Early Steps Operations Handbook

Early Steps Policy Handbook
7/1/2010

Denotes a federal imposed policy required by the IDEA
State imposed policy not required by the IDEA Denotes a state imposed policy not required by the IDEA or federal regulation

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Component	3.0 First Contacts/Evaluation/Assessment
Authority:	IDEA Sections 631, 632, 634, 635, 636 34 CFR, Sections 303.16, 303.17, 303.300, 303.321, 303.322, 303.323, 303.344, 303.345, 303.403, 303.404
Intent:	These policies are intended to ensure that a timely, comprehensive multi-disciplinary evaluation to confirm eligibility for early intervention services and a multidisciplinary assessment to determine the child’s level of functioning in all the required developmental domains is conducted for infants and toddlers under the age of three referred to Early Steps. These policies ensure identification of the child’s unique strengths and needs in each developmental domain and the services appropriate to meet those needs.
Sections:	3.1.0	IDEA, Part C Eligibility	Page 1
	3.2.0	First Contacts	Page 3
	3.3.0	Developmental Screening	Page 4
	3.4.0	Evaluation/Assessment	Page 5
	3.5.0	Evaluation	Page 6
	3.6.0	Assessment	Page 7

	3.1.0 IDEA, Part C Eligibility
Policy		Reference/Related Documents
	3.1.1 A child under the age of three is eligible for services under Part C of the IDEA if he/she has a diagnosed physical or mental condition that has a high probability of resulting in developmental delay or has developmental delay. There are no financial eligibility requirements.	Operations Guide 3.1.1 IDEA §632(5)(A) IDEA §634(1)
	3.1.2 Established conditions fall into one of the following areas: Genetic and metabolic disorders Neurological disorder Autism Spectrum Disorder Severe attachment disorder Significant sensory impairment (vision/hearing) Infants who weigh less than 1,200 grams at birth	Operations Guide 3.1.2 34 CFR §303.16 Note 1
	3.1.3 If the child has an established condition that has a high probability of resulting in a developmental delay, a written confirmation from a licensed physician of the diagnosis is required to establish eligibility OR In the case of (a) severe attachment disorder or autism spectrum disorder, a healthcare practitioner acting within his/her scope of practice or (b) in case of hearing loss, a licensed audiologist. Written confirmation of the diagnosed condition must be in the child’s Early Steps record.	Operations Guide 3.1.3 34 CFR §303.16(a)(2)
	3.1.4 Developmental delay meets or exceeds 1.5 standard deviations below the mean in two or more developmental domains or 2.0 standard deviations below the mean in one or more of the following developmental domains, as measured by appropriate diagnostic instruments and procedures: Cognitive Physical (including vision and hearing) Communication Social or Emotional Adaptive	Operations Guide 3.1.4 IDEA §632(4)(C) IDEA §632(5)(A)(i) IDEA §635(a)(1) 34 CFR §303.322(c)(3)(ii)
	3.1.5 No single procedure will be used as the sole criterion for determining a child’s eligibility for Early Steps.	34 CFR §303.323(c)
	3.1.6 A standard score on an appropriate standardized instrument must be one component of the process to determine eligibility if a child does not have an established condition.	Operations Guide 3.1.6
	3.1.7 Children moving to Florida and transferring from an IDEA Part C program in another state must meet Florida’s eligibility criteria.	Policy Handbook 5.5.5 Operations Guide 3.1.7 34 CFR §303.300
	3.1.8 The evaluation and assessment of each child must: Be conducted by personnel trained to utilize appropriate methods and procedures. Be based on informed clinical opinion that documents use of multiple sources of information. Include a review of pertinent records related to the child's current health status and medical history.	Operations Guide 3.1.8 34 CFR §303.300(a) 34 CFR §303.322(c)(1) 34 CFR §303.322(c)(2) 34 CFR §303.322(c)(3)(i)
	3.1.9 Eligibility or ineligibility for Early Steps must be documented on the child’s IFSP.	Operations Guide 3.1.9 34 CFR §303.16
	3.1.10 If the child is found ineligible for Early Steps, the family must receive a copy of the evaluation results.	Policy Handbook 8.2.1 Policy Handbook 12.3.6 Operations Guide 3.1.10
	3.2.0 First Contacts
Policy		Reference/Related Documents
	3.2.1 The first contacts process occurs between referral and the initial evaluation/assessment during the first 44 days of the family’s involvement with Early Steps.	Operations Guide 3.2.1
	3.2.2 Initial contact must be made with the family within 5 calendar days from the date the referral is made.	Operations Guide 3.2.2
	3.2.3 The assigned service coordinator who is an ongoing member of the IFSP team is required to have a conversation with the family prior to the day of the initial evaluation/assessment to gather information to prepare for the evaluation and/or assessment and to provide the family with information about Early Steps.	Policy Handbook 4.2.0 Operations Guide 3.2.3
	3.2.4 The first contacts activities must be at times convenient to the family.	Operations Guide 3.2.4 Instructions for Completing the Early Steps IFSP, Form A
	3.2.5 Any family assessment that is conducted must be voluntary on the part of the family. If an assessment of the family is carried out, the assessment must: Be conducted by personnel trained to utilize appropriate methods and procedures. Be based on information provided by the family through a personal interview. Incorporate the family's description of its resources, priorities, concerns, and everyday routines, activities, and places related to enhancing the child's development.	Operations Guide 3.2.5 34 CFR §303.322 34 CFR §303.322(d)(2)(3)
	3.2.6 During first contacts, the family must be informed of the availability of and provided the contact information for the local Family Resource Specialist (FRS).	Family Resource Specialist Contact List
	3.2.7 A procedure must be in place for the service coordinator to provide IFSP team members with a summary of first contact information, including screening results and the recommendations for the evaluation and assessment team.	Operations Guide 3.2.7
	3.2.8 A minimum of three documented consecutive unsuccessful attempts to contact the family using more than one method of contact must be made prior to eligibility determination and the consent for services before closing a child to Early Steps due to unsuccessful contact attempts.	IDEA §631(b)(1)
	3.3.0 Developmental Screening
Policy		Reference/Related Documents
	3.3.1 Although screening is not required during First Contacts, a developmental screening with a recommended instrument may be helpful to the evaluation and assessment team when a child does not have an established condition or obvious developmental delay.	Operations Guide 3.2.1 Operations Guide 3.3.1
	3.3.2. Early Steps does not conduct universal screening.	Operations Guide 3.3.2
	3.3.3 If the family chooses to pursue further evaluation after a screening indicates the child is functioning at age level in all five developmental domains, then one of the following must occur: An evaluation/assessment is provided. OR The Local Early Steps decides not to provide an evaluation/assessment, and gives written prior notice, including procedural safeguards to the family. The notice must specify that an evaluation is being refused and the reasons for refusal.	Policy Handbook 8.4.4 Operations Guide 3.3.3
	3.3.4 When the screening indicates the child may have a developmental delay but the family does not consent to the evaluation, the Local Early Steps must: Document the family’s lack of consent to the evaluation in writing. Explain to the family that the child will not be able to receive an evaluation, assessment, or services unless consent is given. Explain the nature of the evaluation and assessment and other services that would be available if the child were to meet eligibility criteria.	Operations Guide 3.3.4 34 CFR §303.404 Form CMS-ES 1064-Use of Private Insurance - English Form CMS-ES 1064-Use of Private Insurance - Spanish Form CMS-ES 1064-Use of Private Insurance - Creole
	3.3.5 If the child does not proceed to the evaluation and assessment, the service coordinator will provide the family with the screening results.
	3.4.0 Evaluation/Assessment
Policy		Reference/Related Documents
	3.4.1 Prior written consent for the evaluation and/or assessment must be obtained on the state-approved form before testing occurs.	Operations Guide 3.4.1 34 CFR §303.16 34 CFR §303.322 (c)(3)(ii) 34 CFR §303.404 Form CMS-ES 1064-Use of Private Insurance - English Form CMS-ES 1064-Use of Private Insurance - Spanish Form CMS-ES 1064-Use of Private Insurance - Creole
	3.4.2. The family must receive written prior notice of the scheduled date for the evaluation or assessment within a reasonable amount of time prior to it occurring. The written prior notice must be provided in the parents’ native language unless it clearly is not feasible to do so.	Operations Guide 3.4.2 34 CFR §303.403
	3.4.3 The evaluation and assessment must be completed within 45 days of the date the child is referred to Early Steps for determination of IDEA, Part C eligibility.	Operations Guide 3.4.3 34 CFR §303.321
	3.4.4 At least two different disciplines in areas appropriate to address the child’s presenting condition(s) must be involved in conducting the evaluation/assessment. For children who are Medicaid eligible, Medicaid requirements for evaluation and assessment must be met.	Operations Guide 3.4.3 Operations Guide 3.4.4 34 CFR §303.17 34 CFR §303.322
	3.4.5 Evaluation and assessment procedures must be nondiscriminatory and must be administered so as not to be racially or culturally discriminatory.	34 CFR §303.323
	3.4.6 Evaluation and assessment materials and procedures are to be administered in the parents’ native language or mode of communication, unless it clearly is not feasible to do so.	Operations Guide 3.4.6 34 CFR §303.323
	3.4.7 The evaluation and/or assessment must include opportunities to observe the child in typical routines/activities.
	3.4.8 ESSO will ensure that the requirements of evaluation and assessment are implemented by all affected public agencies and service providers in the state.	34 CFR §303.322(a)(2)
	3.4.9 In the event of exceptional circumstances that make it impossible to complete the evaluation and assessment within 45 days (e.g., if a child is ill), LES will: Document those circumstances. Develop and implement an interim IFSP, to the extent appropriate and consistent with 34 CFR §303.345(b)(1) and 34 CFR §303.345(b)(2).	Policy Handbook 5.40 34 CFR §303.322(e)(2)
	3.5.0 Evaluation
Policy		Reference/Related Documents
	3.5.1. Each child referred to Early Steps must have an initial evaluation, unless the child: Has an established condition or Has had an evaluation within the past 90 days using one of Florida’s recommended evaluation tools or a tool that meets Florida policy as set forth in 3.5.2 below. Has screening results that indicate the child is functioning at an age appropriate level.	Policy Handbook 3.5.3 Policy Handbook 3.6.1 Operations Guide 3.5.1 Policy Handbook 3.3.3
	3.5.2 The evaluation must determine the child’s developmental status in each of the following domains: Communication Self-help/adaptive Cognitive Physical (including fine and gross motor and vision and hearing) Social/emotional	Operations Guide 3.5.2 34 CFR §303.16(a)(1) 34 CFR §303.322(c)(3)(ii)
	3.5.3 Each child with an established condition must receive an initial and ongoing assessment to determine the present level of functioning of the child as required by Policy Handbook 3.5.2.	34 CFR §303.322 34 CFR §303.344(a)
	3.5.4 Reserved
	3.5.5 The results of the initial evaluation must be documented on the IFSP.	Operations Guide 3.5.5 IDEA §636(d)(1) 34 CFR §303.344(a)
	3.6.0 Assessment
Policy		Reference/Related Documents
	3.6.1 Each eligible child must receive an initial and ongoing assessment to help identify: The child’s strengths and unique needs in each of the developmental areas in Policy 3.5.2 above and the services appropriate to meet those needs. The resources, priorities and concerns of the family and the supports and services necessary to enhance the family’s capacity to meet the developmental needs of their child with a disability.	Operations Guide 3.6.1 34 CFR §303.322 34 CFR §303.322(c)(3)(iii)
	3.6.2. Reserved
	3.6.3 The results of the assessment must be documented on the Individualized Family Support Plan that serves as the assessment report.	Operations Guide 3.6.3 34 CFR §303.344