Supported Living Services for Your Adult Child in California

Ms. Dumlao is a San Diego attorney specializing in issues related to regional center, special education, IHSS, Medi-Cal, Social Security and other agencies that provide public benefits to people with disabilities. She also is a staff attorney at the University of San Diego Legal Clinics.

By Wendy Dumlao, Esq.

As your child with autism reaches the age of majority (age 18), thinking about how he can become more independent in your community is important. Between ages 18 and 22, your child will begin to age out of special education and will require services from other agencies. If your child is a client of California’s Regional Center system, you should begin to think about how to transition your child to greater independence using Supported Living Services (SLS).

SLS is one type of Regional Center services that can maximize your child’s independence. SLS provides caregivers to assist your child to live in his own home. Although the law prohibits funding for SLS in a parents’ home, it cannot be denied based on the severity of a person’s disability. SLS includes, but is not limited to, assisting with choosing and moving into a home; assisting individuals to care for their own personal needs; cooking; paying bills and other services to help them live in their own home.

Depending on your Regional Center, the amount funded toward SLS might be limited. Calfornia Welfare & Institutions Code section 4648.4 states, “no regional center may pay any provider…a rate that is greater than the rate that is in effect on or after June 30, 2008 unless… regional center demonstrates that the approval is necessary to protect the consumer’s health and safety and the department has granted prior written authorization.” Some regional centers have frozen SLS vendor rates at a flat rate. This makes it difficult for SLS vendors to support people with high needs. Although DDS allows many types of rate structures for services, if the regional center will only fund at a flat rate, early submission of a Health & Safety Waiver might be necessary.

If you have encountered this obstacle, work with your SLS vendor to try to work around this legislation. If that approach is not helpful, you should request that your Regional Center either fund the SLS budget or submit a Health & Safety Waiver to the Department of Developmental Services (DDS) for that level of funding. This process can be slow, therefore it is important to request a SLS assessment before your child is 18 years. Getting SLS for a Regional Center consumer can take up to a year or longer. For people with high needs, getting SLS has proven to be even more difficult.

To help parents understand the process, here are two examples of young people affected by autism and how they accessed SLS:

Annie is a young woman with autism who recently turned 18 years old and received a certificate of completion from her high school. She recently started at a day program 30 hours per week and attends weekdays from 8 a.m.-2 p.m. Annie is looking into moving into her own apartment, but will need some support to live independently. She does not have any aggressive behaviors and does not require awake staff at night, but does require staff at night. She qualifies for the maximum In-Home Supportive Services (IHSS) as 283 hours per month (with the state reduction she receives 260 of IHSS per month). Her parents can help with her care needs two Saturdays each month (48 hours monthly). Annie has determined she would like to have SLS with Vendor A. Regional center will only fund a flat rate of $4800/month to Vendor A, due to the law that froze SLS vendor rates.

Will she be able to access SLS without a Health & Safety Waiver submitted to DDS for approval?

Running calculation of hours –

730 hours in a month (24/7 supervision)
-120 hours (day program)
610 hours remaining
-260 (IHSS hours)
350 hours remaining
-48 (natural supports)
302 hours remaining to be covered

Annie most likely will require a rate of $12/hour.

302 hours x $12/hour = $3,624
$3,624 + administrative costs & overhead = about $4800/month

YES, Annie will be able to receive SLS at a flat rate and will not have to request a Health & Safety Waiver to get SLS services from her Regional Center.

Johnny is a 22-year-old young man with autism who has aged out of special education. He also recently started at a day program 30 hours per week and attends the day program from 8 a.m.-2 p.m. Johnny would like to live in his own apartment, but will need 24/7 support to live independently. He is non-verbal, does not have any aggressive behaviors, but does attempt to elope when he feels nervous and cannot communicate his needs. He will require awake staff for his safety. Johnny qualifies for the maximum IHSS as 283 hours per month (with the state reduction she receives 260 of IHSS per month). His parents can help with his care needs two weekends per month (92 hours). Johnny and his parents would like to have SLS with Vendor A. Regional center will only fund a flat rate of $4800/month to Vendor A, due to the law that froze SLS vendor rates. Can he access SLS without a Health & Safety Waiver submitted to DDS for approval?

Running calculation of hours –

730 hours in a month (24/7 supervision)
-120 hours (day program)
610 hours remaining
-260 (IHSS hours)
350 hours remaining
-48 (natural supports)
302 hours remaining to be covered

Johnny most likely will require a rate of $15/hour due to his needs.

254 hours x $15/hour = $3,810
$3,810 + administrative costs ($1,000) & overhead(15%) = about 5,531/month

NO, Johnny will need a Health & Safety Waiver because the cost exceeds the flat rate. In this situation, his parents should request the Waiver be submitted. If Regional Center denies this, a Notice of Action should be requested as the first step towards an appeal.

To learn how to more effectively navigate the Regional Center system for a teen or adult child who is transitioning to greater independence, attend Wendy Dumlao’s session, “Maximizing Independent Living,” at Empowering Autism on Saturday, October 19 at San Diego State University.