Developmental services.

The Lanterman Developmental Disabilities Services Act makes the State Department of Developmental Services responsible for providing various services and supports to individuals with developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Pursuant to that law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities. Existing law prohibits regional centers from purchasing any service that would otherwise be available from Medi-Cal, Medicare, and private insurance, among other sources, when a consumer or a consumer's family meets the criteria of this coverage, but chooses not to pursue that coverage. Existing law also prohibits regional centers from purchasing medical or dental services for a consumer 3 years of age or older unless the regional center is provided with documentation of a Medi-Cal, private insurance, or health care service plan denial, and the regional center determines that an appeal of the denial by the consumer or the consumer's family does not have merit. This bill would remove the requirement for the regional center to determine that the appeal of the denial by the consumer or the consumer's family does not have merit. The bill also would specify that a consumer or family is not required to appeal the denial of services from another agency that has a legal responsibility to serve all members of the general public and is receiving public funds for providing those services in order for a regional center to purchase those services as part of a consumer's individual program plan.