California family guide

Medi-Cal waivers and disability programs for children in California

For most California children with a developmental disability, the front door is your local regional center, which assesses eligibility at no charge and, for eligible children under 18, can open the Medi-Cal HCBS waiver even when family income is too high for regular Medi-Cal. Children with serious medical conditions may also qualify for California Children's Services, In-Home Supportive Services, and the HCBA waiver, and each has its own door you can knock on this week.

Last verified: September 2026

Find programs to ask about Step-by-step plan

The short answer

Five things you can do today

  • Call your regional center and ask for an intake. DDS says there is no charge for the diagnosis and eligibility assessment, and most services and supports are free regardless of age or income. Find yours in the regional center list below.
  • If your child is under 3, ask for Early Start. Infants and toddlers up to 36 months who have a developmental delay, or are at risk of a developmental disability, may qualify. The DDS Early Start BabyLine is 800-515-2229.
  • Ask the regional center about the HCBS waiver and "institutional deeming." For children under 18, this rule can make your child eligible for full Medi-Cal based on the child's own income, not yours.
  • If your child has a serious medical condition, call your county California Children's Services (CCS) office. CCS will not pay for care provided before the date your child becomes eligible, so apply early.
  • If your child needs hands-on care at home, apply for IHSS with your county IHSS office using form SOC 295.

This guide is general information, not medical or legal advice. Every program makes its own decision, so confirm details with the agency. Contacts are listed in each program card below.

Programs at a glance

The California programs worth asking about

California spreads disability help across several departments. The Department of Developmental Services (DDS) runs the regional center system. The Department of Health Care Services (DHCS) runs Medi-Cal and the HCBA waiver, and runs California Children's Services in partnership with county health departments. The Department of Social Services (CDSS) oversees In-Home Supportive Services. In the Lanterman Act, California law says the State "accepts a responsibility for persons with developmental disabilities." Here is what each program does, in plain words.

DDS, through 21 regional centers

Regional center services (the Lanterman Act)

Who it is for
People with a disability that begins before age 18, is expected to continue indefinitely, and is a substantial disability. Qualifying conditions include intellectual disability, cerebral palsy, epilepsy, autism, and other disabling conditions defined in state law. Children from birth to age 4 may qualify provisionally without a diagnosis.
What it can help with
Assessment and diagnosis, a service coordinator, lifelong individualized planning, purchase of services in your child's plan, family support, and help finding other community resources.
How you get on it
Referral or self-referral. Contact your local regional center for an intake and assessment.
Official page: DDS eligibility

DDS, through regional centers

Early Start (ages 0 to 3)

Who it is for
Infants and toddlers from birth to 36 months who have a developmental delay or are at risk of having a developmental disability, and their families.
What it can help with
Early intervention services, planned with your family through an Individual Family Service Plan.
How you get on it
Referral. Contact your regional center's Early Start intake line, or call the DDS Early Start BabyLine at 800-515-2229.
Official page: DDS Early Start

Medi-Cal waiver, run through regional centers

HCBS Waiver for Californians with Developmental Disabilities

Who it is for
Regional center clients of any age with autism, intellectual disabilities, or developmental disabilities who meet an ICF/IID level of care and have full-scope Medi-Cal. Children under 18 can get that Medi-Cal through institutional deeming.
What it can help with
The federal listing includes respite care, behavioral intervention, therapies, family support services, specialized medical equipment and supplies, environmental accessibility adaptations, and vehicle modifications.
How you get on it
Through your regional center, which determines waiver eligibility. DDS says enrollment is a choice.
Official page: DDS HCBS programs

Medi-Cal waiver, run through regional centers

Self-Determination Program (SDP)

Who it is for
Eligible regional center clients. DDS says SDP became available statewide on July 1, 2021, on a voluntary basis.
What it can help with
More control over an individual budget, so your family can choose the services and supports in your child's plan. The federal listing includes respite, an independent facilitator, therapies, and technology.
How you get on it
Ask your regional center service coordinator.
Official page: DDS Self-Determination

DHCS Medi-Cal waiver, through local waiver agencies

Home and Community-Based Alternatives (HCBA) Waiver

Who it is for
People of any age who are medically fragile or technology dependent and meet a hospital, nursing facility, or ICF/IID level of care.
What it can help with
The federal listing includes care management, private duty nursing, home and facility respite, waiver personal care, family and caregiver training, and environmental accessibility adaptations.
How you get on it
Application (form DHCS 1320) to the HCBA waiver agency that serves your county or zip code. DHCS says the waiver reached maximum capacity and a waiting list took effect July 12, 2023. Applicants under 21 are among those DHCS prioritizes when a slot opens.
Official page: DHCS HCBA Waiver

DHCS, through county CCS offices

California Children's Services (CCS)

Who it is for
Children from birth up to age 21 with a CCS-eligible medical condition. Examples in state guidance include nervous system conditions that cause physical disability, congenital anomalies, blood disorders such as sickle-cell anemia, and cystic fibrosis. Learning disabilities alone are not eligible. Families not on full-scope Medi-Cal must have an adjusted gross income of $40,000 or less, or expect out-of-pocket costs for the condition above 20 percent of that income.
What it can help with
DHCS lists diagnostic and treatment services, medical case management, and physical and occupational therapy for the eligible condition. DHCS says the Medical Therapy Program does not have an income limit.
How you get on it
Application to the CCS office in the county where you live. Your child's doctor can help you document the condition.
Official page: DHCS CCS

CDSS, through county IHSS offices

In-Home Supportive Services (IHSS) for children

Who it is for
Children with a disability who need help to stay safely at home. CDSS says a child receiving SSI is automatically eligible, and a child whose income is too high for SSI may qualify with a share of cost. A Medi-Cal eligibility determination is required.
What it can help with
Domestic and personal care services, accompaniment to health appointments, paramedical services, and protective supervision when needed because of the child's functional limitations.
How you get on it
Application (SOC 295) to your county IHSS office, plus a Health Care Certification (SOC 873). A county social worker visits your home.
Official page: CDSS IHSS for Children

DHCS, apply through Covered California or your county

Medi-Cal (California's Medicaid)

Who it is for
Depending on income, Medi-Cal offers free or low-cost health care. IHSS requires a Medi-Cal eligibility determination, and the HCBS waiver requires full-scope Medi-Cal, so this is often the foundation.
What it can help with
Covered California lists preventive care, primary and emergency care, dental and vision, prescriptions, and mental health treatment.
How you get on it
Application. Apply through Covered California, or contact your local Medi-Cal office. Covered California's phone line is (800) 300-1506.
Official page: Covered California Medi-Cal
Find your regional center: all 21, with main phone numbers

From the DDS Regional Center Listings. Los Angeles County is split among several centers by health district, so Los Angeles families should confirm with the DDS regional center lookup. DDS asks you to call before sending anyone's personal health information.

California regional centers, areas served, and main phone numbers
Regional centerAreas servedMain phone
Alta CaliforniaAlpine, Colusa, El Dorado, Nevada, Placer, Sacramento, Sierra, Sutter, Yolo, Yuba916-978-6400
Central ValleyFresno, Kings, Madera, Mariposa, Merced, Tulare559-276-4300
Eastern Los AngelesLA County health districts of Alhambra, East Los Angeles, Northeast, Whittier626-299-4700
Far NorthernButte, Glenn, Lassen, Modoc, Plumas, Shasta, Siskiyou, Tehama, Trinity530-222-4791
Frank D. LantermanLA County health districts of Central, Glendale, Hollywood-Wilshire, Pasadena213-383-1300
Golden GateMarin, San Francisco, San Mateo415-546-9222
HarborHealth districts of Bellflower, Harbor, Long Beach, Torrance310-543-0100
InlandRiverside, San Bernardino909-890-3000
KernInyo, Kern, Mono661-327-8531
North BayNapa, Solano, Sonoma707-256-1182
North Los Angeles CountyHealth districts of East Valley, San Fernando, West Valley818-778-1900
Redwood CoastDel Norte, Humboldt, Mendocino, Lake707-462-3832 ext. 289
Regional Center of the East BayAlameda, Contra Costa510-618-6100
Regional Center of Orange CountyOrange714-796-5100
San AndreasMonterey, San Benito, Santa Clara, Santa Cruz408-374-9960
San DiegoImperial, San Diego858-576-2996
San Gabriel/PomonaLA County cities of El Monte, Monrovia, Pomona, Glendora909-620-7722
South Central Los AngelesLA County health districts of Compton, San Antonio, South, Southeast, Southwest213-744-7000
Tri CountiesSan Luis Obispo, Santa Barbara, Ventura805-962-7881
Valley MountainAmador, Calaveras, San Joaquin, Stanislaus, Tuolumne209-473-0951
WestsideLA County health districts of Inglewood, Santa Monica-West310-258-4000

Source: DDS Regional Center Listings, accessed September 2026. Each listing also shows a separate Early Start intake line.

Interactive helper

Which program should I ask about?

Answer four quick questions and we will highlight the program cards above that are worth raising on your first calls.

This is a starting point, not a decision. Only the agency can decide whether your child qualifies. When in doubt, ask about every program that might fit.

1. How old is your child?
2. What best describes your child's main need?
3. Does your child have full-scope Medi-Cal now?
4. Is your child already a regional center client?

How to apply, step by step

Your first calls, in order

You can do several of these at the same time. Keep a notebook with the date, the name of the person you spoke with, and what they said.

  1. Find your regional center

    Use the list above or the DDS regional center lookup. If you are unsure where to start, DDS's information line is 833-421-0061 (TTY 711), or email info@dds.ca.gov.

  2. Ask for an intake and eligibility assessment

    For a child under 3, ask for Early Start, or call the BabyLine at 800-515-2229. For older children, ask for an assessment under the Lanterman Act. DDS says the diagnosis and eligibility assessment are free. Once your child is eligible, a service coordinator helps build a plan.

  3. Ask about the HCBS waiver and institutional deeming

    At planning meetings, ask: "Is my child eligible for the HCBS waiver, and can institutional deeming give my child full-scope Medi-Cal?" The regional center decides waiver eligibility based on Medi-Cal status, level of care needs, and your choice.

  4. Apply for Medi-Cal if your child is not enrolled

    Apply through Covered California or contact your local Medi-Cal office. Covered California's line is (800) 300-1506. IHSS requires a Medi-Cal eligibility determination, so this step matters even if you expect to be over the income limit.

  5. For a serious medical condition, contact county CCS

    Apply to California Children's Services in the county where you live. Ask your child's doctor for records that describe the diagnosis, because a CCS medical consultant reviews them. If your child needs physical or occupational therapy, ask about the Medical Therapy Program.

  6. For help with daily care, apply for IHSS

    Submit form SOC 295 to your county IHSS office. Services cannot be authorized until the county receives a Health Care Certification (SOC 873), so ask your child's doctor to complete it quickly. CDSS notes that health care providers may not charge you a fee to fill out IHSS eligibility forms.

  7. For complex medical needs, apply for the HCBA waiver

    Find the waiver agency for your county or zip code in the table on the DHCS HCBA waiver page, request an application, and submit it to that agency. DHCS encourages new applicants to apply and secure a place on the waiting list. For questions, DHCS lists (833) 388-4551 (toll-free) and HCBAlternatives@dhcs.ca.gov.

  8. If the answer is no, you can appeal

    For regional center decisions about eligibility or services for someone age 3 or older, DDS has an appeals process. Contact the DDS Office of Community Appeals and Resolutions at 833-538-3723 or Appeals@dds.ca.gov. Early Start has its own complaint processes for children under 3.

Want to estimate what a year of care costs while you wait? Try our therapy and equipment cost explorer, or compare states with the Medicaid waiver state finder.

The waiting list, honestly

What waiting really looks like in California

In California, whether a waiting list matters depends on which program you are talking about.

Regional center services

According to DDS, California's regional centers provide the full scope of state-funded services to all eligible people, whether or not they enroll in the HCBS waiver. The waiver changes how services are paid for and can open the door to full Medi-Cal through institutional deeming, but DDS says the same person-centered planning and quality of care apply either way. That is why enrollment in the HCBS waiver is described as a choice.

The HCBA waiver

The HCBA waiver works differently. DHCS says the program has reached maximum capacity and a waiting list has been in place since July 12, 2023. When a slot becomes available, applicants who meet Reserve Capacity criteria are prioritized, and DHCS lists applicants under 21 years of age among them. DHCS publishes current enrollment and waitlist numbers on an enrollment dashboard that it updates monthly. We are not publishing a wait time, because we could not verify one from an official source. Ask your waiver agency where your child stands.

Why to apply now, even if you are unsure

  • Coverage does not reach backward. The Medi-Cal provider manual says CCS will not pay for services provided before the date a child becomes eligible.
  • IHSS starts with paperwork. Services cannot be authorized until the county has the completed SOC 873.
  • Assessments are free. A regional center assessment costs nothing, so there is little downside to asking.
  • The HCBA list has a start line. DHCS encourages new applicants to apply and secure a place on the waiting list with their waiver agency.

What to say when you call

A script to borrow

This is only a suggestion. Use your own words. The goal is to ask clearly and write down the answers.

Suggested call script

"Hi, my name is ____. I live in ____ County, and I am calling about my child, ____, who is ____ years old."

"My child has ____ (diagnosis, or the delays you see). Day to day, they need help with ____."

"I would like to request an intake and eligibility assessment. Can you tell me the next step and how long it usually takes?"

"Can you also tell me whether my child might qualify for the HCBS waiver, and whether institutional deeming could apply?"

"Who will be my contact, and what is the best way to reach you? Can you send that in writing?"

Documents to gather (suggested)

  • Your child's birth certificate and proof of California residence
  • Medi-Cal card or notice, and any private insurance cards
  • Diagnosis letters, medical records, and recent evaluations
  • School records, such as an IEP, if your child has one
  • A list of doctors, therapists, and medications
  • A short note describing a typical day and the help your child needs
  • Your most recent tax return, if you are applying for CCS
  • Any letters or decisions you have received, with dates

Reading about your child's diagnosis? See our pages on cerebral palsy, autism spectrum disorder, and Down syndrome, or browse the full resource library.

Questions families ask

Frequently asked questions

Does it cost anything to get a regional center assessment?

No. DDS says there is no charge for the diagnosis and eligibility assessment, and that most services and supports are free regardless of age or income.

We earn too much for Medi-Cal. Can my child still get it?

Possibly. Under institutional deeming, a child under 18 who is eligible for the HCBS waiver can be found eligible for Medi-Cal based only on the child's own income and resources, not the parents'. DDS says this eligibility lasts as long as the child is enrolled in the waiver. Ask your regional center.

Does my child need a diagnosis before contacting a regional center?

Not always. DDS says a child from birth to age 4 may qualify for provisional eligibility without a diagnosis if the disability is not solely physical and the child has significant functional limitations in at least two major life activities. Infants and toddlers up to 36 months with a delay may qualify for Early Start.

Can a parent be paid to provide IHSS for a minor child?

It depends on the IHSS sub-program. CDSS says a parent cannot be the provider in the Personal Care Services Program, but minors in the Community First Choice Option, IHSS Plus Option, or IHSS-Residual may hire any provider who completes enrollment. Tell the county your provider preference when you apply.

Does CCS have an income limit?

For families not on full-scope Medi-Cal, adjusted gross income must be $40,000 or less, unless expected out-of-pocket costs for the condition exceed 20 percent of that income. DHCS says the Medical Therapy Program does not have an income limit.

Is there a waiting list for the HCBA waiver?

Yes. DHCS says the HCBA waiver reached maximum capacity and a waiting list took effect July 12, 2023. DHCS encourages new applicants to apply with the waiver agency for their area to secure a place on the list. When a slot opens, applicants who meet Reserve Capacity criteria, which include applicants under 21, are prioritized.

What if the regional center says my child is not eligible?

You can appeal. DDS's appeals process covers disputes about eligibility and about the nature, scope, or amount of services for people age 3 and older. Contact the Office of Community Appeals and Resolutions at 833-538-3723 or Appeals@dds.ca.gov.

Need help while you wait?

Teagan's Crown helps children 21 and under with special needs, and the families who fight for them. Apply for help and tell us what your child needs.

Sources

Where this information comes from

We used only official government pages. Program rules change, so confirm details with the agency before you rely on them.

  1. DHCS, Home and Community-Based Alternatives Waiver, accessed September 2026
  2. DHCS, California Children's Services Program Overview, accessed September 2026
  3. DDS, Regional Center Eligibility and Services, accessed September 2026
  4. DDS, Regional Centers, accessed September 2026
  5. DDS, Regional Center Listings, accessed September 2026
  6. DDS, Regional Center Lookup, accessed September 2026
  7. DDS, Home and Community-Based Services Programs, accessed September 2026
  8. DDS, The HCBS Waiver for Individuals With Developmental Disabilities (brochure, revised May 2018), accessed September 2026
  9. DDS, Early Start, accessed September 2026
  10. DDS, Appeals and Complaints, accessed September 2026
  11. DDS, Lanterman Act and Related Laws, accessed September 2026
  12. California Welfare and Institutions Code Section 4501, accessed September 2026
  13. California Welfare and Institutions Code Section 4512, accessed September 2026
  14. Medicaid.gov, California Waiver Factsheet, accessed September 2026
  15. Medicaid.gov, CA Home and Community Based Alternatives Waiver (0139.R06.00), accessed September 2026
  16. Medi-Cal Provider Manual, California Children's Services Program Eligibility (page updated June 2022), accessed September 2026
  17. CDSS, IHSS for Children, accessed September 2026
  18. CDSS, In-Home Supportive Services Program, accessed September 2026
  19. CDSS, County IHSS Offices, accessed September 2026
  20. Covered California, Medi-Cal for Individuals and Families, accessed September 2026

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More help for California families

Also useful: Medicaid waiver finder, what a year of care costs, and the full resource library.

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