California Legislature—2015–16 Regular Session

Assembly BillNo. 1285

Introduced by Assembly Member Thurmond

February 27, 2015

An act to amend Section 4659 of the Welfare and Institutions Code, relating to developmental services.


AB 1285, as introduced, Thurmond. Developmental services: regional centers.

Existing law, the Lanterman Developmental Disabilities Services Act, requires the State Department of Developmental Services to contract with regional centers to provide services and supports to individuals with developmental disabilities and their families, and requires regional centers to identify and pursue all possible sources of funding for consumers receiving those services.

This bill would make technical, nonsubstantive changes to those provisions.

Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.

The people of the State of California do enact as follows:

P1    1


Section 4659 of the Welfare and Institutions Code
2 is amended to read:



(a) Except as otherwise provided in subdivision (b) or
4(e), the regional center shall identify and pursue all possible sources
5of funding for consumers receiving regional center services. These
6sources shall include, but not be limited to, both of the following:

P2    1(1) Governmental or other entities or programs required to
2provide or pay the cost of providing services, including Medi-Cal,
3Medicare, the Civilian Health and Medical Program for Uniform
4Services, school districts, and federal supplemental security income
5and the state supplementary program.

6(2) Private entities, to the maximum extent they are liable for
7the cost of services, aid, insurance, or medical assistance to the

9(b) Any revenues collected by a regional center pursuant to this
10section shall be applied against the cost of services prior to use of
11regional center funds for those services. This revenue shall not
12result in a reduction in the regional center’s purchase of services
13budget, except as it relates to federal supplemental security income
14and the state supplementary program.

15(c) Effective July 1, 2009, notwithstanding any other law or
16regulation, regional centers shall not purchase any service that
17would otherwise be available from Medi-Cal, Medicare, the
18Civilian Health and Medical Program for Uniform Services,
19In-Home Support Services, California Children’s Services, private
20insurance, or a health care service plan when a consumer or abegin insert end insert
21begin insertconsumer’send insert family meets the criteria of this coverage but chooses
22not to pursue that coverage. If, on July 1, 2009, a regional center
23 is purchasing that service as part of a consumer’s individual
24program plan (IPP), the prohibition shall take effect on October
251, 2009.

26(d) (1) Effective July 1, 2009, notwithstanding any other law
27or regulation, a regional center shall not purchase medical or dental
28services for a consumer three years of age or older unless the
29regional center is provided with documentation of a Medi-Cal,
30private insurance, or a health care service plan denial and the
31regional center determines that an appeal by the consumer orbegin insert the
32consumer’send insert
family of the denial does not have merit. If, on July
331, 2009, a regional center is purchasing the service as part of a
34consumer’s IPP, this provision shall take effect on August 1, 2009.
35Regional centers may pay for medical or dental services during
36the following periods:

37(A) While coverage is being pursued, but before a denial is

P3    1(B) Pending a final administrative decision on the administrative
2appeal if thebegin insert consumer’send insert family has provided to the regional center
3a verification that an administrative appeal is being pursued.

4(C) Until the commencement of services by Medi-Cal, private
5insurance, or a health care service plan.

6(2) When necessary, the consumer orbegin insert the consumer’send insert family
7may receive assistance from the regional center, the Clients’ Rights
8Advocate funded by the department, or the state council in pursuing
9these appeals.

10(e) This section shall not impose any additional liability on the
11parents of children with developmental disabilities, or to restrict
12eligibility for, or deny services to, any individual who qualifies
13for regional center services but is unable to pay.

14(f) In order to best utilize generic resources, federally funded
15programs, and private insurance programs for individuals with
16developmental disabilities, the department and regional centers
17shall engage in the following activities:

18(1) Within existing resources, the department shall provide
19training to regional centers, no less than once every two years, in
20the availability and requirements of generic, federally funded and
21private programs available to persons with developmental
22disabilities, including, but not limited to, eligibility requirements,
23the application process and covered services, and the appeal

25(2) Regional centers shall disseminate information and training
26to all service coordinators regarding the availability and
27requirements of generic, federally funded, and private insurance
28programs on the local level.