Purchase of Services Policy Statement

The Frank D. Lanterman Regional Center may purchase services and supports for persons with developmental disabilities ("clients") when such services and supports will:

1. Prevent or alleviate the developmental disability
   
2. Prevent the dislocation of a minor client from his or her home or the dislocation of an adult client from his or her home community
   
3. Enable the client to approximate the pattern of everyday living of a nondisabled person of the same age, or lead to a more independent, productive and normal life in the community or permit interaction with persons without disabilities in positive, meaningful ways. Clients also include infants under the age of three who have conditions which put them at risk of developmental disability, as determined by an interdisciplinary team (Welfare & Institutions Code § § 4501, 4502, 4646, subd. (a), 4648, subd. (a)(1).)

"Services and supports for persons with developmental disabilities" means specialized services and supports or special adaptations of generic services and supports directed toward the alleviation of a developmental disability or toward the social, personal, physical, or economic habilitation or rehabilitation of an individual with a developmental disability, or toward the achievement and maintenance of independent, productive, normal lives for persons with developmental disabilities. The determination of which services and supports are necessary for each client shall be made through the Individual Program Plan/Individualized Family Service Plan ("IPP/IFSP") process. The determination shall be made on the basis of the needs and preferences of the client or, when appropriate, the clients’s family, and shall include consideration of a range of service options proposed by the IPP/IFSP participants, the effectiveness of each option in meeting the goals stated in the IPP/IFSP, and the cost effectiveness of each option. (Welfare & Institutions Code 4512, subd. (b).)

Public resources which are available to implement any service or support and any other sources of available funding and/or voluntary provision of service and support to a client, such as the natural support of family, friends and associates, or circles of support, shall be investigated and pursued, if appropriate, prior to the Regional Center’s purchase of service. Parents of minor clients may voluntarily purchase some portion of their child’s care, beyond that required by law for support of minor clients; and parents of adult clients may voluntarily purchase some or all of the adult clients’s care. In those instances where it is determined that another agency or individual should be responsible to purchase or provide a service, the Regional Center will assist the client and/or family in obtaining the needed service. While the Regional Center is pursuing funding from another agency or individual, it may purchase urgently needed services and supports until that agency or individual purchases or provides the services and supports. Any retroactive funding received from an outside agency or individual should be applied to offset the payment or payments made by the Regional Center during the time that such service or support was being pursued. (Welfare & Institutions Code § § 4648, subd. (a)(8), 4659, 4685, subd. (c)(6) and 4791, subds. (c) and (h)(1)(A), Family Code § § 3900 and 3910.)

In identifying a minor client’s service and support needs, the Regional Center shall take into account the parents’ responsibility to provide services to the minor client. With regard to diapers and child care, except in unusual circumstances, the Regional Center shall fund only those services and supports which are more than the parents would be responsible to provide for a child without a developmental disability. For minors in out-of-home placement or in or on leave from a State Developmental Center, the Regional Center shall look to the parents to meet their share of costs for the minor’s care. For children under the age of three years, regional centers may use private insurance as a generic service only if there is not cost to the family as a result of its use. Cost includes deductibles, co-pays, or a reduction in the lifetime benefit cap. Regional centers may pay the cost of accessing private insurance (e.g. deductible and co-pay amounts). (34 CFR 303.520(b)(3)(I). (Welfare & Institutions Code § § 4659, 4685, subd. (c)(6), 4782 and 4784, Family Code § 3900.)

The IPP/IFSP process is at the heart of the Regional Center’s function to plan for and meet the needs of the client and his or her family. Services and supports may be purchased to meet a client’s needs associated with a developmental disability when such services and supports will accomplish all or any part of the goals and objectives contained in the client’s IPP/IFSP. Individual Program Plans/Individualized Family Service Plans shall be prepared jointly by one or more representatives of the Regional Center, including the service coordinator, the person with a developmental disability, and where appropriate, the person’s parents, legal guardian, or conservator and any other persons invited by the client or his or her parent, guardian or conservator. (Welfare & Institutions Code § § 4646 and 4646.5.)

As further outlined in Welfare & Institutions Code § § 4646 and 4646.5:

• Each IPP/IFSP shall contain a statement of goals, based on the client’s needs, preferences and life choices, with a statement of specific, time-limited objectives for implementing the client’s goals and addressing his or her needs.
  
• These objectives shall be stated in terms that allow measurement of progress or monitoring of service delivery.
  
• The goals and objectives should maximize opportunities for the client to develop relationships, be part of community life in terms of housing, work, school and leisure, increase control over his or her life, acquire increasingly positive roles in community life and develop competencies to pursue these goals.
  
• Each service and support must be identified in the IPP/IFSP and must be associated with one or more objectives targeted for the client.
  
• Each IPP/IFSP shall also set forth a schedule of the type and amount of each service and support to be purchased by the Regional Center or obtained from generic agencies or other resources and shall identify the providers of service responsible for attaining each objective.
  
• There shall be a schedule of regular periodic review and reevaluation of the IPP/IFSP to determine if planned services have been provided and if objectives have been fulfilled within the times specified and if the client and his or her family is satisfied with the IPP/IFSP and its implementation.

(See also, Welfare & Institutions Code § § 4512, subd. (b), 4640.7, 4646, 4646.5, 4648 and 4750.)

To the fullest extent possible, services and supports should be provided which are culturally appropriate, integrated with mainstream community life, promote client and family empowerment and involve clients and their families in the development, implementation, monitoring and evaluation of services and supports. (Welfare & institutions Code § § 4501, 4502, 4512, 4640.7, 4646, 4646.5, 4685 and 4688.)

Services and supports may be purchased only from providers

• (a) who are vendored or otherwise authorized by the Department of Developmental Services to provide such services and supports
  
• (b) who have a rate of payment for vendored or contracted services provided by the Department of Developmental Services
  
• (c) for whom the Regional Center has issued prior authorization for the purchase of the specific service for the client involved
  
• (d) who adhere to the quality of care standards set forth by the Regional Center, the Department of Developmental Services, the Welfare & Institutions Code and the California Code of Regulations related to the service and support provided.

The Regional Center shall consider the following when selecting a provider of client services and supports:

1. A provider’s ability to deliver quality services and supports which will accomplish the specified IPP/IFSP objective
   
2. A provider’s success in achieving the objectives in the IPP/IFSP
   
3. Where appropriate, the existence of licensing, accreditation, or professional certification
   
4. The cost of providing services and supports of comparable quality by different providers
   
5. A provider’s innovation and ability to promote cost-effectiveness
   
6. The ability of the provider to develop and facilitate services in natural environments with natural supports
   
7. The ability of the provider to empower clients and their families, when appropriate, to make choices in their own lives, including where and how they live, their relationships with people in the community, the way they spend their time, including education, employment and leisure, the pursuit of their personal future, and program planning and implementation
   
8. The ability of the provider to implement services and supports which result in a more independent, productive and normal life for the client.

Continued funding of services and supports may be authorized only if the client, and where appropriate, the client’s parent, legal guardian or conservator and the Regional Center agree that (a) the planned services and supports have been provided as specified above, and (b) reasonable progress has been made toward meeting the client’s IPP/IFSP objectives. (Welfare & Institutions Code § § 4648, 4651, 4685.)

The Frank D. Lanterman Regional Center will not purchase any service or support which is considered by recognized professionals to be potentially harmful to clients (Welfare & Institutions Code § § 4502 and 4503).

Persons with developmental disabilities have the same legal rights and responsibilities guaranteed all other individuals by the United States Constitution and the Constitution and laws of the State of California. Services shall be purchased for eligible client without regard to race, color, creed, national origin, citizenship, sex, age or condition of physical or mental disability. No otherwise qualified person, by reason of developmental disability, shall be excluded from participation in, denied the benefits of or subjected to discrimination under any program or activity which receives public funds. (Welfare & Institutions Code § 4502.)

This policy statement shall be considered together with the specific purchase of service standards set forth below for each type of service. The types of services set forth herein are not all inclusive. Individual circumstances related to a developmental disability may warrant additional services not specifically stated. Exceptions to the Purchase of Service guidelines, to the types of services or to the specific standards for each type of service may be made when considering individual needs. Any such exception shall be reviewed by the Regional Center executive director or designee.

If the regional center denies any service or seeks to stop current services, the client, and/or his or her representative can appeal the proposed decision by making a request for a fair hearing. Additional information and assistance can be provided by the client’s service coordinator.

ADOPTED BY BOARD OF DIRECTORS: JANUARY 26, 2000