Transcript ITCA Webinar Series 2011 Part C Regulations

2011 PART C R EGULATIONS
O VERVIEW
2

History at national and state level

Presentation of significant changes in
the new regulations

Highlight resulting policy changes for
EarlySteps

Describe process for making changes
and timeline for implementation
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H IERARCHY
OF
A UTHORITY

IDEA Part C Act of 2004: PL 108-446 –references
by section number “Sec 631-644”

Also references to other Federal laws and
sections of IDEA, ex. Sec 619

September 28, 2012 Final Regulations—called
Code of Federal Regulations 34 CFR Part 303
references by Subparts A-H and within subparts
303.1 through 303.734

Federal Guidance Documents and Policy letters

State Policies

Practice Documents and Guidance
D EFINITIONS ,
P UBLIC AWARENESS
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AND
C HILD F IND
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§303.300 G ENERAL .

New Regulation discuss the three phases in the
program and service components subpart:

Pre-referral

Public awareness program

Child find system

Referral

Post-referral

Screening

Evaluation and assessment

Development, review and implementation of
IFSPs
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§303.301 P UBLIC AWARENESS PROGRAM -INFORMATION FOR PARENTS .

(a)(2) Adopt procedures for assisting the primary referral
sources described in §303.303(c) in disseminating the
information described in paragraph (b) of this section to
parents of infants and toddlers with disabilities.

(c) Information specific to toddlers with disabilities. Each
public awareness program also must include a
requirement that the lead agency provide for informing
parents of toddlers with disabilities of the availability of
services under section 619 of the Act not fewer than 90
days prior to the toddler’s third birthday.
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§303.302 C OMPREHENSIVE
FIND SYSTEM .
CHILD

Added Home Visiting Programs,

Child Protection and Welfare including CAPTA, Family
Violence Prevention and Services Act, in place

Early Hearing Detection and Intervention (EHDI), in place

Children’s Health Insurance Program (CHIP) & Child Care
to list of programs for required child find coordination—in
place
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§303.302 Comprehensive child
find system.

Primary Referral Sources:

Added:

Public agencies and staff in the child welfare
system, including child protective services and
foster care—in place

Homeless family shelters

Domestic violence shelters and agencies
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§303.303 R EFERRAL P ROCEDURES

Provide for referring a child as soon as possible, but
in no case more than seven days, after the child has
been identified currently two days

Clarified issue of siblings who may have case of
abuse
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§303.310 P OST - REFERRAL
T IMELINE

Screening, initial evaluation, initial assessments
of the child and family and the initial IFSP
meeting must be completed within 45 days from
the date the lead agency or EIS provider receives
the referral Review changes

Exceptions that must be documented in the file:


Child/parent unavailable

Parent has not provided consent despite documented
repeated efforts
Must be completed as soon as possible after the two
exceptions no longer exist
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§303.310 S CREENING P ROCEDURES

Lead agency may adopt screening Already in place in
Louisiana

Provide parent notice of intent to screen including right to
evaluation and obtain parental consent

If screening is positive – with notice and consent move to
evaluation and assessment

If screening is negative – notify parent of results and their
right to request an evaluation

At any point during the screening process, the parent can
request and consent to evaluation
E VALUATION AND A SSESSMENT
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§303.321 E VALUATION OF THE C HILD
AND A SSESSMENT OF THE C HILD AND
FAMILY

Evaluation: Procedures used by qualified personnel to
determine a child’s initial and ongoing eligibility


Use of medical and other records (without formal
evaluation process) if records indicate the child meets
eligibility criteria
Assessment: Procedures used by qualified
personnel to:

identify a child’s strengths and needs and the services
necessary to meet those needs throughout the time of
the child’s eligibility.

Identify the family’s resources, priorities and concerns
and the services and supports needed to meet their
child’s needs
§303.321 E VALUATION OF THE C HILD
AND A SSESSMENT OF THE C HILD AND
FAMILY ( CONTINUED )
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
INFORMED CLINICAL OPINION

Qualified personnel must use informed clinical opinion
when conducting an evaluation and assessment of the
child.

Lead agency must ensure that informed clinical opinion
may be used as an independent basis to establish a
child‘s eligibility …even when other instruments do not
establish eligibility;

In no event may informed clinical opinion be used to
negate the results of evaluation instruments used to
establish eligibility
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§303.321 E VALUATION OF THE C HILD
AND A SSESSMENT OF THE C HILD AND
FAMILY ( CONTINUED )


Assessment of the child must include:

Review of results from evaluation process

Personal observations of the child

Identification of the child’s needs in each developmental
domain
Assessment of the family must be:

Voluntary

Based on assessment tool and interview

Include family’s description of its resources, concerns and
priorities related to enhancing the child’s development
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§303.321 Evaluation of the Child
and Assessment of the Child and
Family (continued)

MULTIDISCIPLINARY

The involvement of two or more separate disciplines
or professions and with respect to:

Evaluation of the child…and assessments of the child
and family ...may include one individual who is
qualified in more than one discipline or profession;

The IFSP Team in §303.340 must include the
involvement of the parent and two or more individuals
from separate disciplines or professions and one of
these individuals must be the service coordinator
(consistent with §303.343(a)(1)(iv)).
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§303.26 N ATURAL
E NVIRONMENTS

Settings that are natural or typical for a
same-aged infant or toddler without a
disability and may include the home or
community settings consistent with the
provisions of §303.126.

“[the Department] does not believe that a
clinic, hospital or service provider’s office is a
natural environment for an infant or toddler
without a disability; therefore, such a setting
would not be natural for an infant or toddler
with a disability.”
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§303.209 T RANSITION TO
P RESCHOOL AND O THER P ROGRAMS


Application requirement - Policies and
procedures to ensure a smooth
transition for children who are:

Moving to preschool or other appropriate
services; or

Exiting Part C
Inter or Intra Agency Agreement that
includes timelines, roles and responsibilities
for transition
§303.209 T RANSITION
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
Transition Plan:

Reviews program options

Inclusion of families

Timeline - Not fewer than 90 days, not more than
9 months prior to the child’s third birthday

Part of IFSP

Includes steps:

For exiting

Needed transition services
§303.344 CONTENT OF
IFSP
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
(b) family information as identified in:

303.321(c)(2) A family-directed assessment must be conducted by
qualified personnel in order to identify the family’s resources,
priorities, and concerns and the supports and services necessary to
enhance the family's capacity to meet the developmental needs of the
family's infant or toddler with a disability. The family-directed
assessment must-
(i) Be voluntary on the part of each family member participating
in the assessment;

(ii) Be based on information obtained through an assessment
tool and also through an interview with those family members
who elect to participate in the assessment; and

(iii) Include the family’s description of its resources, priorities,
and concerns related to enhancing the child’s development.
IFSP
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
(e) Other Services:

Identify medical and other services that the child
or family needs or is receiving through other
sources, but that are neither required nor funded
under this part; and

If those services are not currently being provided,
include a description of the steps the service
coordinator or family may take to assist the child
and family in securing those other services.
IFSP F ORM -T RANSITION
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
(iii) Confirmation that child find information about the
child has been transmitted to the LEA … and with
parental consent … transmission of additional
information needed by the LEA to ensure continuity of
services from the Part C program to the Part B
program, including a copy of the most recent
evaluation and assessments of the child and the
family and most recent IFSP … and

Identification of transition services and other
activities that the IFSP Team determines are
necessary to support the transition of the child.
Subpart E: Procedural
Safeguards
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
General Responsibilities

Confidentiality of Information

Parental Consent and Notice

Surrogate Parent

Dispute Resolution Procedures
G ENERAL R ESPONSIBILITIES
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
Adds requirement to make available to
parents an initial copy of the child’s early
intervention record, at no cost to the
parents.

Provide a copy of each evaluation,
assessment, and IFSP as soon as possible
after each IFSP meeting.
P ROCEDURAL S AFEGUARDS :
D EFINITIONS
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
Definitions were moved to the definitions section

Expanded the definition of parent
P ROCEDURAL S AFEGUARDS :
N OTICE AND C ONSENT
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
Clarifies parental consent required before:

Administering screening

All evaluations and assessments

Providing early intervention services

Use of public benefits or insurance or private
insurance are accessed, if required

Disclosure of personally identifiable information
consistent with requirements
§ § 303.401 – 417
Confidentiality of Information
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
Defines early intervention records

Reinforces applicability of FERPA to Part C

Includes opt-put policy for notification

Adds GEPA and EDGAR provisions to
language about destruction of records

Changed timeline for parental access to
records from 45 days to 10 days
§303.432-434 State
Complaints
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
Adding requirement the complaint must
include- signature and contact information
for complainant, and if related to a specific
child, name/address of child, name of
provider, description of problem and
proposed resolution

Requires party filing complaint to provide
copy to agency or provider serving child at
same time as filing complaint
TOPIC : F INANCE
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U SE

O F PUBL IC
B ENEF ITS
Use of public benefits (Medicaid):

Must provide written notification to parents;

Must ensure no cost protection provisions;

May not require parents to enroll in public benefits or insurance
program; and

Must obtain consent if use does not meet the no cost protection
provisions.

Statement of no-cost protections and that if the family refuses to
consent, the child is still eligible to receive all IFSP services that the
family has consented to;

Right to withdraw consent at any time; and

Statement of general categories of cost that the parent may incur.
§303.520 P OLICIES RELATED TO USE OF
PRIVATE INSURANCE TO PAY FOR PART C
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SERVICES

Use of private insurance:


Must obtain written parental consent

At initial IFSP;

Each subsequent time consent for services is
required due to increase in service provision;
Any cost for use must be included in system of
payments policy

Policy must be provided to the family that
identifies potential cost that may be incurred
W HAT ’ S N EXT ?
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
Public Comment on proposed changes

Make revisions and submit policies with
Application, due April 16

Receive approval from OSEP to implement

Update our guidance materials—Practice Manual

Provide training on changes
C HILD C OUNT
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12000
10000
8000
Point in Time
6000
Cumulative
Year
4000
2000
0
2004
2005
2006
2007
2008
2009
2010
2011
E NROLLED P ROVIDERS
33
2500
2000
1500
1000
500
0
2004
2005
2006
2007
2008
2009
2010
F UNDING AND S ERVICE E XPENDITURES
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30000000
25000000
20000000
Funding
Federal
15000000
State
Totals
Service Expenditures
10000000
5000000
0
2004
2005
2006
2007
2008
2009
2010
2011
E XPENDITURE R EDUCTION
R ECOMMENDATIONS
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
Continue team service decision process

Eligibility Criteria Changes—reduce the number
of children eligible for services

Family Cost Participation—implement the sliding
scale for shared costs by families approved by
OPH but never implemented

Service Rate Cuts
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B RAINSTORMING FOR YOUR
IDEAS