Provisional Eligibility
Birth to 5 Years
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- Early Start – Birth to 3 Years
- Provisional Eligibility – Birth to 5 Years
- Transitioning from Early Childhood Services
About Provisional Eligibility
Provisional eligibility widens the range of young children who are eligible for services from the regional center.
Children who are birth to 3 years old and receiving Early Start services, may additionally be made provisionally eligible, and also receive Lanterman Act services in addition to Early Start services.
A child who is 3 or 4 years of age may qualify for provisional eligibility for regional center services, without needing a diagnosis of developmental disability as specified in W&I Code section 4512(a)(1). The child might not have an eligible diagnosis yet, or they may not have a substantial enough disability.
A disability solely physical in nature does not meet the eligibility criteria.
Provisional Eligibility is not an extension of Early Start. It is not a requirement of provisional eligibility for a 3 or 4-year-old child to have been served in Early Start. A child exiting Early Start may be eligible for Lanterman Act services under the provisional eligibility criteria. Likewise, a child who is 3 or 4 years of age who did not receive Early Start services, may be provisionally eligible.
Provisional eligibility for regional center services is for a child who demonstrates significant functional limitations in at least two major life activities outlined in W&I Code section 4512(a)(2):
- Dressing and feeding (Self-care)
- Listening and talking (Receptive and expressive language)
- Learning, thinking and problem solving (Cognitive milestones)
- draws a circle when you show how
- avoids touching hot objects, like a stove, when you give a warning
- Walking and moving (Mobility)
- Making choices, telling you what your child wants (Self-direction)
Children who receive services through provisional eligibility can receive them until age 5. At that time, they will have to meet the more stringent eligibility requirements for Lanterman Act services. If they don’t, the Lanterman Act services will end.
Similar to individuals who are eligible pursuant to W&I Code section 4512(a)(1), a child who is determined to be provisionally eligible will receive Lanterman Act Services through the Individual Program Plan (IPP) process. If one regional center says your child is provisionally eligible, then provisional eligibility stays until your child turns 5 years old. Also, your child will be provisionally eligible at any of the 21 regional centers, if you move.
A child who was made eligible for regional center services under Provisional Eligibility is not eligible for the Home and Community-Based Services (HCBS) Waiver, does not qualify for institutional deeming, and is not eligible to participate in the Self-Determination Program.
Learn more about Lanteraman Act Services
Learn more about Individual Program Plans
Reassessment of Infants and Toddlers Receiving Early Intervention Services
An infant or toddler receiving early intervention services from the regional center shall be assessed by the regional center at least 90 days prior to the date that they turn 3 years of age for purposes of determining their eligibility for Lanterman Act services.
That assessment shall first determine if the child has a developmental disability under W&I Code section 4512(a)(1). If the regional center determines that the child does not have a developmental disability, the regional center shall determine if the child is provisionally eligible for Lanterman Act services.
If the regional center determines the child does not have a developmental disability and is not provisionally eligible for Lanterman Act services, the regional center shall give adequate notice about the transition out of Early Start.
Assessment of Children Ages 3 or 4 Who are Referred to the Regional Center
A child referred to the regional center who is 3 or 4 years of age and has not received early intervention services shall be assessed pursuant to W&I Code section 4643. That assessment shall first determine if the child has a developmental disability under W&I Code section 4512(a)(1).
If the regional center determines that the child does not have a developmental disability, the regional center shall determine if the child is provisionally eligible for Lanterman Act services.
If the regional center determines the child does not have a developmental disability and is not provisionally eligible for Lanterman Act services, the regional center shall give adequate notice pursuant to W&I Code section 4701.
Reassessment of Children who are Provisionally Eligible
A child who is provisionally eligible shall be reassessed at least 90 days before turning 5 years of age. The child shall meet the definition of developmental disability set forth in W&I Code section 4512(a)(1) to be eligible for ongoing regional center services at 5 years of age.
Regional center services for a child who was provisionally eligible and who does not meet the definition in W&I Code section 4512(a)(1) shall end when the child is 5 years of age.
If an appeal of the finding of ineligibility is filed no later than 30 days after receipt of the notice of the proposed action, regional center services the child was receiving shall continue during the appeal process as outlined in W&I Code section 4715. You must appeal within 60 days to challenge the regional center’s decision.
FAQs:
FAQ
Get Answers
What if my child is denied provisional eligibility?
If denied eligibility or services, the fair hearing process is a process for resolving disagreements between the regional center and individuals served. Under the fair hearing process, disagreements may be about services, eligibility or any decision or action of the regional center with which you disagree. The fair hearing process may include an informal meeting, mediation, and a state level hearing with an Administrative Law Judge.
What is the difference between Lanterman Act Eligibility and Lanterman Act Provisional Eligibility?
Lanterman Act Eligibility
All of the following must be met:
- Diagnosed with intellectual disability, autism, epilepsy, cerebral palsy, and/or other disability that resembles an intellectual disability and/or results in the individual requiring similar services to an individual with an intellectual disability.
- The disability originates prior to age 18, is expected to be lifelong, and constitutes a substantial disability for the individual.
- Substantial means a significant functional limitation in three or more of the following areas: self-care, receptive and expressive language, learning, mobility, or self-direction
Lanterman Act Provisional Eligibility
All of the following must be met:
- A child is 3 or 4 years of age
- The disability is not solely physical in nature
- The child has significant functional limitations in at least two of the areas of major life activity: self-care, receptive and expressive language, learning, mobility or self-direction
How does the Regional Center decide if a condition is covered by the Lanterman Act?
- The regional center performs an assessment by reviewing the individual’s history, records, diagnosis and past services.
- They may also have a doctor or psychologist administer tests. The child/adult and their family should participate in the assessment process. This will help the regional center understand cultural values, language, religion, education, social and financial issues.
- The regional center must consider what you or your family says, so the assessment can be thorough and sensitive to your culture, family and community.
What does it mean to be Status 1, 2 or U?
Each individual has a client master file (CMF) as part of the statewide client management system. The CMF is the primary source for demographic, case status and service coordinator information. As part of this file, individuals have an active status code.
Status Code 1: Children birth to age 3 who are at risk of having a developmental disability or who have a developmental delay but have not been diagnosed as having a developmental disability. Children with a status code 1 qualify for early intervention services.
Status Code U: Children who are determined provisionally eligible are assigned a status code “U”
Status Code 2: People diagnosed as having a developmental disability who are served in the community (not in a state developmental center).