The New Part C Federal Regulations and National Trends in Service Delivery

1. The New Part C Federal Regulations and National Trends in Service Delivery Getting Into the System

2. Education of Individuals with Disabilities- 20 U.S.C. code is the Federal Statute or Law Chapter 33- has sections 1400-1482 Reauthorization of previous laws now IDEA 2004 Subchapters that apply to our Part C discussion today Subchapter III- Infants and Toddlers with Disabilities Introduction • You know you’re are looking at a Statute if you see a 1400 or 600 citation

3. Regulations are also law They give more details than statute They are not organized in the same order as the 1400’s (600’s) Regulations for Subchapter III - called Early Intervention Program for Infants and Toddlers with disabilities numbered 303 Federal Regulations- September 2011

4. State Regulations

5. Not every thing in the text changed Many parts have been in the regulations since 1997 and before Order of sections and numbers all changed Impacts finding sections, or citing sections Need to know highlights of what did change General comments

6. Orient yourself

7. Subpart A-Purpose and Definitions of terms used in the Act Subpart B and C- What states need to have in place for their system of services and assure in order to receive funds (often called the state application Subpart D- child find, evaluations and assessments and the IFSP Subpart E- Procedural Safeguards Subpart F- Use of funds Subpart G- State interagency coordinating council Subpart H- State monitoring and enforcement Road Map-Regulations

8. Getting into Early Intervention Development of the IFSP Implementation and Ongoing Monitoring of IFSP Services Transition Woven into the above sections are changes in applicable procedural safeguards and fiscal implications Organization of the Changes

9. We are only highlighting significant changes that might impact you. All Clear??

10. Requires that a family served in Part C be included in the development of the transition plan (303.209(d)(ii) Clarifies if the child is not eligible, must be given prior written notice including parents rights to dispute the eligibility determination through Part C dispute resolution (303.322) An initial notice is given when a child is referred to part C informing them of their rights confidentiality and records (303.404(d) Parental request to view records no more than 10 days after request (303.405(a) No cost to parents for copies of evaluation and assessment and IFSP (303.409(c) General rule that parental consent is required before any participating part C agency can release information (303.414) Emphasis on “Family Engagement”

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12. Central Directory of early intervention services must be accessible to the general public and include accurate and updated information (303.117) States must have procedures for helping all primary referral sources have and give information to parents specific to infants and toddlers with disabilities (303.301 (a) (2) Lead agency must inform parents of the availability of what is offered under 619 (preschool services) not fewer than 90 days before the child turn three.(303.301( c) Added a few more primary referral sources- all who must refer a child as soon as possible but in no case more than 7 days after the child has been identified (303.303) Getting into services: Pre-referral

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14. Within the 45 day timeline (which has not changed) the lead agency may conduct a screening prior the evaluation and assessment (303.310) Getting into Services 45 day timeline has not changed

15. Provide parent notice of intent to screen including the right to evaluation 303.320(a)(1)(i) Obtain parent consent prior to any screening 303.420(a)(1) If screening is positive- give notice and consent to move to evaluation or, If screening is negative- notify parents of the results and their right to still ask for an evaluation (303 320 (a) (2) If they do…. These procedures apply Can’t delay the 45-day timeline!

16. Insert State Specifics

17. Evaluation MUST include: Administration of an evaluation instrument Child’s history including parent interview Identification of child’s level of functioning in all domains Gathering information from other sources to understand the full picture(parents permission before gathering) Reviewing medical or other records. Informed clinical opinion Evaluation and Assessment of the Child and Family (303.321)for eligibility

18. 2 exceptions to the 45 day timeline (303.310(b) (2) Clarifies initial evaluation and initial assessment related to eligibility 303.321(a)(2)(i) Multidisciplinary IFSP team- parent and at least two other individuals from separate disciplines and one must be the service coordinator. (303.24) Native language of the child and parent (303.259a), 303.321(a)(5) and (a)(6) Addition of a family assessment “tool” with the interview. Other changes impacting evaluation and assessment

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20. Definitions? Activity? Reflection? Resources?

21. The New Part C Federal Regulations and National Trends in Service Delivery IFSP Development, Implementation, and Ongoing Monitoring of the IFSP

22. Outcome and results Each service provided as soon as possible after parent consent Adds pre-literacy and math skills as appropriate to outcomes Defined length and duration IFSP Development

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24. Location of services on the IFSP Justification statement made- no change Justification is made by the IFSP team (which includes the parent and other team members Must be based on the child’s outcome Re-affirmed Natural Environments Must be consistent with 303.13(a)(8) and 303.26 and 303.126

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26. Conduct follow up activities to determine that appropriate EI services are provided (303.34(b)(9) Coordinate funding sources for Early Intervention Services (only- not for other services) Service coordination- 303.34 Added to the responsibilities of service coordinators

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28. Now includes 17 services: Added Sign Language and Cued Speech Left in nursing and nutrition even though the statute does not list Clarified information on hearing aids and medical devices that are surgically implanted Services (303.13) Can you name the other EI Services? Hint: There are 15 left!

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30. States may establish a system of payment and must have written policies including: the use of public benefits (Medicaid and state insurance, Tricare) Use of private insurance Family fees or cost participation fees Payment for services 303.500(b) and 303.521 Must meet all requirements in 303.520 and 303.521

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32. Payment system and schedule of fess Basis and amount of the fees Definition of the ability and inability to pay and a process for determining Assurance regarding services to be provided at no cost Provision regarding failure to provide income information Provision that permits the lead agency to use Part C funding to pay for some cost Procedural safeguards Written policies

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34. Must provide written notification to parents Must ensure no cost protection provisions May not require parents to enroll in public benefits or insurance program an Must obtain consent consistent with 303.7 and 303,420(a)(4) If parent does not provide consent, the state must still make available those part C services on the IFSP(303.520(a)(iii) Use of Public Benefits 303.520(a)

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36. Must obtain written parental consent: At the initial IFSP Each time after if an increase in services is recommended Any cost for use must be included in system of payments policy Policy must be given to the family that identifies any potential cost to them Use of private insurance 303.520 (b)

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38. Can not decrease available lifetime coverage or any other insured benefit Can not result in the parents paying for services that would otherwise be covered by the public benefits or insurance program Can not result in an increase in premiums or discontinuation of public benefits or insurance Can not cause a loss of eligibility for home and community based waivers based on aggregated health related expenses No cost protection 303.520(a)(ii)(A-D)

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40. Definitions? Activity? Reflection? Resources?

41. The New Part C Federal Regulations and National Trends in Service Delivery Transition

42. OPT out policy- 303.401(e ) Permits states to adopt a policy that requires E.I. providers to inform parents of the intended disclosure of personally identifiable information to the SEA and LEA and allows a parent a specified time period to object to the disclose. Transition

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44. For children exiting Part C and potentially eligible for Part B, the lead agency must notify the SEA and LEA not fewer than 90 days before the child’s 3rd birthday that s/he will reach the age of eligibility for services under Part B Notice includes name, date of birth and contact information Notification- 303.209 (b) (1)(i) Unless the parent has chosen to opt out

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46. Conference must be held with family approval at least 90 days but not more than 9 months before the child’s 3rd birthday (potentially eligible for B) (303.209 (c ) Conference or meeting must meet IFSP meeting requirements and the conference and IFSP 6 month or annual Meeting may be combined (303.209 (e ) Transition Conference and Meeting

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48. Plan must be included in the IFSP Plan must be established not fewer than 90 days and not more than 9 months before the third birthday Must include steps for the child and family to exit Part C any transition services that the IFSP team identifies as needed Steps to support the child to preschool Part B, Head start early education, or child care Transition Plan- 303.209

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50. Definitions? Activity? Reflection?