Coordinating care in California

Waivers

What are California's HCBS waivers?

HCBS Waiver for the Developmentally Disabled (HCBS-DD Waiver)

California's 1915(c) Medicaid waiver funding regional-center services in homes and communities as the alternative to intermediate-care facilities — roughly $3 billion in federal funding flows through it. Available to Medi-Cal-eligible regional-center consumers meeting the facility level of care; the current renewal took effect January 1, 2023.

Self-Determination Program (SDP)

A statewide option (open to all eligible regional-center consumers since July 1, 2021) giving participants an individual budget tied to their Individual Program Plan, with freedom to choose services, staff, and supports. Enrollment runs through the person's regional center.

Regional-center system (Lanterman Act)

California's defining structure: 21 community-based nonprofit regional centers under contract with the Department of Developmental Services handle assessment, eligibility, case management, and purchase of services in each person's Individual Program Plan — an entitlement model no other state uses.

• California is an entitlement state for developmental services: the Lanterman Act (Welfare & Institutions Code §§4501–4502) obligates the state to serve eligible people with developmental disabilities, so there is no capped-slot IDD waiver waitlist of the kind most states run. Entitlement does not mean instant delivery of every service — capacity and provider availability still shape real timelines.
• National waitlist statistics need care here: KFF's multi-state waiting-list figures do not break out California's IDD entitlement, so headline numbers about state waiver waitlists should not be attributed to California's developmental-services system.

Agencies

Who runs services in California?

California Department of Developmental Services (DDS)

Oversees services for Californians with intellectual and developmental disabilities — the regional-center system, the DD Waiver, and the Self-Determination Program.

California Department of Health Care Services (DHCS)

The state Medicaid (Medi-Cal) agency administering the waiver authorities, including the HCBS-DD Waiver and SDP.

Regional-center directory (DDS)

The live directory of all 21 regional centers with counties served and contacts — the actual front door for families.

School

What's specific about IEPs in California?

• California Education Code §56344 requires the assessment to be completed and the IEP developed within 60 days of parental consent to the assessment plan (school breaks longer than five schooldays don't count against the clock).
• Special education is coordinated regionally through SELPAs — Special Education Local Plan Areas — with 100+ listed in the state's directory.