What Parents Need to Know:The New Part C Federal Regulations

and National Trends in Service Delivery

Lynda Cook PletcherMay 10, 2012

Region 6 Parent Conference

Introduction

Education of Individuals with Disabilities- 20 U.S.C. code is the Federal Statute or LawChapter 33- has sections 1400-1482Reauthorization of previous laws now IDEA 2004Subchapters that apply to our Part C discussion todaySubchapter III- Infants and Toddlers with Disabilities

Know you’re are looking at a Statute if you see a 1400 or

600 citation

Federal Regulations- September 2011 Regulations are also lawThey give more details than statuteThey 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

General comments

Not every thing in the text changedMany parts have been in the regulations since 1997 and beforeOrder of sections and numbers all changed Impacts finding sections, or citing sectionsNeed to know highlights of what did change

Orient yourself

Road Map-RegulationsSubpart A-Purpose and Definitions of termsUsed in the ActSubpart 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 applicationSubpart D- child find, evaluations and assessments and the IFSPSubpart E- Procedural SafeguardsSubpart F- Use of fundsSubpart G- State interagency coordinating councilSubpart H- State monitoring and enforcement

Today’s Organization of the Changes

• 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

All Clear??We are only highlighting significant changes that

might impact you.

Emphasis on “Family Engagement”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)

Getting into services: Pre-referralCentral 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 ServicesWithin the 45 day timeline (which has not changed) the lead agency may conduct a screening prior the evaluation and assessment (303.310)

If they do…. These procedures apply

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)

Can’t delay the 45-day timeline!

Evaluation and Assessment of the Child and Family (303.321)for eligibility

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

Other changes impacting evaluation and assessment

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.

IFSP DevelopmentOutcome and resultsEach service provided as soon as possible after parent consentAdds pre-literacy and math skills as appropriate to outcomesDefined length and duration

Re-affirmed Natural EnvironmentsLocation of services on the IFSP Justification statement made- no changeJustification is made by the IFSP team (which includes the parent and other team members Must be based on the child’s outcome

Must be consistent with 303.13(a)(8) and 303.26 and

303.126

Service coordination- 303.34

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)

Added to the responsibilities:

Services (303.13)Now includes 17 services: Added Sign Language and Cued SpeechLeft in nursing and nutrition even though the statute does not listClarified information on hearing aids and medical devices that are surgically implanted

Can you name the other E.I. services?

Hint: there are 15 left!

Payment for services 303.500(b) and 303.521

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 insuranceFamily fees or cost participation fees

Must meet all requirements in 303.520 and 303.521

Written policiesPayment system and schedule of fessBasis and amount of the feesDefinition of the ability and inability to pay and a process for determiningAssurance regarding services to be provided at no costProvision regarding failure to provide income informationProvision that permits the lead agency to use Part C funding to pay for some costProcedural safeguards

Use of Public Benefits 303.520(a)

Must provide written notification to parentsMust ensure no cost protection provisionsMay not require parents to enroll in public benefits or insurance program anMust 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 private insurance 303.520 (b)

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 policyPolicy must be given to the family that identifies any potential cost to them

No cost protection 303.520(a)(ii)(A-D)

Can not decrease available lifetime coverage or any other insured benefitCan not result in the parents paying for services that would otherwise be covered by the public benefits or insurance programCan not result in an increase in premiums or discontinuation of public benefits or insuranceCan not cause a loss of eligibility for home and community based waivers based on aggregated health related expenses

TransitionOPT 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.

Notification- 303.209 (b) (1)(i)

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 BNotice includes name, date of birth and contact information

Unless the parent has chosen to opt out

Transition Conference and MeetingConference 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 Plan- 303.209

Plan must be included in the IFSPPlan must be established not fewer than 90 days and not more than 9 months before the third birthdayMust include steps for the child and family to exit Part C any transition services that the IFSP team identifies as neededSteps to support the child to preschool Part B, Head start early education, or child care

Digging deeper- ResourcesFinal Federal Regulations for Part C of IDEA 2004

• Federal Register: https://www.federalregister.gov/articles/2011/09/28/2011-22783/early-intervention-program-for-infants-and-toddlers-with-disabilities

An html version with targeted links (9/28/2011, effective 10/28/2011).

• PDF version: http://www.gpo.gov/fdsys/pkg/FR-2011-09-28/pdf/2011-22783.pdf

• OSEP's Part C of the IDEA Website: http://idea.ed.gov/part-c/search/new

• Video of Major Changes: http://www.youtube.com/watch?v=w4dwwRIumSA A 20-minute video featuring Alexa Posny, Assistant Secretary of the U.S. Department of Education's Office of Special Education and Rehabilitative Services (OSERS), highlights some of the major changes to the regulations.

• NECTAC Collection of resources: http://www.nectac.org/partc/303regs.asp