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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 6.0

Early Intervention Services and Supports

Authority:

IDEA Sections 602, 631, 632, 635, 636, 637, 639

34 CFR Sections 303.12, 303.13, 303.128, 303.322, 303.340, 303.343, 303.344, 303.403, 303.525

Florida Statutes 1003.575

Intent:

These policies are intended to ensure that early intervention services and supports appropriately meet the needs of each child and family residing in Florida who are eligible for IDEA, Part C.

Sections:

6.1.0

General Requirements

Page 1

 

6.2.0

Team Based Primary Service Provider

Page 5

 

6.3.0

Consultation

Page 5

 

6.4.0

Assistive Technology

Page 6

 

6.5.0

Health Services

Page 8

 

6.6.0

Medical Services

Page 8

 

6.7.0

Respite

Page 8

 

6.8.0

Early Childhood Education

Page 10

 

6.9.0

Plan of Care

Page 10

 

6.10.0

Reserved

Page 10

 

6.11.0

Timeliness of Early Intervention Services and Supports

Page 11

 

6.12.0

Requirements for Children/Families with Inactive Status

Page 11

 

6.1.0 General Requirements

Policy

Reference/Related Documents

Federal imposed policy required by the IDEA

 

6.1.1 ESSO and LES must ensure the availability of the following services to eligible children and their families: 

A.      Assistive Technology Devices and Services

B.     Audiology

C.     Family Training, Counseling, and Home Visits  (Early Intervention Sessions)

D.     Health Services

E.     Medical Services

F.      Nursing Services

G.     Nutrition Services

H.     Occupational Therapy

I.         Physical Therapy

J.       Psychological Services (including mental health and behavioral services)

K.     Respite

L.      Service Coordination

M.     Sign Language and Cued Language

N.     Social Work Services

O.    Special Instruction

P.     Speech Language Pathology

Q.    Translation/Interpretation

R.     Transportation and related costs

S.     Vision Services

T.      Other services necessary to meet IFSP outcomes.

Operations Guide 6.1.1

IDEA §632(4)(E)

IDEA §637(a)(3)(B)

 

Federal imposed policy required by the IDEA

6.1.2 Early intervention services and supports must be determined by the IFSP team.

 

Policy Handbook 5.3.6

Operations Guide 6.1.2

IDEA §632(4)(C)

Federal imposed policy required by the IDEA

6.1.3 LES must ensure that all services authorized by the IFSP team are provided to the child/family.

 

Policy Handbook 1.4.3

Operations Guide 6.1.3

IDEA §631(b)(1)

IDEA §631(b)(2)

IDEA §631(b)(3)

Federal imposed policy required by the IDEA

6.1.4 To the maximum extent appropriate to meet the needs of the child, early intervention services and supports must be provided in natural environments and within the context of everyday daily routines, activities and places.

Policy Handbook 5.3.7

Policy Handbook 5.3.14

Operations Guide 6.1.4

IDEA §632(4)(G)

 

Federal imposed policy required by the IDEA

6.1.5 The IFSP team, which includes the family, may decide that outcomes cannot be achieved satisfactorily for the infant or toddler in a natural environment and the justification for this decision must be on the IFSP.

Policy Handbook 5.3.7

Operations Guide 6.1.5

IDEA §635(a)(16)(B)

IDEA §636(d)(5)

 

Federal imposed policy required by the IDEA

6.1.6 Any justification for services provided outside of the child's everyday routines, activities, and places must be directly related to the child's outcomes, reflect the needs of the child and family, and be documented on the IFSP.

Operations Guide 6.1.6

IDEA §635(a)(16)(B)  

IDEA §636(d)(5)

IFSP Instructions, Form G

Federal imposed policy required by the IDEA

6.1.7 Early intervention services and supports must meet the standards of the state and be designed to meet the developmental needs of an infant or toddler with a disability in any one or more of the following domains:

A.      Physical development

B.     Cognitive development

C.     Communication development

D.     Social or emotional development

E.     Adaptive development.

Operations Guide 3.5.2

IDEA §632(4)(C)

IDEA §632(4)(D)

34 CFR §303.12

 

Federal imposed policy required by the IDEA

6.1.8 Early intervention services and supports must be provided by qualified personnel.

Policy Handbook 10.3.1

IDEA §632(4)(A)

Federal imposed policy required by the IDEA

6.1.9 Early intervention services and supports must be provided at no cost to the family except in accordance with the state’s system of payment. 

Policy Handbook 1.5.1

Policy Handbook 1.5.5

IDEA §632(4)(B)

 

Federal imposed policy required by the IDEA

6.1.10 Early intervention services and supports must be provided in a way that enhances family/caregiver competence, confidence and capacity to meet their child’s developmental needs and desired outcomes.

Operations Guide 6.1.10

IDEA §636(a)(2)

 

Federal imposed policy required by the IDEA

6.1.11 Each LES will be assigned a geographic area of the state so that resources under the IDEA, Part C will be available for all geographic areas of the state.

IDEA §637(a)(7)

 

State imposed policy not required by the IDEA

6.1.12 A child may be enrolled in only one LES at any given time.

Operations Guide 6.1.12

Federal imposed policy required by the IDEA

6.1.13 The IFSP team will ensure that services are necessary to meet the unique needs of the child and family.

Policy Handbook 5.3.6
Operations Guide 6.1.13

34 CFR §303.12

Federal imposed policy required by the IDEA

6.1.14 LES must have culturally competent services available.

Operations Guide 6.1.14

34 CFR §303.128(b)    

Federal imposed policy required by the IDEA

6.1.15 Early intervention services and supports must be based on the priorities, concerns and resources of the family as well as the evaluation and assessment results.

Policy Handbook 5.1.1

Policy Handbook 5.3.2

34 CFR §303.322(b)(2)(ii)

34 CFR §303.340(b)(2)

Federal imposed policy required by the IDEA

6.1.16 Early intervention services and supports decisions must not be based solely on the following:

A.      A specific diagnosis

B.     Provider/therapist bias

C.     Nature or severity of disability

D.     Age of child

E.     Availability of services

F.      Availability of space

G.     Administrative convenience

H.     Payment method or amount

I.         Preference of any single IFSP team member.

34 CFR §303.322(b)(2)(ii)

34 CFR §303.340(b)(2)

 

Federal imposed policy required by the IDEA

6.1.17 Early intervention services must be based on scientifically based research, to the extent practicable, are available to all infants and toddlers with disabilities and their families, including Indian infants and toddlers with disabilities and their families residing on a reservation geographically located in the state and infants and toddlers with disabilities who are homeless children and their families.

IDEA §635(a)(2)

State imposed policy not required by the IDEA

6.1.18 The minimum frequency and intensity of supports and services necessary to achieve progress toward an identified outcome must be used as the initial point of consideration by the IFSP team. 

Operations Guide 6.1.18

Federal imposed policy required by the IDEA

6.1.19 The IFSP team must not reduce the level of services to a family based on services the family has accessed outside the IFSP process using the family’s own resources.

Operations Guide 6.1.19

34 CFR §303.343

34 CFR §303.344(d)(e)

 

 

6.2.0  Team-Based Primary Service Provider

Policy

Reference/Related Documents

State imposed policy not required by the IDEA

6.2.1 All LES must implement a team-based primary service provider approach to service delivery.

Operations Guide 6.2.1

State imposed policy not required by the IDEA

6.2.2 The IFSP team must select a team member as the (Primary Service Provider) PSP for all children receiving direct services from Early Steps.

Policy Handbook 5.3.15

Operations Guide 6.2.2

 

State imposed policy not required by the IDEA

6.2.3 The IFSP team must ensure that each child is supported by a team of individuals who have expertise necessary to meet the needs of the child and family. The team members will work together to provide support and direction to one another.

Operations Guide 3.2.7

Operations Guide 6.2.3

 

State imposed policy not required by the IDEA

6.2.4 The IFSP team will have specialists available, as appropriate, to address the individualized needs of infants and toddlers served.

 

Operations Guide 6.2.4

 

6.3.0 Consultation

Policy

Reference/Related Documents

State imposed policy not required by the IDEA

6.3.1 The date and time of the consultation must be shared with the family prior to the meeting. When the family wants to participate in the consultation, the professionals must accommodate this request.

 

Operations Guide 6.3.1

State imposed policy not required by the IDEA

6.3.2 The state-approved Consultation Among Service Provider Team Members form must be completed and submitted to the LES when consultation among IFSP team members occurs.

Operations Guide 6.3.2

 

State imposed policy not required by the IDEA

6.3.3  The state-approved Participant Documentation of Initial and Follow-up Eval/Assess/IFSP form must be completed and submitted to the LES for each IFSP team member who participates in an IFSP meeting or transition conference.  Use of the form is optional when conducting initial and follow-up evaluations.

Operations Guide 6.3.3

 

 

 

6.4.0 Assistive Technology

Policy

Reference/Related Documents

State imposed policy not required by the IDEA

6.4.1 An assistive technology assessment must be completed before purchasing an assistive technology device.

 

Policy Handbook 3.4.5

Policy Handbook 3.4.6

Policy Handbook 3.4.7

Policy Handbook 3.6.3

State imposed policy not required by the IDEA

6.4.2 The assistive technology assessment must be conducted by the IFSP team.

Operations Guide 6.4.2

State imposed policy not required by the IDEA

6.4.3 The IFSP team must include at least one of the following for children needing an assistive technology assessment:

A.      Audiologist

B.     Local Assistive Technologist (LATS) 

C.     Occupational Therapist

D.     Orientation and Mobility Specialist

E.     Physical Therapist

F.      Speech-Language Pathologist.

 

State imposed policy not required by the IDEA

6.4.4 Recommendations from the assistive technology assessment must include needed services, supports and devices determined necessary by the IFSP team to assist the child to achieve an identified outcome.

Operations Guide 6.4.4

State imposed policy not required by the IDEA

6.4.5 All assistive technology devices must be purchased through the local CMS area office unless:

A.      The item is billable to Medicaid or private insurance, or

B.     The item is less expensive if purchasing directly from the manufacturer.

Local Early Steps will work with their respective local CMS area office to ensure effective cooperation and coordination.

Operations Guide 6.4.5

CMS Network Statewide Offices

 

State imposed policy not required by the IDEA

6.4.6 Equipment that is not covered by Medicaid’s Durable Medical Equipment and Medical Supply Services Coverage and Limitations Handbook, which is purchased from an assistive technology vendor, must be reimbursed at no more than 80% of the usual and customary charge to the general public. 

Operations Guide 6.4.6

 

State imposed policy not required by the IDEA

6.4.7 The IFSP team must follow Medicaid’s durable medical equipment requirements for Medicaid recipients when purchasing assistive technology devices.

Durable Medical Equipment and Medical Supply Services Coverage and Limitations Handbook

 

State imposed policy not required by the IDEA

6.4.8 Any needed assistive technology device must be available to enable the child/family to benefit from other early intervention services.

Operations Guide 6.4.8

State imposed policy not required by the IDEA

6.4.9 LES that maintain lending libraries for assistive technology devices must develop local procedures that outline the rights and responsibilities of families regarding the lending and returning of such devices.

Operations Guide 6.4.9

 

Federal imposed policy required by the IDEA

6.4.10 Assistive technology does not include a medical device that is surgically implanted, or the replacement of such device.

IDEA §602(1)(B)

State imposed policy not required by the IDEA

6.4.11 LES must inform families who are temporarily provided assistive technology devices or who use the lending library, of their right to request that an assistive technology device be transferred with the child when transitioning to another agency if the child will profit from continued use of the device.

Operations Guide 6.4.11

1003.575, F.S.

 

Florida Interagency Agreement for the Transfer of Assistive Technology

 

State imposed policy not required by the IDEA

6.4.12 Families that decide to request the transfer of a loaned assistive technology device must do so in writing.

 

Operations Guide 6.4.12

1003.575, F.S.

 

Florida Interagency Agreement for the Transfer of Assistive Technology

State imposed policy not required by the IDEA

6.4.13 The LES must acknowledge receipt of a written request to transfer a loaned assistive technology device and return a signed copy of the request to the family within 10 working days.

Operations Guide 6.4.13

1003.575, F.S.

 

Florida Interagency Agreement for the Transfer of Assistive Technology

State imposed policy not required by the IDEA

6.4.14 The LES must notify the family of approval or denial of the transfer of a loaned assistive technology device within 30 working days of the written request.

Operations Guide 6.4.14

1003.575, F.S.

 

Florida Interagency Agreement for the Transfer of Assistive Technology

 

6.5.0 Health Services

Policy

Reference/Related Documents

Federal imposed policy required by the IDEA

6.5.1 Health services are an early intervention service only when they are necessary to enable the infant or toddler to benefit from the other early intervention services or supports.

Operations Guide 6.5.1

IDEA §632(4)(E)(x)

34 CFR §303.13

 

 

6.6.0 Medical Services

Policy

Reference/Related Documents

Federal imposed policy required by the IDEA

6.6.1 Medical services are an early intervention service only when provided to infants and toddlers for diagnostic, evaluative or consultative purposes to assist the LES in determining a child’s eligibility for Early Steps or to determine required early intervention services or supports.

Operations Guide 6.6.1

IDEA §632(4)(E)(viii)

34 CFR §303.12(D)(5)

 

 

6.7.0 Respite

Policy

Reference/Related Documents

Federal imposed policy required by the IDEA

6.7.1 Respite is an early intervention service when it is identified on the IFSP as necessary to enable the family or caregiver to participate or receive other early intervention services to meet the IFSP outcomes.

Operations Guide 6.7.1

3/13/2003 OSEP Letter to David K. Steele

 

State imposed policy not required by the IDEA

6.7.2 Selection of a respite provider and arrangements for the specific dates, time, and location of respite must be made by the family, not the LES or service coordinator.  

Operations Guide 6.7.2

State imposed policy not required by the IDEA

6.7.3 Early Steps does not fund respite provided by a family member (mother, father, sibling, aunt, uncle, grandparent, step-relative or in-laws).

 

State imposed policy not required by the IDEA

6.7.4 The service coordinator must obtain a signed agreement indicating the family  will comply with the following:

A.      Return all unused funds within 30 days after the end of the respite authorization period.

B.     Make all arrangements for the delivery of respite.

C.     Select a respite provider who is not a family member to provide the respite.

D.     Complete and return required respite documentation within 30 days after the end of the respite authorization period.

Operations Guide 6.7.4

 

 

State imposed policy not required by the IDEA

6.7.5 The service coordinator must obtain the following documentation within 30 days after the end of the respite authorization period:

A.      Child’s name

B.     Date respite provided

C.     Length of time respite provided

D.     Total cost

E.     Name and signature of respite provider

F.      Signature of parent/caregiver.

  Operations Guide 6.7.5

 

6.8.0 Early Childhood Education

Policy

Reference/Related Documents

Federal imposed policy required by the IDEA

6.8.1  While child care itself is not considered an early intervention service, the IFSP team may determine that Early Steps fund a portion of child care costs (Early Child Education) for a particular child when the child needs supervised participation with same aged peers who do not have disabilities and no other socialization or peer opportunities are available in the child’s daily routines.

Operations Guide 6.8.1

2/27/1995 OSEP Letter to Ms. Sheryl Dicker

 

Federal imposed policy required by the IDEA

6.8.2  When the family decides to place the child in a child care setting for any time beyond that identified in the IFSP, Early Steps is not responsible for payment of the additional child care costs.

2/27/1995 OSEP Letter to Ms. Sheryl Dicker

 

6.9.0 Plan of Care

Policy

Reference/Related Documents

State imposed policy not required by the IDEA

6.9.1 The designated service provider must develop a Plan of Care for all children receiving early intervention sessions through Early Steps, regardless of Medicaid eligibility.

Policy Handbook 12.5.3

 

Florida Medicaid Early Intervention Services Coverage and Limitations Handbook

 

State imposed policy not required by the IDEA

6.9.2  A Plan of Care is required for all children receiving early intervention sessions.

Operations Guide 6.9.2

 

Florida Medicaid Early Intervention Services Coverage and Limitations Handbook

 

IFSP Instructions POC Note

State imposed policy not required by the IDEA

6.9.3  When the IFSP is being used as the Plan of Care for a child receiving Medicaid, the requirements set forth in the Medicaid Early Intervention Services Coverage and Limitations Handbook must be followed.  

IFSP Instructions POC Note

IFSP Instructions POC Note

 

 

6.10.0

Policy

Reference/Related Documents

 

 [Reserved]

 

 

6.11.0 Timeliness of Services

Policy

Reference/Related Documents

Federal imposed policy required by the IDEA

6.11.1 Early intervention services and supports will be delivered in a timely manner, which is defined by Early Steps to be as soon as possible, but within 30 calendar days from when the family consented to the service or by the start date of the authorization period listed on the IFSP unless there is documentation of a child or family related issue or natural disaster which caused the delay. 

Operations Guide 6.11.1

IDEA §635(a)(10)(D)

34 CFR §303.525

 

 

6.12.0 Requirements for Children/Families With Inactive Status

Policy

Reference/Related Documents

Federal imposed policy required by the IDEA

6.12.1  The Local Early Steps must ensure that no child and family, who have been determined eligible for Early Steps and have an IFSP, are closed to Early Steps because the child and family could not be located. 

Policy Handbook 1.4.3

Operations Guide 6.12.1

IDEA §631(b)(1)

State imposed policy not required by the IDEA

6.12.2  The LES will designate a child and family that has an IFSP and cannot be located as “inactive” after appropriate and reasonable attempts to contact the family have been taken.

Operations Guide 6.12.2

 

 

State imposed policy not required by the IDEA

6.12.3  The LES shall ensure that Early Steps services and supports listed on Form G of the IFSP are terminated once the child and family have been designated “inactive”.

Operations Guide 6.12.2

 

Federal imposed policy required by the IDEA

6.12.4      The service coordinator will provide written prior notice to the family indicating the termination of the specific Early Steps services on the IFSP prior to the end date of the authorization period on the IFSP.

Policy Handbook 8.4.1

Policy Handbook 8.4.2

Policy Handbook 8.4.5

Operations Guide 6.12.4

IDEA §639(a)(6)

34 CFR §303.403(a)

State imposed policy not required by the IDEA

6.12.5  [Reserved]

 

State imposed policy not required by the IDEA

6.12.6    The LES will close a child and family who have been identified as “inactive” from Early Steps only when:

A.      The family responds to attempts to contact and withdraws from Early Steps, or

B.     The family responds to attempts to contact and it is determined via review of the IFSP outcomes with the family that the child has met all outcomes and is no longer in need of Early Steps services, or

C.     The child turns three.

Operations Guide 6.12.2C

Operations Guide 6.12.6

Operations Guide 12.3.11

 


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