No. 37984 (Amendment): Rule R398-20. Early Intervention

(Amendment)

DAR File No.: 37984
Filed: 09/10/2013 05:09:12 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this change is to implement the parent participation fee increase for the Baby Watch Early Intervention Program as modified in the 2013 General Legislative Session through S.B. 2.

Summary of the rule or change:

The change implements the parent participation fee for the Baby Watch Early Intervention Program under Part C of the Individuals with Disabilities Education Act. The change also simplifies the rule by eliminating unnecessary portions of the previous rule.

State statutory or constitutional authorization for this rule:

• Section 26-10-2

Anticipated cost or savings to:

the state budget:

The Division does not anticipate any cost or savings to the state budget. The state budget only covers the cost of billing and collection of fees. These state budget costs will remain the same since they are independent of any applied fee schedule, including the new fee schedule.

local governments:

Local governments entities who operate a Baby Watch program may see an increase in fee collections for some families. However, this increase may be offset by parents choosing to leave the program rather than pay a higher fee.

small businesses:

Small businesses who operate a Baby Watch program may see an increase in fee collections for some families. However, this increase may be offset by parents choosing to leave the program rather than pay a higher fee.

persons other than small businesses, businesses, or local governmental entities:

Agencies operating a Baby Watch program may see an increase in fee collections for some families. However, this increase may be offset by parents choosing to leave the program rather than pay a higher fee. No individuals operate a Baby Watch program.

Compliance costs for affected persons:

Some parents of children enrolled in the program will be subject to a higher monthly fee. The new fee schedule adds five increments between monthly fees of $100 to $200, with corresponding modified income brackets.

Comments by the department head on the fiscal impact the rule may have on businesses:

There will be no impact on business. This rule does not affect the provider reimbursement.

David Patton, PhD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Family Health and Preparedness, Children with Special Health Care Needs
44 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113

Direct questions regarding this rule to:

• Susan Ord at the above address, by phone at 801-584-8441, by FAX at 801-584-8496, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

12/02/2013

This rule may become effective on:

12/09/2013

Authorized by:

David Patton, Executive Director

RULE TEXT

R398. Health, Family Health and Preparedness, Children with Special Health Care Needs.

[R398-20. Early Intervention.

R398-20-1. Authority and Purpose.

This rule implements the early intervention program under Part C of the Individuals with Disabilities Education Act (IDEA) and implementing regulations found at 34 CFR 303.500 for children with disabilities under three years of age, and their families. It is authorized by Utah Code Section 26-10-2.

The Utah Department of Health is designated as the lead agency responsible for the administration of the program.

 

R398-20-2. Services.

(1) The Department provides the following services to eligible individuals and their families, based on individual assessment as required by the IDEA implementing regulations:

(a) Assistive technology;

(b) Audiology services;

(c) Family training, counseling, and home visits;

(d) Health services;

(e) Medical services, but only for diagnostic or evaluation purposes;

(f) Nursing services;

(g) Nutrition services;

(h) Occupational therapy;

(i) Physical therapy;

(j) Psychological services;

(k) Service Coordination;

(l) Social work services;

(m) Special instruction;

(n) Speech-language pathology services;

(o) Transportation; and

(p) Vision services.

(2) Infants and toddlers from birth through to thirty-six months who are classified according to IDEA requirements as a person with a disability are eligible to receive services. These include children with a diagnosed physical or mental condition that has a high probability of resulting in a developmental delay or who show delays at or below 1.5 Standard Deviations below the mean, or at or below the 7th percentile in one or more areas of development.

(3) Services must be based on the child's written Individualized Family Service Plan (IFSP) for providing services developed according to IDEA requirements.

 

R398-20-3. Fees.

(1) The parents of a eligible child shall pay a monthly fee for services according to the schedule established in the Fee Table. The monthly fee is applicable for any month in which a service is provided or scheduled and not timely canceled, except for the month in which the child attains 36 month of age. The Department shall not charge a fee for the following IDEA activities and services:

(a) implementation of child find, such as child developmental screening, or public awareness activities;

(b) evaluation and assessment;

(c) service coordination;

(d) activities to assist a child and the family to receive the rights, procedural safeguards, and authorized services;

(e) activities related to the development, review and evaluation of the Individual Family Service Plan;

(f) activities related to child and family rights, including the administrative complaint process and mediation; and

(g) specialized services related to sensory loss provided through the Utah Schools for the Deaf and Blind (USDB) Parent Infant Program or Deaf Blind services.

(2) The Department shall not charge a fee for services to a child if:

(a) the child receives services only though the USDB pursuant to an ISFP;

(b) the child is a ward of the state; or

(c) the child's family meets Head Start income eligibility guidelines.

(4) The Department shall not charge a fee for services if the child or the child's family receives benefits under any of the following programs:

(a) Medicaid;

(b) Temporary Assistance to Needy Families (TANF);

(c) Women Infants and Young Children (WIC);

(d) Refugee Resettlement Program (RCA); and

(e) Primary Care Network (PCN).

(3) The fee is a per family fee without regard to the number of eligible children receiving services.

(5) The monthly fee is as follows:

 

TABLE

FEES

 Percent of         186             200             250 poverty  Family fee         10.00           20.00           30.00  Family                         ANNUAL INCOME size    2             22,543.00       22,543.01-      24,240.01-                  or less         24,240.00       30,300.00     3             28,384.00       28,384.01-      30,520.01-                  or less         30,520.00       38,150.00     4             34,224.00       34,224.01-       36800.01-                  or less         36,800.00       46,000.00     5             40,064.00       40,064.01-      43,080.01-                  or less         43,080.00       53,850.00    6             45,905.00       45,905.01-      49,360.01-                  or less         49,360.00       61,700.00     7             51,745.00       51,745.01-      55,640.01-                  or less         55,640.00       69,550.00     8             57,586.00       57,586.01-      61,920.01-                  or less         61,920.00       77,400.00  Add for each      5,840.00        6,280.00        7,850.00 additional family member  PART TWO OF TABLE  Percent of         300             400             500 poverty  Family fee         40.00           50.00           60.00  Family                         ANNUAL INCOME size    2             30,300.01-      36,360.01-      48,480.01-                  36,360.00       48,480.00       60,600.00     3             38,150.01-      45,780.01-      61,040.01-                  45,780.00       61,040.00       76,300.00     4             46,000.01-      55,200.01-      73,600.01-                  55,200.00       73,600.00       92,000.00     5             53,850.01-      64,620.01-      86,160.01-                  64,620.00       86,160.00      107,700.00     6             61,700.01-      74,040.01-      98,720.01-                  74,040.00       98,720.00      123,400.00     7             69,550.01-      83,460.01-     111,280.01-                  83,460.00      111,280.00      139,100.00     8             77,400.01-      92,880.01-     123,840.01-                  92,880.00      123,840.00      154,800.00  Add for each      9,420.00       12,560.00       15,700.00 additional family member  PART THREE OF TABLE  Percent of         600             700 poverty  Family fee         80.00          100.00  Family                ANNUAL INCOME size    2             60,600.01-      72,720.01-                  72,720.00       84,840.00     3             76,300.01-      91,560.01-                  91,560.00      106,820.00     4             92,000.01-     110,400.01-                 110,400.00      128,800.00     5            107,700.01-     129,240.01-                 129,240.00      150,780.00     6            123,400.01-     148,080.01-                 148,080.00      172,760.00     7            139,100.01-     166,920.01-                 166,920.00      194,740.00     8            154,800.01-     185,760.01-                 185,760.00      216,720.00  Add for each     18,840.00       21,980.00 additional family member

 

R398-20-4. Income Reporting-Fee Determination.

(1) The child's family shall annually report the family income using the Fee Determination Form to determine the monthly family fee. The IFSP team shall review the form at its six-month review. The family may submit an updated form if there is a change in income.

(2) The Fee Determination Form provides guidelines to the family on what should be counted in its report of income.

(3) Completion of the form is voluntary. However, a child's parents who choose not to complete the Fee Determination Form must pay the maximum level on the fee schedule.

(4) Upon request, the family must provide a copy of the most recent federal income tax filing to the Department and its early intervention providers to verify family income as reported by the child's parents. If the federal income tax filing is unavailable, the parents may submit the prior three months' check stubs to extrapolate annual income.

 

R398-20-5. Hardship, Extenuating Circumstances.

(1) An eligible child shall not be denied service because of a family's inability to pay. If a family is able to pay, but chooses not to, the Department may withhold services.

(2) The Department may waive all or part of the fee if there are extenuating family circumstances that affect a family's ability to pay, such as long-term hospitalization of a family member, casualty loss, moving expense, or other unusual expenses.]

R398-20. Early Intervention.

R398-20-1. Authority and Purpose.

This rule implements the parent cost participation fee for the Baby Watch Early Intervention program under Part C of the Individuals with Disabilities Education Act(IDEA). This fee was mandated by the Utah State Legislature in the 2003 General Session, and modified in the 2013 General Session.

 

R398-20-2. Definitions.

(1) "Department" means the Utah Department of Health.

(2) "Provider" means a local direct service provider with whom the Department contracts to provide Part C services.

 

R398-20-3. Fees.

(1) The parent or legal guardian of an eligible child shall pay a monthly cost participation fee if their child is enrolled in the early intervention program and receives fee eligible services. The monthly fee is applicable for any month in which at least one billable service is:

(a) provided; or

(b) scheduled and not canceled within required time frames.

(2) Fees shall be charged based on a sliding fee schedule established by the Department. The sliding fee schedule shall begin at 185% of the most recently published federal poverty guidelines.

(3) The maximum fee on the sliding fee schedule shall be $200 per month.

(4) The family cost participation fee shall not be charged if the child or the child's family receives benefits under any of the following programs:

(a) Medicaid;

(b) Temporary Assistance to Needy Families;

(c) Family Employment Plan - Cash Assistance;

(d) Women Infants and Young Children;

(e) Early Head Start;

(f) Primary Care Network; or

(g) Children's Health Insurance Program

 

R398-20-4. Income Reporting and Fee Determination.

(1) Each child's parent or legal guardian shall annually report the family income using the Department's Family Fee Determination Form to determine the monthly family fee.

(2) Upon request, the parent or legal guardian must provide a copy of the most recent federal income tax filing to the Department and its early intervention providers to verify family income as reported by the child's parent or legal guardian. If the federal income tax filing is unavailable, the parent or legal guardian may submit the prior three months' check stubs to extrapolate annual income.

(3) Completion of the Family Fee Determination Form is voluntary. If a child's parent or legal guardian chooses not to complete the Family Fee Determination Form, the family must pay the maximum level on the fee schedule.

 

R398-20-5. Hardship, Extenuating Circumstances.

(1) An eligible child shall not be denied service because of a family's inability to pay. The provider may waive all or part of the fee if there are extenuating family circumstances that affect a family's ability to pay, such as long-term hospitalization of a family member, casualty loss, moving expense, or other unusual expenses.

(2) If a family is able to pay, but chooses not to pay, the Department may instruct the local early intervention program to withhold fee eligible services.

 

R398-20-6. Services Not Subject to Fees.

(1) In accordance with Federal IDEA regulation, providers may not charge a fee for the following IDEA activities and services:

(a) implementation of child find, such as child developmental screening, or public awareness activities;

(b) evaluation and assessment;

(c) service coordination;

(d) activities to assist a child and the family to receive the authorized services;

(e) activities related to the development, review and evaluation of the Individualized Family Service Plan;

(f) activities related to child and family rights, including the administrative complaint process and mediation; or

(g) specialized services related to sensory loss provided through the Utah Schools for the Deaf and the Blind Parent Infant Programs, or Deaf Blind services.

 

KEY: early intervention, education, disabilities

Date of Enactment or Last Substantive Amendment: [August 6, 2003]2013

Notice of Continuation: July 31, 2008

Authorizing, Implemented, or Interpreted Law: 26-10-2

 

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