WELFARE AND INSTITUTIONS CODE
SECTION 4659.5-4659.8
4659.5. (a) This article shall apply to any dispute over the
provision of services where the regional center believes that a
generic agency, as defined in subdivision (g), is legally obligated
to fund or provide a service or services that are contained in the
individualized family service plan or individual program plan for any
child under six years of age.
(b) This article shall apply only to disputes over which entity is
to deliver or pay for a specific type, frequency, or duration of
services, or any combination thereof, when the services are contained
in the individualized family service plan or individual program plan
for any child under six years of age. This article shall not apply
to the resolution of disputes between a consumer or his or her
authorized representative and a regional center over the provision
of, or payment for, a service, nor shall this article apply to the
determination of eligibility for any service.
(c) This article does not apply when the dispute has been decided
after a due process hearing or resolved by the agreement of all
parties, in a proceeding under the California Early Intervention
Services Act (Title 14 (commencing with Section 95000) of the
Government Code) in which the regional center and local educational
agency have been joined.
(d) This article does not apply to a dispute over the type,
frequency, and duration of service when a consumer has requested
mediation or a due process hearing under the California Early
Intervention Services Act (Title 14 (commencing with Section 95000)
of the Government Code) and the regional center and local educational
agency have been joined in the proceeding.
(e) This article does not modify the mandated responsibility of a
regional center or a local educational agency to fund services
identified in the individualized family service plan as set forth in
subdivisions (b) to (e), inclusive, of Section 95014 of the
Government Code and Sections 52106 to 52110, inclusive, of Title 17
of the California Code of Regulations.
(f) This article does not modify the responsibilities of regional
centers to fund services pursuant to this division.
(g) For purposes of this article, "generic agency" means a
publicly funded agency referred to in paragraph (8) of subdivision
(a) of Section 4648, except that the term does not apply to Medi-Cal
specialty mental health plans that are governed by dispute resolution
processes outlined in Chapter 11 (commencing with Section 1810.100)
of Division 1 of Title 9 of the California Code of Regulations, an
individual, organization, or entity operating under a Medi-Cal
managed care plan contract with the State Department of Health Care
Services under Chapter 7 (commencing with Section 14000) or Chapter 8
(commencing with Section 14200) of Part 3 of Division 9, the
Genetically Handicapped Persons Program, administered by the State
Department of Health Care Services pursuant to Article 1 (commencing
with Section 125125) of Chapter 2 of Part 5 of Division 106 of the
Health and Safety Code, or to the California Children's Services
Program administered by the State Department of Health Care Services
pursuant to Article 5 (commencing with Section 123800) of Chapter 3
of Part 2 of Division 106 of the Health and Safety Code.
4659.7. (a) Whenever a regional center believes that a generic
agency is responsible for providing or paying for a service required
pursuant to Sections 4646.5 to 4648, inclusive, or Section 95020 of
the Government Code and specified in the consumer's individualized
family service plan or individual program plan, and the generic
agency is not providing or funding the service or services, the
regional center may submit a written notification of the failure to
provide the service and a request for dispute resolution to the
appropriate generic agency. Any regional center that files written
notification of the failure to provide a service and a request for
dispute resolution with a generic agency as set forth in this
section, shall provide written notification of its request for
resolution to the consumer's parent, legal guardian, or authorized
representative. The regional center may withdraw its request for
dispute resolution at any time during this process.
(b) (1) Upon receipt of the written notification made by the
regional center, the generic agency and the regional center shall
have 15 calendar days to meet to resolve the dispute unless the
generic agency notifies the regional center in writing that it needs
additional time, up to 15 days, to make an initial assessment of
whether the child meets the basic eligibility requirements for the
program or type of service in question.
(2) The generic agency and the regional center shall prepare a
written copy of the meeting resolution which shall be mailed to the
parent, guardian, or other authorized representative within 10
calendar days of the meeting. The resolution shall specify the
regional center or generic agency responsible for providing the
service.
(c) (1) If the dispute cannot be resolved to the satisfaction of
the regional center and the generic agency, within 10 calendar days
of the meeting, each party shall submit his or her contentions on the
issue in writing to the Director of the Office of Administrative
Hearings within 30 calendar days of the meeting. The Director of the
Office of Administrative Hearings, or his or her designee, shall
review the issue and issue a written decision within 30 calendar days
of receipt of the case. The decision shall specify the regional
center or generic agency responsible for the service or services. The
Office of Administrative Hearings may award reimbursement
retroactively to the date the prevailing party initiated the
provision of the services that were in dispute. A written copy of the
resolution shall be mailed to the parent, guardian, or authorized
representative, the Director of Developmental Services, the regional
center, and the generic agency involved in the dispute resolution
process.
(2) The decision of the Director of the Office of Administrative
Hearings, or his or her designee, shall be the final administrative
decision for all agencies that are parties to the dispute.
(3) Nothing in this article shall be construed to supersede
regional center or generic agency procedures for subsequent review
and modification, as appropriate, of the type, frequency, or duration
of services pursuant to the agency's program or treatment planning
process.
(d) (1) The submission of a notification pursuant to subdivision
(a) shall not interfere with a consumer's right to receive the
services and supports in his or her individualized family service
plan or individual program plan on a timely basis.
(2) Arrangements for the provision of an interim service or
services may be made by written agreement between the regional center
and the generic agency, provided the child's individualized family
service plan or individual program plan is not altered, except as to
which agency delivers or pays for the service if the service or
services are included in the individualized family service plan or
individual program plan.
(e) Nothing in this section shall prevent a consumer or his or her
authorized representative from pursuing administrative remedies
otherwise available, including remedies pursuant to Chapter 7
(commencing with Section 4700) of Division 4.5, of this code or
Sections 52160 to 52174, inclusive, of Title 17 of the California
Code of Regulations or, after exhaustion of any applicable
administrative remedies, pursuing available remedies through a civil
action in any court of competent jurisdiction.
(f) Once the dispute resolution procedures have been completed,
the agency determined responsible for the service shall pay for and
provide the service, and shall reimburse the other agency that
provided the service pursuant to subdivision (d), if applicable.
(g) The State Department of Developmental Services shall pay for
the services provided by the Office of Administrative Hearings
pursuant to this section.
4659.8. The resolution under this article of whether a regional
center or generic agency is the responsible party for providing the
service in a particular matter shall not set a precedent for the
resolution of any other matter.
WELFARE AND INSTITUTIONS CODE
SECTION 4659.5-4659.8
4659.5. (a) This article shall apply to any dispute over the
provision of services where the regional center believes that a
generic agency, as defined in subdivision (g), is legally obligated
to fund or provide a service or services that are contained in the
individualized family service plan or individual program plan for any
child under six years of age.
(b) This article shall apply only to disputes over which entity is
to deliver or pay for a specific type, frequency, or duration of
services, or any combination thereof, when the services are contained
in the individualized family service plan or individual program plan
for any child under six years of age. This article shall not apply
to the resolution of disputes between a consumer or his or her
authorized representative and a regional center over the provision
of, or payment for, a service, nor shall this article apply to the
determination of eligibility for any service.
(c) This article does not apply when the dispute has been decided
after a due process hearing or resolved by the agreement of all
parties, in a proceeding under the California Early Intervention
Services Act (Title 14 (commencing with Section 95000) of the
Government Code) in which the regional center and local educational
agency have been joined.
(d) This article does not apply to a dispute over the type,
frequency, and duration of service when a consumer has requested
mediation or a due process hearing under the California Early
Intervention Services Act (Title 14 (commencing with Section 95000)
of the Government Code) and the regional center and local educational
agency have been joined in the proceeding.
(e) This article does not modify the mandated responsibility of a
regional center or a local educational agency to fund services
identified in the individualized family service plan as set forth in
subdivisions (b) to (e), inclusive, of Section 95014 of the
Government Code and Sections 52106 to 52110, inclusive, of Title 17
of the California Code of Regulations.
(f) This article does not modify the responsibilities of regional
centers to fund services pursuant to this division.
(g) For purposes of this article, "generic agency" means a
publicly funded agency referred to in paragraph (8) of subdivision
(a) of Section 4648, except that the term does not apply to Medi-Cal
specialty mental health plans that are governed by dispute resolution
processes outlined in Chapter 11 (commencing with Section 1810.100)
of Division 1 of Title 9 of the California Code of Regulations, an
individual, organization, or entity operating under a Medi-Cal
managed care plan contract with the State Department of Health Care
Services under Chapter 7 (commencing with Section 14000) or Chapter 8
(commencing with Section 14200) of Part 3 of Division 9, the
Genetically Handicapped Persons Program, administered by the State
Department of Health Care Services pursuant to Article 1 (commencing
with Section 125125) of Chapter 2 of Part 5 of Division 106 of the
Health and Safety Code, or to the California Children's Services
Program administered by the State Department of Health Care Services
pursuant to Article 5 (commencing with Section 123800) of Chapter 3
of Part 2 of Division 106 of the Health and Safety Code.
4659.7. (a) Whenever a regional center believes that a generic
agency is responsible for providing or paying for a service required
pursuant to Sections 4646.5 to 4648, inclusive, or Section 95020 of
the Government Code and specified in the consumer's individualized
family service plan or individual program plan, and the generic
agency is not providing or funding the service or services, the
regional center may submit a written notification of the failure to
provide the service and a request for dispute resolution to the
appropriate generic agency. Any regional center that files written
notification of the failure to provide a service and a request for
dispute resolution with a generic agency as set forth in this
section, shall provide written notification of its request for
resolution to the consumer's parent, legal guardian, or authorized
representative. The regional center may withdraw its request for
dispute resolution at any time during this process.
(b) (1) Upon receipt of the written notification made by the
regional center, the generic agency and the regional center shall
have 15 calendar days to meet to resolve the dispute unless the
generic agency notifies the regional center in writing that it needs
additional time, up to 15 days, to make an initial assessment of
whether the child meets the basic eligibility requirements for the
program or type of service in question.
(2) The generic agency and the regional center shall prepare a
written copy of the meeting resolution which shall be mailed to the
parent, guardian, or other authorized representative within 10
calendar days of the meeting. The resolution shall specify the
regional center or generic agency responsible for providing the
service.
(c) (1) If the dispute cannot be resolved to the satisfaction of
the regional center and the generic agency, within 10 calendar days
of the meeting, each party shall submit his or her contentions on the
issue in writing to the Director of the Office of Administrative
Hearings within 30 calendar days of the meeting. The Director of the
Office of Administrative Hearings, or his or her designee, shall
review the issue and issue a written decision within 30 calendar days
of receipt of the case. The decision shall specify the regional
center or generic agency responsible for the service or services. The
Office of Administrative Hearings may award reimbursement
retroactively to the date the prevailing party initiated the
provision of the services that were in dispute. A written copy of the
resolution shall be mailed to the parent, guardian, or authorized
representative, the Director of Developmental Services, the regional
center, and the generic agency involved in the dispute resolution
process.
(2) The decision of the Director of the Office of Administrative
Hearings, or his or her designee, shall be the final administrative
decision for all agencies that are parties to the dispute.
(3) Nothing in this article shall be construed to supersede
regional center or generic agency procedures for subsequent review
and modification, as appropriate, of the type, frequency, or duration
of services pursuant to the agency's program or treatment planning
process.
(d) (1) The submission of a notification pursuant to subdivision
(a) shall not interfere with a consumer's right to receive the
services and supports in his or her individualized family service
plan or individual program plan on a timely basis.
(2) Arrangements for the provision of an interim service or
services may be made by written agreement between the regional center
and the generic agency, provided the child's individualized family
service plan or individual program plan is not altered, except as to
which agency delivers or pays for the service if the service or
services are included in the individualized family service plan or
individual program plan.
(e) Nothing in this section shall prevent a consumer or his or her
authorized representative from pursuing administrative remedies
otherwise available, including remedies pursuant to Chapter 7
(commencing with Section 4700) of Division 4.5, of this code or
Sections 52160 to 52174, inclusive, of Title 17 of the California
Code of Regulations or, after exhaustion of any applicable
administrative remedies, pursuing available remedies through a civil
action in any court of competent jurisdiction.
(f) Once the dispute resolution procedures have been completed,
the agency determined responsible for the service shall pay for and
provide the service, and shall reimburse the other agency that
provided the service pursuant to subdivision (d), if applicable.
(g) The State Department of Developmental Services shall pay for
the services provided by the Office of Administrative Hearings
pursuant to this section.
4659.8. The resolution under this article of whether a regional
center or generic agency is the responsible party for providing the
service in a particular matter shall not set a precedent for the
resolution of any other matter.
WELFARE AND INSTITUTIONS CODE
SECTION 4659.5-4659.8
4659.5. (a) This article shall apply to any dispute over the
provision of services where the regional center believes that a
generic agency, as defined in subdivision (g), is legally obligated
to fund or provide a service or services that are contained in the
individualized family service plan or individual program plan for any
child under six years of age.
(b) This article shall apply only to disputes over which entity is
to deliver or pay for a specific type, frequency, or duration of
services, or any combination thereof, when the services are contained
in the individualized family service plan or individual program plan
for any child under six years of age. This article shall not apply
to the resolution of disputes between a consumer or his or her
authorized representative and a regional center over the provision
of, or payment for, a service, nor shall this article apply to the
determination of eligibility for any service.
(c) This article does not apply when the dispute has been decided
after a due process hearing or resolved by the agreement of all
parties, in a proceeding under the California Early Intervention
Services Act (Title 14 (commencing with Section 95000) of the
Government Code) in which the regional center and local educational
agency have been joined.
(d) This article does not apply to a dispute over the type,
frequency, and duration of service when a consumer has requested
mediation or a due process hearing under the California Early
Intervention Services Act (Title 14 (commencing with Section 95000)
of the Government Code) and the regional center and local educational
agency have been joined in the proceeding.
(e) This article does not modify the mandated responsibility of a
regional center or a local educational agency to fund services
identified in the individualized family service plan as set forth in
subdivisions (b) to (e), inclusive, of Section 95014 of the
Government Code and Sections 52106 to 52110, inclusive, of Title 17
of the California Code of Regulations.
(f) This article does not modify the responsibilities of regional
centers to fund services pursuant to this division.
(g) For purposes of this article, "generic agency" means a
publicly funded agency referred to in paragraph (8) of subdivision
(a) of Section 4648, except that the term does not apply to Medi-Cal
specialty mental health plans that are governed by dispute resolution
processes outlined in Chapter 11 (commencing with Section 1810.100)
of Division 1 of Title 9 of the California Code of Regulations, an
individual, organization, or entity operating under a Medi-Cal
managed care plan contract with the State Department of Health Care
Services under Chapter 7 (commencing with Section 14000) or Chapter 8
(commencing with Section 14200) of Part 3 of Division 9, the
Genetically Handicapped Persons Program, administered by the State
Department of Health Care Services pursuant to Article 1 (commencing
with Section 125125) of Chapter 2 of Part 5 of Division 106 of the
Health and Safety Code, or to the California Children's Services
Program administered by the State Department of Health Care Services
pursuant to Article 5 (commencing with Section 123800) of Chapter 3
of Part 2 of Division 106 of the Health and Safety Code.
4659.7. (a) Whenever a regional center believes that a generic
agency is responsible for providing or paying for a service required
pursuant to Sections 4646.5 to 4648, inclusive, or Section 95020 of
the Government Code and specified in the consumer's individualized
family service plan or individual program plan, and the generic
agency is not providing or funding the service or services, the
regional center may submit a written notification of the failure to
provide the service and a request for dispute resolution to the
appropriate generic agency. Any regional center that files written
notification of the failure to provide a service and a request for
dispute resolution with a generic agency as set forth in this
section, shall provide written notification of its request for
resolution to the consumer's parent, legal guardian, or authorized
representative. The regional center may withdraw its request for
dispute resolution at any time during this process.
(b) (1) Upon receipt of the written notification made by the
regional center, the generic agency and the regional center shall
have 15 calendar days to meet to resolve the dispute unless the
generic agency notifies the regional center in writing that it needs
additional time, up to 15 days, to make an initial assessment of
whether the child meets the basic eligibility requirements for the
program or type of service in question.
(2) The generic agency and the regional center shall prepare a
written copy of the meeting resolution which shall be mailed to the
parent, guardian, or other authorized representative within 10
calendar days of the meeting. The resolution shall specify the
regional center or generic agency responsible for providing the
service.
(c) (1) If the dispute cannot be resolved to the satisfaction of
the regional center and the generic agency, within 10 calendar days
of the meeting, each party shall submit his or her contentions on the
issue in writing to the Director of the Office of Administrative
Hearings within 30 calendar days of the meeting. The Director of the
Office of Administrative Hearings, or his or her designee, shall
review the issue and issue a written decision within 30 calendar days
of receipt of the case. The decision shall specify the regional
center or generic agency responsible for the service or services. The
Office of Administrative Hearings may award reimbursement
retroactively to the date the prevailing party initiated the
provision of the services that were in dispute. A written copy of the
resolution shall be mailed to the parent, guardian, or authorized
representative, the Director of Developmental Services, the regional
center, and the generic agency involved in the dispute resolution
process.
(2) The decision of the Director of the Office of Administrative
Hearings, or his or her designee, shall be the final administrative
decision for all agencies that are parties to the dispute.
(3) Nothing in this article shall be construed to supersede
regional center or generic agency procedures for subsequent review
and modification, as appropriate, of the type, frequency, or duration
of services pursuant to the agency's program or treatment planning
process.
(d) (1) The submission of a notification pursuant to subdivision
(a) shall not interfere with a consumer's right to receive the
services and supports in his or her individualized family service
plan or individual program plan on a timely basis.
(2) Arrangements for the provision of an interim service or
services may be made by written agreement between the regional center
and the generic agency, provided the child's individualized family
service plan or individual program plan is not altered, except as to
which agency delivers or pays for the service if the service or
services are included in the individualized family service plan or
individual program plan.
(e) Nothing in this section shall prevent a consumer or his or her
authorized representative from pursuing administrative remedies
otherwise available, including remedies pursuant to Chapter 7
(commencing with Section 4700) of Division 4.5, of this code or
Sections 52160 to 52174, inclusive, of Title 17 of the California
Code of Regulations or, after exhaustion of any applicable
administrative remedies, pursuing available remedies through a civil
action in any court of competent jurisdiction.
(f) Once the dispute resolution procedures have been completed,
the agency determined responsible for the service shall pay for and
provide the service, and shall reimburse the other agency that
provided the service pursuant to subdivision (d), if applicable.
(g) The State Department of Developmental Services shall pay for
the services provided by the Office of Administrative Hearings
pursuant to this section.
4659.8. The resolution under this article of whether a regional
center or generic agency is the responsible party for providing the
service in a particular matter shall not set a precedent for the
resolution of any other matter.
