Arizona Early Intervention Program IDEA 2011 Requirements Procedural Safeguards - Prior Written Notice and Consent-

Consent - What’s New? Activity ScreeningNew Child AssessmentNew Use of Insurance (Public/Private)New

Activities that Require Consent and Prior Written Notice ActivityRequires Consent Requires Prior Written Notice ScreeningXX EvaluationXX Eligibility DeterminationX Child AssessmentX Initiate/Change Provision of ServicesXX Use of Insurance (Private or Public)X Disclosure of Records & Personally Identifiable Information X

Prior Written Notice Prior Written Notice is required under IDEA, Part C to ensure families are provided information about the actions being proposed or refused surrounding their child’s participation in AzEIP before the action takes place.

Prior Written Notice Is intended to give families information so they can make informed choices and decisions in the delivery of supports and services for their child and family.

Prior Written Notice Must be given to the parents a reasonable time before the Early Intervention Program proposes or refuses to initiate or change: Identification (screening); Evaluation; Placement (eligibility); and The provision of appropriate early intervention services.

Prior Written Notice The notice must be in sufficient detail to inform the parent about: The action that is being proposed or refused; The reasons for taking the action; and All procedural safeguards available under the federal regulations, including a description of mediation, how to file a complaint and a due process hearing, and the timelines under those procedures.

Prior Written Notice The notice must be: understandable to the general public, and provided in the native language of the parent, unless it is clearly not feasible to do so. –if the native language or other mode of communication of the parent is not a written language, the notice must be translated orally or by other means to the parent in the parent’s native language or other mode of communication, unless clearly not feasible to do so.

Prior Written Notice Table ActivityAzEIP Form to be used Identification – Determining if Child Suspected of a Developmental Delay Propose to Conduct ScreeningConsent for Screening – Prior Written Notice (GCI-1082A) Evaluation Propose to evaluate to determine initial AzEIP eligibilityConsent for Evaluation – Prior Written Notice (GCI-1038A) Refuse to evaluatePrior Written Notice (GCI-1050A) Propose to evaluate to re-determine AzEIP eligibilityPrior Written Notice (GCI-1050A) Placement – Eligibility Determination Propose eligibility after completion of record reviewPrior Written Notice (GCI-1050A) Propose eligibility after completion of evaluationPrior Written Notice (GCI-1050A) Refuse eligibility after completion of evaluation Prior Written Notice (GCI-1050A) Propose to change eligibility status after re-evaluationPrior Written Notice (GCI-1050A) Provision of Early Intervention Services Propose the type, intensity, frequency, methods and/or duration of early intervention services IFSP Informed Consent by Parent(s) for Services Page (GCI-1021O) Propose to change the type, intensity, frequency, methods and/or duration of early intervention services Refuse to provide the type, intensity, frequency, methods and/or duration of an early intervention service Prior Written Notice (GCI-1050A) Prior Written Notice (GCI-1050A) Refuse to change the type, intensity, frequency, methods and/or duration of an early intervention service

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