SERVICE POLICY
PHYSICAL AND OCCUPATIONAL THERAPY SERVICES
Tri-Counties Regional Center may authorize funding for physical and/or occupational therapy services when those services are prescribed by a physician; when significant deficits exist in gross and/or fine motor skills or in self help skills; and when the therapy is necessary and likely to make a significant improvement in the individual’s capabilities or to prevent deterioration of function or of health.
Tri-Counties Regional Center may authorize funding for specialized physical and occupational therapy services only when it has been determined by the Planning Team that the therapies are required as a direct consequence of the developmental disability; that provision of the therapy services are necessary; and all generic and private resources, including private medical insurance, deny necessary specialized therapy services.
For individuals receiving early intervention services, consumers in public school programs and consumers who reside in health care facilities, physical and/or occupational therapy services are expected to be provided as part of the individual’s program, rather than as a separately funded service.
For children under the age of three (3), Tri-Counties Regional Center may use private insurance as a generic service only if there is no cost (deductibles, co-pays, or a reduction in the lifetime benefit cap) to the family as a result of its use. Tri-Counties Regional Center may pay the cost of accessing private insurance (for example, deductible or co-pay amounts). [34 CFR 303.520(b)(3)(i)]
