Appeals – Valley Mountain Regional Center

Our Commitment to Teamwork

At Valley Mountain Regional Center one of our codes of ethics is teamwork. We are committed to working as a team with our colleagues and community and the cornerstone of teamwork is mutual respect. While our roles are often separate, we will focus on common goals, sharing equally in the benefits and daily challenges of making difficult decisions.

When We Disagree

Sometimes despite our best efforts, there may be a time when we just can’t agree with each other. This can happen in any relationship. We don’t take it personal and we hope you don’t either. Luckily the Lanterman Act was prepared for this event as well and has designed an appeal process aimed at protecting the rights of people with disabilities and their families.

If this happens, clients or families may ask us to review our decision, to make sure all information was considered. We will make every effort to resolve disagreements informally, through discussion with your Service Coordinator, or their supervisor. A VMRC Service Coordinator can also provide our clients/families with information on how to contact the Office of Client Rights Advocacy, if there are complaints about how services are provided.

If the matter continues to be unresolved, our Assistant Directors with several years of experience will work with you to try to resolve the dispute in an informal mediation. If we are unable to resolve concerns informally, clients may ask the regional center to review our decision through the appeal process. An appeal is a formal request for someone to change a decision about an individual’s eligibility for services, or about the services he or she receives.

You have the right to appeal our decisions and we will support you in exercising that right. If this issue is still not settled our Compliance Manager may meet with you in a more formal setting which could either include more mediation or state level fair hearing between you and our Compliance Manager with a California Administrative Law Judge who will make a ruling to end the dispute process.

Great Resources for You About Your Appeals Rights

The Department of Developmental Services believes the California developmental services community is best served by the open exchange of information and opinions. DDS is also committed to providing mechanisms for the resolution of problems and complaints when they arise. A number of formal processes have been established for handling appeals and complaints. Click for the DDS Appeals Page

Types of Appeals

There are different dispute resolution and complaint processes depending on the service or if you are a consumer, family member, or service provider. Below are some helpful links to these processes:

Consumer and Family Complaint
Consumer Denial of Personal Rights
Fair Hearing
Early Start Complaint
Early Start Mediation Conference
Early Start Due Process
Provider Vendorization Appeal
Residential Provider Facility Appeal
Provider Rate Appeal

Appeal Outcomes

Below is an ongoing tally of the types of appeals and the outcomes at Valley Mountain Regional Center. To view the required report that the Department of Developmental Services publishes to the community, click here. Also this information is shared more regularly with our Board of Directors Consumer Services Committee and their information can be found here.

Date RC Received Fair Hearing	Fair Hearing Issue	Date of Resolution or Withdrawal	Outcome
2/21/2023	Berkeley CIP Program	3/02/2023	Agreement reached in Informal Meeting
1/19/2023	Bathtub	1/31/2023	Agreement reached in Informal Meeting
1/09/2023	Car Seat Harness	1/13/2023	Agreement reached in Informal Meeting
1/03/2023	Tracker renewal	1/10/2023	Agreement reached prior to Informal Meeting
12/20/2022	Eligibility	1/04/2023	Agreed in Informal Meeting to redetermination and found eligible.
12/05/2022	Eligibility	12/14/2022	Determined eligible
11/28/2022	Digital lock	12/15/2022	Agreement reached in Informal Meeting
10/31/2022	Fence, locks, Air Tag	NA	Pending
10/21/2022	PA	11/23/2022	Agreement reached in informal meeting.
10/17/2022	Respite, Water Safety	10/29/2022	Agreeable solution determined prior to meeting.
10/05/2022	Staff ticket for trip	11/29/2022	State level hearing denied claimant’s appeal.
9/16/2022	Transportation	11/04/2022	State level hearing denied claimant’s appeal.
9/12/2022	Eligibility	9/27/2022	RC agreed in Informal to reopen for determination and eventually found eligible.
9/08/2022	Insurance Co-pay	9/23/2022	Agreement reached during Informal Meeting
9/07/2022	Camp, Mileage, GPS Tracker	9/28/2022	Agreement reached in Informal Meeting
9/07/2022	Camp, Mileage, GPS Tracker	9/28/2022	Agreement reached in Informal Meeting
8/30/2022	Social Recreation	12/16/2022	Claimant representative withdrew
8/30/2022	Social Recreation	12/16/2022	Claimant representative withdrew
8/30/2022	Development of Person-Centered Plan	9/13/2022	Agreement reached at informal meeting
8/30/2022	Social Rec Program	9/29/2022	Agreement reached in Mediation
8/30/2022	Social Rec Program	9/29/2022	Agreement reached in Mediation
8/30/2022	Mileage, camp, computer, phone	9/09/2022	Parent withdrew prior to informal meeting.
8/30/2022	Mileage, camp, computer, social recreation	9/09/2022	Parent withdrew prior to informal meeting.
8/25/2022	Dental	9/07/2022	Withdrew following informal meeting with an agreement to continue to work on options for receiving the service.
8/24/2022	Eligibility	09/06/2022	Agreement reached in Informal Meeting to reopen for further assessment.
8/10/2022	Eligibility	8/25/2022	Family withdrew following informal meeting
8/08/2022	Insurance Co-pays	11/21/2022	State level hearing denied claimant’s appeal.
8/05/2022	PA Hours	8/29/2022	Agreement reached in informal meeting
7/07/2022	Adaptive Equipment	8/12/2022	Agreement reached in Mediation
6/21/2022	Home modifications, television, outdoor kitchen	8/18/2022	State level hearing denied claimant’s appeal.
6/14/2022	Vehicle Modification	9/20/2022	State level hearing denied claimant’s appeal.
5/31/2022	Eligibility	6/10/2022	Reopened for further assessment.
5/25/2022	Insurance Co-pays	6/03/2022	Determined in Informal Meeting that family was eligible for co-pay assistance.
5/9/22	DME	6/29/2022	Alternate service agreed upon after informal meeting.
5/4/2022	Eligibility	6/09/2022	Reopened and found eligible.
4/15/2022	Insurance Co-Pays	4/22/2022	VMRC assisted in getting co-pay removed from insurance.
4/11/2022	Eligibility	4/28/2022	Reopened for assessment
4/07/2022	Social Recreation	5/19/2022	Agreement reached in mediation.
3/28/2022	Eligibility	4/07/2022	Individual withdrew prior to informal meeting.
3/21/2022	Insurance Co-Pays	6/02/2022	State level hearing ruled in favor of regional center.
3/02/2022	Insurance Co-pays	3/25/2022	Family withdrew
1/04/2022	Eligibility	3/04/2022	RC agreed to reopen for eligibility determination.
12/28/2021	Intensive ABA	2/06/2022	Agreement reached in the informal meeting.
12/22/2021	Eligibility	02/10/2022	Consumer found eligible following the informal meeting.
12/6/2021	Eligibility	1/12/2022	Withdrawn to pursue further testing
11/3/2021	Personal Assistance Hours	11/18/2021	RC agreed to fund prior to informal meeting
11/3/2021	Personal Assistance Hours	11/18/2021	RC agreed to fund prior to informal meeting
10/30/2021	Sleep Safe Bed	01/10/2022	Funded through consumer’s insurance
10/07/2021	ABA Co-Pays	12/16/2021	Claimant withdrew at end of State Level Hearing
9/20/2021	Respite Hours	9/30/2021	Claimant withdrew after Informal Meeting.
9/09/2021	Eligibility	9/13/2021	Reopened for eligibility review prior to Informal Meeting
9/01/2021	Eligibility	9/10/2021	Reopened for eligibility review prior to Informal Hearing
8/13/2021	Personal Assistance Hours	11/22/2021	Claimant withdrew prior to state level hearing.
7/20/2021	SSP Restoration	7/22/2021	RC agreed to fund prior to Informal Meeting due to change in circumstances.
7/16/2021	Eligibility	8/05/2021	Claimant submitted new information and was reopened for eligibility determination.
7/12/2021	Speech Therapy Co-Pays	9/10/2021	RC provided service following Informal Meeting and submission of further documentation.
6/10/2021	Respite Hours	8/18/2021	Agreement reached in Informal Meeting
05/14/2021	ABA co-pays	8/27/2021	OAH dismissed at State Level Hearing
05/14/2021	SDP-pool	6/18/2021	Resolution at Mediation
04/22/2021	Eligibility	11/4/2021	Determined eligible after receiving additional reports
04/16/2021	Van Conversion	05/05/2021	Claimant withdrew prior to Informal meeting
04/09/2021	ABA services	7/20/2021	Agreement reached after further information was received by RC.
04/07/2021	ABA co-pays	04/22/2021	RC provided service at Informal meeting
03/16/2021	Second Opinion Evaluation	05/03/2021	OAH dismissed issue at State Level Hearing
03/03/2021	Eligibility	04/01/2021	RC made eligible at Informal meeting
01/29/2021	EIBT Services	02/04/2021	RC provided service at Mediation
01/25/2021	Respite Reimbursement	03/26/2021	RC provided service after Informal meeting
01/25/2021	Respite reimbursement	03/26/2021	RC provided service after Informal meeting
01/19/2021	Out of home placement	02/01/2021	RC provided service at Informal meeting
01/15/2021	Eligibility	02/09/2021	Claimant withdrew without prejudice after Informal meeting
12/3/2020	Home Modification	12/23/2020	RC provided service at Informal meeting
10/20/2020	Autism Assessment	11/5/2020	Claimant withdrew without prejudice prior to Informal meeting
9/10/2020	Eligibility	12/18/2020	Claimant withdrew without prejudice at Informal meeting
9/1/2020	Intake application	1/13/2021	RC provided service at Informal meeting
8/19/2020	Co Pays	9/11/2020	RC provided service at Informal meeting
8/3/2020	Eligibility	8/21/2020	Claimant withdrew without prejudice after Informal meeting
7/30/2020	Eligibility	8/31/2020	RC made eligible at Informal meeting
7/7/2020	Eligibility	7/16/2020	Claimant withdrew without prejudice at Informal meeting
6/8/2020	Behavioral Services	6/22/2020	RC provided service at Informal meeting
6/4/2020	Behavioral Services	6/19/2020	RC provided service at Informal meeting
5/20/2020	Eligibility	5/27/2020	Claimant withdrew without prejudice at Informal meeting
4/30/2020	Behavioral Services	5/29/2020	RC provided service at Informal meeting
4/29/2020	Therapy	11/10/2020	Claimants appeal denied at State Level Hearing
4/27/2020	Eligibility	1/29/2021	RC provided eligibility assessment at Informal meeting
4/20/2020	Transportation	11/10/2020	Claimants appeal denied at State Level Hearing
3/20/2020	HCBS Waiver	5/19/2020	RC partially funded requested service at Informal meeting
3/16/2020	Eligibility	4/13/2020	Claimant withdrew without prejudice at Informal meeting
2/27/2020	Eligibility	1/5/2021	RC made eligible prior to State Level Hearing
2/20/2020	Transportation	3/6/2020	RC partially funded requested service at Informal meeting
2/4/2020	Stair Lift Track	2/12/2020	RC partially funded service at Informal meeting
2/3/2020	Eligibility	5/26/2020	Claimant withdrew without prejudice after Informal meeting
1/29/2020	Eligibility	2/10/2020	Claimant withdrew
1/21/2020	Eligibility	2/18/2020	Eligibility denied at Informal Meeting
1/13/2020	Eligibility	2/20/2020	Claimant withdrew without prejudice