1. Procedural Safeguards Forms and Guidance Sharon Walsh and Ross Taylor, Systems Improvement Project, University of North Carolina-Chapel Hill December 8, 2010

2. 2 WA System Improvement Project Over Arching Project Goals:  A more consistent approach to the provision of early intervention services statewide  Increase practitioner use of evidence-based early intervention practices to better meet child and family outcomes  Infuse an infant mental health perspective into early intervention services

3. 3 System Improvement Activities  Revise and develop new forms (e.g., IFSP, procedural safeguards)  Develop guidance (e.g., IFSP, procedural safeguards, fiscal, and other ) Revise policies and proceduresRevise policies and procedures Develop competenciesDevelop competencies Develop on-line training modulesDevelop on-line training modules Develop long-term implementation planDevelop long-term implementation plan

4. 4 Procedural Safeguards Webinar will focus on procedural safeguards forms:Webinar will focus on procedural safeguards forms: –Some required and some optional –When each form is used –Forms will be effective around March 2011 Will not cover:Will not cover: –Dispute resolution –Confidentiality of information Webinar is being recorded and additional procedural safeguard training providedWebinar is being recorded and additional procedural safeguard training provided Questions/answers will be captured todayQuestions/answers will be captured today

5. 5 Agenda Review of Key DocumentsReview of Key Documents –ESIT Parent Rights –Procedural Safeguards TA Guide ESIT Procedural Safeguard FormsESIT Procedural Safeguard Forms Discussion of Important ConceptsDiscussion of Important Concepts –Written prior notice – Parental Consent Procedural Safeguards within the Components of the ESIT ProcessProcedural Safeguards within the Components of the ESIT Process

6. 6 Key Documents “Individuals with Disabilities Education Act“Individuals with Disabilities Education Act (IDEA) Part C Procedural Safeguards (Parent Rights)” “Individuals with Disabilities Education Act“Individuals with Disabilities Education Act (IDEA) Part C Procedural Safeguards (Parent Rights)” - Condensed version “Procedural Safeguards Requirements Technical“Procedural Safeguards Requirements Technical Assistance and Training Guide”

7. 7 Required Procedural Safeguard Forms IFSP Agreement – To provide written prior notice and obtain consent from the parent(s) prior to initiating or refusing to initiate IFSP services.IFSP Agreement – To provide written prior notice and obtain consent from the parent(s) prior to initiating or refusing to initiate IFSP services. IFSP Review Agreement – To provide written prior notice and obtain consent from the parent(s) prior to initiating or refusing to initiate IFSP services after an IFSP review.IFSP Review Agreement – To provide written prior notice and obtain consent from the parent(s) prior to initiating or refusing to initiate IFSP services after an IFSP review.

8. 8 Optional Model ESIT Procedural Safeguard Forms Authorization for Release of RecordsAuthorization for Release of Records Confirmation of Individualized Family Service Plan (IFSP) ScheduleConfirmation of Individualized Family Service Plan (IFSP) Schedule Declining Participation in the ESIT ProgramDeclining Participation in the ESIT Program Declining One or More Early Intervention ServicesDeclining One or More Early Intervention Services

9. 9 Optional Model ESIT Procedural Safeguard Forms Notice and Consent for ScreeningNotice and Consent for Screening Notice & Consent for Initial Evaluation/AssessmentNotice & Consent for Initial Evaluation/Assessment Notice & Consent for Evaluation/AssessmentNotice & Consent for Evaluation/Assessment Parent Written Prior NoticeParent Written Prior Notice Record of AccessRecord of Access

10. 10 Written Prior Notice ESIT must give written prior notice before: Proposing to do something new, orto do something new, or change something in place alreadychange something in place alreadyRefusing to do something new, orto do something new, or change something the parent is requestingchange something the parent is requesting Always provide a copy of the ESIT Parent Rights and explain to parents

11. 11 Parental Consent Written Parental Consent must be obtained before: –Conducting screening –Conducting any evaluation and assessment –Initiating or changing any early intervention services; –Using parent private and/or public insurance –Releasing confidential information about a child and family

12. 12 Referral Step 1- Referral ReceivedStep 1- Referral Received a.Parent Referral b.Referral by Primary Referral Source Step 2- Determination of Surrogate ParentStep 2- Determination of Surrogate Parent * * * * * * * * Declining Participation in the ESIT Program

13. 13 Intake Step 1 - Intake ProcedureStep 1 - Intake Procedure Step 2 - Complete Screening As NecessaryStep 2 - Complete Screening As Necessary Step 3 - Determining Need for Evaluation/AssessmentStep 3 - Determining Need for Evaluation/Assessment * * * * * * * * * * Authorization for Release of Records Notice and Consent for Screening (ESIT Parent Rights) Parent Written Prior Notice (ESIT Parent Rights) Declining Participation in the ESIT Program Notice & Consent for Initial Evaluation/Assessment (ESIT Parent Rights)

14. 14 Evaluation and Assessment Activities Step 1 - Establishing the MDTStep 1 - Establishing the MDT Step 2 – Completion and Documentation of MDT ActivitiesStep 2 – Completion and Documentation of MDT Activities Step 3 - Documentation of EligibilityStep 3 - Documentation of Eligibility a.Child Is Eligible b.Child Is Not Eligible * * * * * * * * * * Parent Written Prior Notice (ESIT Parent Rights) Declining Participation in the ESIT Program

15. 15 Individualized Family Service Plan Activities Step 1 – Initial IFSP Meeting a.Written Notice of the IFSP Meeting b.IFSP Meeting in Native Language c.Family Assessment d.IFSP Consent 1.Providing Written Prior Notice and Obtaining Consent for All Early Intervention Services Recommended by the IFSP Team 2.Declining Participation in ESIT: 3.Declining One or More Part C Services Recommended by the IFSP Team * * * * * * * * * * * Confirmation of Individualized Family Service Plan (IFSP) Schedule IFSP Agreement (ESIT Parent Rights) Declining Participation in the ESIT Program Declining One or More Early Intervention Services

16. 16 IFSP Activities Step 2 – IFSP Reviews: a.Written Notice of the IFSP Review Meeting b. IFSP Meetings in Native Language c.Written Prior Notice d.Ongoing Eligibility * * * * * * * * * * Confirmation of Individualized Family Service Plan (IFSP) Schedule Parent Written Prior Notice (ESIT Parent Rights) IFSP Review Agreement (ESIT Parent Rights) Notice & Consent for Evaluation/Assessment (ESIT Parent Rights)

17. 17 IFSP Activities Step 3 - Annual IFSP: a.Written Notice of the Annual IFSP Meeting b. IFSP Meetings in Native Language c.Written Prior Notice d.Ongoing Eligibility * * * * * * * * * * Confirmation of Individualized Family Service Plan (IFSP) Schedule Parent Written Prior Notice (ESIT Parent Rights) IFSP Agreement (ESIT Parent Rights)

18. 18 Transition Activities Step 1 - Transition Plan Step 2 – LEA Notification: a.Notification of children shortly reaching the age of eligibility for preschool special education b.Notification of children deemed potentially eligible for preschool special education (referral to Part B) Step 3 - Referral to Other Community Programs Step 4 - Transition Meeting: a. Part B Transition Meeting b.Other Transition Meeting * * * * * * * * Authorization for Release of Records Parent Written Prior Notice (ESIT Parent Rights)

19. 19 Systems Improvement Project Karen Walker, ESIT Program Administrator (360) 725-3516 Karen.Walker@del.wa.gov Kathy Grant-Davis ARRA Project Consultant (360) 725-3519 Kathryn.Grant-Davis@del.wa.gov Kathi Gillaspy, UNC (919) 843-5950 Kathi.Gillaspy@unc.edu Joicey Hurth, UNC (919) 962-7323 Joicey.Hurth@unc.edu Anne Lucas, UNC (804) 379-3833 alucas3@comcast.net

20. http://www.del.wa.gov/esit