Legislation Affecting Service Providers

There are a lot of rules when it comes to early intervention services. Do you ever wonder, "Why do I have to get this evaluation done so quickly?" or, "What does it technically take to qualify a child to receive early intervention services?" If so, it would be valuable for you to read the legislation that governs your practice in early intervention, because that is where the answer to questions such as these lie. Since it is hard to find the time and energy to devote to the undertaking that is reading and understanding legislation while working full time as a service provider, this page is devoted to summarizing key points of early intervention legislation that are relevant to service providers.

IDEA Part C

This is the current federal law mandating that infants and toddlers with disabilities be offered early intervention services. This law leaves several things up to the discretion of the state, so "states develop their own policies and procedures based on what IDEA requires," (2). States must follow IDEA Part C requirements, but may also go above and beyond what IDEA mandates. Because of this, this page will focus on Nebraska's policies and procedures (Rule 52 & 480 NAC 3) that are consistent with IDEA Part C as this will be more specific to Nebraska early intervention practitioners than delineating IDEA Part C.

Rule 52

Here is what Rule 52 says that applies to service providers:

    • Entering Child Information: Information about the child in early intervention services, including name, birthdate, county and district of legal residence, program setting, type of disability, types of services received, date and reason for discontinuing early intervention services, State Ward status and indication of appointment of surrogate (if necessary), and initial verification date, must be entered into the NDE Portal. This is done through GOLD. Depending on your district, it may fall under the service provider's responsibility for entering this information into GOLD. (92 NAC 52-004.03A)
    • Time of referral to IFSP: Once the referral to early intervention services is made, the screenings, initial evaluation, initial assessments, and the IFSP meeting must be completed within 45 calendar days of the referral, UNLESS the family is unavailable to participate in the evaluations, assessments, or IFSP meeting due to extenuating circumstances, OR the family does not give consent to have their child evaluated. (92 NAC 52-006.02)
    • Right to Evaluation:
        • A child under the age of three MUST receive a timely, comprehensive, and multidisciplinary evaluation if referred to early intervention services - UNLESS the child automatically qualifies to receive early intervention services based on medical or other records (92 NAC 52-006.05A)
        • If a parent requests and consents to an evaluation of the child during a screening process, that child MUST be evaluated, even if the screening results indicate the child will not qualify. (92 NAC 52-006.03C)
    • Evaluation:
        • The evaluation and assessments MUST be conducted in the family's native language, unless it is clearly unfeasible to do so (92 NAC 52-006.05D)
        • You must use more than one procedure as the criterion for eligibility. Procedures that can be used include:
            • Administering an evaluation assessment
            • Take the child's history
            • Identify child's level of functioning in each developmental area
            • Gather information from family members, caregivers, medical providers, social workers, and/or educators about child's strengths and needs
            • Review medical, educational, or other records (92 NAC 52-006.06)
    • How a child qualifies for developmental delay:
        • A child has a diagnosed physical or mental condition that will likely result in a substantial developmental delay (i.e. chromosomal abnormalities, severe attachment disorders, etc.). (92 NAC 52-006.04)
        • Diagnostic instruments reveal that a child has a significant delay in Cognitive , Physical , Communication, Social/Emotional, and/or Adaptive development, as shown by 2.0 or more standard deviations below the mean for one developmental area, or 1.3 or more standard deviations below the mean in two developmental areas. (92 NAC 52-006.04)
    • Other eligibility qualification: A child can also qualify for eligibility to receive early intervention services if service providers use informed clinical opinion to determine that the child should receive early intervention services, even when other instruments do not establish eligibility. Informed clinical opinion CANNOT be used to negate the results of evaluations instruments that do qualify a child for eligibility. (92 NAC 52-006.05B2)
    • MDT Written Report: The multidisciplinary team must prepare a written report of the results of the evaluations and assessments, including statements about:
        • Whether the child qualifies as an infant or toddler with a disability
        • The basis for making that determination
        • The child's strengths and needs in each developmental area
        • A list of the team members including the parents and individuals representing two or more separate disciplines
        • Team members certifying that the report matches their conclusion. If it does not, that team member must submit a separate statement about their conclusion (92 NAC 52-006.09)

A copy of the MDT Written Report MUST be given to the parent (92 NAC 52-006.10)

    • If a child qualifies for early intervention services (IFSP Meetings):
        • The multidisciplinary team, including parents, must participate in the development, review, and implementation of the Individualized Family Service Plan (IFSP) (92 NAC 52-007.01)
        • A review of the IFSP must occur every six months, or more often if the conditions warrant or the parents request a review, to determine the progress made toward achieving the IFSP outcomes, whether modifications to the IFSP outcomes is necessary, or whether modifications to the early intervention services is necessary. (92 NAC 52-007.02B)
        • An IFSP meeting to evaluate and revise the IFSP must be held on an annual basis to ensure that the early intervention services provided are appropriate for the child and the family. (92 NAC 52-007.02C)
        • The IFSP meetings and reviews MUST be conducted in the family's native language, unless it is clearly unfeasible to do so (92 NAC 52-007.02D)
        • Services MUST begin within 30 days of parents consenting to those services (92 NAC 52-007.02E)
        • The following individuals must participate in each IFSP meeting: people directly involved in administering the evaluations and assessments, service providers who will be providing services, and a representative of the school district. If any of these people could not attend the meeting, they must be involved through other means including a telephone conference call, having an authorized representative attend the meeting, or making pertinent records available at the meeting. (92 NAC 52-007.03)
    • IFSP Written Report must include:
        • A statement of the child's present levels in each of the developmental areas. (92 NAC 52-007.04A)
        • A statement of the measurable outcomes or results expected to be achieved, including the criteria, procedures, and timeline for determining progress toward the outcomes and determining modifications necessary to the outcomes or the services provided. (92 NAC 52-007.04B)
        • A statement of the specific early intervention services that are necessary to meet the goals of the child and the family, including the length (amount of time the service is provided each session, i.e. 30 minutes), duration (amount of time until service is not needed, i.e. when child is expected to achieve the outcomes on the IFSP), frequency (the number of sessions that will be provided within the duration), intensity , and method of delivering the services (whether the service is provided on an individual or a group basis). (92 NAC 52-007.04C)
        • A statement that the early intervention services will be provided in a natural environment to the maximum extent possible, or a justification as to why services will not be provided in a natural environment. (92 NAC 52-007.04C3)
        • A statement about the location of early intervention services. (92 NAC 52-007.04C4)
        • A statement about the projected date for initiation of early intervention services (cannot be more than 30 days after parents consent to the services). (92 NAC 52-007.04D)
    • Natural Environments:
        • Early intervention services should be provided in natural environments including the home and community settings in which the child participates. (92 NAC 52-007.06A)
        • Early intervention services should only be provided in settings outside of the natural environment when agreed upon by parents and the IFSP team that the services cannot be achieved satisfactorily in the natural environments. (92 NAC 52-007.06B)
    • Year-Round Continuous Services are to be provided to children and families in early intervention and may only be interrupted, modified, or changed for reasons involving the child's needs. (92 NAC 52-007.07)
    • Transitioning to Preschool
        • If a toddler receiving early intervention services is eligible for preschool services, the service coordinator will convene a conference with the family and school district to discuss the services the toddler can receive outlined in Rule 51 and to establish a transition plan in the IFSP. This conference must take place between 9 months and 90 days before the child's third birthday. (92 NAC 52-008.01A & 92 NAC 52-008.04B)
        • If a toddler receiving early intervention services is determined as NOT eligible for services under Part B of IDEA, the service coordinator will convene a conference with the family and providers of other appropriate services to discuss other appropriate services the toddler may receive. (92 NAC 52-008.01B)
        • IFSP services must continue beyond age three UNTIL the toddler begins receiving services under Rule 51. This is not the case if the parents have not consented to evaluation for Rule 51 services after the district has requested consent for evaluation. (92 NAC 52-008.03)
    • Confidentiality and Notice to Parents: Confidentiality of personally identifiable information must be maintained. Included in this, parents have the right to get written notice of exchanging information among agencies, and written consent to exchange that information. (92 NAC 52-009.01A)
    • Parents' Right to Records: Parents have a right to inspect and review records relating to their child, unless otherwise documentd that the parent(s) do not have that authority under applicable State laws (i.e. custody, foster care, guardianship, separation, or divorce). (92 NAC 52-009.02B)
    • Parental consent must be obtained if:
        • An early intervention service provider seeks to use a parent's private insurance or benefits to pay for the provision of an early intervention service in the IFSP. (92 NAC 52-011.04A1a)
        • There is a proposed increase in the provision of services in the IFSP. (92 NAC 52-011.04A1b)

480 NAC 3

This document contains regulations specific to services coordination, however it contains information that can be helpful to service providers as well. The following are the highlights from 480 NAC 3 that are also relevant to service providers:

  • Services Coordinator Responsibilities include but are not limited to:
      • Coordinating the provision of early intervention services;
      • Coordinating screenings, evaluations, and assessments as appropriate; and
      • Coordinating, facilitating, and monitoring service provision to ensure the services are provided in a timely manner. (480 NAC 3-003.01)
  • Referrals are accepted from any source. After a referral, the services coordinator must contact the family within 7 days to set up a time to meet face-to-face for an intake meeting. (480 NAC 3-004.04)
  • Eligibility for Services Coordination: A family cannot receive early intervention services coordination unless the child qualifies to receive early intervention services. (480 NAC 3-005.02)
  • IFSP Reviews can be requested by any team member, but are all initiated by the services coordinator. (480 NAC 3-008.02B)
  • IFSP Document: the contents of this document that service providers can contribute to must include:
      • Status of the child (present levels of each area of development based on evaluation and assessment data);
      • Statement of the family's priorities, concerns, and resources related to the child's development
      • Results or outcomes for child/family with criteria, procedures, and timelines to determine progress
      • Specific early intervention services included in the plan (frequency, length, intensity, method of delivery, location where services will be provided, projected dates for beginning of services, and anticipated duration of services)
      • An educational component promoting school readiness including pre-literacy language and numeracy skills (for children who are 3 years-old). (480 NAC 3-008.06)
  • Good Faith Effort: Each service provider must make a good faith effort to assist eligible children in achieving their IFSP outcomes. They will NOT be held accountable if a child does not make progress toward outcomes. (480 NAC 3-008.08)
  • Transition Conference Annual Notice: The notice must include explanations of the difference between services provided under Rule 52 and those provided under Rule 51 and the types of services that will be offered to the child under Rule 51. (480 NAC 3-009.01)
  • Transition Plan: The Services Coordinator AND the IFSP team must ensure a transition plan is included in the IFSP not fewer than 90 days, and not more than 9 months, before the child's third birthday. The plan must include procedures to prepare the child for changes in service delivery and setting, and steps for the child and family to exit from early intervention services, which may include discussions with, and training of, parents regarding future placements and the transition. (480 NAC 3-009.04)

References:

  1. Early Intervention Services Coordination, 480 NAC 3 §§003-009.
  2. Key Terms to Know in Early Intervention. (2017, October 3). Retrieved from https://www.parentcenterhub.org/keyterms-ei/#eis
  3. Regulations and Standards for the Provision of Early Intervention Services 92 NAC 52 §§004-011.