ACCESSING ASSISTIVE TECHNOLOGY
Chapter 4
REGIONAL CENTERS
Table of Contents
Question Page
1. What
are regional centers?......................................................................... 1
2. What
is a developmental disability?............................................................. 1
3. Who
is eligible for regional center services?................................................. 2
4. What
is assistive technology under the Lanterman Act?................................ 2
5. As
a person with a developmental disability, do I have a right to receive needed
assistive technology?.............................................................................................. 2
6. What
kinds of services and supports can I get?............................................ 3
7. How
can I get assistive technology through the regional center?.................... 3
8. How
do I apply for regional center services?............................................... 4
9. What
are the procedures for assessment?.................................................... 4
10. What
happens after the regional center finds me eligible for regional center
services? 4
11. What
is an Individual Program Plan (IPP)?................................................. 4
12. Why
is the IPP so important?.................................................................... 5
13. What
is the IPP assessment process?.......................................................... 5
14. Who
is responsible for creating the IPP?..................................................... 5
15. How
do regional centers secure the services and supports I need?................. 6
16. Where
must the regional center provide assistive technology for its consumers? 7
17. What
types of assistive technology can the regional center provide to help children
with developmental disabilities live at home?....................................................... 7
18. What
types of assistive technology are available through the regional center as
family supports for adults with developmental disabilities?................................................... 7
19. Can
the regional center provide assistive technology to help me live in my own
home? 8
20. Who
has the responsibility for providing and maintaining assistive technology? 8
21. Who
pays for the services and supports listed in my IPP?............................ 8
22. Can
a regional center refuse to provide equipment because it does not have enough
money? 9
23. Who
owns the adaptive equipment the regional center buys?........................ 9
24. What
can I do if I disagree with a regional center decision?........................... 9
25. When
must I receive written notice?......................................................... 10
26. What
must the regional center include in its written notice?......................... 11
27. I
do not understand English. How will I understand what the regional center is
telling me when it sends me a letter?.................................................................................... 11
28. What
if the regional center makes a change in my services or supports in order to
protect my health or safety? When does it have to give me notice?............................... 12
29. Can
I keep my current services while I appeal a regional center decision?..... 12
30. What
do I do if the regional center doesn’t send me a notice according to the
timelines, or sends a notice but without the required information?........................................... 12
31. Who
can appeal the regional center’s decision?.......................................... 13
32. How
do I file an appeal?.......................................................................... 13
33. What
if my disagreement is with a developmental center?........................... 14
34. What
are my rights in the fair hearing process?.......................................... 14
35. Can
someone be appointed to help me in my appeal?................................. 14
36. What
are area boards?............................................................................. 15
37. Do
I have the right to look at my regional center records?........................... 15
38. What
is the first step in the hearing process?.............................................. 15
39. What
happens at an informal meeting if I decide to have one?..................... 16
40. What
if I don’t speak English?.................................................................. 16
41. What
is mediation?.................................................................................. 17
42. What
are the pros and cons of going through mediation?............................. 17
43. What
is the next step if mediation fails or we don’t mediate?....................... 18
44. Do
I have to tell the regional center what documents and witnesses I will use at
the hearing? 18
45. What
happens at the fair hearing?............................................................. 18
46. When
will I get a decision by the hearing officer?....................................... 20
47. Is
this decision final?............................................................................... 20
48. Can
I appeal a final administrative decision I don’t like?............................. 20
49. How
do I make a complaint that my rights have been violated?................... 21
50. How
do I know whether to file a complaint or ask for a fair hearing?........... 22
ATTACHMENTS TO CHAPTER 4.................................................................. 23
Regional Center List.......................................................................................... 24
Alta California
Regional Center.......................................................................... 24
Central Valley Regional Center........................................................................... 25
Eastern Los Angeles Regional Center.................................................................. 25
Far Northern Regional Center............................................................................ 25
Frank D. Lanterman Regional Center................................................................. 26
Golden Gate Regional Center............................................................................. 26
Harbor Regional Center..................................................................................... 27
Inland Regional Center...................................................................................... 27
Kern Regional Center........................................................................................ 28
North Bay Regional Center................................................................................ 29
North Los Angeles County Regional Center........................................................ 29
Redwood Coast Regional Center........................................................................ 29
Regional Center of the East Bay......................................................................... 30
Regional Center of Orange County..................................................................... 30
San Andreas Regional Center............................................................................. 31
San Diego Regional Center................................................................................ 31
San Gabriel/Pomona Regional Center................................................................. 32
South Central Los Angeles Regional Center......................................................... 32
Tri-Counties Regional Center............................................................................. 33
Valley Mountain Regional Center....................................................................... 33
Westside Regional Center.................................................................................. 34
Area Board on Developmental Disabilities........................................................... 35
Appendix L Fair Hearing Flow Chart.................................................................. 36
Chapter 4
REGIONAL CENTERS
Regional centers are nonprofit corporations that
contract with the Department of Developmental Services (DDS). They provide
assessment and case management for people with developmental disabilities. They
also buy necessary services and equipment based upon individual needs.
There are 21 regional centers throughout California. Each
serves a specified geographical area. The law that established regional centers
and authorizes services for people with developmental disabilities is called
the Lanterman Act. You will find the law in the California Welfare and
Institutions Code beginning with Section 4500. There is a list of all 21
regional centers in the attachments to this chapter.
Developmental disabilities, for purposes of
regional center eligibility, include: mental retardation; cerebral palsy;
epilepsy; autism; and “other disabling conditions” that are related to mental
retardation or require treatment similar to treatment required for people with
mental retardation. 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). Infants who have a high risk of developing a developmental disability are also eligible for regional center services. The Lanterman Act defines “high risk infant” as 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
of the general population. Women who are at high risk of giving birth to a
child with a developmental disability are also entitled to services through the
regional center system. Welf. & Inst. § 4642.
Regional centers must serve people with developmental
disabilities, women at high risk of giving birth to a child with a
developmental disability, and infants at high risk of becoming developmentally
disabled.
Welf. & Inst. §§ 4512(a), 4642.
You do not need to be a U.S. citizen to receive regional
center services, but you must live in California to qualify.
The Lanterman Act calls assistive technology adaptive
equipment and supplies, and transportation services. Assistive
technology is part of the services and supports offered by regional centers
that can help in social, personal, physical, or economic habilitation or
rehabilitation. Welf. & Inst. § 4512(b). The Lanterman Act also specifies "special adaptive equipment such as wheelchairs, hospital beds, communication devices, and other necessary appliances and supplies” as a support that must be available when necessary. Welf. & Inst. 4685(c)(1). But it does not give a complete list of assistive technology that you can ask your regional center to provide. Regional centers must make sure that you get the assistive technology that will help you meet the goals of the Lanterman
Act and of your own individual program plans.
Yes. As a regional center consumer, you have the right to
receive needed services and supports, such as assistive technology, in the
least restrictive environment. You must show that the assistive technology is
necessary to foster your developmental potential. The AT must help you achieve the most independent, productive,
and normal life possible. Welf. & Inst. § 4502(a). You should be prepared to show that your need for the assistive technology is related to your developmental disability.
Under the Lanterman Act, the phrase “services and supports
for persons with developmental disabilities” includes equipment, supplies, and
transportation services to:
(1)
Alleviate developmental disabilities;
(2)
Habilitate or rehabilitate individuals; or
(3)
To help them achieve and maintain independent, productive, and normal
lives.
See, generally, Welf. & Inst. § 4512(b). The Individual Program Plan (IPP) determines which equipment you need. The IPP must reflect your needs and preferences or (when appropriate) those of your family. It must also be cost-effective.
Welf. & Inst. § 4646. Any equipment should include training in using and caring for the device for you, your family, and your assistants.
If you are not a regional center consumer, you must apply
for eligibility to the regional center. The regional center does assessments to
determine the nature of your disability. Once you become a regional center
consumer, you, your representative (where appropriate) and the regional center
develop an Individual Program Plan (IPP). The IPP describes your goals and
objectives, and the services and supports you need necessary to achieve them.
The IPP should list any assistive technology you need.
To start the process you, the individual with a disability
(or an advocate or parent) may write to the regional center, telephone, or
visit the center. Within 15 working days
after you request services, the regional center must complete an initial
intake. During initial intake, the regional center will give you information
and advice on its services and the services of other agencies. Welf. & Inst. Code § 4642.
A regional center staff person asks questions at the
initial intake to determine the nature of your disability. Welf. & Inst. § 4642. The regional center will also conduct an assessment. In the assessment, qualified professionals collect information and evaluate you to find out about your disability. The staff person also decides whether or not assessments are 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. § 4643 (b).
Ordinarily, assessments must take place within 60 days. If unusual circumstances prevent
completion of the assessment within 60 days, the regional center can extend the
assessment time by one 30-day period. However, it must get advance written
approval from DDS to extend the time. Welf. & Inst. § 4643.
After the assessment is finished, the regional center
decides whether you are eligible for services. If the regional center finds
that you are not eligible, you may request a fair hearing to challenge the
decision. (See questions on hearing procedures starting at question 24.)
If you are eligible for services, the regional center is
responsible for developing an Individual Program Plan (IPP) within 60 days after completing the assessment. Welf. & Inst. § 4646(c). The regional center must then make sure you get the services and supports listed in the IPP.
An IPP is a written document. It describes your goals and
objectives, and the services and supports you need 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.
The IPP is like an agreement between you and the regional
center. It is an agreement to provide services and supports. If there is a
service you need, you must make sure it gets written in your IPP. Every
service or support should be listed, including any you will get from a “generic
agency.”
If a service is in your IPP, the regional center must either provide it or help
you get it from another agency. Welf. & Inst. § 4646.5(a)(4). If a service is not written in your IPP, you cannot count on getting it from the regional center. If the regional center includes a service or support in your IPP but does not provide it, or tries to end it or change it without your agreement, you can file a complaint or
an appeal. See Questions 24 - 32 and 48.
The IPP process starts with gathering information and
doing an assessment. Welf. & Inst. § 4646.5(a)(1). The assessment examines your life goals, capabilities, strengths, preferences, barriers, and any concerns or problems. It should consider any assistive technology needs you may have. The assessment process must reflect awareness of, and sensitivity to, your lifestyle and
cultural background and when appropriate, it must include that of your family.
For a child, the process should include a review of the child's strengths,
preferences and needs, and those of the family as a whole.
A team develops your IPP, but it is your plan and
should reflect your preferences. The IPP Team may include your service
coordinator,
you and, where appropriate, your parents, legal guardian or conservator. Others
may participate in developing the IPP if you or (when appropriate) your parent,
legal guardian, or conservator invite them to do so. The IPP team must review
your IPP as often as necessary, based on your progress or changing needs, but no
less than once every three years. If you or your parent, legal guardian, or
conservator ask for an IPP review, a review meeting must take place within 30 days. Welf. & Inst. §4646.5(b).
Your IPP is developed by your planning team and should be
done in a “person-centered” way, focusing on the needs and preferences of the
consumer. Your planning team is made up of at least you, your authorized
representative (if you have one); your parents, your conservator or guardian,
if appropriate; anyone else you want to have at the meeting; and one or more
representatives of the regional center, including your service coordinator or
social worker. Welf. & Inst. § 4512(j). If you live in a developmental center, the developmental center staff will attend.
Decisions on services and supports and where you will get
them must be made by an agreement between you, your authorized representative,
your family (if appropriate), and the regional center. The planning team must
make these decisions at the meeting. Welf. & Inst. § 4646(d).
The regional center must get the services necessary to
carry out the objectives stated in your 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.
Welf. & Inst. § 4648(a)(1).
The regional center may secure the services you need
either by helping you get the services from another agency (such as a public
school, California Children's Services, Medi-Cal, etc.) or by purchasing the
services from providers. Welf. & Inst. § 4646.5(a)(4). A provider cannot continue to furnish services unless you (or your parent, guardian, or conservator) agree that the provider is giving you the planned services and supports, and that you are making reasonable progress toward your stated objectives.
A regional center may not deny you services or equipment
based on where you live. For instance, a child who lives in a board and care
facility is entitled to the same services as a child who lives with her family.
The regional center must provide assistive technology as a service or support
whether you live in the community in your own home, in a foster care home, in a
health care facility, licensed community care facility, or in a residential
facility. Welf. & Inst. § 4648(a)(9).
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 wheelchairs,
hospital beds, communication devices, and other necessary appliances and
supplies that enable the child to live at home. Welf. & Inst. § 4685(c)(1). The child’s IPP should include all necessary assistive technology. If the family is considering out-of-home placement, the regional center must meet with the family to find out what supports would allow the child to stay at home. Welf. & Inst. § 4685 (c) (2).
People with developmental disabilities have the right to
have relationships, to marry, to be a part of a family, and to parent. If you
are a parent with a developmental disability, the regional center can provide
assistive technology to support your family. That could include adaptive
equipment such as wheelchairs, hospital beds, communication devices, and other
appliances and supplies that your family needs. Welf. & Inst. § 4687(f).
Yes. If you prefer to live in a home that you own or
lease, the Lanterman Act specifically requires that the regional center provide
the services or supports that enable you to do so. Welf. & Inst. § 4648(a)(1). This includes the responsibility for securing and maintaining adaptive equipment and supplies necessary for independent living. You should include your preference to live in your own home and any assistive technology you need to do so in your IPP.
The regional center has the primary responsibility to make
sure that you get needed supports and services, including assistive technology.
Welf. & Inst. § 4648(a). When possible, it can help you get the technology through other agencies, such as school districts and Medi-Cal. It can also contract with private agencies, organizations, or businesses for the appropriate services and supports. Welf. & Inst. § 4648(a)(3). The regional center has the responsibility of monitoring the supports provided to make sure that they meet your needs and that they are satisfactory. Welf. & Inst. § 4689(e). Regional Center staff may help in upgrading equipment when necessary. Welf. & Inst. § 4648(d)(1).
The regional center is responsible for making sure that
you get assistive technology listed in your IPP. It may pay for the service or
support, or help you get all necessary services from other sources. It is
important that you get 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
must help the consumer 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 you
and your family secure that funding.
The regional center should make sure that there are no gaps
in needed services. If a public agency or private entity refuses to pay
promptly for a service or support that you need (and it would otherwise be a
regional center responsibility), the regional center should pay for the service
until the responsible party agrees to pay. Welf. & Inst. § 4648 (g).
Funds are always limited, but a regional center must base
its decisions about which services and supports to provide on your individual
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 buy services, the regional center must provide services and supports based
on your individual needs and preferences, as determined through your IPP
process.
You can and should ask for a fair hearing if the regional center says it is
denying or reducing services or supports because it does not have enough money.
If the regional center buys equipment for you, the
regional center owns the equipment. You have exclusive use of the equipment
until you move from the area, outgrow the equipment, or no longer need it. At
that time you must return it to the regional center. If you are moving to an
area covered by a different regional center, you should ask both regional
centers to work out an arrangement so you can take the equipment with you.
If you disagree with any regional center or developmental
center decision to deny technology (or any other service) that you believe you
need, you can appeal. Welf. & Inst. § 4710.5(a). Because there are time limits for giving you notice, starting the appeal, and taking every step of the appeal process, we have included a “Time Line” chart in the attachments to this chapter.
The process begins with you telling the regional center
you disagree with a decision it made. At that point it must send you written
notice within five working days. Welf. & Inst. 4710 (b).
You must appeal a decision to stop, change or cut back a
service or support within 10 days of
being notified if you want that service or support to continue until the appeal
process is over. Welf. & Inst. § 4715 (a). Otherwise you have 30 days to file an appeal for a fair hearing.
Welf. & Inst. § 4710.5 (a). If you wait that long, however, the regional center can stop, cut back or change the services or supports during the appeal process. This is true even if you win your right to those services or supports at the hearing.
You must receive written notice when:
·
You apply for regional center services and the regional center
says you are not eligible. Welf. & Inst. § 4710(e).
·
The regional center says that you are no longer eligible. Welf. & Inst. § 4710(a)(2).
·
The regional center says it will not provide a service that you
request. Welf. & Inst. § 4710(b).
·
The regional center wants to cut back, change or stop a service
that is in your IPP, without your agreement. Welf. & Inst. § 4710(a)(1).
·
The regional center says it does not have the money to provide
services for you. Welf. & Inst. § 4710(c).
If the regional center decides that it will not provide a
service or support you ask for, it must give you written notice by certified
mail within 5 working days (weekends
and holidays not included). Welf. & Inst. § 4710(b). If you are already receiving the service and the regional center stops, reduces or changes it, you must receive notice at least 30 days before
the regional center changes anything. Welf. & Inst. § 4710(a)(1).
Sometimes regional centers do not send written notice when
they decide to deny or change a service you want or need. That is illegal. You
should ask for written notice when you do not agree with a regional center
decision. Then you can decide whether or not you want to appeal.
The notice must be clear and in a language you understand.
It must include:
·
Exactly what the regional center intends to do;
·
The reasons for its action and the date of the action;
·
The specific law, regulation or policy that the regional center
believes allows it to take the action;
·
Where and how to file an appeal, including telling you about any
deadlines;
·
A description of the appeal process and how you can review your
regional center records to help prepare your case;
·
Where you can get advocacy help; and
·
Notice that your current services will continue if your request
for a fair hearing is postmarked within 10 days of the date you receive
the notice. Welf. & Inst. § 4701.
Adequate notice is important so that:
·
You will know what the regional center plans to do;
·
You know the specific facts, laws, and policies on which the
regional center bases its decision;
·
You can make an informed decision about whether to appeal; and
·
You can prepare adequately for an appeal.
All notices that a regional center sends you must be in
the language that you or your authorized representative understands. Welf. & Inst. § 4701(n). If you do not understand English, or if you do not understand English well, you must make sure to tell your service coordinator. You should mail your service coordinator a letter, in your own language. Tell him that you need notices in your language. Have him put
your letter into your regional center file.
If you ever receive a notice that is in a language that
you do not understand, call your service coordinator immediately. Ask for a
notice in your own language. Timelines will not begin running until you receive
a notice that you understand.
If the regional center reduces, changes or stops a service
for your health or safety, you do not have to get advance notice. You must get
notice no more than 10 days after the
regional center takes action. Welf. & Inst. § 4710(f). Time for appealing the action begins running when you receive the notice, not when the action took place.
The law says that you have a right to continue services
that the regional center wants to change or stop if your request for a hearing
is postmarked or received by the regional center within 10 days of receiving the written notice. Welf. & Inst. § 4715. This very important right is often called “aid paid pending.”
The regional center is supposed to follow the law and
provide you with adequate notice. However, it is best not to depend on the
regional center for timing your appeal. If you use the timelines in the chart
at the end of this chapter, you will be sure not to miss a deadline.
If you do not get adequate notice, you should immediately
contact the clients’ rights advocate (CRA) at the regional center. You should
call and write. You should also contact the person who signed the notice (if it
arrived later than the timelines indicate). Ask the regional center to cancel
the decision and send you a new, proper notice that meets the requirements of
the Lanterman Act. If the regional center agrees to cancel the decision and
send you a new notice, be sure to follow the timelines for appealing the
decision.
If the regional center refuses to send a new notice, you
can file a complaint. Notify your CRA that the regional center has violated
your right to adequate notice. See question 49.
You should also file a request for a fair hearing about
the issue that you disagree with, even if the regional center does not agree to
send a new notice. It is important to protect your appeal right (and your
right to continue receiving services during the appeal process) by filing a
request for a fair hearing as soon as you can. You should do this even if you
believe the notice is inadequate. You can note in your appeal request that
you are also submitting a complaint about inadequate notice.
The following people can request a hearing: The person
applying for or receiving services and supports; that person’s legal guardian,
conservator or authorized representative (someone acting on his behalf); a
minor’s parent or other person with legal custody. Welf. & Inst. § 4703.
When the regional center gives you notice of its action or
proposed action, it must also give you information about mediation, informal
hearings and fair hearings. Welf. & Inst. § 4701. It must provide you with the correct forms to fill out to ask for a fair hearing. Welf. & Inst. § 4710.5(b). If you make the request to appeal verbally, the regional center worker must give you the form to make a fair hearing request. That person must ask you if you want help filling out the form and help you if you do. Welf. & Inst. § 4710.5(c).
The duty of the regional center to help you fill out the
form to request a fair hearing is so important that any employee of the
regional center who willfully fails to give you the form and help you fill it
out would be guilty of a misdemeanor. Welf. & Inst. § 4710.5(c). If no one gives you the form, send a letter to the regional center asking for a hearing anyway.
The same process and time limits apply for the
developmental center to give you notice of a proposed action and for you to
appeal the developmental center’s action. All of the rules for an appeal to a
developmental center and a regional center are the same. We will refer only to
regional centers to keep it simpler.
The regional center must also inform you of your rights in
writing. Those rights include:
·
The right to be present at all proceedings and to give evidence
in writing or by speaking;
·
The right to have your own witnesses and to cross-examine the
regional center’s witnesses;
·
The right to appear in person and the right to have a lawyer,
advocate or someone else represent you;
·
The right to have access to regional center records that relate
to you and the issues in dispute; and
·
The right to an interpreter who is acceptable to both you and the
regional center.
Welf. & Inst. § 4701(f) (see also Welf. & Inst. §§ 4710.8(c), 4712(h).)
The regional center must also tell you about your right to
receive information on advocacy help, including information on your area board
and Disability Rights California. Welf. & Inst. § 4701(g).
The area board may appoint a person or agency to help you
in the appeals procedure if anyone believes that, without a representative,
your rights or interests will not be protected. The appointment must be in
writing. Both the area board and your CRA must be notified of this concern. A
copy of the appointment must be given to your authorized representative and the
regional center. Welf. & Inst. § 4705(e).
Area boards oversee the services provided to consumers.
There are 13 area boards in California. A list of the area boards, with their
addresses, telephone numbers, and the counties they serve are in the
attachments to this chapter. The area boards encourage and help in setting up
citizen advocacy organizations. Those advocacy organizations provide practical
services to people with developmental disabilities and oversee the services
other agencies provide. Welf. & Inst. §§ 4548.
The area boards also do public education and outreach.
They seek advice from professionals in the field of developmental disabilities,
from consumers and their families, and from representatives about services in
the area. In 2003, the staff and offices of the area boards became part of the
State Council on Developmental Disabilities. The area boards help the State
Council prepare the state plan and may prepare an area-wide plan. Statewide,
the area boards are a part of the State Council on Developmental Disabilities
which provides advice to state agencies, the State Council, and the Legislature. Welf. & Inst. §§ 4548.
Yes. The regional center (or developmental center) must
give you or your authorized representative access to your records within 3 three working days after a written or oral
request to see them. Welf. & Inst. §§ 4726 and 4728. You have a right to see any records in your regional center file, including records the regional center got from others. The regional center must also help you understand the records at your request. Welf. & Inst. § 4728. You will want to review your file and get copies of relevant records before the hearing.
You have the right to an informal meeting with the
regional center to try to resolve the dispute. You have the right to bring an
authorized representative with you to this meeting. Welf. & Inst. § 4710.8. The regional center must offer this meeting to you, but you can decide to not have an informal meeting. We think mediation is more likely to result in an agreement. See question number 41. You can ask for an informal meeting and, if not satisfied with the
result, can then ask for mediation. Welf. & Inst. § 4710.9(b). However, either you or the regional center can “waive” mediation (decide not to mediate). If that happens, you still have a right to a fair hearing, the last step in the process, without meeting with the regional center informally. It is your choice.
An informal meeting is a meeting between you, your
representative (if you have one), and the regional center’s director or someone
acting for the director. Welf. & Inst. § 4710.7. The purpose of the meeting is to see if you can resolve the dispute or, if that is not possible, to see if you can clarify or reduce the areas where you and the regional center disagree. It will be held at a time mutually agreeable to you and the regional
center. Welf. & Inst. § 4710.6(a).
Within 5 working days
of an informal meeting, the regional center director or the person acting for
the director must send you a written decision. Welf. & Inst. § 4710.7(b). The written decision must:
(1)
Identify each issue in the appeal;
(2)
Decide on each issue identified;
(3)
State the facts supporting each decision;
(4)
Set out the laws, regulations and policies upon which each ruling is
based.
Welf. & Inst. § 4710.7(c).
If you agree with the regional center's decision following
an informal meeting, you must withdraw your hearing request. The decision will
go into effect 10 days after receipt of
your withdrawal. Welf. & Inst. § 4710.9(a). If you disagree with the informal decision, you should ask to continue to mediation or a state-level hearing within 10 days of the date you receive it.
The informal meeting is conducted in English. However, if
you (or your parent, guardian or conservator who attends the meeting) do not
understand English, the regional center must provide an interpreter. The
interpreter must be competent and acceptable to the person who needs the
interpreter and to the regional center director (or the person acting for the
director). The regional center must pay any cost of an interpreter. Welf. & Inst. § 4710.8(c).
“Mediation” is an important part of the regional center
appeal process. DDS contracts for independent, trained mediators to conduct
mediations. Either you or the regional center can say you do not want to
mediate. In that case, you will go directly to a state-level hearing. Welf. & Inst. § 4711.5.
If you both agree to mediation, it must be scheduled
within 30 days of the request for an
appeal. Welf. & Inst. § 4711.5(c)(2). A mediator will sit down informally with you and the regional center and try to resolve the disagreement you have. The mediator will meet with you and the regional center to try to find common ground and issues on which you can agree. Mediators are trained to help people look at new or different
solutions. The mediator has no power to force you to agree anything, but tries
to help you reach an agreement.
Many disputes are settled in mediation. It is in your best
interest to be as prepared as possible for a mediation. You should know what
all of the documents that relate to your case say. You should have spoken to
potential witnesses and know what they are likely to say at a hearing. This
will increase your ability to decide what you can or should agree to during
mediation. Even if you don’t settle in mediation, you will have done some of
the preparation for a hearing.
We think that mediation is generally a good idea. It does
take some time, but, other than that you have nothing to lose. Mediation gives
both sides another chance to reach an agreement. The help of an independent
mediator increases the possibility you will reach an agreement or resolution.
Even if mediation is not successful, it will often give you more information
about the regional center’s point of view. Such information may be helpful if
there is a fair hearing. On the negative side, mediation takes time and energy.
If it seems that there is absolutely no hope for agreement, you can decide to
waive mediation. We know of many instances, however, where the parties did
settle in mediation even though they saw that there was no real hope for
agreement before.
If you or the regional center does waive mediation, make
sure that you are prepared to proceed to the fair hearing. Waiving mediation
may result in the hearing being scheduled sooner than if you go to mediation.
If you disagree with the decision from the informal
meeting, do not go to mediation, or do not reach agreement through mediation,
the next step is a fair hearing. That hearing will be in front of an
administrative law judge (also called a hearing officer). The hearing must be
held within 50 days of filing the
appeal. A delay can be allowed by the administrative law judge if either you or
the regional center ask, and if there is a good reason – such as a witness is
not available. Welf. & Inst. § 4712(a).
A further continuance (delay) is available for:
·
The death of a spouse, parent, child, brother, sister or
grandparent, or the death of your authorized representative, legal guardian or
conservator. Welf. & Inst. § 4712(a)(1);
·
You or your authorized representative is ill. Welf. & Inst. § 4712(a)(2);
·
Sudden and unexpected emergencies, such as court appearances or
scheduling conflicts beyond the control of your authorized representative. Welf. & Inst. § 4712(a)(3); or
·
Unavailability of a witness or evidence if the absence would
result in serious prejudice to your case. Welf. & Inst. § 4712(a)(4).
Yes. At least 5 days
before the hearing, you and the regional center must trade lists of possible
witnesses and copies of the documents you may use at the hearing. Welf. & Inst. § 4712(d). The list of witnesses must include a short statement telling what each witness will testify about. The judge can keep you from using any documents or testimony that you do not disclose. The same goes for the regional center.
The fair hearing is a formal proceeding. It is recorded
(on tape) so the record is clear about what everyone says at the hearing. Welf. & Inst. § 4712(k). The judge takes testimony under oath. Administrative hearings are not as formal as a hearing in a court of law. The rules of evidence are relaxed, but it is much more formal than an informal hearing or mediation.
At a fair hearing you have the right to:
·
Present evidence both in writing and orally;
·
Call witnesses to present your side of the case. You can call
“lay witnesses” (people who have knowledge of the facts) and “expert witnesses”
(such as doctors, psychologists, behavior specialists, vocational therapists,
etc.) who have special training and experience;
·
Have a representative, attorney or advocate in the hearing with
you, either to present your case or to help you present your case; and
·
Have an interpreter if you or your witnesses do not speak English. Welf. & Inst. § 4701(f)(5).
At the beginning of the hearing, both you and the regional
center will have a chance to present the documents you want to use as evidence.
Welf. & Inst. § 4712(i). You should bring four sets of your documents - one set for the judge as exhibits, one for the regional center, one to show to witnesses when necessary, and one to use yourself.
The regional center is now expected to put on its
witnesses first. Welf. & Inst. § 4712(j). You can ask to put on one of your witnesses earlier. However, since the regional center knows why it wants to deny or reduce a service, it is only fair that it present its reasons first. That way, you will be better able to put on evidence
that supports your case.
You will have a chance to ask questions of the regional
center’s witnesses. Then you will be able to put on your case by asking your
own witness questions. The regional center also gets to ask your witnesses
questions.
If you want to have someone appear as a witness, but do
not believe the person will do so voluntarily, you can call the Office of
Administrative Hearings (OAH) and ask for a subpoena. The OAH is the
agency that conducts the hearings. If you want the person to bring certain
documents to the hearing, you can get a subpoena duces tecum from OAH.
On the back of the subpoena you will find instructions for serving it on the
person who will testify or bring documents.
The judge should issue a written decision within 10 days of the hearing, but no later than 80 days from the date your initial appeal is
postmarked (or received by the regional center if you hand delivered it). Welf. & Inst. § 4712.5(a). The judge’s decision should:
·
Give a summary of the facts;
·
Provide a statement of the evidence on which the judge relied;
·
Decide each issue or question presented;
·
Set out the laws, regulations and policies supporting the
decision; and
·
Be in ordinary and concise language. Welf. & Inst. § 4712.5(b).
The judge’s decision is sometimes the final administrative
decision. Sometimes it is not. If the service at issue in the hearing is not
a service paid for by the federal Medicaid Home and Community-Based Waiver, the
hearing officer’s decision is the final administrative decision. Welf. & Inst. § 4712.5(c).
If the service at issue is a service paid for by the Home
and Community-Based Waiver, and the initial notice must say if it is, the
judge’s decision is only a proposed decision. Welf. & Inst. § 4712.5(c). The director of the Department of Health Services can then review the decision and may change it. In that event, the director writes a new decision. Sometimes the director will not review the decision. In any event, the
director must issue a decision within 90 days
of the day you requested your appeal, or the judge’s decision becomes the final
administrative decision.
Yes. You can appeal a final administrative decision to
court. You must do this within 90 days
of receiving the decision. You will probably need a lawyer to do this for you.
If you or the regional center does not want the decision to go into effect, the
court can be asked to issue a “stay.” The regional center can implement a final
administrative decision within 10 days.
If you don’t want a gap in services while you appeal to court, you need to ask
the court for a stay within 10 days. Welf. & Inst. § 4712.5. The regional center can also appeal a hearing decision.
You (or your representative acting on your behalf) have a
right to make a complaint if you believe that any right to which you are
entitled has been abused or kept from you, or has been improperly or
unreasonably denied. You can complain against the regional center,
developmental center, or a service provider. A service provider might be a
community care facility, a day program or transportation providers vendored by
the regional center. Welf. & Inst. § 4731. You can complain on behalf of one person or more. Welf. & Inst. § 4731(a).
The complaint process is best used when the problem
involves failure to provide a required process or failure to meet a time limit.
It cannot not be used if the issue involves a question of the type or amount of
services required by a particular consumer. Those issues are addressed through
the fair hearing process. Welf. & Inst. § 4731(d). See question 50 for a discussion.
You should make the complaint to the director of the
regional center or, if the consumer resides in a state developmental center,
then to the director of the developmental center. Welf. & Inst. § 4731(b). You should make the complaint in writing but can make it verbally by calling or meeting with the director.
The director has 20
working days to investigate the complaint and send you a written
proposal for resolving it. If you are not satisfied with the proposed
resolution, you have 15 working days of
receiving it to refer the complaint to the Director of DDS. The decision must
give you the address to mail your further complaint to. This part of the
complaint must be made in writing. You should tell the Director of DDS why you disagree with the regional center or state developmental center director's decision.
The Director of DDS then has 45 days to
issue a written administrative decision. Welf. & Inst. § 4731(c).
DDS is required to compile the number of complaints filed,
the subject of each complaint and a summary of each decision. This information
must be available to you upon request. Welf. & Inst. § 4731(d).
You should not use the complaint process if there is a
dispute about the nature, scope or amount of services and supports that should
be in your IPP. Welf. & Inst. § 4731(f). You would use the fair hearing procedure for that kind of dispute.
Sometimes it is hard to tell which process to use. For
example, what if the regional center is denying a service to you based on a
policy that contains a limit on services? The policy says the regional center
will not buy computers for consumers under any circumstances. The service is
one you want in your IPP, but the regional center will not even consider
whether you need it because of its own policy limits. We think you can both
file a complaint and request a fair hearing in that case.
The two processes do different things.
The fair hearing will resolve a disagreement over whether you
need a certain service. If you are getting the service, you get to keep the
service while the hearing process continues if you file for a hearing within 10 days of getting the notice.
A successful complaint will help you (and other people in
the future) by stopping the regional center from using a practice or policy
that is illegal. However, you would not necessarily get to keep your services
during the process.
Every year DDS collects all of the complaints filed for
each regional center and developmental center. The subject of each complaint
and the decision will be published. DDS must make this information available to
the public upon request. Welf. & Inst. § 4731(d).
Staff must give you or your parent, guardian, conservator
or representative a written copy of the complaint procedure, in the language
you understand, when you first apply for regional center services or enter a
developmental center. You must also get a copy of the complaint procedure at
every regularly scheduled planning meeting. Welf. & Inst. § 4731(f).
