Regional Center Eligibility and Services: Early Intervention (0–36 months)
Prior to age three, children across California receive early intervention services from Regional Centers if they have been diagnosed with, or are at risk for, developmental delays or developmental disabilities. Early intervention for children under age three is provided pursuant to Part C of the Individuals with Disabilities Education Act (IDEA), the federal law governing special education. Many children receive occupational, physical and speech therapy from the Regional Center during this time, along with center-based programs and other early intervention services.
If you are looking for information about Regional Center services for children ages three and above, please see this article.
What Is a Regional Center?
The California Department of Developmental Services (DDS) describes Regional Centers as “nonprofit private corporations that contract with the Department of Developmental Services to provide or coordinate services and supports for individuals with developmental disabilities.” Although each Regional Center is run independently and may vary slightly in operating policy and funded services and supports, the scope and parameters of Regional Center services and responsibilities are codified in California law by the Lanterman Developmental Disabilities Act, and also by Part C of the federal Individuals with Disabilities Education Act (IDEA), which governs early intervention services from ages 0 to 3.
Eligible consumers throughout the state are generally assigned to Regional Centers based on their county. Within Los Angeles County, consumers are assigned by zip code, and DDS offers a searchable zip-code look-up tool on their website.
Who provides special education services after age 3?
Once a child turns three years old, the child’s school district of residence becomes responsible for providing special education services under IDEA. The transition progress begins several months before the child turns three years old, so that an Individualized Education Plan (IEP) is in place with the school district by the child’s third birthday, which is the day the Regional Center early intervention services end.
Some children will be eligible for continued Regional Center services under the Lanterman Developmental Disabilities Act after they turn three years old, if they have been diagnosed with a developmental disability as defined by California law.
During the transition process, the Regional Center will determine whether your child is eligible to remain a consumer under the Lanterman Act. If you disagree with the Regional Center’s determination, you have the right to file a request for a hearing to appeal their decision.
For more information about services after age three, see our article on the transition from early intervention to Lanterman Act.
What if my child has significant disabilities but is not developmentally delayed?
An infant or toddler with a low-incidence disability may be eligible for early intervention services from the local education agency (LEA) even if the child does not have sufficient developmental delay to qualify for Regional Center services. The CA Education Code defines low-incidence disabilities as “hearing impairments, vision impairments, severe orthopedic impairments, or any combination thereof.” A child may also be dually eligible for LEA and Regional Center early intervention services.
Children aged 0-3 are eligible for early intervention services and supports from the Regional Center if they have been diagnosed with, or are at risk for, developmental delays or developmental disabilities. These services are governed by Part C of the federal Individuals with Disabilities Education Act (IDEA), which also provides the framework for special education through public school districts.
Under California law, children are eligible for early intervention services if they:
1) “have a developmental delay of at least 33% in one or more areas of cognitive, communication, social or emotional, adaptive, or physical and motor development including vision and hearing;” or
2) “have an established risk condition of known etiology, with a high probability of resulting in delayed development” (e.g. a diagnosis of Down Syndrome or other chromosomal difference); or
3) are “considered at high risk of having a substantial developmental disability due to a combination of biomedical risk factors of which are diagnosed by qualified personnel.” Some conditions that might put children at high risk of delay include prematurity, low birth weight, prolonged assisted ventilation in infancy, known prenatal exposure to certain substances, infantile seizures, and others.
Some conditions that might put children at high risk of delay include prematurity, low birth weight, prolonged assisted ventilation in infancy, known prenatal exposure to certain substances, infantile seizures, and others.
Referral and Evaluation
Referrals to the Regional Center may be made by anyone, including parents, family members and medical providers. Parents who have concerns about their child’s development and wish to self-refer can contact their local Regional Center (which can be identified via the state DDS website or zip code lookup tool) and request an evaluation for their child.
The entire process of assessment, eligibility determination, and development of the service plan must take place within 45 days. Once the evaluation is made, the Regional Center must assign a service coordinator to the family, obtain consent from parents to evaluate the child, and schedule and complete developmental evaluations and assessments. If the child is eligible for services, the service coordinator must meet with parents to develop an Individualized Family Service Plan (see the IFSP section below for more information) to address the child’s strengths, needs, goals and parental concerns, and identify the services that will help the child achieve the stated goals.
Typically the assessments will take place in the child’s home. Depending on parental concerns, there may be multiple assessments performed by various providers during the 45-day evaluation period, including a developmental assessment as well as evaluation for specific therapies, e.g. physical therapy, infant stimulation, occupational therapy, and speech therapy.
The Regional Center will likely ask for a copy of the child’s medical records, or request a release so they can seek the records from the provider. If you are able to provide the Regional Center with a copy of medical records, this can expedite the review process. If the child already has a diagnosis and has been evaluated recently, the Regional Center may opt to rely on existing documentation rather than perform its own evaluations for eligibility purposes. They will generally still conduct evaluations to establish recommended services and frequency of services.
How to Appeal a Denial
If the Regional Center determines that your child is not eligible to become a Regional Center consumer and you disagree with their decision, you can file a written appeal within 30 days of receipt of the decision. See this article for information on how to appeal.
The Individualized Family Service Plan (IFSP) Meeting
Once your child’s eligibility has been established, your child will be assigned to a service coordinator, who will contact you to schedule a meeting to draft your child’s Individualized Family Service Plan (IFSP). The IFSP is a document that describes your child’s needs, goals and objectives, as well as the services and supports your child requires to achieve those goals and objectives. Read more about what to expect at your first IFSP meeting and what goes into the written IFSP here.
What Services Can the Regional Center Provide?
Below is a sampling of services available from Westside Regional Center, which services much of West Los Angeles. Each Regional Center operates independently, but the basic framework for EI services will be similar across Regional Centers. Parents must always exhaust private insurance options before being approved for Regional Center funding.
- Occupational therapy can help improve “motor, cognitive, sensory processing, communication, and play skills.”
- Physical therapy may be available to “preserve, enhance, and restore movement and function impaired or threatened by disability, injury, or disease.” Physical therapy services “may include range of motion exercises, parent training and an assessment for equipment needs.” In cases where the Regional Center determines that equipment is necessary, they will still require that parents exhaust all generic resources, which may include private insurance, Medi-Cal, and California Children’s Services, as well as the Local Educational Agency if the child has a low-incidence disability.
- Speech therapy may become available around the ages of 18-24 months "if your child demonstrates delays in speech and language.” While the Regional Center will usually refuse to assess prior to 18 months, sometimes parents are able to obtain a private speech and language assessment through insurance at an earlier age, particularly if the child has identified feeding or swallowing issues. At that point, parents may need to request a Fair Hearing to determine whether the child may receive speech therapy at an earlier age to address a known delay.
- Feeding therapy may be available to babies and toddlers with identified swallowing or chewing difficulties. Feeding therapies may be provided by occupational or speech therapists, often depending on whether the problem is based in swallowing or in oral motor planning.
- Infant Development Services (Infant Stimulation) is specialized instruction and parent education services provided at home or in a therapeutic preschool-type setting to address developmental needs. Typically center-based programs begin at age 18 months, and some center-based programs have speech, occupational, physical and/or behavioral therapies embedded into the program. Because this is not typically a service that private insurance companies cover, many families receive Infant Stim at home and through center-based programs even if PT/OT/speech therapies are delivered privately.
- Parents may be able to access Regional Center-led classes and training, including behavior classes and support groups, as well as possible funding for conferences or trainings outside of the Regional Center.
- Behavioral intervention services may be available for children who need direct services. Parent/caregiver participation is required. Many families report struggling to get the Regional Center to assess for and diagnose Autism Spectrum Disorder (ASD) in children between 2 years and 2 years, 6 months. If families can obtain a diagnosis and referral for ABA from private insurance, they may have more success accessing these services at an earlier age.
Medical Equipment, Formula, and Incontinence Supplies
The service coordinator can assist families in investigating various avenues of funding for medically necessary medical equipment, incontinence supplies (diapers, wipes, barrier creams, underpads and sheet protectors), and formula and/or nutritional supplements. If all generic resources have been explored and exhausted, a Regional Center might consider purchasing the item as the payor of last resort.
While WRC does list incontinent supplies as a potential early intervention service, in practice they typically refuse to cover diapers until a child turns five years old, and their Purchase of Service Standards are consistent with this policy. However, they offer a potential exception if the parents can demonstrate that diapering expenses constitute a severe financial hardship. Medi-Cal typically begins to cover diapering at age three when incontinence supplies are medically necessary and have been denied by the private insurance.
A Regional Center may fund in-home respite services for the purpose of providing parents with relief from the ongoing care and supervision of their child with developmental disabilities. The number of respite hours provided is based largely on the extent of the child’s care needs, as well as extenuating family circumstances. Additional respite hours may be available on an emergency basis, e.g., due to a family health emergency or due to shutdowns during the COVID-19 pandemic, or for parents to attend training or conferences related to the child’s disability.
Because respite services are allocated to the extent that a child’s care needs exceed those of a typically-developing child, Regional Centers often place more restrictions on respite care for children participating in Early Intervention services. Regional Centers may require that there be a diagnosed developmental disability (as opposed to a risk of developmental delay), and in the absence of a diagnosis they might only permit respite hours for parents to attend trainings relevant to the IFSP. You may also be asked to demonstrate that ordinary babysitting services will not meet your child’s needs, and you may be expected to pay a portion of the costs for care (see the section below on the Annual Family Participation Fee and Family Cost Sharing Program).
Payer of Last Resort
You will hear the service coordinator refer to the Regional Center as the “payor of last resort.” This means they only fund services if there is no other entity (called a “generic resource”) responsible for funding them. The Regional Center will always require you to exhaust private and community resources prior to approving funding. For children with private medical insurance, the Regional Center will require that you exhaust the insurance benefit for a service or receive a written denial before it will approve funding.
Below are some scenarios (by no means exhaustive) in which the “payer of last resort” designation can create disputes between families and Regional Centers:
- A child who has developmental delays and also has a low-incidence disability (defined under CA law as “hearing impairments, vision impairments, severe orthopedic impairments, or any combination thereof”) may have a right to services from both the Regional Center and the local educational agency (LEA; usually the school district). The LEA’s services may be insufficient to meet the child's needs (e.g. a center-based program without adequate supports or socialization opportunities), but the Regional Center may still argue that a generic resource is available and deny funding for a more appropriate center-based program.
- A family receiving IHSS may occasionally be denied respite because the Regional Center counted IHSS (especially protective supervision) as a generic resource for respite. This practice varies from Regional Center to Regional Center.
- For older children (age 3 or 4 and above, depending on the Regional Center), a child may be eligible to receive incontinence supplies from Medi-Cal, but may be allergic to the available brands and be unable to locate a Medi-Cal provider who can supply appropriate diapers. Families will have to establish the medical necessity of having the diapers covered by RC because Medi-Cal is no longer an available resource.
- A child has available health insurance coverage only for therapy visits conducted in clinic, but the child requires in-home services due to the nature and extent of their disability. Again, families will need to establish the medical necessity of in-home therapies, and provide a denial from the insurance company for this service.
Medi-Cal and Copayment Assistance
Through California’s Medi-Cal institutional deeming waiver for individuals with developmental disabilities, many Regional Center clients are able to enroll in full-scope Medi-Cal (i.e., Medi-Cal that includes the full range of covered benefits and not just emergency services) without regard to parental income, so long as the child’s personal income and resource levels fall below program thresholds.