Tri-Counties Regional Center

Applying for Services

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Service Regulations

Rules that are related to looking for services

Here is some information for you to consider when selecting and/or requesting services:

1. TCRC will not fund any service that is considered experimental, optional or elective in nature.

2. A person's private or generic resource will be considered before authorization of regional center funding.

3. Children in Early Start, school-age children and persons living in health care facilities will be expected to receive health care and therapies, including behavior intervention, as part of these programs.

4. The Planning Team must determine that services are required as a direct result of the developmental disability.

5. Tri-Counties Regional Center will advocate for and work with persons and their family members to make sure that generic and private therapy service providers provide treatment to meet the needs of persons with developmental disabilities.

6. It is the financial responsibility of persons or their families to pay premiums and meet any required deductible amount or co-payment liabilities as determined by generic resources andlor private insurance carriers. Exception: under the federally funded Early Start Program, the regional center can be required to pay an insurance deductible or co-pay.

7. Except as legally prohibited by the terms of a Special Needs Trust, trust funds established for the care or benefit of a person are considered a private resource and, therefore, it is expected that this source of funds be used prior to regional center funds.

8. If a generic or private resource initially denies a required service that Tri-Counties Regional Center has determined to be the responsibility of that resource, the denial will be appealed. Tri-Counties Regional Center may authorize funding for a service while an individual or family member appeals a denial of service by a generic or private resource under the following circumstances:

8a. The Planning Team will make the determination that the service is required to protect a person's health and safety, or that a prolonged wait for the service will have an irreversible impact on the person's health and safety; and

8b. The Planning Team will consider the person's risk for regression and the capacity of the individual to regain any loss of function or ability if the service is not provided in a timely manner.

9. The purchase of any service must be both clinically and fiscally an effective use of public funds.

10. Exception Policy: Tri-Counties Regional Center recognizes that some individual needs are so unique that they may not be addressed in a Service Policy and may require an exception. Such requests for an exception to a Service Policy will be made through the Planning Team process.

 

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