Accessing Services for Children over the age of 3
· Services for children who are 3 years old or older in the state of California are funded 3 ways. 1. Through your local school district (until age 22)
2. Through medical insurance/Medi-Cal
3. Through the county (through your local Regional Center).
You can get services through one, two, or all three of these funding sources at the same time, with the exception of ABA services being covered by insurance and the county. You cannot have behavioral services funded by both medical insurance and the county.
(You can also pay for services privately, though this can get very expensive very quickly and this is something most families are not able to afford. Consider accessing all funded services before paying privately for services.)
School District Services
If your child had Early Intervention services through the county their program will facilitate an assessment for your child through your local school district. If they do not initiate this, ask your coordinator to begin the process.
If your child is preschool age and has not had early intervention services and you suspect the need for services you can call the special education department of your local school district and ask about their assessment process.
If your child is over 5 and is in kindergarten or above in your local school district or attends a private school, speak to your child’s teacher about your concerns.
If a child qualifies for school district assessment, they will be assessed in all areas of suspected disability. You will bring your child for the assessments likely to a school and a need for services will be determined. You will also likely be asked to fill out assessments yourself and will be interviewed by individuals from the assessment team.
If your child qualifies for services, they will be given an IEP (Individualized Education Plan) that reports the services qualified to receive (special education, speech, OT, APE, PT, Vision, Health, etc. ) as well as a plan for accommodations that will benefit your child.
School District Services are specifically for children who display an EDUCATIONAL need for services. This means that their ability to learn in a school environment is compromised due to their disability.
Medical Insurance Services
Children who are receiving services in school may also receive services outside of school if they have medical insurance that covers their services.
Common services families can access outside of school are: Speech, OT, PT and ABA. Children may also qualify for counseling services.
If you are interested in accessing services through your insurance, contact your child’s pediatrician or your insurance company to get information on the process.
If your insurance tries to tell you that if your child doesn’t qualify for a service solely because they are receiving that service in school, this is NOT NECESSARILY TRUE. Push forward and continuing asking for an assessment in your area of suspected need.
Services may be funded through a family’s personal medical insurance, or a child may qualify for their own medical insurance through the state. Every insurance plan offers and covers different services and services are accessed in different ways, depending on the individual plan.
County Services
Country sources, such as the local Regional Center may support families of children with significant disabilities while they are also in school.
These programs may provide support to families by answering questions they have about local services, support groups, and helping families keep track of their child’s goals
If a child has a diagnosis of autism, the county can offer ABA services if they do not have Medi-Cal (State Funded) insurance or they do not have behavioral health coverage through their insurance.
Children with significant disabilities may be able to qualify for respite care through the county. Respite care is essentially childcare/babysitting that is free of cost to families.
Children with significant disabilities who do not meet the low-income requirements to be able to qualify for Medi-Cal may also be able to qualify for Medi-Cal (free health insurance) due to their disability. County social workers can support this process. There is a process through the county, where families are approved for a “waiver” that waives the financial qualifications of the family and allow the child to access state funded medical insurance due to their disability.
Children with significant disabilities that have Medi-Cal insurance may also qualify for IHSS (In Home Supportive Services) which is funding that helps offset extra costs for caring for a child with a disability. Families may get registered as caregivers for their child and receive funding directly or they may use their funding to hire extra support.