1. 1 TO FEE OR NOT TO FEE: THAT IS THE QUESTION! February 7, 2005 National OSEP Early Childhood Conference Susan D. Mackey Andrews, Facilitator Ron Benham, MA Terry Harrison, NJ Kate Numerick, MO

2. 2 Introduction Family Cost Participation –Original legislation for Part C established the requirement for states to use a variety of resources to pay for or provide Part C services, including public and private insurance. –Also provided the opportunity for states to implement policies and procedures that require the use of family fees for some Part C services, under the condition that no services be denied based upon the family’s inability to pay

3. 3 –Family fees may not be charged for ChildFind, evaluation and assessment for eligibility, IFSP development, for procedural safeguards or service coordination. –However this does not mean that all of the Part C services that may be billed to third party resources are limited to IFSP services – third party payments could include all costs related to the identification, service planning and delivery including service coordination.

4. 4 Outcomes for Participants Understand some of the impetus behind Family Fees for Part C services Learn from colleagues what approach or process they followed in developing Family Fees for Part C services Discuss lessons learned

5. 5 Agenda Each presenter will provide up to a 15 minute overview, which complements their handout. Question and Answer session will follow the presentations

6. 6 Overview Range of family cost options and issues Terminology –“At no cost” vs. “free” services Factors for consideration: –State Demographics –Administrative ease –Policy and procedures development and implementation, and accountability

7. 7 Family Fees –Costs incurred by a family for “non- entitled” or mandated services provided by a state’s Part C system Excludes services include ChildFind, service coordination, evaluation and assessment, the development of the IFSP and procedural safeguards

8. 8 Family Cost Participation –More broad includes access to and utilization of private insurance, other public resources such as Title V/CSHCN, SCHIP And, payment of co-pays, deductibles as well as family fees –Takes into account the inter- relationship between all funding sources, not just Part C

9. 9 Financial/Resource Case Management –A planned activity intentionally conducted with families to introduce a variety of resources available to families now and potentially over their child’s lifespan, and provide training and support to families to permit the ongoing and appropriate access to resources as their child ages into other systems.

10. 10 Presentations Ron Benham, Massachusetts Terry Harrison, New Jersey Kate Numerick, Missouri

11. 11 Summary Impetus for fees is largely external Stakeholder participation throughout the development process is critical Family opinion is heard by decision makers Is the juice worth the squeeze? Management or administrative considerations –Collection, Reporting, Refusals to Pay

12. 12 Where to Get More Information www.ideainfanttoddler.org/contact.htm –Family Cost Participation Survey (see Orientation Section) or, if not an ITCA member, contact IDEAITCA@aol.com to purchase the report for $30.00 IDEAITCA@aol.com www.mass.gov/dph/fch/ei.htm www.state.nj.us/health/fhs/epihome.htm