PUT AWAY THE PANIC BUTTON! IMPLEMENTING THE NEW PART C FEDERAL REGULATIONS IN VIRGINIA Part 2 June 27, 2012

Do you have these forms? If not, please print them before we start - Family Cost Share Agreement, Temporary Family Cost Share Agreement, Notice of Child and Family Rights and Safeguards Including Facts About Family Cost Share, IFSP Forms-July1.htm#pm Forms-July1.htm#pm

Make sure you write down your questions!

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What is Your Primary Role in Early Intervention? A.Local System Manager or Program Administrator B.Service Coordinator C.EI Service Provider D.Family Member look left

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Overview/Reminders New regulations released September 2011 Must begin implementing July 1, 2012 Virginia prioritizing parent protections Have until June 30, 2013 to have “ documents ” in place Regulation s for EI Program for Infants and Toddlers with Disabilities numbered 303

Road Map - Regulations Subpart A-Purpose and Definitions of terms used in the Act Subpart B and C- What states need to have in place for their system of services and assure in order to receive funds (often called the state application) Subpart D- child find, evaluations and assessments and the IFSP Subpart E- Procedural Safeguards Subpart E- Procedural Safeguards Subpart F- Use of funds Subpart F- Use of funds Subpart G- State interagency coordinating council Subpart H- State monitoring and enforcement

Procedural Safeguards

Access to Records Initial copy of record, copies of IFSP and ED Form at no cost to family ( (c)) 10-day timeline when parent requests to review records ( (c)) Expansion of what can be maintained in permanent record ( (b))

Scavenger Hunt On what page of the revised Notice of Child and Family Rights and Safeguards Including Facts About Family Cost Share document does the information about records start? a.9 b.4 c.1

Notice and Consent If child not eligible, must be given prior written notice including parents rights to dispute the eligibility determination ( ) Initial notice about confidentiality and records when a child is referred ( (d)) Procedures when parent refuses consent to release records ( (c))

Surrogate Parents ( ) 30-day timeline for assigning Surrogate cannot be a provider of any service to child or family member Must consult with public agency assigned care of child Judge may assign surrogate

Administrative Complaints ( ) Must file within 1 year of alleged violation What must be included in complaint has been expanded Must forward copy to the agency/provider at same time filed with state Can extend timeline for mediation

Due Process Hearing ( ) Available to any child referred Copy of transcript, written copy of findings and decisions at no cost to parent Either party can request extension

In Virginia: Procedural Safeguards Revised Notice of Child and Family Rights and Safeguards Revised Strengthening Partnerships Minor revisions to some procedural safeguards forms

System of Payments

Blood Pressure Check How high is your anxiety level as we start talking about system of payment (family cost share requirements)? My blood pressure is … a.Sky high b.Slightly above normal c.Normal d.Below normal … I feel faint!

Use of Public Insurance ( (a)) May not require parents to enroll in public benefits or insurance program Must meet consent requirements  Child does not have Medicaid yet  Child has Medicaid  Release of info for billing Public insuranc e = Medicai d

No Cost Protections ( (a)(ii)) Cannot decrease available lifetime coverage or any other insured benefit Cannot result in parents paying for services that would otherwise be covered by the public benefits or insurance program Cannot result in increase in premiums or discontinuation of public benefits or insurance Cannot cause a loss of eligibility for home and community based waivers based on aggregated health related expenses

Use of Public Insurance (cont’d) ( (a)) Must provide written notification to parents  Consent requirements  Categories of costs  No cost protection provisions

Scavenger Hunt On what page of the Notice of Child and Family Rights and Safeguards Including Facts About Family Cost Share can you find the information you need to explain to families about use of Medicaid/FAMIS to pay for EI services? a.14 b.16 c.13 d.15

Use of Private Insurance ( (b)) Must obtain written parental consent:  At the initial IFSP  At IFSP Review if services increase Lack of consent cannot result in denial of services if family unable to pay TRICARE treated as private insurance in Virginia

Use of Private Insurance ( cont’d) ( (b)) Copy of policies to parent when consent is sought Any cost for use must be included policies

Scavenger Hunt On what page of the Notice of Child and Family Rights and Safeguards Including Facts About Family Cost Share can you find the information you need to explain to families about use of private insurance to pay for EI services? a.14 b.16 c.13 d.15

Written Policies ( ) Payment system and schedule of fess Basis and amount of the fees Definition of the ability and inability to pay and a process for determining Assurance regarding services to be provided at no cost Provision regarding failure to provide income information Provision that permits the lead agency to use Part C funding to pay for some costs

Procedural Safeguards ( (e)) Written policies must include informing parents of dispute resolution options Must provide copy of these policies when obtaining consent for services

In Virginia: Intake Combined Rights document and Facts About Family Cost Share Revised Facts About Family Cost Share  Notification requirements  No cost protections  Costs associated with private insurance  Written policies

In Virginia: Before Initial IFSP Family Cost Share Agreement Form -OR- Temporary Family Cost Share Agreement Form Release of information to bill

Family Cost Share Agreement Form

Release of Information

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Temporary Family Cost Share Agreement Form

Choose the Correct Form Prior to initial IFSP, family chooses not to provide income information and pay full fee Prior to initial IFSP, family cannot find tax return in their moving boxes but doesn’t want to delay services Temporary Family Cost Share Agreement Form Family Cost Share Agreement Form

In Virginia: IFSP Review Notice of Rights and Safeguards Including Facts About Family Cost Share Consent for private insurance if services increasing  Frequency, length, duration  Change from group to individual

IFSP - Page 9

When to Use Box on Page 9 1.Child is covered by private insurance 2.Family has consented to use of insurance 3.Services are increasing

In Virginia: Annual IFSP Notice of Rights and Safeguards Including Facts About Family Cost Share New Family Cost Share Agreement Form  Temporary FCS Form, if needed

The Bottom Line Already in Place Consent for Medicaid Consent for private insurance at initial and annual Written policies Procedural safeguards for payment Consent to release information for billing New Consent for private insurance when services increase (added to page 9 of IFSP) Notification requirements (added to Facts About Family Cost Share)

Blood Pressure Re- Check Blood pressure higher or lower now?

Next Steps Get electronic forms ready to go Participate in July regional meetings Share information with local staff and providers Next Steps:

QUESTIONS?