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From Approval to Actual Support

A practical guide to finding where support stopped: at a regional center, generic resource, FMS, provider, or actual delivery.

What you need to know

An approval or a signed plan does not necessarily mean support has started. Begin with what the participant wants and identify which part of implementation remains unconfirmed.

Confirm participant direction and communication access.
Check the regional-center-to-FMS handoff and provider readiness, not just a reported authorization.
Verify actual delivery: who will act, by when, what evidence will show the support works, and what happens if the handoff fails.

Different steps may happen at the same time. Do not wait to address immediate safety issues or applicable appeal deadlines.

Do not enter identifying details or upload records. This guide does not collect or transmit responses. You can review the checkpoints without an account.

Use these nine perspectives in whichever order helps, or consider several at once. They are not universal legal requirements or a mandatory sequence. Separate verified facts, unverified claims, disputed decisions, and open tasks. For each organization, verify its authority and whether usable support is actually available.

When a service decision is disputed, check appeal deadlines and continuation protections promptly. A checklist does not pause deadlines. View appeal rights.

If a missing support creates an immediate health or safety danger, contact responsible clinical and service providers promptly and use emergency services when appropriate.

Begin with the person, not the paperwork

What does the person want to make possible, preserve, or change? What already works? The intended outcome gives purpose to every question about services and funding.

Several barriers may exist at once: coverage through a generic resource, a regional-center decision, an FMS mapping error, missing clinical orders, transportation, or staffing. Map each barrier separately. Different organizations have different authority and duties; a referral or authorization does not prove that another system delivered usable support.

For each outstanding barrier, note the decision or task, the organization that can act, available evidence, the next request, a review date, and the real-life change that would demonstrate progress. Urgent safety problems and appeal deadlines must not wait until other tasks are completed.

Participant direction and accessible planning

Before treating a decision as agreed, confirm how the participant received information, communicated, and directed the plan. Language access, AAC, interpreters, and supporters affect whether the meeting actually worked.

See owner, evidence, and next questions

Responsibility to verify: IPP team and responsible service coordinator; the participant determines their direction.
Evidence to obtain: Participant's communication; dated request; language or communication arrangements; relevant IPP pages, including unresolved points.
Next question: What did the person communicate? What was requested, agreed, disputed, or left open? Who will correct a record that does not reflect their direction?
When it is NOT resolved: A meeting, interpreter attendance, or signature does not by itself prove informed agreement or implementation.

Decision, written record, and appeal protection

Identify the exact service, amount, effective dates, and decision-maker. Keep existing agreed services separate from proposed or disputed changes. Some decisions require written notices; appeals and timely requests to continue existing services have specific rules.

See owner, evidence, and next questions

Responsibility to verify: Regional center for its decisions, notices, and related authorization; relevant appeal body for the appeal process.
Evidence to obtain: Written decision and IPP agreement; requested versus approved details; any Notice of Action; correspondence and appeal confirmations.
Next question: What is the decision and governing basis? Has a notice been issued if required? What are the appeal deadlines and applicable continuation protections?
When it is NOT resolved: Neither an unaddressed objection nor 'we are reviewing it' proves a final agreement. Do not wait for the implementation checklist to investigate appeal deadlines.

Generic resources: truly available or only named?

IHSS, WPCS, Medi-Cal, private insurance, schools, county programs, housing or employment resources may have separate duties and appeals. Being told to 'use a generic resource' is not proof that the specific needed support is accessible and operating.

See owner, evidence, and next questions

Responsibility to verify: Each responsible insurer, public program, agency, or school for its own eligibility, decisions, delivery and remedies; IPP team and regional center for coordination and remaining IPP needs within applicable law.
Evidence to obtain: Application and referral dates; eligibility/coverage decisions; authorized scope and hours; benefit limitations; provider availability, qualifications, geography, language, accessibility, waitlists and actual start date; written denials or appeals.
Next question: Does it cover THIS task for THIS person, at the required time and location, with a capable provider? Who is helping resolve access barriers, and how is the uncovered need recorded and reviewed?
When it is NOT resolved: Do not double-bill or assume SDP can purchase a service available through a generic agency. Equally, an eligibility letter, insurance card, referral, or number of approved hours does not prove timely, task-capable support is actually available. Funding questions require case-specific legal review.

Individual budget and Spending Plan: exact version

For SDP, distinguish an individual budget amount from the certified Spending Plan and the services permitted within it. Older versions, missing lines, incorrect rates or quantities, and year-end extensions can create misleading 'approval' claims.

See owner, evidence, and next questions

Responsibility to verify: IPP team and regional center for their decisions, required certification and continuity steps; participant for direction and Spending Plan development.
Evidence to obtain: Current budget and Spending Plan versions; certification, service codes, units, rates, periods, corrections, any continuation notice or purchase-of-service record.
Next question: Which exact version controls today? Does the service line reflect agreed scope, dates, rate, and units? If services should continue, what operational instructions reached the FMS?
When it is NOT resolved: A previous plan, a proposed increase, or an extension on paper is not evidence of operational funds. Do not merge agreed services with disputed changes.

Regional center → FMS: sent is not loaded

An authorization may be issued but rejected, not received, mismapped, or loaded against the wrong month, worker, service code or rate. Each transmission and acknowledgment is a separate evidence state.

See owner, evidence, and next questions

Responsibility to verify: Regional center for issuing/transmitting its authorization; FMS for receipt, acceptance, mapping and reporting errors; designated parties for reconciling differences.
Evidence to obtain: Transmission date and recipient; FMS acknowledgment; accepted units, dates and rates; rejected messages; portal display; correction owner.
Next question: Was the authorization issued, sent, received, accepted, and loaded correctly? Which entity will repair any mismatch—and when?
When it is NOT resolved: 'Sent' is not 'received'; 'received' is not 'accepted'; a portal line does not guarantee a provider can deliver or be paid.

FMS employer, vendor and payroll setup

A certified plan may still stall on missing signatures, employer records, worker documents, qualifications, model choice, contracting, or vendor enrollment. Payroll reports can also be inconsistent with hours worked or money actually received.

See owner, evidence, and next questions

Responsibility to verify: FMS for its enrollment, payment workflow and ledger; employer or vendor for documents and eligible service delivery; regional center for its authorization and program responsibilities.
Evidence to obtain: Employer and worker setup confirmations; eligibility/qualification checks; vendor contracts where needed; approved hours; timesheets; payment status and actual remittance evidence.
Next question: What exact document or decision is missing? Who can sign it? Have timesheets been accepted? Does 'paid' mean the worker or vendor actually received the money?
When it is NOT resolved: Do not assume that an FMS portal status or total spending amount proves that each worker, date, rate and payment is accurate. Reconcile without double billing.

Provider capacity, clinical orders, and safe start

A listed provider may not accept the service, travel to the home, have sufficient staff, obtain necessary clinical orders, support 2-person tasks, offer the participant's language, or meet the requested schedule.

See owner, evidence, and next questions

Responsibility to verify: Provider for its capacity, qualifications and operational conditions; authorizing program and clinical professionals for their own decisions; regional center/IPP team for unresolved supports within their authority.
Evidence to obtain: Capacity acceptance; required orders; staffing and training; backup coverage; service locations; start date; transportation and communication arrangements.
Next question: Who will actually perform the task, safely, where and when? What happens if they cannot staff it or a worker calls out? What interim support is available?
When it is NOT resolved: A provider referral, waitlist, plan meeting, or unsigned staffing proposal is not service. A health-and-safety gap needs prompt escalation to the responsible entities.

Service delivery, funding and payment are different

Even when support occurs, the worker may not be paid or the participant may not receive all agreed hours. Distinguish authorized, scheduled, performed, documented, billed and actually paid events.

See owner, evidence, and next questions

Responsibility to verify: Service provider and worker for accurate service records; FMS or payer for adjudication and payment; responsible program for authorization or claim corrections.
Evidence to obtain: Dates worked and service delivered; timesheets, invoices and utilization; claim or payroll history; discrepancies; confirmation that the participant actually received support.
Next question: Which hours happened, which were missed, what amount was billed, and what was paid to whom? Do ledgers, statements and worker records reconcile?
When it is NOT resolved: Do not call a service delivered because an authorization exists, nor paid because an invoice was submitted or a portal says 'Good to Pay'.

Outcome, backup plan, and closing the loop

Completion is the participant's experience of usable support—not the completion of a meeting, an appeal, a referral, or an administrative checklist. Several agencies may have unresolved tasks at once.

See owner, evidence, and next questions

Responsibility to verify: Each involved agency or provider for its own outstanding action; the participant/IPP team for checking whether supports meet documented goals.
Evidence to obtain: Actual support compared to need, health and safety concerns, communication access, feedback from the participant, missed-shift backup, ongoing discrepancies and next review date.
Next question: Is the support available where and when needed? Can the person use it safely? Who acts next, by when, what evidence will confirm success, and what happens if the handoff fails?
When it is NOT resolved: Do not close an issue until the specific objective is met or the unresolved gap, responsible party, rights and remedy are clearly recorded.

Printable follow-up worksheet

Download the worksheet as a PDF. If several barriers are open, use a separate worksheet for each. Record the responsible party, evidence, next action, review date, and what remains unresolved. Do not share confidential information in public forms.

Download follow-up worksheet (PDF)

One-page PDF for printing or saving. The questions also remain available below in HTML.

What does the person want and communicate, and how was that confirmed?
What support is needed, and which agency or program may provide it?
What was requested, agreed, authorized, or disputed?
Which document and version exist? What still needs verification?
Which generic resource is actually available, and which is not?
Who must act next, and what is their responsibility?
When is a response, service, or correction expected?
What will prove the support started and works?
If it does not happen, what is the alternative, right, or follow-up?

Official references and further guidance

These sources do not automatically resolve an individual dispute. Verify the particular program, controlling authority, effective date, and applicable decision.

For more information, see How Hero Works, SDP Resources, or Start a Conversation.