2011 Part C Regulations

1. 2011 Part C Regulations Areas: Child Find, Public Awareness, Evaluation and Assessment, Transition, Finance,SICC

2. Overview • 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

3. Hierarchy of Authority • 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 • ‘

4. Definitions,Public Awareness and Child Find

5. §303.300 General. • 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

6. §303.301 Public 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.

7. §303.302 Comprehensive child find system. • 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

8. §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

9. §303.303 Referral Procedures • 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

10. §303.310 Post-referral Timeline • 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

11. §303.310 Screening Procedures 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

12. Evaluation and Assessment

13. §303.321 Evaluation of the Child and Assessment of the Child 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

14. §303.321 Evaluation of the Child and Assessment of the Child and Family (continued) • 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 14

15. §303.321 Evaluation of the Child and Assessment of the Child 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

16. §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)). 16

17. §303.26 Natural Environments • 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.” 

18. §303.209 Transition to Preschool and Other Programs • 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

19. §303.209 Transition • 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

20. §303.344 CONTENT OF IFSP • (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.

21. IFSP • (e) Other Services: • Identify medical and other services that the child or family needsor 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.

22. IFSP Form-Transition • (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.

23. Subpart E: Procedural Safeguards • General Responsibilities • Confidentiality of Information • Parental Consent and Notice • Surrogate Parent • Dispute Resolution Procedures

24. General Responsibilities • 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.

25. Procedural Safeguards: Definitions • Definitions were moved to the definitions section • Expanded the definition of parent

26. Procedural Safeguards: Notice and Consent • 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

27. § § 303.401 – 417 Confidentiality of Information • 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

28. §303.432-434 State Complaints • 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

29. Topic: FinanceUse of public Benefits • 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.

30. §303.520 Policies related to use of private insurance to pay for Part C 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

31. What’s Next? • 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

32. Child Count Point in Time and Cumulative Counts 8 years

33. Enrolled Providers 2004-2010

34. Funding and Service Expenditures

35. Expenditure Reduction Recommendations • 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

36. Brainstorming for your ideas