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  1. LANTERMAN ACT Your Services and Supports: Changes in the Law

  2. What Happened? • Changes were made in the law by the California legislature. • Changes became effective on July 28, 2009, when trailor bill language (TBL) was enacted (unless otherwise specified). • Changes to IPP’s and IFSP’s require notice by the regional center. 2


  4. No Changes to: • Eligibility (except early start) • IPP Process • Appeal Rights PLUS • California will apply for new state plan amendment so that regional centers can put more people on a federal waiver and receive more federal money 4

  5. Changes to Specific Services and Supports 5

  6. Respite: 90 hours every 3 months unless there is an exception 6

  7. EXCEPTIONS: • family needs extra time to help you • 7 • extra time needed to keep you in your home

  8. Expanded Scope of Duties for In-Home Respite Workers • In-Home Respite Workers-NEW SERVICES!! • Colostomy and ileostomy: changing bags and cleaning stoma • Urinary catheter: changing and emptying bags and care of catheter site • Gastrostomy: feeding/hydration and cleaning stoma and adding medication if ordered 8

  9. YOU STILL HAVE RIGHTS!!!!! Wheneverservices and supports have been changed or terminated you can request a hearing!!! 9

  10. What to do???? • ***file a 4731 complaint ***as an individual person ***as a group of people 10 • ***file a hearing request ***10 days for aid paid pending ***otherwise, file within 30 days

  11. New Program Options • Individual Choice Budget Model --self-directed services --finite budget --look for this in 2010 • Custom Endeavors Option --day program alternative --20-80 hours per month --develop/maintain employment or volunteer activities --to be offered by service providers • Senior Program --over 50 years of age --service providers must offer this option --staff ratio 1:8 11

  12. Supported Living Services • WHAT’S NEW? • must use available natural/generic supports • vendors costs must be necessary/reasonable • cost effective rates • limited circumstances rent, mortgage, lease payments, household expenses paid by regional center • roommates must share the same SLS vendor as long as IPP goals are met • need to apply for IHSS within 5 days of moving into SLS 12

  13. IHSS—Questions To Ask • Do you qualify for In-Home Support Services? • Have you applied for IHSS? • What happens if you don’t apply? • Do you qualify for gap funding by the regional center? • Are there extraordinary circumstances that may qualify you for an exemption? 13

  14. Transportation • What’s New? • Adults: must use available public transportation if it can be safely accessed and utilized • Regional centers must fund least expensive transportation that meets the individual’s needs as set forth in the IPP • For minor children living with parents, transportation funded only if family unable to provide • Parent(s) must provide reasons in writing 14

  15. BEHAVIORAL SERVICES • New Standards for purchasing behavioral services: • Service provider needs to use evidence-based practices. • Services promote positive social behaviors and address issues with learning and social interaction. • Once goals achieved, regional center may discontinue services. • Question whether all of your child’s behaviors have been addressed. 15

  16. HCBS Waiver for Consumers • Qualify if: eligible for M/Cal (including institutional deeming) and severity criteria met. • Services provided pursuant to the waiver: • case management • homemaker • home health aide • respite care • respite care facility • adult family homes • certified family homes • community recreation settings, • camping services • licensed family day care 16

  17. Waiver Services Continued…. • licensed preschool • voucher respite care • habilitation, environmental accessibility adaptations • skilled nursing • transportation • specialized medical supplies • chore services • personal emergency response systems • family training • adult residential care • specialized therapeutic services 17

  18. Regional center cannot take away waiver services that you need to stay in the community!! Request a hearing within 10 days to get aid paid pending—otherwise, request a hearing within 30 days. Put on the hearing request: “I want my right to this service under the DD waiver to be determined!!” 18

  19. Suspension of Services • What services are suspended? • Camping and associated travel • Social recreation activities • Educational services ages 3-17 • Non-medical therapies (art, dance, music, recreation) Exceptions? --Primary or critical means of ameliorating the physical, cognitive, or psychosocial effects of developmental disability --Necessary to enable consumer to remain at home; no alternative service available Individual Choice Model expected 2010!!! 19

  20. Experimental Treatment • Experimental treatment, therapeutic services, or non-clinically proven treatments can no longer be provided • All treatment and services must be: --effective and safe --known risks and complications --general physician practice If you do not agree: talk with your doctor get a letter ask for an IPP request a hearing 20


  22. Annual Statement of Services and Supports • Who must be notified: consumer parents guardian conservator authorized representative • What information must be provided: type unit month cost • Why: to make sure you are receiving the agreed upon services and supports 22

  23. Least Costly Providers • New Providers: • Must meet your needs and the needs of your family per your IPP • Must have comparable services and supports • Must have integrated services and not be more restrictive • (regional center needs to consider federal funding and cost of transportation) 23

  24. Parental Fees/Out-of-Home Placement • Regional centers can collect fees for children under the age of 18 living in an out-of-home placement • Fees based on share of cost based on income • No fees if below federal poverty level • Parents can: question fees, appeal in writing to DDS, stop paying until decision • FOLLOW PROCEDURES TO AVOID COLLECTION!!! 24

  25. Quality Assurance System • Why change the QA System? • To better evaluate your services and supports • To improve your services and supports! • What did the old system look like? • Evaluations of transfers • Life quality assessment • Triennials for people in CCF’s • What does the new QA system look like? • Consumer and family satisfaction/assessments • Provision of services and supports/assessments • Personal outcomes/assessments 25

  26. Uniform Holiday Schedule • Programs involved? • Day programs • Work activity programs What has changed? This change standardizes the holiday schedule for these programs and increases the total number from 10 to 14 days, which are yet to be determined. 26 Presentation approved September 22, 2009, by Jeanne Molineaux, Director, OCRA