California Medicaid Waiver Guide

California works differently from most states. Services for people with intellectual and developmental disabilities are an entitlement under the Lanterman Developmental Disabilities Services Act — there is no waiting list to become eligible. The California Department of Developmental Services (DDS) contracts with 21 nonprofit regional centers across the state, and your local regional center is the single front door: it determines eligibility, coordinates services, and pays for the supports in your plan. Much of this is funded through the Home and Community-Based Services Waiver for the Developmentally Disabled (HCBS-DD), a Medicaid (Medi-Cal) 1915(c) waiver that draws roughly $3 billion in federal funding for regional center services. Regional center eligibility itself is not income-based, so people who do not have Medi-Cal can still receive state-funded services through the same system.

Under the Lanterman Act, a person qualifies for regional center services if they have a substantial developmental disability that began before age 18 and is expected to continue indefinitely — specifically intellectual disability, cerebral palsy, epilepsy, autism, or a condition closely related to intellectual disability or requiring similar treatment. “Substantial” means significant functional limitations in at least three major life areas. Children under 3 with a delay or established risk can qualify more broadly through Early Start. Regional center eligibility is an entitlement and is not means-tested; Medi-Cal and an ICF/IID level of care are only required to fund a person's services specifically through the HCBS-DD waiver.

California does not have a waiting list to become eligible for regional center services. Because the Lanterman Act makes services an entitlement, the state must provide the supports in an eligible person's Individual Program Plan (IPP). Some specific services can still involve provider capacity or scheduling delays, and the Self-Determination Program — once phased in — is now open statewide.

Type

Entitlement (no waiting list)

Typical timeline

After you request services, the regional center generally completes an eligibility assessment within about 120 days, and your first IPP meeting is held within 60 days of an eligibility determination.

How to check status

Contact your local regional center (find it at dds.ca.gov/rc) to check the status of an intake, assessment, or service request.

1. Find your regional center

   Use the DDS directory to find the regional center that serves your county, then call to request an intake.

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2. Request intake & assessment

   For a child under 3, ask for Early Start. For age 3 and up, request a Lanterman Act eligibility assessment. The regional center reviews records and may arrange evaluations.

3. Receive an eligibility decision

   The regional center confirms whether the person has a qualifying developmental disability — usually within 120 days for ages 3 and older.

4. Develop your plan (IPP or IFSP)

   If eligible, you build a person-centered Individual Program Plan (IPP), or an Individual Family Service Plan (IFSP) for Early Start, that lists goals and the services to meet them.

5. Enroll in Medi-Cal & the waiver, then choose providers

   Your service coordinator helps confirm Medi-Cal and HCBS-DD waiver enrollment where it applies, then arranges providers — or you can choose the Self-Determination Program to direct your own budget.

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• The person's age, diagnosis, and county of residence.
• Medicaid status or whether you still need to apply.
• Current supports, urgent needs, and living situation.
• School, medical, evaluation, or eligibility documents.
• Questions about waitlists, timelines, and next steps.

Exact covered services depend on the waiver, assessed need, Medicaid rules, funding, and state program requirements. Confirm services, availability, and payment acceptance with the state, support coordinator, and provider.

California's Self-Determination Program (SDP) gives participants an individual budget to plan and purchase their own services, including hiring and managing their own staff with help from an independent facilitator and a financial management service. SDP became available statewide to all eligible regional center consumers in July 2021 on a voluntary basis.

1. Early Start (birth–3)

   Infants and toddlers with a delay or established risk receive early intervention through their regional center under an Individual Family Service Plan (IFSP). Refer a child through the Early Start BabyLine.

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2. School age (3–22)

   Public schools provide special education through an IEP under IDEA, while the regional center continues to coordinate non-educational services through the IPP.

3. Transition to adulthood (14–22)

   IEP transition planning, the California Department of Rehabilitation, and the regional center work together on employment, post-secondary, and independent living goals.

4. Adult services

   Regional centers coordinate adult supports — supported/independent living, day and employment programs, behavioral services, and residential options — often funded through the HCBS-DD waiver or the Self-Determination Program.

5. Decision-making at 18

   Families weigh limited conservatorship, powers of attorney, and supported decision-making as the person reaches adulthood.

If a regional center denies, reduces, or ends a service, you can appeal under the Lanterman Act. You have 60 days from the Notice of Action to request an informal meeting, mediation, or fair hearing — but only 30 days if you want the service to keep running during the appeal. That shorter deadline is called “aid paid pending,” and filing on day 31 forfeits it even though your appeal is still valid. You have a right to a hearing before an Administrative Law Judge no more than 50 days after DDS receives your request, with a written decision within 10 working days after it ends. Disability Rights California and its Office of Clients' Rights Advocacy (OCRA) provide free help.

Lanterman Act

California's Lanterman Developmental Disabilities Services Act, which makes services for people with developmental disabilities an entitlement delivered through regional centers.

Regional center

One of 21 nonprofit organizations under contract with DDS that determine eligibility and coordinate and pay for services in a defined service area.

DDS

The California Department of Developmental Services, the state agency that oversees regional centers and the HCBS-DD waiver.

HCBS-DD Waiver

The Home and Community-Based Services Waiver for the Developmentally Disabled — the Medi-Cal 1915(c) waiver that draws federal funding for regional center services.

IPP

Individual Program Plan — the person-centered plan (age 3 and up) that lists a regional center consumer's goals and the services to meet them.

IFSP

Individual Family Service Plan — the early intervention plan for children under 3 in the Early Start program.

Self-Determination Program (SDP)

A voluntary option that gives a participant an individual budget to direct their own services and hire their own staff.

Medi-Cal

California's Medicaid program, which funds HCBS-DD waiver services for eligible regional center consumers.

OCRA

The Office of Clients' Rights Advocacy, run by Disability Rights California, providing a clients' rights advocate for every regional center.