Get on Top of the New Part C Regs! Changes in the 2011 IDEA Part C Regulations and the Impact on ESIT Program Policies and Procedures Anne Lucas, Joicey Hurth, Kathi Gillaspy and Karen Walker 1

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

Expected Outcomes To understand the major changes in the 2011 regulations compared to the 1999 regulations To understand the implications of these changes to ESIT program policies and procedures To think about the application of these changes on local program policies, procedures and practices 3

4 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 4

5 IDEA Part C Side-By-Side Comparison art_C_Regulations_Side_by_Side.pdf Released October 14, 2011 by: – Council for Exceptional Children – Division for Early Childhood of CEC (DEC) – IDEA Infant Toddler Coordinators Association

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7 Session Topics Program and Service Components (Screening, Evaluation and Assessment, IFSP) Transition Finance Other changes and additions Group Discussion

8 Program and Service Components (Screening, Evaluation and Assessment, IFSP)

9 Key Changes: Program and Service Components Child Find Primary Referral Sources Referral Definition of Evaluation Evaluation Procedures Timelines Screening Evaluation Definition of Assessment Informed Clinical Opinion Family Assessment IFSP Content IFSP Service Other Services Natural Environments Transition

10 Program and Service Components Pre-referral  Public awareness  Child find Referral Post-referral  Screening  Evaluation and assessment  Development, review & implementation of IFSPs

11 Changes to Child Find Requires “rigorous standards” to appropriately identify children to reduce need for future services Added programs for coordination of child find efforts  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

12 Referral Added CAPTA language with clarification that intent is not to include siblings of child, but only child “substantiated” Requires referral as soon as possible, but in no case more than 7 days, after the child has been identified 12

13 Primary Referral Sources Emphasis on word “include” 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 13

14 Timeline Retains 45 day timeline from date the lead agency or EIS provider receives a referral to the IFSP meeting Establishes two circumstances in which 45 day timeline would not apply:  Child or parent is unavailable due to exceptional family circumstances  Parent has not provided consent despite documented repeated attempts 14

15 Screening Policies and Procedures Lead agency may adopt screening Screening procedures  Means activities …that are carried out by, or under the supervision of, the lead agency or EIS provider to identify, at earliest possible age, infants and toddlers suspected of having a disability and in need of early intervention services  Includes the administration of appropriate instruments by personnel trained to administer those instruments 15

16 Screening Requirements Must provide prior written notice of intent to screen, including right to evaluation, and obtain parental consent If screening results indicate:  “child is suspected of having a disability” must provide written prior notice and obtain consent to conduct evaluation/assessment  “child is not suspected of having a disability” must provide written prior notice including right to request evaluation

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

Informed Clinical Opinion 18 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

19 Additional IFSP NE Language “ The determination of the appropriate setting for providing early intervention services to an infant or toddler with a disability, including any justification for not providing a particular early intervention service in the natural environment for that infant or toddler with a disability and service, must be- - (1) Made by the IFSP Team (which includes the parent and other team members); (2) Consistent with the provisions in §§ (a)(8), , and ; and (3) Based on the child‘s outcomes that are identified …” 19

20 IFSP Transition Language 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

21 Transition

22 Transition Includes timelines for ONE notification of children who “may be eligible for special education” Includes option for an opt-out policy Requires notification to LEA and SEA Clarifies transition plan is not separate document – part of IFSP Requires interagency and intra-agency agreements Transition conference must meet IFSP requirements 22

Transition Plan 23 Transition Plan must be developed in the IFSP not fewer than 90 days – and at the discretion of all parties, not more than 9 mos – before the toddlers 3 rd birthday

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

25 Transition Conference For a child who “may be eligible” for preschool services under Part B:  Not fewer than 90 days, but not 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

26 Finance

27 Finance Provisions Cannot require parent to enroll in Medicaid or other public insurance program Need consent to use Medicaid if parent not already enrolled or will incur any cost Requires written notice if state wants to use Medicaid including consent to release personal information to Medicaid agency Requires consent for use of private insurance each time consent for services is required unless state legislation meets specified requirements 27

28 Use of Public Benefit: Consent 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 the child or child’s parents for home and community-based waivers based on aggregate health-related expenditures

29 Private Insurance 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 is not be the basis for increasing insurance premiums of infant/toddler, parent, or child’s family members covered under insurance policy

Finance Provisions 30 Requires parents get copy of family cost participation policies and procedures, identifying potential costs that parent may incur Co-pays, deductibles and premiums are family costs Prohibits disproportionate family cost related to public and private insurance Cannot be charged more than actual cost of service

31 Finance “A State may establish, consistent with §§303.13(a)(3) and (b), a system of payments for early intervention services under Part C of the Act, including a schedule of sliding fees or cost participation fees (such as co- payments, premiums, or deductibles) required to be paid under Federal, State, local, or private programs of insurance or benefits for which the infant or toddler with a disability or the child’s family is enrolled, that meets the requirements of §§ and ” 31

32 Certification of Financial Responsibility Each application must include a certification to the Secretary that the arrangements to establish financial responsibility for the provision of Part C services among appropriate public agencies under § and the lead agency’s contracts with EIS providers regarding financial responsibility for the provision of Part C services both meet the requirements in subpart F of this part (§§ through ) and are current as of the date of submission of the certification

33 Other Changes and Additions

34 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:  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 § (a)  Obtain certification from each EIS provider that an unduplicated and accurate count has been made

35 Discussion Activity Write down on worksheet the impact of Regulation changes:  3 key things that will benefit children and families  3 key things that will impact practice or require a significant change in practice Share with 1 other person Write down on worksheet what supports are needed to implement new regulations Full group sharing

36 Resources Overview and Discussion of 2011 Part C Regs: IDEA 2004 – Building the Legacy (Regs, resources): ITCA Regs Webpage (Side-by-Side, PPTs) ESIT website:

37 For More Information on the Regs Contact ESIT Program Consultant Participate in LLA calls and meetings Watch for more information through or ESIT website

38 Contact Information Anne Lucas, NECTAC/WRRC Joicey Hurth, NECTAC/NERRC Kathi Gillaspy, NECTAC Karen Walker, ESIT