Unmet Needs: What Are They and How Can Self-Determination Help?
One of the many benefits of the Self-Determination Program, which opened to all eligible Regional Center clients in July, is that it addresses unmet needs. This refers to any services you couldn’t access for a variety of reasons, or needs that were not covered in your child’s Individualized Program Plan (IPP). Common examples include not being able to use your respite hours because you weren’t able to find a provider in your area, or not being able to take social skills classes because you could only use Regional Center vendors and the options weren’t a good fit. To get the lowdown on unmet needs, we spoke with Special X Independent Facilitator and Person-Centered Planner Carla Lehmann and Special X Care Navigator Lisa Carey.
What are some examples of unmet needs?
An unmet need is any situation where you didn’t get the right service. Some examples include:
- You couldn’t find a provider in your area so you weren’t able to get in-home support such as respite or personal assistance
- Regional Center provided hours but you didn’t use them, had them taken away, or couldn’t use them because you didn’t have anyone to help
- Your child wasn’t able to safely access services such as therapies due to Covid
- Your child couldn’t access services such as social skills classes because you could only use Regional Center vendors and the options were not a good fit
- Parent counseling and support
How do I provide documentation of unmet needs?
Carla tells us that documentation depends on what you need and what you’re asking for.
- If you’re not getting enough respite hours, you have to create a schedule showing where you need the respite hours and why. You also have to show that it’s not covered by IHSS or other generic resources. If you have a lot of IHSS hours and you are asking for more respite hours, they’ll say, “You’re supposed to use your IHSS hours for that.” If you present a schedule or calendar that shows your daily activities and exactly where you need the respite hours, that’s a way of showing unmet needs.
- Some Regional Centers will provide services like social skills classes easily, but other Regional Centers might not. Provide anything you have to show your need.
- Some service coordinators are more responsive than others, so it’s always good to send your request in writing; if you don’t get a response in a reasonable amount of time, you can escalate it.
Is anything excluded from the “unmet needs” category?
Carla explains that you always have to use generic resources first; this usually refers to your health care plan or the school district if your child is in school.
- If you’re not getting speech therapy, you first have to go to the school district and your insurance; if you get denial letters from them, Regional Center may give you the service if you can demonstrate the need. “You can really ask for anything from the Regional Center and they’ll decide whether they’ll give it to you or not. You could ask for something they aren’t offering, such as swim lessons. They might deny you and you might go to a hearing, and maybe you’ll win,” Carla says.
- Not all unmet needs will require going to a hearing. “If you never used your social skills classes because you couldn’t find a provider, you can just ask for more social skills classes. But if it’s something out of the ordinary like swim lessons or they are refusing to give you more respite hours, you’ll most likely go to a fair hearing.”
Are there services Regional Center offers that I might not know about?
Lisa tells us that parents may not realize they can get specific services. "For many parents, when their child turns three years old, they're told they can’t get any more services because it's now the school's responsibility. But this isn't true. Regional Center offers various classes and workshops, as well as adaptive skills classes, and they should fund the difference if their school is not providing enough support."
For more information on Regional Centers and what they can offer, read our Regional Center 101 article.
How can Self-Determination help with unmet needs?
- Lisa explains that the Self-Determination Program will help address unmet needs more easily: “The whole concept of Self-Determination is that the person can decide for themselves. If your budget was $10,000 last year and you had to spend it all, they have to give you the same amount again; but maybe your budget should have been $20,000 but you couldn't find any respite workers. This is something you might document, but you should be able to ask for it whether you’re in Self-Determination or not."
- With Self-Determination, rather than providing documentation to show Regional Center that you have unmet needs and potentially going to a fair hearing to try to fight for the services you need, you can address them in your child's Person-Centered Plan and use your certified budget for services and supports that are not usually approved by the Regional Center, such as social and recreational activities (check out this list of approved Self-Determination services on the DDS website). "You should be able to use your budget however you want, especially if it meets goals in the IPP," Carla says.
- For more in-depth information about Self-Determination, watch our Q&A with Carla here, and stay tuned for more to come on the subject throughout the summer! If you'd like to be added to our biweekly Self-Determination emails, send us an email at email@example.com, and keep an eye on our Facebook page for more Self-Determination events and news!