1. JANUARY 26, 2012 Lanterman Act Changes Presented by: Janis White, Ed.D., Chief Operating Officer, Regional Center of Orange County and Jacqueline Miller, Esq. Office of Clients’ Rights Advocacy

2. 1.Annual Family Program Fee 2.Adult Service for Consumers age 18 – 22 3. Transportation Services 4. Supported Living Services 5. Behavior Services 11 Changes in the Law 1

3. 6. Health Benefit Cards 7. Tailored Day Service / Voucher Community Based Training Service 8. Payment in Facilities with ARM Rates 9. Prevention Program 10. Administrative Changes 11. Financial Management Services requirement 11 Changes in the Law 2

4. 3 DRC has individual fact sheets in several languages on each of these changes. Go to: www.disabilityrightsca.org to find the fact sheets you want.

5. 4 Here

6. Budget Updates can also be found on the Regional Center of Orange County Website

7. Annual Family Program Fee A fee will be charged for families with children who meet ALL of the following criteria:  The child is eligible for services from a RC,  The child is under 18,  The child lives with his/her parents,  The child or family receives services beyond needs assessment and service coordination,  The child does not receive Medi-Cal (including the waiver),  The child receives services beyond those under the FCPP, and  The family’s adjusted gross income is over 400% of the federal poverty level (FPL). 5

8. Amount of the Fee If the adjusted gross income of the family is between 400% and 800% of FPL, the family pays $150 per year, per family, regardless of the number of regional center eligible children in the family. If the adjusted gross income of the family is over 800% of FPL, the family pays $200 per year, per family, regardless of the number of regional center eligible children in the family. 6

9. Exemptions Exemptions allowed if : Necessary to maintain the child in the family home. Existence of an extraordinary event that impacts the parents’ ability to pay the fee or the parents’ ability to meet the care and supervision needs of the child. The existence of a catastrophic loss that temporarily limits the ability of the parents to pay and creates a direct economic impact on the family. 7

10. Implementation Implementation was legislated to begin 7/1/2011. Should occur at the next scheduled review or modification of the IPP/IFSP. If that date has passed, letters will be sent to families to implement. Non-payment of the fee CANNOT result in termination of services, delayed services, or reductions in services. 8

11. 2011 HHS Poverty Guidelines 9 Persons in Family 48 Contiguous States and D.C. 1$10,890 214,710 318,530 422,350 526,170 629,990 733,810 837,630 For each additional person, add 3,820

12. Annual Family Program Fee Schedule

13. Regional Center Services for 18 – 22 year olds 10 This change applies to consumes age 18-22 who do not have a diploma or certificate of completion. Applies to:  Consumers 18-22 who are attending school and are either receiving or want/need certain services.  Consumers 18-22 who have left school and are currently receiving the listed services from the regional center.  Consumers who are not attending school and not receiving the prohibited services.

14. These services include:  Day Program  Vocational Education  Work Service  Independent Living Program  Mobility Training and Related Transportation Services 11

15. Regional Center Services for 18 – 22 year olds cont. Exemptions in Extraordinary Circumstances:  If through the IPP process, it is determined that the school cannot appropriately meet your needs for the listed services.  An individualized determination that an extraordinary circumstance exists to justify granting an exemption.  Examples: health and safety, services listed in IEP are not available, or extraordinary family circumstances. Schedule an IPP Meeting to discuss any extraordinary circumstances. 12

16. Transportation Services  If a consumer is receiving transportation services from the regional center, a transportation access plan shall be developed when: 13

17. 14 1. The regional center is purchasing private, specialized transportation services or services from a residential, day or other provider, to transport the consumer to and from day or work services; 2. The planning team has determined that a consumer’s community integration and participation could be safe and enhanced through the use of public transportation services; and, 3. The planning team has determined that generic transportation services are available and accessible.

18. The transportation access plan shall identify the services and supports necessary to assist the consumer in accessing public transportation. This includes, but is not limited to, mobility training services, and the use of transportation aides. 15

19. Supported Living Services (SLS) 16 If you have or plan to have a housemate who also receives SLS, the IPP team must consider whether tasks performed by the service provider can be appropriately shared.

20. Each Person’s Needs Have To Be Met 17 The service provider must have the opportunity to give input to the IPP team. For some, it will be talked about when your next IPP is due.

21. Examples 18 Meal Preparation and Cleanup Meal Planning Laundry Errands

22. SLS Independent Assessments 19 If your SLS costs exceed 125% of the statewide average, the regional center must obtain an Independent Assessment. Currently $55,245 per year. See Fact Sheets on specific requirements.

23. Behavior Services 20 Parents or Legal Guardians of a minor must sign a verification of services form (standardized DDS form) to indicate receipt of services. Failure to sign the form cannot result in a change or termination of your child’s behavioral services.

24. Health Benefit Cards 21 You must provide the regional center with copies of any health benefits cards under which you or your child are eligible to receive health benefits. Includes, among others:  Private Health Insurance  Medi-Cal or Medicare  TRICARE (Military Benefits)

25. New Day Service Options 22 Tailored Day Service:  Includes an individual service design determined through the IPP process that maximizes the consumer’s individual choices and needs.  Will generally include fewer days or hours than a traditional day program.  Allows for flexibility in the duration and intensity of services.  Must encourage opportunities to further develop or maintain employment, volunteer activities, or pursuit of postsecondary education.  Increase the consumer's ability to lead an integrated and inclusive life.

26.  Consumer-directed service that assists the consumer in developing skills required for community integrated employment or to participate in volunteer activities, or both, and the assistance that is needed for the consumer to secure employment or volunteer positions or pursue secondary education. 23 Vouchered Community Based Training Service (VCBT)

27. Specific Rules for Participants in VCBT 24 Service must be provided in natural environments in the community that is separate from the consumer’s residence; A consumer, parent, or conservator that is vendored as a VCBT Service must use the service of a financial management services (FMS) entity; A consumer’s parent or conservator cannot be a direct support worker employed by the VCBT Service vendor; A consumer that is vendored as a VCBT Service must also be eligible for a regional center-funded bus pass, if appropriate; and, A VCBT Service is limited to a maximum of 150 hours per quarter.

28. Mixed Payment Rates for Alternative Residential Model Rates (ARM) 25 Consumers who live in an ARM rate facility (group home) may now remain at the same facility if the consumer's needs change to require a lower level of service and support.

29. Early Start Prevention Program 26 Effective 7/1/2011, no referrals will be made for children 0-3 to a RC prevention program. New at-risk children will participate in the Prevention Resources and Referral Programs (PRRS) administered through the Family Resource Centers (FRC).

30. FRC 27 The Family Resource Centers will provide outreach, information, and referral services to community services for children under 36 months of age who are otherwise not eligible for the Early Start Program or Lanterman Act services through the regional centers. Referrals can come from RC or the medical community following an evaluation that finds the baby at risk. Referrals cannot be self made. The FRC will assist families in re-applying to the local RC when it is suspected that the child may be eligible for services under Early Start or the Lanterman Act.

31. Administrative Changes to the Lanterman Act 28 Consumers or families should not be adversely affected by these changes: 1. Electronic billing to RC by service providers. 2. Competency evaluations in juvenile proceedings. 3. Eliminated exemption of some vendors from the 4.25% reduction in payment in effect through June 30, 2012.

32. Financial Management Services Emergency regulations created so that the State is meeting the Medicaid Home and Community Based Services (HCBS)-Developmental Disabilities Waiver requirements. Effective October 1, 2011. Applies to consumers on the HCBS Waiver receiving:  Voucher: day care, respite, nursing, community based training, or transportation services. Requires a consumer or family member to use a financial management service (FMS) provider. 29

33. Financial Management Services cont. Amount of services remains the same. Consumer or family member can choose staff. FMS will handle payroll and accounting including tax and insurance withholding and payments, and reimbursements to service providers. Regional centers vendor the FMS. Alternatives to using FMS  Services provided by regional center vendor.  Current provider becomes staff of regional center vendor. 30

34. 31 Remember, if the services in your IPP/IFSP are changed under the new laws, you should receive a Notice of Action and you may have Due Process Rights