Changes to the Alaska Part C Policies and Procedures

1. Changes to the Alaska Part C Policies and Procedures Megan Vinh, Sara Doutre, and Anne Lucas

2. Special Thanks Presentation adapted from presentation developed by Sharon Walsh for the IDEA Infant Toddler Coordinators Association and the Division of Early Childhood Council for Exceptional Children

3. Agenda Introduction IDEA Part C Regulations Program and Service Components (Screening, Evaluation and Assessment, IFSP) Transition Finance Other changes and additions Group Discussion Resources

4. Introduction Who we are? What were we asked to do? How did we ensure usability?

5. IDEA Part C Regulations • Final regulations were published in Federal Register September 28, 2011 • Became effective October 28, 2011 • New regulations must be implemented by July 1, 2012 • Written policies and procedures must be in place July 1, 2013 • Public comment and hearings required

6. Program and Service Components (Screening, Evaluation and Assessment, IFSP)

7. Key Changes • Child Find • Primary Referral Sources • Referral • Definition of Evaluation • Evaluation Procedures • Timelines • Evaluation • Definition of Assessment • Informed Clinical Opinion • Family Assessment • IFSP Content • IFSP Service • Other Services • Natural Environments • Transition

8. Program and Service Components • Pre-referral • Public Awareness (pg. 10) • Child find (pg. 10, 52) • Referral (pg. 57) • Post-referral • Evaluation and assessment (pg. 60) • Development, review & implementation of IFSPs ((pg. 65)

9. Changes to Child Find • Requires “rigorous standards” to appropriately identify children to reduce need for future services (pg. 52) • Added programs for coordination of child find efforts (pg. 53) • Home visiting • Child Protection and Welfare including CAPTA • Family Violence Prevention and Services Act • Early Hearing Detection and Intervention (EHDI) • Children’s Health Insurance Program (CHIP) • Child Care

10. Referral Added CAPTA language with clarification that intent is not to include siblings of child, but only child “substantiated” (pg. 57) Requires referral as soon as possible, but in no case more than 7 days, after the child has been identified (pg. 57)

11. Primary Referral Sources • Emphasis on word “include” (pg. 57) • Added: • Public agencies and staff in the child welfare system, including child protective services and foster care • Homeless family shelters • Domestic violence shelters and agencies

12. Timeline • Retains 45 day timeline from date the lead agency or EIS provider receives a referral to the IFSP meeting (pg. 59) • Establishes two circumstances in which 45 day timeline would not apply: (pg.60) • Child or parent is unavailable due to exceptional family circumstances • Parent has not provided consent despite documented repeated attempts

13. Evaluation • An evaluation is required unless eligibility has been determined through review of records (pg. 63) • If child is found eligible, the following are required: (pg. 63) • Multidisciplinary assessment of child (including review of evaluation results, observation, etc.) (pg. 64) • Family-directed assessment of the family (using assessment tool and interview with those family members who elect to participate) (pg. 64) • Evaluation and assessment must be conducted in native language unless clearly not feasible (pg. 65)

14. Informed Clinical Opinion (pg. 2) Used by qualified personnel when conducting evaluation and assessment Used as independent basis to establish a child’s eligibility even when instruments do not establish eligibility In no event may ICO be used to negate the results of evaluation instruments

15. Additional IFSP NE Language (pg. 22) • “The determination of appropriate setting for providing early intervention services to an infant or toddler with a disability, including justification for not providing a particular early intervention services in the natural environment for that infant or toddler with a disability must be— • Made by the IFSP Team (which includes the parent and other team members) • Consistent with provisions in §§ 303.13(a)(8), 303.26, and 303.126; and • Based on the child’s outcomes that are identified”

16. IFSP Transition Language (pg. 27) Adds “and services” to “steps” Confirmation that child find information (notification) 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... Identification of transition services and other activities that the IFSP Team determines are necessary to support the transition of the child

17. Transition (pg. 24)

18. Transition (pg. 24) Includes timelines for ONE notification of children who “may be eligible for special education” (pg. 25) Includes option for an opt-out policy Requires notification to LEA and SEA (pg.25) Clarifies transition plan is not separate document –part of IFSP (pg.27) Requires interagency and intra-agency agreements (pg. 24) Transition conference must meet IFSP requirements (pg.26)

19. Transition Plan Transition Plan must be developed in the IFSP not fewer than 90 days– and at the discretion of all parties, not more than 9 months—before the toddler’s 3rd birthday (pg. 27)

20. Transition Notification to SEA and LEA No fewer than 90 days before 3rd birthday, if child “may be eligible for preschool services under Part B”, must notify SEA and LEA of the child. (pg. 25) If Part C eligibility is determined more than 45 days but less than 90 days before 3rd birthday, and child “may be eligible for preschool”, must notify SEA and LEA as soon as possible after determining eligibility. (pg. 25) If child is referred fewer than 45 days before 3rd birthday, and child “may be eligible for preschool” with parental consent, must notify SEA and LEA—no eligibility determination for Part C required. (pg. 26)

21. Transition Conference (pg. 26) • For a child who “may be eligible” for preschool services under Part B: • Not fewer than 90 days, but more than 9 months prior to the child’s third birthday • With the approval of the family, must convene conference with Lead agency, family, LEA • For other children, the lead agency with approval of family, must make reasonable effort to convene a conference with family and other appropriate providers of service

22. Extended IFSP Option • If a child who previously received early intervention services under Part C is found eligible for preschool services under Part B, Alaska will offer parents the choice of: (pg. 28) • The extended IFSP option- the child and family would continue to receive early intervention services with an education component that promotes school readiness and incorporates preliteracy, language, and numeracy skills through IFSP; or • Special education preschool services through and individualized IEP as a student with a disability • Extended IFSP option applies to children with disabilities at age three until the beginning of the school year following the child’s third birthday. (pg. 28)

23. Finance (pg. 90)

24. Finance Provisions Cannot require parent to enroll in Medicaid or other public insurance program (pg. 97) Need consent to use Medicaid if parent not already enrolled or will incur any cost (pg. 97) Requires written notice if state wants to use Medicaid including consent to release personal information to Medicaid agency (pg. 98) Requires consent for use of private insurance each time consent for services is required (pg. 99)

25. Use of Public Benefit: (pg. 97) • Consent is required if-- • Decrease available lifetime coverage or any other insured benefit for child or parent under program • Result in the child’s parents paying for services that would otherwise be covered by the public benefits or insurance program • Result in any increase in premiums or discontinuation of public benefits or insurance for child or child’s parents or • Risk loss of eligibility for child or child’s parents for home and community-based waivers based on aggregate health-related expenditures

26. Private Insurance (pg. 99) • Consent does not apply if private insurance statute provides: • Use of private insurance does not count towards or result in a loss of benefits due to annual or lifetime health insurance coverage caps for infant/toddler, parent, or child’s family members covered under insurance policy • Use of private health insurance does not negatively affect availability of health insurance to infant/toddler, parent, or child’s family members covered under insurance policy, and insurance coverage may not be discontinued for these individuals due to use of insurance to pay for services and • Use of private insurance can not be the basis for increasing insurance premiums of infant/toddler, parent, or child’s family members covered under insurance policy

27. Finance Provisions Requires parents get copy of family cost participation policies and procedures, identifying potential costs that parent may incur (pg. 99) Co-pays, deductibles and premiums are family costs (pg. 99) Prohibits disproportionate family cost related to public and private insurance (pg. 101) Cannot be charged more than the actual cost of services (pg. 101)

28. Finance (pg. 90) Alaska has established, consistent with 34 CFR §§303.13(a)(3) and 303.203(b), a System of Payments for early intervention services under Part C of IDEA, including a schedule of sliding fees required to be paid under for services in which the infant or toddler with a disability or child’s family is enrolled, that meets the requirements of 34 CFR §§303.520 and 303.521

29. Other Changes and Additions

30. Data Reporting • “…the lead agency must conduct its own child count or use EIS providers to complete its child count. If the lead agency uses EIS providers to complete its child count, then the lead agency must: (pg. 111) • Establish procedures to be used by EIS providers in counting the number of children with disabilities receiving early intervention services • Establish dates by which those EIS providers must report to the lead agency to ensure that the State complies with §303.721(a) • Obtain certification from each EIS provider than an unduplicated and accurate count has been made

31. Discussion Activity What requirements are you excited to implementwithin your own program? What changes may be required to successfully implement these new requirements? What supports are needed to implement the changes to Alaska’s Policies and Procedure?

32. Resources • Alaska Infant Learning Program (Public Comment Page) http://dhss.alaska.gov/ocs/Pages/infantlearning/reports/default.aspx • Overview and Discussion of 2011 Part C Regs: http://osep-part-c.tadnet.org/materials • IDEA 2004 – Building the Legacy (Regs, resources): http://idea.ed.gov/part-c/search/new • ITCA Regs Webpage (Side-by-Side, PPTs) http://www.ideainfanttoddler.org/regulations.htm

33. Contact Information • Megan Vinh, TACS mvinh@uoregon.edu • Anne Lucas, TACS Anne.lucas@unc.edu • Sara Doutre, Doutre Consulting Sara@doutreconsulting.com