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Early Steps Policy Handbook
7/1/2010

Federal imposed policy required by the IDEA Denotes a federal imposed policy required by the IDEA
State imposed policy not required by the IDEA Denotes a state imposed policy not required by the IDEA or federal regulation

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Component 1.0

General Supervision and Administration

Authority:

IDEA Sections 616, 631, 632, 634, 635, 637, 638, 640, 641

34 CFR Sections  80.25, 303.3, 303.100, 303.110, 303.111, 303.112, 303.124, 303.125, 303.128, 303.140, 303.142, 303.145, 303.160, 303.161, 303.162, 303.164, 303.165, 303.167, 303.168, 303.169, 303.170, 303.171, 303.172, 303.173, 303.174, 303.175, 303.176, 303.300, 303.320, 303.321, 303.322, 303.323, 303.340, 303.342, 303.343, 303.344, 303.345, 303.500, 303.501, 303.520, 303.521, 303.527, 303.528, 303.560, 303.600, 303.601, 303.602, 303.603, 303.604, 303.650, 303.651, 303.652, 303.653, 303.654

Florida Statutes 286.011, 391.301, 391.302, 391.303, 391.304, 391.305, 391.306, 391.307, 391.308, 393, 393.064

Intent:

These policies are intended to ensure that the State of Florida develops and implements a statewide, comprehensive, coordinated, multidisciplinary, interagency system to provide early intervention services and supports for infants and toddlers with disabilities and their families in accordance with the Individuals with Disabilities Education Act (IDEA), Part C, the Children’s Medical Services Developmental Evaluation and Intervention Program (ss. 391.301-391.308, Florida Statutes) and the Developmental Disabilities Program (Chapter 393, Florida Statutes).

Sections:

1.1.0

General Authority

Page 1

 

1.2.0

Requirements for a Statewide System

Page 2

 

1.3.0

State Application and Assurances

Page 6

 

1.4.0

Financial Policies and Procedures

Page 7

 

1.5.0

System of Payments

Page 10

 

1.6.0

Use of Public and Private Insurance

Page 11

 

1.7.0

State Interagency Coordinating Council

Page 15

 

1.8.0

Monitoring, Technical Assistance and Enforcement

Page 19

 

1.1.0 General Authority

Policy

Reference/Related Documents

Federal imposed policy required by the IDEA

1.1.1  The Florida Department of Health Children’s Medical Services (CMS) Early Steps State Office (ESSO) is the lead agency, appointed by the Governor, to administer and oversee the Individuals with Disabilities Education Act (IDEA), Part C in Florida.

34 CFR §303.142

34 CFR §303.500

34 CFR §303.501

391.308, F.S.

 

Federal imposed policy required by the IDEA

1.1.2  The ESSO is responsible for all necessary administrative functions to ensure statewide implementation of the early intervention system.

Operations Guide 1.1.2

34 CFR §303.145(b)

 

State imposed policy not required by the IDEA

1.1.3  Each Local Early Steps (LES) will implement the Developmental Evaluation and Intervention Program (DEI) to identify and serve at risk infants in the Neonatal Intensive Care Unit (NICU), based on the availability of funds. 

Policy Handbook 13.1.1

391.301, F.S.

391.302, F.S.

391.303, F.S.

391.304, F.S.

391.305, F.S.

391.306, F.S.

391.307, F.S.

State imposed policy not required by the IDEA

1.1.4  The ESSO will implement the State’s early intervention system for infants and toddlers from birth to age three who are eligible for services through Chapter 393, F.S.

391.308, F.S.

393.064(2), F.S.

 

 

 

1.2.0 Requirements for a Statewide System Under Part C of the IDEA

Policy

Reference/Related Documents

 

Federal imposed policy required by the IDEA

1.2.1  The ESSO will comply with Individuals with Disabilities Education Act (IDEA), Part C and meet the requirements outlined in 1.2.2 through 1.2.22 below.

IDEA §634

IDEA §635(a)(10)

 

 

Federal imposed policy required by the IDEA

1.2.2  The ESSO is responsible for defining the eligible population within the parameters set forth by the IDEA, Part C in order to appropriately identify infants and toddlers with disabilities who need early intervention services. 

Policy Handbook 3.1.0

IDEA §635(a)(1)

34 CFR §303.161

 

 

Federal imposed policy required by the IDEA

1.2.3  The ESSO will maintain an easily accessible, up-to-date, Central Directory of resources statewide to assist professionals and families with children with developmental delays and disabilities.  The ESSO will ensure that the Central Directory is accessible through the agency’s website or other appropriate means.

Policy Handbook 2.2.0

Policy Handbook 2.2.1

Operations Guide 1.2.3

IDEA §635(a)(7)

34 CFR §303.162

 

 

Federal imposed policy required by the IDEA

1.2.4  The ESSO will ensure compliance with the federal timelines related to eligibility determination, including evaluation and assessment, the Individualized Family Support Plan (IFSP), provision of services listed in the IFSP and the transition conference.

Policy Handbook 3.4.3

Policy Handbook 5.5.1

Policy Handbook 6.11.1

Policy Handbook 7.3.1

Policy Handbook 7.4.1

34 CFR §303.321
34 CFR §303.322

34 CFR §303.342

 

Federal imposed policy required by the IDEA

1.2.5  The ESSO will ensure that a systematic plan is in place for increasing public awareness and education about the availability of early intervention services and disseminating such information to parents with premature infants or infants with other physical risk factors associated with learning or developmental complications. 

Policy Handbook 2.1.0

Policy Handbook 2.1.3

IDEA §635(a)(6)

34 CFR §303.164

 

 

 

Federal imposed policy required by the IDEA

1.2.6  The ESSO will assure public participation in the State’s early intervention system by developing a plan to ensure:

A.      Meaningful involvement of underserved groups, including minority, low-income, homeless, and rural families and children with disabilities who are wards of the state, in the planning and implementation of all the requirements of Individuals with Disabilities Education Act (IDEA), Part C.

B.     These families have access to culturally competent services within their local geographical areas.

IDEA §637(b)(7)

34 CFR §303.128

 

 

State imposed policy not required by the IDEA

1.2.7  The ESSO will ensure that any external workgroup meetings convened to make recommendations about an issue impacting Early Steps and/or to take official actions will be declared a public meeting and open to the public at all times.

Operations Guide 1.2.7

286.011, F.S.

 

 

Federal imposed policy required by the IDEA

1.2.8  The ESSO will implement child find procedures to identify, locate, and evaluate children in need of early intervention services, which must be well coordinated with other federal programs as identified.

Policy Handbook 2.1.0

Policy Handbook 2.1.5

Operations Guide 1.2.8

IDEA §635(a)(5)

34 CFR §303.165

34 CFR §303.320(a)(b)(c)

34 CFR §303.321(a)(b)(c)(d)(e)

34 CFR §303.322(a)(b)(c)(d)(e)

 

 

Federal imposed policy required by the IDEA

1.2.9  The ESSO will ensure the development of criteria and nondiscriminatory procedures for determining eligibility of infant and toddlers.

Policy Handbook 3.4.5

34 CFR §303.300

34 CFR §303.323

 

Federal imposed policy required by the IDEA

1.2.10  The ESSO will ensure that the State’s Individualized Family Support Plan (IFSP) process and document meet the federal requirements as outlined in 34 CFR §§303.340, 303.342, 303.343, 303.344, and 303.345.

IDEA §635(a)(4)

34 CFR §303.167

 

 

Federal imposed policy required by the IDEA

1.2.11  The ESSO will ensure a comprehensive system of personnel development for the training of a variety of personnel needed to meet the requirements of the IDEA, Part C including public and private providers, referral source, paraprofessionals and service coordinators

Policy Handbook 10.1.2

IDEA §635(a)(8)

34 CFR §303.168

 

 

Federal imposed policy required by the IDEA

1.2.12  The ESSO will establish qualifications to ensure that personnel providing early intervention services are appropriately and adequately prepared and trained.

Policy Handbook 10.1.1

Policy Handbook 10.1.2

IDEA §635(a)(9)

IDEA §637(a)(3)(B)

34 CFR §303.169

 

Federal imposed policy required by the IDEA

1.2.13  The ESSO will ensure that families are adequately informed of their rights and that procedural safeguards are implemented throughout the early intervention process.

Policy Handbook 8.1.2

IDEA §635(a)(13)

34 CFR §303.170

 

 

Federal imposed policy required by the IDEA

1.2.14  The ESSO will ensure that any and all supervision and monitoring activities required of Individuals with Disabilities Education Act (IDEA), Part C are implemented.

IDEA §616

34 CFR §303.171

 

 

 

Federal imposed policy required by the IDEA

1.2.15  The ESSO will establish procedures for responding to complaints and resolving conflicts and will ensure the right to due process procedures for all families involved in the early intervention system.

Policy Handbook 8.1.1

Operations Guide 1.2.15

34 CFR §303.172

 

Federal imposed policy required by the IDEA

1.2.16  The ESSO shall provide assurance that early intervention programs at both the state and local level are operated based on acceptable standards of budgetary and fiscal management and that all individuals participating in the program understand and work in accordance with these procedures.

IDEA §637(b)(6)

34 CFR §303.125

 

Federal imposed policy required by the IDEA

1.2.17  The ESSO will establish and implement policies and procedures to assure the timely reimbursement of the costs of early intervention services and the method and rate of reimbursement.

IDEA §635(a)(12)

34 CFR §303.173

34 CFR §303.528

 

 

Federal imposed policy required by the IDEA

1.2.18  The ESSO will establish agreements or other appropriate written methods with other state agencies involved in the provision of services to families and children and/or the early intervention system in order to define financial responsibility for the provision of service, establish procedures for a timely resolution of disputes, and ensure effective cooperation and coordination.

 

Policy Handbook 11.1.1

IDEA §635(a)(10)(F)

34 CFR §303.174

 

 

 

Federal imposed policy required by the IDEA

1.2.19  The ESSO will determine the methods by which required State and federal information will be collected, maintained and reported to the Secretary. 

Policy Handbook 12.3.2 through 12.3.11

IDEA §635(a)(14)

34 CFR §303.176

 

Federal imposed policy required by the IDEA

1.2.20  The ESSO will develop policies and procedures pertaining to the contracting for, or make other arrangements with, public or private providers of early intervention services

IDEA §635(a)(11)

34 CFR §303.175

 

State imposed policy not required by the IDEA

1.2.21 The LES may hire direct service staff or contract on an annual basis with enrolled individuals or agencies that employ enrolled individuals in each service area throughout the state for the coordination, oversight and implementation of the Early Steps in the local area.

 

Operations Guide 1.2.21

 

 

State imposed policy not required by the IDEA

1.2.22    The ESSO will allocate funds annually to each LES based on the approved allocation formula in a lump sum that does not distinguish between funds for DEI or IDEA, Part C services.  It is the responsibility of the LES to budget funds in accordance with the approved contract budget to ensure provision of all Early Steps services.

 

Operations Guide 1.2.22

 

 

 

1.3.0  State Application and Assurances

Policy

Reference/Related Documents

 

Federal imposed policy required by the IDEA

1.3.1  In order to receive federal funds under IDEA, Part C the ESSO will submit to the U.S. Department of Education (U.S. DOE) an annual application, including any new or revised state policies addressing the minimum components of a statewide system under IDEA, Part C, a description of the use of funds and a statement of assurances, as outlined in the IDEA, Part C and instructed by the Office of Special Education Programs (OSEP).

IDEA §637

34 CFR §303.100

34 CFR §303.110

34 CFR §303.140

34 CFR §303.160

 

 

Federal imposed policy required by the IDEA

1.3.2  Prior to adopting a new or revised policy that is not in the current state application, the ESSO will:

A.      Publish the application or policy in a manner that will ensure circulation throughout the State of Florida for at least a 60-day period, with an opportunity for comment on the application or policy for a minimum of 30 days during that period.

B.     Hold public hearings, on the application or policy during the 60-day period, providing notice at least 30 days before the hearings are conducted.

IDEA §637

34 CFR §303.110

 

 

Federal imposed policy required by the IDEA

1.3.3  The ESSO will request the U.S. DOE/OSEP to waive compliance with the timelines in Policy Handbook 1.3.2 above, when it is determined that there are circumstances that would warrant such an exception and the timelines that will be followed provide an adequate opportunity for public participation and comment.

IDEA §637

34 CFR §303.110(b)

 

 

Federal imposed policy required by the IDEA

1.3.4  The ESSO will publish the hearing notice in newspapers or announce in other media, or both, with adequate coverage to notify the general public throughout the state, including individuals with disabilities and parents of infants and toddlers with disabilities, about the hearings and the opportunity to comment on the application or policy.

IDEA §637(a)(8)

34 CFR §303.111

 

 

Federal imposed policy required by the IDEA

1.3.5  The hearing notice will be in sufficient detail to inform the public about:

A.      The purpose and scope of the state application or policy, and its relationship to Individuals with Disabilities Education Act (IDEA), Part C.

B.     The length of the comment period and the date, time, and location of each hearing.

C.     The procedures for providing oral comments or submitting written comments.

IDEA §637

34 CFR §303.111

 

 

Federal imposed policy required by the IDEA

1.3.6  The ESSO will hold public hearings in a sufficient number and at times and places that afford interested parties throughout the state a reasonable opportunity to participate.

IDEA §637

34 CFR §303.112

 

 

Federal imposed policy required by the IDEA

1.3.7  Before adopting the State application, and before adopting a new or revised policy not contained within the application, the ESSO will:

A.     Review and consider all public comments.

B.     Make any modifications it deems necessary in the application or policy.

IDEA §637

34 CFR §303.110

 

 

Federal imposed policy required by the IDEA

1.3.8  When submitting the State's application or policy to the U.S. DOE/OSEP, the ESSO will include copies of news releases, advertisements, and announcements used to provide notice to the general public, including individuals with disabilities and parents of infants and toddlers with disabilities.

IDEA §637

34 CFR §303.110

 

 

 

1.4.0  Financial Policies and Procedures

Policy

Reference/Related Documents

 

Federal imposed policy required by the IDEA

1.4.1  Individuals with Disabilities Education Act (IDEA), Part C funds will not be used to supplant existing state and local funds.

IDEA §637(b)(5)

34 CFR §303.124

 

 

Federal imposed policy required by the IDEA

1.4.2 

A.      Individuals with Disabilities Education Act (IDEA), Part C funds shall not be used to satisfy a financial commitment for services that would otherwise have been paid for from another public or private source, including any medical program administered by the Secretary of Defense.   

B.     Individuals with Disabilities Education Act (IDEA), Part C funds may be used for direct services for eligible children and their families that are not otherwise provided from other public or private sources.

Operations Guide 1.4.2

IDEA §637(b)(5)(B)

IDEA §638(1)

IDEA §640(a)

34 CFR §303.3

34 CFR §303.527(a)

 

 

Federal imposed policy required by the IDEA

1.4.3  As Florida receives IDEA, Part C funds, any child determined eligible for IDEA, Part C must receive early intervention services authorized on the IFSP and continue to receive those services until the IFSP team determines that the services are no longer necessary to meet the child and family's developmental outcomes or until the child’s third birthday, whichever comes first.

Policy Handbook 6.1.2

Policy Handbook 6.1.3

Operations Guide 1.4.3

IDEA §631(b)(1)

IDEA §631(b)(2)

IDEA §631(b)(3)

IDEA §637

34 CFR §303.100

34 CFR §303.110

34 CFR §303.140

34 CFR §303.160

 

State imposed policy not required by the IDEA

1.4.4  The LES or service provider must bill public or private sources or third party payer for direct services for eligible children and their families unless the family denies permission for reasons specified in Policy Handbook 1.6.9 and documents such reasons on Form CMS-ES 1064-Use of Private Insurance.  LES or service providers shall not collect Individuals with Disabilities Education Act (IDEA), Part C funds for direct services unless third party collection is denied by the third party payer, and written evidence of denial is on file with the service provider.  The provider will be reimbursed in accordance with contract specifications.

Policy Handbook 1.6.9

Operations Guide 1.4.4

 

Form CMS-ES 1064-Use of Private Insurance - English

 

Form CMS-ES 1064-Use of Private Insurance - Spanish

 

Form CMS-ES 1064-Use of Private Insurance - Creole

 

State imposed policy not required by the IDEA

1.4.5  The order in which funding for services are to be sought is as follows: 

A.       Commercial insurance

B.      Medicaid

C.      Community funding

D.      Other state program funds

E.      Other federal program funds

F.       IDEA, Part C funds

 

 

Federal imposed policy required by the IDEA

1.4.6  Individuals with Disabilities Education Act (IDEA), Part C funds may be used to pay for the provision of services and supports when:

A.      The responsible entity fails to provide or pay for services that have been authorized by the IFSP.

B.     The determination of payment responsibility has not been made and services must be provided prior to such a determination.

C.     It is necessary to prevent a delay in the timely provision of services to eligible infants and toddlers and their family

1.      Early intervention services and supports.

2.      Other functions and services authorized under Individuals with Disabilities Education Act (IDEA), Part C, including child find and evaluation and assessment.

3.      Eligible health services.

After the determination of payment responsibility has been made, the Local Early Steps will seek reimbursement of the interim payment, to the maximum possible, by the responsible entity for the IDEA, Part C funds previously expended. 

Operations Guide 1.4.6

IDEA §640(a)

IDEA §640(b)(2)(A)

IDEA §640(b)(2)(B)

34 CFR §303.527(b)(1)(2)

 

 

 

Federal imposed policy required by the IDEA

1.4.7  Individuals with Disabilities Education Act (IDEA), Part C funds can be appropriately used as the payor of last resort to ensure that early intervention services are provided in the natural environment if a third party payer does not cover the provision of a particular early intervention service in the setting specified to be the natural environment on the Individualized Family Support Plan (IFSP).

Operations Guide 1.4.7

IDEA §640(a)

IDEA §640(b)(2)(A)

34 CFR §303.3

34 CFR §303.527(b)(1)(2)

 

Federal imposed policy required by the IDEA

1.4.8  Individuals with Disabilities Education Act (IDEA), Part C funds may be used to expand and improve on early intervention services for eligible children and their families that are not otherwise provided from other public or private sources.

IDEA §638(2)

34 CFR §303.3

 

 

Federal imposed policy required by the IDEA

1.4.9  The ESSO may use funds under IDEA, Part C that are reasonable and necessary for administering the early intervention program for infants and toddlers with disabilities.

34 CFR §303.3

34 CFR §303.560

 

 

Federal imposed policy required by the IDEA

1.4.10  Individuals with Disabilities Education Act (IDEA), Part C funds may be used to pay co-payments and deductibles to third party payers for authorized services when necessary for the child and family to access services, as identified on the IFSP.

Operations Guide 1.4.10

34 CFR §303.520(b)(3)

 

 

 

Federal imposed policy required by the IDEA

1.4.11    Individuals with Disabilities Education Act (IDEA), Part C funds appropriated for Early Steps that are not fully expended in the year in which they were appropriated will “roll forward” and become available to Early Steps during the subsequent fiscal year. 

Operations Guide 1.4.11

34 CFR §303.145

 

 

Federal imposed policy required by the IDEA

1.4.12    Policies related to how services to IDEA, Part C eligible children and their families will be paid must be reflected in the interagency agreements required in Policy Handbook 11.2.1 and 11.2.2.

34 CFR §303.520(a)(2)

 

Federal imposed policy required by the IDEA

1.4.13

A.      Proceeds from public or private insurance will not be treated as program income for purposes of 34 CFR §80.25.

B.     If the LES spends reimbursement from federal funds, e.g. Medicaid, those funds are not considered to be in contradiction of Policy Handbook 1.4.1.

34 CFR §303.520(d)(1)(2)

 

 

Federal imposed policy required by the IDEA

1.4.14 The ESSO as the IDEA, Part C Lead Agency, will not construe any provision in the IDEA Part C statute or regulations as permitting the state to reduce medical or other assistance available or to alter eligibility under Title V of the Social Security Act (SSA) (relating to maternal and child health) or Title XIX of the SSA (relating to Medicaid for children eligible under this part) within the state.

34 CFR §303.527(c)

 

1.5.0  System of Payments

 

Policy

Reference/Related Documents

 

Federal imposed policy required by the IDEA

1.5.1  The Early Steps system of payments does not include a schedule of sliding fees but includes the use of public and private insurance as outlined in section Policy Handbook 1.6.0.

IDEA §632(4)(B)

34 CFR §303.520(b)(2)

34 CFR §303.521(A)

 

 

 

Federal imposed policy required by the IDEA

1.5.2  The Early Steps system will ensure that:

A.      Fees will not be charged for the services that a child is otherwise entitled to receive at no cost to the parents.

B.     The inability of the parents to pay for services will not result in the denial of services to the child or the child’s family.

34 CFR §303.520(b)(1)(2)(3)(4)

 

Federal imposed policy required by the IDEA

1.5.3  No services that a child is entitled to receive are delayed or denied because of disputes between agencies regarding financial or other responsibilities.

34 CFR §303.520(c)

 

Federal imposed policy required by the IDEA

1.5.4  The ESSO will not charge fees to parents for the following services and supports:

A.      Implementation of the child find requirements.

B.     Evaluation and assessment.

C.     Service coordination.

D.     Administrative and coordinative activities related to:

1.  The development, review and evaluation of IFSPs.

2.  The implementation of procedural safeguards and the other components of the statewide system of early intervention services.

 

IDEA §632(4)(B)

34 CFR §303.521(b)

 

 

 

Federal imposed policy required by the IDEA

1.5.5  The LES will discuss with each family the use of their insurance to pay for early intervention services.  This discussion must include determin­ing whether the family will incur a financial loss if their insurance is used to pay for these services. 

IDEA §632(4)(B)

 

 

1.6.0  Use of Public and Private Insurance

Policy

Reference/Related Documents

 

State imposed policy not required by the IDEA

1.6.1  A LES representative will discuss with each family the use of their insurance.  This discussion may include the following:

A.      Obtaining written consent/refusal from the family to bill insurance.

B.     Reviewing the family’s insurance booklet to determine coverage information.

C.     Contacting or assisting the family in contacting the insurance company by phone to determine whether or not a provider is available, able to provide services in the natural environment and covered under the insurance plan.

D.     Explaining Early Steps policy regarding payment of services.

E.     Documenting all correspondences in the child’s Early Steps record

Operations Guide 1.6.1

 

State imposed policy not required by the IDEA

1.6.2  When there is indication that public and/or private insurance is available to cover an IFSP authorized service, the LES must not reimburse a provider for that service unless denial of payment by the insurance company has been documented in writing on company letterhead or an Explanation of Benefits (EOB), in accordance with contract specifications.  When a denial, EOB or written statement, is not in the Early Steps record, the record must contain documentation of all reasonable attempts to obtain these documents.

Operations Guide 1.6.2

 

State imposed policy not required by the IDEA

1.6.3  When the family consents to bill its private or public insurance, the service provider must pursue all insurance denials of service coverage unless the insurance company’s policy is very clear and it has been confirmed that a particular service is not covered or is only covered for a specific number of sessions.

Operations Guide 1.6.3

 

State imposed policy not required by the IDEA

1.6.4  Documentation of payment denial by the insurance company is not required when the IFSP indicates that the public/private insurance company will not be billed for services.  There must be documentation in the Early Steps record as to the circumstances that led to the decision not to access the family’s insurance. 

 

 

State imposed policy not required by the IDEA

1.6.5  When there are difficulties obtaining payment from public and private insurance companies for services that are appropriate for coverage, the LES must obtain all relevant information and assist/instruct the family in filing an appeal with the insurance company.

Operations Guide 1.6.5

 

State imposed policy not required by the IDEA

1.6.6  If the LES receives no response from the insurance company or a pattern of denied claims is established, the LES will forward all relevant documentation related to the claim to the ESSO program manager for their service area. The ESSO will submit information to the Agency for Health Care Administration or the Office of Insurance Regulation (OIR), for investigation as appropriate.

 

 

State imposed policy not required by the IDEA

1.6.7  Disallowance of payment for failure of the provider to follow proper billing procedures, incorrect diagnosis code or other correctable reasons for disallowance by public and private insurance will not constitute grounds for payment from Early Steps funds.  

 

 

Federal imposed policy required by the IDEA

1.6.8  While services must not be delayed or denied because of disputes regarding financial or other responsibilities, the LES will not be responsible for payment to the service provider because the parent(s) refused payment of benefits to the service provider when the family has allowed access to their insurance and the insurance company has paid the parent directly. 

The LES must ensure service provision is continued, in such case, this may require the use of another service provider when the current provider refuses to continue services.  

Operations Guide 1.6.8

34 CFR §303.520(c)

 

 

Federal imposed policy required by the IDEA

1.6.9  The family may choose not to have their insurance accessed when:

A.      Use of insurance would significantly decrease available lifetime coverage or decrease any other insured benefit(s).

B.     Use of insurance would increase premiums or lead to the discontinuation of insurance.

 

34 CFR §303.520

 

 

State imposed policy not required by the IDEA

1.6.10  Documentation of family’s consent or denial to bill insurance will be recorded on form CMS-ES 1064-Use of Private Insurance.

Form CMS-ES 1064-Use of Private Insurance - English

Form CMS-ES 1064-Use of Private Insurance - Spanish

Form CMS-ES 1064-Use of Private Insurance - Creole

 

State imposed policy not required by the IDEA

1.6.11  A family may not deny access to insurance:

A.      In order to “save” benefits until after the child turns three years of age.

B.     When the child/family is enrolled in the Medicaid program and the service is a Medicaid billable service.

C.     When the child is enrolled only in the DEI component of Early Steps.

D.     When the child is enrolled in the CMS Network

 

 

Use of Medicaid

 

State imposed policy not required by the IDEA

1.6.12  The LES and service providers must enroll with the state Medicaid program and request payment for services in accordance with all Medicaid rules, including those pertaining to service authorizations, in order to access Medicaid funds for all covered services provided to Medicaid enrolled families, including targeted case management, DME, therapies and early intervention services.

Policy Handbook 8.5.6H

Operations Guide 1.6.12

 

Florida Medicaid Early Intervention Services Coverage and Limitations Handbook

 

Florida Medicaid Therapy Services Coverage and Limitations Handbook

 

Federal imposed policy required by the IDEA

1.6.13  Individuals with Disabilities Education Act (IDEA), Part C  funds cannot be used to duplicate or supplement payments made by Medicaid.  Service providers must agree to accept Medicaid payment rate as payment in full for the service authorized by the IFSP.

34 CFR §303.527(a)

 

 

 

State imposed policy not required by the IDEA

1.6.14  Service providers can not request additional funds from families to supplement established Medicaid and ESSO rates, including Medicaid HMO rates.

Operations Guide 1.6.14

 

State imposed policy not required by the IDEA

1.6.15  The ESSO will fund services based on the prevailing State of Florida Medicaid rate for services, when such a rate has been established. 

Florida Medicaid Early Intervention Services Coverage and Limitations Handbook

 

Florida Medicaid Therapy Services Coverage and Limitations Handbook

 

State imposed policy not required by the IDEA

1.6.16  When there is not an established Medicaid rate for a specific service, the ESSO  may establish and use a payment rate for the service.

 

Operations Guide 1.6.16

 

State imposed policy not required by the IDEA

1.6.17 For services that have no standard rate of payment and no rate shown on the Early Steps Service Code Taxonomy, the rate of payment will be the rate entered by the service provider and reported on the fiscal report which must not exceed 60% of the usual and customary charge for the service. 

 

 

 

1.7.0  State Interagency Coordinating Council

Policy

Reference/Related Documents

 

Federal imposed policy required by the IDEA

1.7.1  The ESSO will establish and maintain a statewide, interagency coordinating council to assist and advise the ESSO in coordinating activities for the planning and implementation of the IDEA, Part C component of Early Steps.

IDEA §641(a)(1)
34 CFR §303.600

 

 

Federal imposed policy required by the IDEA

1.7.2  Members of the council, known as the Florida Interagency Coordinating Council for Infants and Toddlers (FICCIT), must be appointed by the Governor and membership must reasonably represent the population of the state.

IDEA §641(a)(2)

34 CFR §303.600(b)

 

 

Federal imposed policy required by the IDEA

1.7.3  The Governor shall designate a member of FICCIT,  to serve as the chairperson of the council or require FICCIT to do so. Any member of FICCIT who is a representative of the ESSO may not serve as the chairperson of the council.    

IDEA §641(a)(3)

34 CFR §303.600(c)

 

 

Federal imposed policy required by the IDEA

1.7.4  The composition of FICCIT must include the following:

A.      At least 20 percent of the members must be parents, including minority parents of infants or toddlers with disabilities or children with disabilities aged 12 or younger, with knowledge of, or experience with, programs for infants and toddlers with disabilities.

B.     At least one member must be a parent of an infant or toddler with a disability or a child with a disability aged six years or younger. 

C.     At least 20 percent of the members must be public or private providers of early intervention services and supports.

D.     At least one member must be from the Florida Legislature.

E.     At least one member must be involved in personnel preparation.

F.      At least one member must be from each of the state agencies involved in the provision of, or payments for, early intervention services and supports to infants and toddlers with disabilities and their families and have sufficient authority to engage in policy planning and implementation on behalf of these agencies.

G.     At least one member must be from the state educational agency responsible for preschool services to children with disabilities and have sufficient authority to engage in policy planning and implementation on behalf of that agency.

H.     At least one member must be from the agency responsible for the state regulation of health insurance.

I.         At least one member must be from a Head Start agency or program in the state.

J.       At least one member must be from a state agency responsible for child care.

K.     At least one member must be from the agency responsible for the state Medicaid program.

L.      At least one member must be a representative designated by the Office of the Coordinator for Education of Homeless Children and Youth.

M.     At least one member must be a representative from the state child welfare agency responsible for foster care.

N.     At least one member must be a representative from the state agency responsible for children’s mental health.

IDEA §641(b)

34 CFR §303.601

 

 

Federal imposed policy required by the IDEA

1.7.5  FICCIT may also include other members selected by the Governor, including a representative from the Bureau of Indian Affairs (BIA) or where there is no school operated or funded by the BIA, from the Indian Health Service or the tribe or tribal council. The Governor may appoint one member to represent more than one agency.

IDEA §641(b)(2)

34 CFR §303.601(b)

 

 

Federal imposed policy required by the IDEA

1.7.6  FICCIT shall meet at least quarterly and in such places as it deems necessary.  The FICCIT meetings must:

A.      Be publicly announced sufficiently in advance of the dates they are to be held to ensure that all interested parties have an opportunity to attend.

B.     To the extent possible, be open and accessible to the general public.

C.     Provide interpreters for persons who are deaf and other necessary services, both for FICCIT members and participants.  

IDEA §641(c)

34 CFR §303.603(a)(b)(1)(2)(c)

 

 

Federal imposed policy required by the IDEA

1.7.7  Subject to the approval of the governor, FICCIT may prepare and approve a budget using funds under Individuals with Disabilities Education Act (IDEA), Part C to:

A.      Conduct hearings and forums.

B.     Reimburse members of FICCIT for reasonable and necessary expenses for attending council meetings and performing council duties (including child care for parent representatives).

C.     Pay compensation for a FICCIT member if the member is not employed or must forfeit wages from other employment when performing official FICCIT business.

D.     Hire staff.

E.     Obtain the services of professional, technical and clerical personnel as may be necessary to carry out the performance of its functions under Individuals with Disabilities Education Act (IDEA), Part C.

F.      Obtain interpreters for persons who are deaf and other necessary services for FICCIT members and participants who attend the meetings. 

Operations Guide 1.7.7

IDEA §641(d)

34 CFR §303.602

34 CFR §303.603(c)

 

 

 

Federal imposed policy required by the IDEA

1.7.8  The functions of FICCIT shall include the following:

A.        Advise and assist the ESSO in the development and implementation of the policies that constitute the statewide system.

B.       Assist the ESSO in achieving the full participation, coordination and cooperation of all appropriate public agencies in the state.

C.       Assist the ESSO in the effective implementation of the statewide system, by establishing a process that includes (a) seeking information from service providers, service coordinators, parents and others about any federal, state or local policies that impede timely service delivery; (b) taking steps to ensure that any policy problems identified are resolved.

D.      Assist the ESSO, to the extent appropriate, in the resolution of disputes.

E.        Advise and assist the ESSO regarding the provision of appropriate services for children aged birth to three years.

F.        Advise appropriate agencies in the state with respect to the integration of services for infants and toddlers with disabilities and at-risk infants and toddlers and their families, regardless of the eligibility of at-risk infants and toddlers for early intervention services and supports in the state.  

G.       Advise and assist the ESSO in the identification of sources of fiscal and other support for services for early intervention programs.

H.        Advise and assist the ESSO in the assignment of financial responsibility to the appropriate agency.

I.           Advise and assist the ESSO in the promotion of the interagency agreements.

J.        Advise and assist the ESSO in the preparation of applications and amendments to those applications.

K.       Advise and assist the state educational agency regarding the transition of toddlers with disabilities to preschool and other appropriate services.

L.        Prepare an annual report to the governor and U.S. DOE secretary on the status of early intervention programs for infants and toddlers with disabilities and their families operated within the state.

M.     Submit the report to the U.S. DOE secretary by a date that the secretary establishes that contains the information required by the secretary for the year for which the report is made.

IDEA §641(e)

IDEA §641(e)(2)

34 CFR §303.650

34 CFR §303.651

34 CFR §303.652

34 CFR §303.653

34 CFR §303.654

 

 

 

Federal imposed policy required by the IDEA

1.7.9  No member of FICCIT may cast a vote on any matter that is likely to provide direct financial benefit to that member or otherwise give the appearance of a conflict of interest.

IDEA §641(f)

34 CFR §303.604

 

Federal imposed policy required by the IDEA

1.7.10  FICCIT members shall serve without compensation from funds available under IDEA, Part C, except as allowed in Policy Handbook 1.7.7 above.

IDEA §641(d)

34 CFR §303.602

 

 

1.8.0 Monitoring, Technical Assistance and Enforcement

Policy

Reference/Related Documents

Monitoring

Federal imposed policy required by the IDEA

1.8.1  ESSO will monitor LES, using quantifiable and qualitative indicators to adequately measure performance, in the areas of child find and transition services and any others specified by U.S. DOE/OSEP.

Operations Guide 1.8.1

IDEA §616(a)(3)(B)

 

 

Federal imposed policy required by the IDEA

1.8.2  ESSO monitoring of LES will focus on IDEA, Part C State Performance Plan indicators and improving early intervention results and functional outcomes for infants and toddlers with developmental delays and disabilities and their families. 

IDEA §616(a)(2)

 

Federal imposed policy required by the IDEA

1.8.3  The ESSO will monitor LES using quantifiable and qualitative indicators to adequately measure performance standards as specified in the LES contract and collect valid and reliable information as needed to report annually to the U.S. DOE/OSEP.

IDEA §616(a)(3)(B)

IDEA §616(b)(2)(B)(i)

 

Federal imposed policy required by the IDEA

1.8.4  The ESSO will collect data through monitoring or sampling. 

IDEA §616(b)(2)(B)(i)

 

State imposed policy not required by the IDEA

1.8.5  The ESSO monitoring of LES will be done through Quality Assurance Reviews on at least annual basis in accordance with the provisions of Early Steps Continuous Improvement Process and policies, as specified in the LES contract.          

 

State imposed policy not required by the IDEA

1.8.6  The ESSO monitoring of LES will include analyzing performance and compliance trends across LES and statewide. The analysis will serve as the basis for decision-making regarding personnel development and training needs, resource allocation, statewide and local technical assistance, implementation of incentives and enforcement actions, determinations and policy revision and clarification. The analysis will include a review of the following information:  

A.      Progress towards the State Performance Plan (SPP) targets.

B.     Status of implementation of the team-based Primary Service Provider model.

C.     Identified training needs.

D.     Dispute resolution issues.

E.     Feedback from families.

F.      Results of Quality Assurance monitoring.

G.     Timely correction of noncompliance.

 

Federal imposed policy required by the IDEA

1.8.7  LES found out-of-compliance through monitoring activities will be required to correct noncompliance as soon as possible but no later than one year of identification.

Operations Guide 1.8.7

IDEA §616

 

State imposed policy not required by the IDEA

1.8.8  Each LES will monitor local service providers using, at a minimum, the quantifiable and qualitative local performance standards specified in the LES contract.

 

Federal imposed policy required by the IDEA

1.8.9  Any LES that does not correct noncompliance within one year of notification will be subject to sanctions which may include, but not be limited to:  increased reporting requirements, participation in mandatory training, and completion of correction activities to address the compliance issue(s).  Enforcement procedures are specified in the LES contract.

Former 34 CFR §300.575/Current 34 CFR 300.626

 

State imposed policy not required by the IDEA

1.8.10  The ESSO will ensure that statewide recognition is provided to those LES demonstrating highest levels of performance and compliance. 

 

State imposed policy not required by the IDEA

1.8.11  The ESSO shall provide technical assistance to all LES, with a special emphasis on those LES demonstrating noncompliance. The ESSO shall customize the technical assistance provided based on the causal factors and identified needs for each LES to improve performance and to achieve or maintain compliance. Technical assistance will be provided in the form of on-site visits, review and feedback on documentation submitted by LES, conference calls with LES, facilitation of training, policy clarification, and connecting the LES to available expertise. 

 

State imposed policy not required by the IDEA

1.8.12  LES with noncompliance will develop a plan for improvement which includes strategies that will be implemented to ensure that noncompliant practices are corrected as soon as possible, but no later than within one year of identification. Requirements and timelines for improvement development and submission of updates will be included in the contracts with each LES. Timelines for achievement will be included in the improvement plan and tracked quarterly.

 

State imposed policy not required by the IDEA

1.8.13  LES will adhere to monitoring activities and continuous improvement procedures outlined by the ESSO and specified in the LES contract.

Operations Guide 1.8.13

State Performance Plan

Federal imposed policy required by the IDEA

1.8.14  The ESSO shall monitor implementation of the Early Steps program through the State Performance Plan. The State Performance Plan shall evaluate statewide efforts to implement the requirements of IDEA, Part C and describe how the state will improve such implementation.

IDEA §616(b)(1)

 

Federal imposed policy required by the IDEA

1.8.15  The State Performance Plan must establish measurable and rigorous targets for the priority areas specified in Policy Handbook 1.8.1 and any others specified by U.S. DOE/OSEP.

IDEA §616(b)(2)(A)

 

Federal imposed policy required by the IDEA

1.8.16  The ESSO will monitor, enforce and annually report on the implementation of the state’s early intervention system in accordance with IDEA, Part C by LES.

IDEA §616(a)(1)

 

Federal imposed policy required by the IDEA

1.8.17  The ESSO will submit the IDEA, Part C State Performance Plan and Annual Performance Report to the U.S. DOE/OSEP for approval in accordance with the approval process outlined in IDEA, Part C and instruction of OSEP. 

IDEA §616(b)(1)(B)

 

Federal imposed policy required by the IDEA

1.8.18  The ESSO will review the State Performance Plan at least once every six years and submit any amendments to U.S. DOE/OSEP.

Operations Guide 1.8.18

IDEA §616(b)(1)(C)

 

Federal imposed policy required by the IDEA

1.8.19  The ESSO will evaluate and report annually to the public on the performance of each LES in a manner that will not disclose personally identifiable information about individual children. 

IDEA §616(b)(2)(C)(ii)(I)

 

Federal imposed policy required by the IDEA

1.8.20  The ESSO will also ensure that the Individuals with Disabilities Education Act (IDEA), Part C State Performance Plan is made available to the public through public means, including posting on the Early Steps website, distribution to the media and through public agencies.

IDEA §616(b)(2)(C)(ii)(I)

 

Federal imposed policy required by the IDEA

1.8.21  The ESSO will report annually to the U.S. DOE/OSEP on the performance of the state under the State Performance Plan in a manner that will not disclose personally identifiable information about individual children or where the data is insufficient to yield statistically reliable information.

IDEA §616(b)(2)(C)(ii)(II)

 

Federal imposed policy required by the IDEA

1.8.22  RESERVED

 

Determination

Federal imposed policy required by the IDEA

1.8.23  The ESSO shall make determination annually about the performance of each LES and take the required actions as outlined in IDEA, Part C, based on information provided by LES in the State Performance Plan, obtained through monitoring and other public information. The determination(s) given to the LES shall include:

A.      Meets the requirements and purposes.

B.     Needs assistance.

C.     Needs intervention.

D.     Needs substantial intervention in implementing the requirements of IDEA, Part C.

Operations Guide 1.8.23

IDEA §616(d)

 

 


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