Self-Determination is a voluntary service delivery system offered by the California Regional Center system to most individuals served by Regional Centers as of July 2021.
No. Self-Determination is voluntary. Traditional Regional Center Services remain available, and it is your choice which service delivery system to be part of.
Prior to July of 2021, Self-Determination was only open for a select number of people via a lottery system. However, it is now open to most people served by Regional Centers. An individual is eligible for Self-Determination if they are Lanterman Act eligible for ongoing services. This means that it’s not only individuals who are 3 or older! If a child is under the age of 3, they may still be eligible for Self-Determination services if they have already been found eligible for ongoing services. This might happen if they were born with Down Syndrome or Cerebral Palsy, for example.
People who are eligible for Self-Determination have to live in the community. The community can mean living with family, living independently (like in Supported Living), or even living in a Community Care Facility (“group home”), Foster Home Agency (“FHA”), or Department of Children & Family Services (DCFS) foster home. Where they can’t live is a Skilled Nursing Facility (SNF) or Intermediate Care Facility (ICF), which are usually funded by Medi-Cal, or an institution (like a developmental center or institution for mental disease), unless there is a plan for them to move into the community within 90 days. The reason for this is because Self-Determination is a waiver through the Center for Medicare & Medicaid Services, federally, and the purpose of these waivers is to keep people in the least restrictive environment. If they are already living in a restrictive environment, the services won’t help avoid that.
As I mentioned before, Self-Determination is a choice, and the participant or their legal guardian needs to make that choice to receive these services. It’s not a “forever” choice though – one thing that’s important to know is that you can try Self-Determination and if it doesn’t work out, you can go back to traditional services. You can’t go back and forth “willy nilly” however; there is a process and a time period.
Self-Determination provides more flexibility in service delivery, but it’s not a free-for-all. The laws, and even some policies, still apply. Self-Determination participation and services are only allowed when the service will meet IPP goals, and when generic resources are not available; just like in traditional services, IHSS will still be the primary payer for personal care, the school district will still have to provide educational services, and typical parental responsibility will still apply. In addition, there are other requirements for services, like age differentiations, that can be discussed on a case by case basis.
One of the beautiful and flexible things about Self-Determination is that people are no longer held to vendored providers, or those who have a contract with the Regional Center; they can use vendored providers, as long as they meet some requirements that are looked at individually, but they don’t have to. There is one exception; every participant must use a vendored Financial Management Service provider who will manage the money, pay providers, and make sure tax and employment laws are followed. Participants and families won’t have access to the money directly and the law doesn’t allow participants or family members to make purchases and be reimbursed; everything has to be paid directly through the FMS agency. You can see more about the Financial Management Service agencies available, as well as different models of Financial Management Services, at https://www.dds.ca.gov/initiatives/sdp/financial-management-service-contact-list/.
Finally, but still quite importantly and before they do anything else, participants need to attend the mandatory orientation that explains the program in detail. There is no obligation to move forward with Self-Determination after orientation, so you have nothing to lose!
In general, a participant or legal representative will need to do the following:
This is extremely dependent on specific circumstances related to individual cases, as well as different Regional Centers, and cannot be guaranteed. However, in general, you can expect it will take at least three to six months from the time the Person-Centered Plan is completed to transition to Self-Determination. It may take longer if there are disagreements with the Regional Center about services or if assessments need to be completed, as well as if a Financial Management Service (FMS) agency has a waitlist, for example.
Not necessarily. One of Phoenix Facilitation’s favorite phrases is “You shouldn’t have to wait for Self-Determination to have your needs met.” Our team can help you advocate for and request additional traditional services if needed while going through the Self-Determination process. It is, however, important to understand that some services are only available via Self-Determination, not traditional services, and cannot be accessed until a person enters Self-Determination. A participant or family member also won’t generally be able to be reimbursed for those services in the meantime, should they choose to pay out of pocket for them.
Most Self-Determination transitional services (Person-Centered Planning and assistance with budget, spending plan, etc.) are paid for by the Regional Center, and the participant should not have any out of pocket expenses related to that. Independent Facilitation after a full transition to Self-Determination is also generally paid for from the spending plan and Regional Center funding, and most participants do not have an out of pocket cost for these services either, although the service budget is not statutorily allowed to be increased for this service. Specific rates for services will be discussed during a consultation with our team, and outlined in the contracts that must be signed before services are initiated. Private pay and sliding scale options may be available depending on specific circumstances or when other funding has been exhausted; please contact us to discuss.
Services are based on individual need, and not all services are available to all participants or families. The specific services available to you or your loved one will be discussed during the Person-Centered Planning and spending plan processes. As in traditional services, the Regional Center is the “payer of last resort” and all generic (non-Regional Center funded) resources must be utilized before the Regional Center will consider funding a service. However, in general, an explanation of what services are available can be found here (English) and here (Spanish). If you have any questions about a specific service, please feel free to contact us.
Yes! Please contact us and note your need for bilingual services. We will link you to an advocate who is fluent in Spanish.