DEPARTMENT OF HUMAN SERVICES Social Services Rules EARLY

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DEPARTMENT OF HUMAN SERVICES Social Services Rules EARLY

Transcript Of DEPARTMENT OF HUMAN SERVICES Social Services Rules EARLY

CodeofColoradoRegulations SecretaryofState StateofColorado

DEPARTMENT OF HUMAN SERVICES

Social Services Rules

EARLY INTERVENTION PROGRAM

12 CCR 2509-10
[Editor’s Notes follow the text of the rules at the end of this CCR Document.]

_________________________________________________________________________

7.900 EARLY INTERVENTION PROGRAM [Rev. eff. 7/1/15]

The Early Intervention Program shall provide services for an infant or toddler, birth through two (2) years of age, with a developmental delay or disability and his or her family through a statewide, comprehensive, coordinated, multidisciplinary, interagency system of early intervention services.

A.

The Early Intervention Program shall provide services consistent with the following requirements:

1.

Sections 27-10.5-701 through 27-105-710 of the Colorado Revised Statutes (C.R.S.);

and,

2.

Sections 10-16-102(46) and 10-16-104(1.3), C.R.S.; and,

3.

Sections 22-20-103 and 22-22-118, C.R.S.; and,

4.

The following portions of the United States Code (U.S.C.), as amended:

a.

20 U.S.C. Section 1232g, (the Family Education Rights and Privacy Act

(FERPA);

b.

20 U.S.C. Sections 1401, 1419, 1431-1441 (the Individuals with Disabilities

Education Act of 2004);

c.

42 U.S.C. Section 1320, (the Public Health Service Act);

d.

42 U.S.C. Section 9801 (the Head Start Act);

e.

42 U.S.C. Section 11431(McKinney-Vento Homeless Assistance Act); and,

f.

The General Education Provisions Act (GEPA) at 20 U.S.C. Sections 1221

through 1235 that applies to applicants for new grant awards under the federal

Department of Education.

5.

The Code of Federal Regulations (C.F.R.), Title 34, Parts 99 AND 303 (2019, which is

incorporated herein by reference; no later amendments or editions are incorporated.

These regulations are available for public inspection at the Colorado Department of

Human Services, Office of Early Childhood, 1575 Sherman St., Denver, CO 80203 or at

www.ecfr.gov. Copies of these regulations are available for reasonable cost during

normal business hours at the U.S. Department of Education, Office of Special Education

and Rehabilitation Services, 400 Maryland Avenue SW, Washington D.C.20202; and,

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6.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy rule,

located at 45 C.F.R. Parts 160 and 164 (2019), herein incorporated by reference; no later

amendments or editions are incorporated by reference. These regulations are available

for public inspection at the Colorado Department of Human Services, Office of Early

Childhood, 1575 Sherman St., Denver, CO 80203 or at www.ecfr.gov. Copies of these

regulations are available for reasonable cost during normal business hours at the U.S.

Department of Health and Human Services, 200 Independence Avenue, SW,

Washington, D.C. 20201.

B.

The Early Intervention Program shall design services to meet the developmental needs of an

eligible infant or toddler and the needs of his or her family related to functional outcomes to

enhance the child’s development in the domains of adaptive development, cognitive

development, communication development, physical development (including vision and hearing),

and, social and emotional development.

C.

Based on the unique needs of each child, early intervention services shall be delivered through a

combination of individualized intervention methods and strategies designed to:

1.

Enhance the capacity of a parent or other caregiver to support a child’s well-being,

development, and learning; and,

2.

Support full participation of a child in his or her community; and,

3.

Meet a child’s developmental needs within the context of the concerns and priorities of

his or her family.

D.

All available resources that pay for early intervention services shall be identified and coordinated,

including, but not limited to, federal, state, local, and private sources.

E.

A system for the resolution of intra- and inter-agency disputes shall be used.

F.

Formal interagency operating agreements, as needed, shall be developed to facilitate the

development and implementation of a statewide, comprehensive, coordinated, multidisciplinary,

interagency system of early intervention services.

G.

A statewide system for compiling data on the early intervention services shall be used to comply

with state and federal reporting requirements.

7.901 EARLY INTERVENTION PROGRAM DEFINITIONS [Rev. eff. 7/1/15]

As used in these rules and regulations, unless the context requires otherwise: “Abuse or child abuse and/or neglect” is defined in Section 19-1-103(1), C.R.S.

“Access to records” means the right for a parent to have the opportunity to inspect, review and obtain copies of records related to evaluation, assessment, eligibility determination, development and implementation of an Individualized Family Service Plan, individual complaints pertaining to the child, and any other relevant information regarding his or her child and family, unless restricted under authority of applicable state law governing such matters of guardianship, separation, or divorce.

“Administrative unit”, as defined in Colorado Department of Education rules in 1 CCR 301-8, 2220-R-2.02, means a school district, board of cooperative services, multi-district administrative unit, or the State Charter School Institute, that is providing educational services to exceptional children.

“Assessment” means the ongoing procedures used throughout the period of eligibility of a child for early intervention services to identify:

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A.

The unique strengths and needs of the child and the early intervention services appropriate to

meet those needs; and,

B.

The resources, priorities, and concerns of a parent and the early intervention services necessary

to enhance the capacity of a parent or other caregiver to meet the developmental needs of the

eligible child within everyday routines, activities and places.

“Atypical Development” means development or behaviors that fall outside the expected range of development in one or more of the five (5) domains referenced in 7.920, I, and emerge in a way that is different from same age peers. They are not attributable to culture or personality and are different in quality, form and function. This can be determined through informed opinion of delay, even when evaluation tools do not establish a thirty-three percent (33%) delay.

“Certified Early Intervention Service Broker” is defined in Section 27-10.5-702(3), C.R.S.

“Child Abuse Prevention and Treatment Act” (CAPTA) means the CAPTA state grant program at 42 U.S.C. Section 5106A that provides states with flexible funds to improve their child protective service systems. Last reauthorized by the CAPTA Reauthorization Act of 2010, the program requires states to provide assurances in their five (5) year child and family services plan that the state is operating a statewide child abuse and neglect program. This program includes policies and procedures that address the needs of drug-exposed infants and provisions for referral of children under age three (3) who are involved in a substantiated case of abuse and neglect to early intervention services under Part C.

“Child Find” is defined in Sections 27-10.5-702(4) and 22-20-103(4), C.R.S. that ensures that infants and toddlers in the state who are eligible for services under Part C, are identified, located and evaluated.

“Child Find program” means the multidisciplinary team within an administrative unit that conducts screening and/or evaluation activities for young children.

“Children experiencing homelessness” means children who lack a fixed, regular, and adequate nighttime residence, in accordance with the McKinney-Vento Homeless Assistance Act, which is defined in Section 7.900, A, 4 and 34 C.F.R. Section 303.17, which is incorporated by reference in Section 7.900, A, 5.

“Coaching” means a relationship-based strategy used by trained personnel with a family member, other caregiver, or another provider to support what is already working to help a child develop and to increase their knowledge and use of new ideas to achieve child or family outcomes.

“Consent” means that the parent has been fully informed of all information relevant to the activity for which consent is sought in the parent’s native language and the parent understands and agrees in writing to the carrying out of the activity.

“Co-payment” means a specified dollar amount that an insured person must pay for covered health care services. The insured person pays this amount to the provider at the time of service.

“Criteria” means standards on which a judgment or decision may be based. “Days” means calendar days unless otherwise indicated.

“Deductible” means the amount that must be paid out-of-pocket before a health insurance company pays its share.

“Developmental delay”, when referenced in these regulations, means a significant delay, defined as the: equivalence of thirty-three percent (33%) or greater delay in one (1) or more of the five (5) domains of development as defined in Section 7.920, I, 7, c, when compared with chronological age; or, presence of atypical development or behavior, as defined in section 7.901.

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“Developmental disability” is defined in Section 27-10.5-102(11), C.R.S..
“Due process procedures” means formal procedures used to resolve a dispute involving an individual child or parent related to any matter described in 34 C.F.R., Sections 303.435-438, which are incorporated by reference in Section 7.900, A, 5.
“Duration” means the specific and measurable period of time a service is provided, specifying the start and end date.
“Early Intervention early start program” means a program separate from early intervention services provided in accordance with Part C that, if the department determines appropriations are adequate, may provide services to children who meet the definition of risk factor and do not meet eligibility criterion as defined in section 7.920, E.
“Early Head Start” means a program funded under the Head Start Act, pursuant to 42 U.S.C. SECTION 9801, incorporated by reference in Section 7.900, A, 4, and carried out by a local agency or grantee that provides ongoing comprehensive child development services for pregnant women, infants, toddlers, and their families.
“Early Intervention Provider Database” means the state database located at www.eicolorado.org that contains information, and Community Centered Board affiliation, about all early intervention providers, including personnel qualifications.
“Established condition” for an infant or toddler means a diagnosed physical or mental condition that has a high probability of resulting in significant delays in development and is listed in the Established Conditions Database.
“Established Conditions Database” means the state database located at www.eicolorado.org that includes the state approved list of established conditions.
“Evaluation” for early intervention services means the procedures used to determine initial and continuing eligibility. Evaluation includes administration of an evaluation tool(s), observation of the child, parent report and a review of pertinent medical records.
“Everyday routines, activities and places” means routines that are customarily a part of a family’s typical day including, but not limited to: meal time; bath time; shopping; play time; outdoor play; activities a family does with its infant or toddler on a regular basis; and, places where the family participates on a regular basis, such as, but not limited to, home, place of worship, store, and child care.
“Evidence-based practices” mean practices that integrate research that has demonstrated efficacy and with consideration of the situation, goals, and values of the child, family and professionals.
“Evidence-informed strategies” mean methods that use nationally recognized recommended practices to inform the effective delivery of early intervention services.
“Family assessment” means a process using a Department-approved assessment tool and parent interview prior to the development of an initial Individualized Family Service Plan.
“Family Educational Rights and Privacy Act (FERPA)” means the federal law that protects the privacy of students’ education records under 20 U.S.C. Section 1232g and 34 C.F.R. Part 99, which is incorporated by reference in Section 7.900, A, 4. FERPA requirements apply to educational agencies and institutions that receive funds under any program administered by the United States Department of Education.
“Frequency” means how often an early intervention service is provided.

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“Guardian” means a person appointed by the court or named in a will and charged with limited, temporary, or full guardian's power and duties, pursuant to Section 15-14-312, C.R.S

“Health Insurance Portability and Accountability Act (HIPAA)” means the privacy rule that establishes national standards and requirements for electronic health care transactions and protects the privacy and security of individually identifiable health information, which is defined in Section 7.900, A, 4.

“Individualized Family Service Plan (IFSP)” means a written plan for providing early intervention services to eligible children and their families, in accordance with 34 C.F.R. Section 303.340, et seq., which is incorporated by reference in section 7.900, A, 5.

“Informed opinion of delay” means the knowledgeable opinion of the evaluation team who use professional expertise and experience to determine the presence of a significant delay in one or more of the five (5) domains of development referenced in Section 7.920, I, 7. Informed opinion of delay may be used as an independent basis to establish a child’s eligibility and may be especially useful in situations where a clear developmental level cannot be gained through the typical evaluation process. Informed opinion may not be used to negate the results of evaluation instruments used to establish eligibility.

“Initial assessment” means the assessment of the child and the family conducted before a child’s first IFSP meeting.

“Intensity” means the length of time that a service is provided each session.

“Mediation” means voluntary procedures used to resolve a dispute involving any matter described in 34 C.F.R. Sections 303.430-437, which are incorporated by reference in Section 7.900, A, 5.

“Method” means how an early intervention service is provided. The type of method may be one of the following:

A.

Individual service provided to a child and family; or,

B.

Co-visit during which services are provided by two professionals during a session; or,

C.

Teaming through regularly scheduled meetings as the formal time for provider-to-provider

information sharing and support in order to develop strategies designed to build the capacity of

parents and other caregivers to meet child and family outcomes; or,

D.

Supervision by a qualified provider who oversees the work of a student or paraprofessional

through observation and guidance, including direction and evaluation of the activities performed

by the supervisee.

“Model” means one of the following constructs in which a child’s and family’s early intervention services shall be provided:

A.

Primary service provider; or,

B.

Multidisciplinary service providers; or,

C.

Single provider; or,

D.

Other model approved by the state.

“Multidisciplinary evaluation team” means a group that is made up of two (2) or more qualified personnel who have different training and experience.

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“Multidisciplinary Service Providers Model” means a model in which two (2) or more qualified providers who have different training and experience provide ongoing services as identified in an IFSP. In this model the providers work independently of each other with minimal interaction with other team members, and perform interventions separately from others while working on discipline-specific goals.

“Native language”, means:

A.

When used with respect to an individual who has limited English proficiency:

1.

The language normally used by that individual, or, in the case of a child, the language

normally used by the parents of the child, except as provided below in “B”; and,

2.

For evaluations and assessments conducted pursuant to section 7.920, I, the language

normally used by the child, if determined developmentally appropriate for the child by

qualified personnel conducting the evaluation and assessment.

B.

When used with respect to an individual who is deaf or hard of hearing, blind or visually impaired,

or for an individual with no written language:

1.

The mode of communication that is normally used by the individual, such as sign

language, Braille or oral communication.

“Natural environments” means the day-to-day routines, activities and places that promote learning opportunities for an individual child and family, in settings such as the family’s home and community that are natural or typical for the child’s peer who have no disabilities.

“Neglect” means an act or failure to act by a person who is responsible for another's well-being so that inadequate food, clothing, shelter, psychological care, physical care, medical care, or supervision is provided. This may include, but is not limited to, denial of meals, medication, habilitation, or other treatment necessities and which is not otherwise within the scope of Article 10.5 of Title 27, C.R.S., or these rules and regulations.

“Parent”, within early intervention services, means:

A.

The biological or adoptive parent; or,

B.

A guardian in a parental relation to the child authorized to act as the child’s parent or authorized

to make early intervention, educational, health or developmental decisions, but not the State if the

child is under the jurisdiction of a court; or,

C.

A foster parent; or,

D.

An individual acting in the place of a biological or adoptive parent, including a grandparent,

stepparent, or other relative with whom the child lives, or an individual who is legally responsible

for the child’s welfare; or,

E.

A surrogate parent who has been appointed in accordance with 34 CFR Section 303.422,

incorporated by reference in Section 7.900, A, 5.

“Part C” means Part C of the IDEA that addresses infants and toddlers, birth through two (2) years of age, with developmental delays or disabilities, or physical or mental conditions with a high probability of resulting in significant delays in development, in accordance with 34 C.F.R. Part 303, which is incorporated by reference in Section 7.900, A, 5.

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“Participating agency” means, as used in early intervention services, any individual, agency, program or entity that collects, maintains, or uses personally identifiable information to implement the requirements and regulations of Part C with respect to a particular child.

A.

This includes:

1.

The Colorado Department of Human Services; and,

2.

Community Centered Boards (CCB) or a Certified Early Intervention Service Broker; and,

3.

Any individual or entity that provides any Part C services, including service coordination,

evaluations and assessments, and other Part C services.

B.

This does not include:

1.

Primary referral sources; or,

2.

Public agencies, such as the Medicaid program, private entities, or private health

insurance carriers, that act solely as funding sources for early intervention services.

“Personally Identifiable Information (PII)” as used in early intervention services means, but is not limited to:

A.

The infant or toddler’s name; or,

B.

The name of the infant or toddler’s parent or other family member; or,

C.

The address of the infant or toddler, or their family; or,

D.

A personal identifier, such as a Social Security Number or other biometric record; or,

E.

Other indirect identifiers such as the child’s date of birth, place of birth, or mother’s maiden name;

or,

F.

Other information that, alone or in combination, is linkable to a specific infant or toddler by a

person in the early intervention community, who does not have personal knowledge of the

relevant circumstances, to identify the infant or toddler with reasonable certainty; or,

G.

Information about a child whose identity is believed by the Early Intervention Program to be

known by the requester of that information.

“Physician” means a person licensed to practice medicine under Section 12-36-101, C.R.S., et seq., the Colorado Medical Practice Act.

“Post-referral screening” means the early intervention activities that take place after a child is referred to the Early Intervention Program and the administrative unit to identify infants and toddlers who are in need of more intensive evaluation and assessment in order to determine eligibility due to a developmental delay.

“Primary Service Provider Model” means a model of service delivery that utilizes one main qualified provider from any discipline that is the best fit to address the child and family outcomes as identified in an IFSP. Other team members support the primary service provider through teaming and may provide covisits under this model.

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“Prior written notice” for early intervention services means written notice that is given to parents a reasonable time before a Community Centered Board or other Certified Early Intervention Service Broker proposes or refuses to initiate or change the identification, evaluation, or placement of the infant or toddler, or the provision of appropriate early intervention services to the child and family.
“Qualified personnel” means personnel who have met the state approved or recognized certification, licensing, registration, or other comparable requirements, to provide evaluations, assessments or early intervention services.
“Referral” for early intervention services means a verbal or written notification from a referral source to the Community Centered Board or administrative unit for the provision of information regarding an infant or toddler, birth through two (2) years of age, in order to identify those who are in need of early intervention services.
“Risk factor” means a 25% delay in two or more domains and, if sufficient appropriations are available, a 25% delay in one domain, or other factors determined by the department to have research that supports the potential for impact on development at a later age such as, but not limited to, a substantiated case of abuse or neglect, neonatal abstinence syndrome (NAS), fetal alcohol spectrum disorders (FASD), lead poisoning, global developmental delays and perinatal mood and anxiety disorders.
“Service coordination” means the activities carried out by a service coordinator to assist and enable a child eligible for early intervention services, and the child’s family, to receive the rights, procedural safeguards, and services that are authorized to be provided under section 7.900, et seq.
“Single Provider Model” means a model of early intervention service provision in which one provider is utilized to meet the child’s and family’s needs as identified in an IFSP.
“State complaint procedures” mean actions taken by the Department to resolve a complaint lodged by an individual or organization regarding any agency or local service provider participating in the delivery of early intervention services that is violating a state or federal requirement.
“Surrogate parent” means an individual appointed by the local Early Intervention Services Program to act in the place of a parent in safeguarding an infant’s or toddler’s rights in the decision-making process regarding screening, evaluation, assessment, development of the IFSP, delivery of early intervention services and transition planning.
“Targeted case management services” means those case management services which are provided as a Medicaid benefit for a specific target group of Medicaid recipients who have a developmental disability and who meet the program eligibility criteria identified in the Medical Assistance rules at 10 CCR 2505-10 Section 8.761.2 (May 30, 2020) published by the Colorado Department of Health Care Policy and Financing. These Department of Health Care Policy and Financing Rules are herein incorporated by reference and do not include any later amendments or editions of these rules. These rules are available for public inspection at the Colorado Department of Human Services, Office of Early Childhood, 1575 Sherman St., Denver, CO 80203 or at www.sos.state.co.us. Copies of these rules are available for reasonable cost during normal business hours at the Colorado Department of Human Services, Office of Early Childhood, 1575 Sherman St., Denver, CO 80203 or the Colorado Department of Health Care Policy and Financing, 1570 Grant St., Denver, CO 80203.
“Telehealth” means a method of service provision that utilizes secure interactive videoconferencing to deliver early intervention services.
“Waiver Services” means those optional Medicaid services defined in the current federally approved Home and Community Based Services (HCBS) waiver document and do not include Medicaid State Plan services.

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7.910 SYSTEM COORDINATION [Eff. 7/1/13]

A.

Local Interagency Coordinating Council

1.

Each Community Centered Board shall have a Local Interagency Coordinating Council

that meets at least quarterly to assure that federal, state, local and private resources are

well-coordinated in local communities to assist families to meet the needs of their infants

or toddlers with developmental delays or disabilities.

2.

Membership of a Local Interagency Coordinating Council shall include, at a minimum:

a.

At least one (1) member who is a parent with a child twelve (12) years of age or

younger and at least one (1) member who is a parent of a child six (6) years of

age or younger, both of whom have knowledge of, or experience with, early

intervention services; and,

b.

A representative of an administrative unit; and,

c.

A representative of a county department of public health; and,

d.

A representative of a county department of social/human services; and,

e.

Members who are public or private providers of early intervention services; and,

f.

Other members of the community at large who are interested in early intervention

services or are involved in the provision of, or payment for, early intervention

services.

3.

The purpose of a Local Interagency Coordinating Council is to advise a Community

Centered Board regarding:

a.

The planning, delivery, and evaluation of early intervention services, including

methods to identify and correct gaps in services; and,

b.

The coordination of services and funding resources; and,

c.

The collection and use of child and family outcomes and program data to inform

early intervention policies and practices within the designated service area.

B.

Interagency Operating Agreements

1.

Each Community Centered Board or other Certified Early Intervention Service Broker, as

defined in Section 7.913, shall, at a minimum, establish and maintain the following

interagency operating agreements:

a.

Administrative unit agreements that include responsibilities for Child Find and

transition activities, and assisting in the development and implementation of the

statewide plan in accordance with Section 27-10.5-704, C.R.S., which is

incorporated by reference as defined in Section 7.900, A, 1; and,

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b.

County departments of social/human services agreements that include

responsibilities for referrals under the Child Abuse Prevention and Treatment Act,

as amended by P.L. 111-320, for a child who is less than three (3) years of age

who is involved in a substantiated case of child abuse or neglect or is identified

as affected by illegal substance abuse, or withdrawal symptoms resulting from

prenatal drug exposure; and,

c.

Early Head Start Program agreements that include responsibilities for the

coordination of available services and avoidance of duplication of effort for

children enrolled in Early Head Start and early intervention services; and,

d.

Other local agency agreements, as needed, that are involved with early

intervention services that specify the responsibilities of each agency.

2.

A Community Centered Board shall ensure that interagency operating agreements are

signed by parties with the authority to carry out the responsibilities of the specific

agencies or programs and are reviewed annually and updated as needed.

7.911 FISCAL MANAGEMENT [Eff. 7/1/13]

A.

A Community Centered Board or Certified Early Intervention Service Broker, as defined in

Section 7.913, shall:

1.

Only purchase early intervention services from providers that meet the qualifications as

defined by the Department; and,

2.

Establish and maintain necessary cost accounting systems according to general

accounting principles to properly record, and allocate separately, the revenue and

expenses for federal Part C of the Individuals with Disabilities Education funds, state-

funded early intervention services, Medicaid funds and private health insurance funds

that are billed through the Community Centered Board, local funds, and other funds used

for the purchase of early intervention services; and,

3.

Ensure that Part C of the Individuals with Disabilities Education Act funds are:

a.

Used only as payor of last resort; and,

b.

May be used to reimburse a parent for copayments and deductibles for early

intervention services documented on his or her child’s IFSP; and,

c.

For purposes of accounting, not commingled with any other funds received.

4.

Track expenditures for each funding source for service coordination, direct services,

management fee and any other expense line item as defined by the Department; and,

5.

Notify the Department of any proposed change of reimbursement rates for any early

intervention service at least fifteen (15) calendar days prior to the use of such rates. All

rates must be computed using the methodology determined by the department.

B.

The maximum reimbursement rate for any early intervention service shall be subject to restriction

by the Department.

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