or conservator agrees that the provider is furnishing the planned services and supports, and that the client is making reasonable progress toward stated objectives. 13. Where must the regional center provide assistive technology for its clients? A regional center may not deny a client services or equipment based on where the client lives. For instance, a child who lives in a board and care facility is entitled to the same services as a child who lives with family. The regional center must provide assistive technology as a service or support to its clients if they live in the community in their own homes, foster care, health care facilities, licensed community care facilities, or residential facilities. Welf. & Inst. § 4648(a)(9). 14. What kinds of services and supports are regional center clients entitled to receive? Under the Lanterman Act, the phrase "services and supports for persons with developmental disabilities" includes equipment, supplies, and transportation services to alleviate developmental disabilities, habilitate or rehabilitate individuals, or to help them achieve and maintain independent, productive, and normal lives. See, generally, Welf. & Inst. § 4512(b). The IPP process determines which equipment a client needs. It must reflect the client's needs and preferences or (when appropriate) those of the family. It must also reflect cost-effective use of public resources.(5) Welf. & Inst. § 4646. Any equipment should include training in the use and care of the device, for the user and the user's family and assistants. 15. What types of assistive technology can the regional center provide in order to help children with developmental disabilities live at home? The Lanterman Act gives priority to the services and supports needed to help a child with a developmental disability live at home when that is what the family prefers. Regional centers may provide adaptive equipment, such as wheelchairs, hospital beds, communication devices, and other necessary appliances and supplies, which will enable the child to live at home. Welf. & Inst. § 4685(c)(1). Necessary assistive technology should be included in the child's IPP. If the family is considering out-of-home placement, the regional center must meet with the family to determine what additional or different supports would allow the child to remain at home. 16. What types of assistive technology are available through the regional center as family supports for adults with developmental disabilities? People with developmental disabilities have the right to have relationships, to marry, to be a part of a family, and to parent. If a parent has a developmental disability, the regional center can provide assistive technology to support the family. It may provide adaptive equipment such as wheelchairs, hospital beds, communication devices, and other appliances and supplies that the family needs. Welf. & Inst. § 4687(f). 17. Can the regional center provide assistive technology to help adults with developmental disabilities live in their own homes? Yes, if adults with developmental disabilities prefer to live in a home that they own or lease, the Lanterman Act specifically requires that the regional center provide the services or supports that enable them to do so. Welf. & Inst. § 4648(a)(1). This includes the responsibility for securing and maintaining adaptive equipment and supplies necessary for independent living. The preference to live in their own homes and any assistive technology needed to enable this should be written in their IPPs. 18. Who has the responsibility for providing and maintaining assistive technology for regional center clients? The regional center has the primary responsibility for providing needed supports and services, including assistive technology. Welf. & Inst. § 4648(a). It typically contracts with private community service providers for the appropriate services and supports. Welf. & Inst. § 4648(f). The regional center has the responsibility of monitoring the supports provided to make sure that they meet the consumer's needs and that they are satisfactory. Welf. & Inst. § 4689(e). Staff may assist in upgrading equipment when necessary. Welf. & Inst. § 4648(d)(1). 19. Who pays for the services and supports listed in the IPP? The regional center is responsible for providing the assistive technology listed in the IPP. It may pay for the service or support, or help clients secure services from other sources. It is important that the client receive all necessary services and supports, including those that may be the responsibility of another agency. If another public agency is legally responsible for providing a service or support (for example, a school district, California Children's Services, Medi-Cal, SSI), the regional center should help the client and family make sure the agency meets its responsibility. The regional center should also find out if a private entity (such as an insurance company) is responsible for any of the costs and help the client and family obtain that funding. The regional center should make sure that no gaps occur in the provision of needed services. If a public agency or private entity refuses to pay promptly for a service or support that a client needs (and would otherwise be a regional center responsibility), the regional center must pay for the service until the responsible party agrees to pay. 20. Can a regional center refuse to provide equipment because it does not have enough money? Funds are always limited, but a regional center must base its decisions about which services and supports to provide on individual clients' needs. The California Supreme Court has said that the Lanterman Act entitles all persons with developmental disabilities to the services and supports they need to lead more independent and productive lives. So long as it has any funds to purchase services, the regional center must provide services and supports based on clients' individual needs and preferences, as determined through the IPP process.(6) A client can and should request a fair hearing if the regional center says it denied or reduced services or supports because it didn't have enough money. 21. Who owns adaptive equipment purchased by the regional center? If the regional center purchases equipment for a client, the regional center owns the equipment. The client has exclusive use of the equipment until he or she moves from the area, outgrows the equipment, or no longer needs it. At that time, the equipment must be returned to the regional center. 22. What happens if a client disagrees with a regional center decision? When a person applies for or receives regional center services, the regional center may deny or terminate those services. If a individual believes a decision is wrong, the client/applicant, or authorized representative may appeal by requesting a fair hearing to challenge the decision. Welf. & Inst. §§ 4700-4715. 23. How can a client find out if the regional center intends to deny eligibility, or change, discontinue or reduce services? The regional center must notify a client whenever it decides: to change, discontinue or reduce, without client permission, any service or support listed in the IPP; or that an individual is not eligible, or is no longer eligible for regional center services; or to deny, without client consent, a service or support that the client wants to include in the IPP. In that case, the regional center must send notice by certified mail no more than 5 working daysafter it makes the decision. Regional centers sometimes fail to provide written notice when requested services and supports are denied. Clients and advocates should insist upon written notice. Welf. & Inst. § 4710(b). 24. Who can appeal the regional center's decision? The following people can request a hearing: the person applying for or receiving services and supports; that person's conservator or authorized representative; a minor's parent or other person with legal custody. Welf. & Inst. § 4703. 25. What are the timelines for appealing a decision of the regional center? A client has 30 days to request a fair hearing from the regional center after receipt of the decision or action with which the client disagrees. Welf. & Inst. § 4710.5(a). Clients who are currently receiving regional center services and want those services to continue during the hearing process must file a hearing request within 10 days after receipt of the regional center's decision. Welf. & Inst. § 4715(a). If the 30-day time limit is missed because adequate notice was not received, the client should request a hearing anyway. 26. What are the steps in the appeal process? The appeal process involves two steps. (1) Once a client requests a hearing, the regional center schedules an informal meeting with the director of the regional center or someone acting for the director. Welf. & Inst. §§ 4710.7, 4710.8. This must take place within 10 days after the hearing request is received. (2) A client who is unhappy with the director's decision can request a state-level hearing conducted by a state hearing office. Welf. & Inst. §§ 4712, 4712.2. The state hearing request must be filed within 10 days after receiving the director's decision. The hearing must take place within 20 days after the regional center receives the request. 27. After the state hearing, what happens? Within 10 days following the hearing, the hearing officer must send the client a written decision. A client who disagrees with the decision has 90 days to file an appeal in Superior Court. Welf. & Inst. § 4712.5. 28. What if a client believes a regional center or state developmental center has denied or violated any rights? The fair hearing process is available whenever a client disagrees with a regional center or state developmental center decision about eligibility or the types or amounts of services and supports, including equipment, to be purchased. If a regional center, a developmental center, or a facility or program providing services or supports under the Lanterman Act appears to have improperly made a denial, then "Title 17 Complaint" can be filed. 17 C.C.R. § 50540. For example, a Title 17 Complaint, as opposed to a fair hearing request, might be filed when: * A regional center has not sent adequate notice of a decision to reduce, deny or terminate services; or * The regional center is not providing a service or support which the IPP team agrees is needed and which is in the IPP; or * Developmental center or community care facility staff have improperly denied an individual's rights. To start the Title 17 Complaint process, the client should contact the regional center or state developmental center clients' rights advocate, preferably in writing. The advocate has 10 working days to investigate and send a written proposal for resolving the complaint. If the complaint cannot be resolved to the client's satisfaction, the rights advocate must refer the complaint, at the client's request, within five working days, to the director of the developmental center or regional center. If the director has not resolved the matter to the client's satisfaction within 10 days after referral, the director must refer the matter to the State Department of Developmental Services for a final administrative decision. ATTACHMENT TO CHAPTER 4 STATE REGIONAL CENTER LISTINGS There are 21 Regional Centers located throughout California. They may provide assessment, diagnosis, and counseling to individuals with developmental disabilities. For further information please call the centers serving your area. (For Los Angeles County see *.) ALTA CALIFORNIA REGIONAL CENTER 2031 Howe Avenue, Suite 100, Sacramento, CA 95825, (916) 924-0400 Serving: Alpine, Colusa, El Dorado, Nevada, Placer, Sacramento, Sierra, Sutter, Yolo, and Yuba counties. CENTRAL VALLEY REGIONAL CENTER 5168 North Blythe, Fresno, CA 93722, (209) 276-4300 Serving Fresno, Kings, Madera, Mariposa, Merced, and Tulare Counties. DEVELOPMENTAL DISABILITIES CENTER OF ORANGE COUNTY Central Tower, Union Bank Square, 530 South Main, Orange, CA 92668, (714) 973-1999 Serving: Orange County *EASTERN LOS ANGELES REGIONAL CENTER 3845 Selig Place, Los Angeles, CA 90031, (213) 224-4700 Serving: Health Districts of Los Angeles County: Alhambra, East Los Angeles, San Gabriel, Pasadenia, and Whittier. FAR NORTHERN REGIONAL CENTER P.O. Box 492418, Redding, CA 96049-2418, 1900 Churn Creek Road, Suite 319, Redding, CA, 96002, (916) 222-4791 Serving: Butte, Glenn, Lassen, Modoc, Plumas, Shasta, Siskiyou, Tehama, and Trinity Counties *FRANK D. LANTERMAN REGIONAL CENTER 3440 Wilshire Boulevard, Los Angeles, CA 90010, (213) 282-1300 Serving; Health Districts of Los Angeles County: Burbank, Central, Glendale, Hollywood, Wilshire, and Pasadena. GOLDEN GATE REGIONAL CENTER 120 Howard Street, Third Floor, San Francisco, CA 94105, (415) 546-9222 Serving: Marin, San Francisco, and San Mateo Counties. *HARBOR REGIONAL CENTER 2131 Hawthorne Boulevard, Torrance, CA 90503, (310) 540-1711 Serving: Health Districts of Los Angeles County: Artesia, Bellflower, L.A. Harbor, El Segundo, Torrance. INLAND REGIONAL CENTER P.O. Box 6127, San Bernardino, CA 92412-6127, 1020 Cooley Drive, Colton, CA 92324, (714) 370-0902 Serving: Riverside and San Bernadino Counties. KERN REGIONAL CENTER 3200 North Sillect Avenue, Bakersfield, CA 93308, (805) 327-8531 Serving: Inyo, Kern, and Mono Counties. NORTH BAY REGIONAL CENTER 1710 Soscol Avenue, Suite 1, Napa, CA 94558-1387, (707) 252-0444 Serving: Napa, Solano, and Sonoma Counties. *NORTH LOS ANGELES COUNTY REGIONAL CENTER 8353 Sepulveda, CA 91343, (818) 891-0893 Serving: Health Districts of Los Angeles County: East Valley, San Fernando, and West Valley. REDWOOD COAST REGIONAL CENTER 808 E Street, Eureka, CA 95501, (707) 445-0893 Serving: Del Norte, Humboldt, Mendocino, and Lake Counties. REGIONAL CENTER OF THE EAST BAY FOR THE DEVELOPMENTALLY DISABLED 1212 Broadway, Suite 200, Oakland, CA 94612, (510) 451-7232 Serving: Alameda and Contra Costa Counties. SAN ANDREAS REGIONAL CENTER 300 Orchard City Drive, #170, Campbell, CA 95008, P.O. Box 50002, San Jose, CA 95150-0002, (408) 374-9960 Serving: Monterey, San Benito, Santa Clara, and Santa Cruz Counties. SAN DIEGO REGIONAL CENTER 4355 Ruffin Road #205, San Diego, CA 92123, (619) 576-2996 Serving: Imperial and San Diego Counties. *SAN GABRIEL/POMONA REGIONAL CENTER P.O. Box 2280, West Covina, CA 91793, 1521 West Cameron Building A, West Covina, CA, 91790, (800) 822-7504 / (818) 814-8811 voice, (818) 338-2507 FAX Serving: Health Districts of Los Angeles County: El Monte, Monrovia and Pomona. SOUTH CENTRAL LOS ANGELES REGIONAL CENTER 2160 West Adams Boulevard, Los Angeles, CA 90018, (213) 734-1884 Serving: Health Districts of Los Angeles County: Compton, San Antonio, South Southeast, and Southwest. TRI-COUNTIES REGIONAL CENTER 5464 Carpinteria Avenue, Suite B, Carpinteria, CA 93013, (805) 684-7196 Serving: San Luis Obispo, Santa Barbara, and Ventura counties. VALLEY MOUNTAIN REGIONAL CENTER P.O. Box 692290, Stockton, CA 95269-2290, 7210 Murray Drive, Stockton, CA 95210, (209) 473-0951 Serving: Amador, Calaveras, San Joaquin, Stanislaus, and Tuolumne Counties. *WESTSIDE REGIONAL CENTER 5901 Green Valley Circle, Culver City, CA 90230, (310) 337-1155 Serving: Health districts of Los Angeles county: Inglewood and Santa Monica-West 1. There are two definitions of "developmental disability." The narrower state definition from the Lanterman Act is the basis for deciding who is eligible for services through DDS and the regional center system. The federal definition (from the Developmental Disabilities Assistance and Bill of Rights Act) is somewhat broader. It defines persons with developmental disabilities as those who became chronically and severely disabled prior to age 22, and who have substantial functional limitations in three of the following seven areas: 1) self-care; 2) communication; 3) ability to learn; 4) mobility; 5) self-direction; 6) independent living; and 7) economic self-sufficiency. The federal definition also includes children between birth and age five who have a condition with a high probability of resulting in a developmental disability if they do not receive services. Protection and Advocacy, Inc., the State Council on Developmental Disabilities, and the Area Boards all use the federal definition. 2. The Lanterman Act defines high risk infant to mean a child less than 36 months of age whose genetic, medical, or environmental history predicts a much greater risk for developmental disability than the risk in the general population. Regional centers provide early intervention services to infants and toddlers (from birth through age two) with disabilities under Part H of the federal special education law, the Individuals with Disabilities Education Act (IDEA). This chapter does not cover Part H services. For information on Part H services, see Chapter 9 on assistive technology through special education. 3. As of July 1, 1996, the 120 days allowed for assessment will change to 60 days. However, if unusual circumstances prevent completion of the assessment within 60 days after intake, the regional center can extend the assessment time by one 30-day period if it obtains advance written approval from DDS. 4. A service coordinator (also called a program coordinator or case manager) is responsible for implementing, overseeing, and monitoring each IPP. The service coordinator is usually, but not always, a regional center employee. The service coordinator can only continue to serve as long as the client or his/her representatives agree that person may serve as service coordinator. The client, the family, advocate, legal guardian, or conservator may perform some or all of the duties of service coordinator if it is appropriate, feasible, and if the regional center director agrees. W.I.C. § 4647. 5. A regional center cannot use "cost effectiveness" to prevent a client from receiving particular types of equipment based on his needs and preferences. "Cost effectiveness" only affects how the regional center provides services and supports. For example, if a client chooses a specific communication device, the regional center may not insist that he use another type simply because it is cheaper. The regional center may choose a less expensive device if it is as effective as the client's chosen device and will meet the goals and objectives of the IPP. 6. The California Supreme Court has ruled that, while regional centers have wide discretion in determining how to implement an IPP, they have no discretion it all in determining whether to implement it--they must do so.