California state law, AB 107, was passed in June 2017 effecting Regional Center clients under three years old (Early Start). The new law clarifies that for Early Start clients that the Regional Center must pay for needed therapy if the child’s health insurance will not cover the therapy, and if the therapy is identified in the child’s individualized family service plan (“IFSP”).
The background of this law is that Regional Centers are the payor of last resort. Meaning if there are any other agencies available to pay for a service, families must use the other agencies. If there are no other agencies to pay, then the Regional Center must pay.
The issue comes up when Early Start children need therapies. The Regional Center requires families to utilize their private health insurance first. However, sometimes when families attempt to have health insurance pay for these services they are not successful because of lack of provider network, contracting rules, waitlist, time conflicts, etc. The new law states that if insurance will not pay for the therapies or services, Regional Center must provide that the therapy or service is in the child’s Individual Family Service Plan (“IFSP”).
The new law also highlights the need for strategic planning for IFSP meetings. Families to make sure all the child’s services or therapies are identified in the Individual Family Service Plan (“IFSP”), regardless of who is paying for the service or therapy.
If you need help planning for your Individual Family Service Plan (“IFSP”) or help with getting Regional Center to pay for a service or therapy, contact me.
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