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					ECI Standards Revisions                                            Initial Draft                              Publish 9/1/2010

    ECI Standards Manual for Contracted Programs—2010 Revisions

    Contents
    Chapter 0: Introduction ................................................................................................................ 9
    Chapter 1: DARS ECI Contract.................................................................................................. 9
      1.1 DARS ECI Contract Overview ......................................................................................... 9
       1.2 Contract Award Process ................................................................................................. 10
       1.3 Contract Execution and Content ................................................................................... 10
       1.4 Service Area Designation ............................................................................................... 10
         1.4.1 Service Area Agreements in Shared Counties .................................................... 10
         1.4.2 Exceptions to Service Area Assignments in Shared Counties ......................... 11
         1.4.3 Notifying DARS of Changes to Contract and Program Information ................. 11
       1.5 Contract Amendments .................................................................................................... 12
       1.6 Budget Revisions ............................................................................................................. 13
       1.7 Remedial Actions ............................................................................................................. 13
         1.7.1 Adverse Actions........................................................................................................ 14
         1.7.2 Nonadverse Actions ................................................................................................. 15
       1.8 Claims for Breach of Contract ....................................................................................... 16
       1.9 Contract Termination for Noncompliance .................................................................... 17
        1.9.1 Time Frames for Appeal Decisions ....................................................................... 17
        1.9.2 Role of the DARS ECI Staff .................................................................................... 18
        1.9.3 Request for Reconsideration .................................................................................. 18
        1.9.4 Contract Closeout..................................................................................................... 18
    Chapter 2: Financial Management .......................................................................................... 21
      2.1 Financial Management Systems ................................................................................... 21
       2.2 Financial Report Submission ......................................................................................... 22
       2.3 Cost Allocation Plans ...................................................................................................... 23
       2.4 Property Management .................................................................................................... 23
         2.4.1 Equipment and Controlled Assets ......................................................................... 23
         2.4.2 Loss or Disposal of Equipment or Controlled Assets ......................................... 24
       2.5 Annual Audit Reports ...................................................................................................... 25
        2.5.1 Requirements for Complying with Annual Audit .................................................. 25
        2.5.2 Applicable Laws and Regulations.......................................................................... 26
        2.5.3 UGCMA and UGMS ................................................................................................. 26
        2.5.4 OMB Circular A-133, Compliance Supplement for State, Local Governme nts,
        and Non-profit Organizations ........................................................................................... 26
        2.5.5 Schedules of Expenditures of Federal and State Awards ................................. 27
    Chapter 3: ECI Costs ................................................................................................................. 27
      3.1 Reimbursement of Allowable Costs.............................................................................. 28
       3.2 Personnel Compensation ............................................................................................... 29

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       3.3 Fringe Benefits ................................................................................................................. 29
       3.4 Travel ................................................................................................................................. 29
       3.5 Contractor-Owned and -Leased Vehicles.................................................................... 30
         3.5.1 Contractor-Owned Vehicles.................................................................................... 30
         3.5.2 Leased Vehicles ....................................................................................................... 31
       3.6 Consumer Transportation............................................................................................... 31
       3.7 Seminars, Meetings, and Conferences ........................................................................ 32
       3.8 Equipment ......................................................................................................................... 32
       3.9 Supplies............................................................................................................................. 34
         3.9.1 Direct Service Supplies ........................................................................................... 34
         3.9.2 Office and Janitorial Supplies ................................................................................. 35
         3.9.3 Controlled Assets ..................................................................................................... 35
       3.10 Contractual Services ..................................................................................................... 36
         3.10.1 Consumer-Related Contractual Services ........................................................... 38
         3.10.2 Nonconsumer Contract Services ......................................................................... 38
       3.11 Space Rental.................................................................................................................. 39
       3.12 Building Use Reimbursement ...................................................................................... 39
       3.13 Interest and Financing Costs ....................................................................................... 40
       3.14 Building Maintenance, Repairs, and Alterations ....................................................... 40
       3.15 Utilities ............................................................................................................................. 42
       3.16 Communications ............................................................................................................ 42
       3.17 Equipment Leasing, Maintenance, and Repairs....................................................... 42
       3.18 Reproduction and Printing Expenses ......................................................................... 43
       3.19 Postage and Shipping................................................................................................... 43
       3.20 Insurance ........................................................................................................................ 44
       3.21 Membership Fees, Subscriptions, and State Licensing Fees ................................ 44
       3.22 Advertising ...................................................................................................................... 45
       3.23 Employee Educational Expenses ............................................................................... 46
       3.24 Food................................................................................................................................. 47
       3.25 Indirect Costs ................................................................................................................. 47
       3.26 Unallowable Costs......................................................................................................... 48
       3.27 Advance Payment on Contracts ................................................................................. 49
    Chapter 4: Maintenance of Effort (MOE) ................................................................................ 50
      4.1 State and Local Funds .................................................................................................... 50
         4.1.1 Family Cost Participation ........................................................................................ 50
       4.2 Other Funds for Support of the ECI Program ............................................................. 52
          4.2.1 Medicaid Administrative Claiming (MAC) ............................................................. 52
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         4.2.2 In-Kind Contributions ............................................................................................... 53
       4.3 Billing for ECI Services ................................................................................................... 53
         4.3.1 Verification of Medicaid Eligibility........................................................................... 54
         4.3.2 Claims for Reimbursement ..................................................................................... 55
       4.4 Financial Reporting Requirements ............................................................................... 55
         4.4.1 Claims ........................................................................................................................ 55
         4.4.2 Collections ................................................................................................................. 56
         4.4.3 Uncollected Claims .................................................................................................. 56
       4.5 In-Kind Contributions....................................................................................................... 57
    Chapter 5: Reserved.................................................................................................................. 57
    Chapter 6: Reserved.................................................................................................................. 57
    Chapter 7: Respite ..................................................................................................................... 57
      7.1 Respite Services under the State Initiative .................................................................. 57
       7.1.1 Service Requirements ................................................................................................. 58
         7.1.2 Financial Requirements........................................................................................... 59
       7.2 Respite Services under Part C of IDEA ....................................................................... 60
    Chapter 8: Transfers .................................................................................................................. 61
      8.1 In-State Transfers ............................................................................................................ 61
         8.1.1 Responsibilities of the Transferring Contractor ................................................... 61
         8.1.2 Responsibilities of the Receiving Contractor ....................................................... 61
       8.2 Transfers to Texas from Another State ........................................................................ 62
    Chapter 9: Outcomes................................................................................................................. 63
      9.1 Outcomes Overview ........................................................................................................ 63
       9.2 Child Outcomes ............................................................................................................... 63
       9.3 Family Outcomes ............................................................................................................. 64
    Chapter 10: Performance Management ................................................................................. 65
      10.1 Performance Management Introduction .................................................................... 65
       10.2 Desk Review Monitoring............................................................................................... 66
       10.3 On-Site Visits ................................................................................................................. 66
         10.3.1 Comprehensive On-Site Monitoring Visits ......................................................... 66
         10.3.2 Follow-up to Comprehensive Monitoring Visits ................................................. 67
         10.3.3 Focused On-site Visits .......................................................................................... 68
       10.4 Determinations ............................................................................................................... 68
         10.4.1 Meets Requirements ............................................................................................. 69
         10.4.2 Needs Assistance .................................................................................................. 69
         10.4.3 Needs Intervention ................................................................................................. 69
         10.4.4 Needs Substantial Intervention ............................................................................ 69
       10.5 Local Reporting.............................................................................................................. 70
       10.6 TKIDS Ad Hoc Data Requests .................................................................................... 70
           10.6.1 Initiating a Request ................................................................................................ 70

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        10.6.2 Reviewing the Request and Determining the Timeline .................................... 71
        10.6.3 Finalizing the Report.............................................................................................. 71
    Chapter 11: Public Outreach .................................................................................................... 71
      11.1 Public Outreach Overview ........................................................................................... 71
       11.2 Public Outreach Plan Development and Implementatio n ....................................... 72
       11.3 Public Outreach Plan Requirements .......................................................................... 72
         11.3.1 Public Outreach Target Audiences ..................................................................... 72
         11.3.2 Public Outreach Plan Structure and Requirements .......................................... 73
       11.4 Interagency Coordination ............................................................................................. 73
         11.4.1 Memoranda of Understanding ............................................................................. 73
         11.4.2 ECI Statewide Coordination ................................................................................. 73
       11.5 Coordination of ECI Services with LEA Special Education Services .................... 74
       11.6 Performance Evaluation ............................................................................................... 75
       11.7 Marketing of Local ECI programs ............................................................................... 75
        11.7.1 Promotional Materials............................................................................................ 75
        11.7.2 Telephone Directory Listing .................................................................................. 75
        11.7.3 Program Identity ..................................................................................................... 75
    Chapter 12: Directory of Community Resources ................................................................... 75
      12.1 Authorities ....................................................................................................................... 75
       12.2 Directory Scope ............................................................................................................. 75
       12.3 Directory Content........................................................................................................... 76
       12.4 Directory Availability...................................................................................................... 76
       12.5 Nonduplication of Efforts .............................................................................................. 76
    Chapter 13: Early Childhood Intervention Providers ............................................................ 76
      13.1 Who Can Provide Early Intervention Services? ....................................................... 76
         13.1.1 Criminal History Search ........................................................................................ 76
         13.1.2 Job Descriptions for Each Position ..................................................................... 77
         13.1.3 Individualized Professional Development Plan (IPDP) .................................... 77
         13.1.4 Provider Health Standards ................................................................................... 78
       13.2 Early Intervention Specialists ...................................................................................... 79
         13.2.1 Entering the ECI Competency Demonstration System (CDS)........................ 79
         13.2.2 Early Intervention Specialist Requirements ....................................................... 80
         13.2.3 Documentation Requirements and Timelines for the CDS ............................. 81
         13.2.4 Loss of Professional EIS Status .......................................................................... 82
         13.2.5 EISs Returning from Inactive Status ................................................................... 82
         13.2.6 Early Intervention Specialist Code of Ethics ...................................................... 83
       13.3 Service Coordinators .................................................................................................... 83
       13.4 Paraprofessional Supervision Requirements ............................................................ 83
         13.4.1 Eligible Activities for Paraprofessionals .............................................................. 84
         13.4.2 Ineligible Activities for Paraprofessionals ........................................................... 84
       13.5 Provider Qualifications for Developmental Services................................................ 84
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       13.6 Provider Qualifications for Autism Spectrum Disorders (ASD) .............................. 86
    Chapter 14: Procedural Safeguards........................................................................................ 86
      14.1 Procedural Safeguards Overview ............................................................................... 86
       14.2 Informing Parents of Procedural Safeguards ............................................................ 87
         14.2.1 Limited English Proficiency................................................................................... 87
       14.3 Child and Parent Rights ............................................................................................... 88
       14.4 Prior Written Notices to Parents.................................................................................. 89
         14.4.1 Prior Written Notice Related to Evaluation......................................................... 90
         14.4.2 Prior Written Notice Related to IFSP .................................................................. 90
       14.5 Informed Consent .......................................................................................................... 90
       14.6 Written Parental Consent ............................................................................................. 91
         14.6.1 Written Parental Consent for Screening, Assessment, and Evaluation ........ 91
         14.6.2 IFSP Procedural Safeguards ............................................................................... 92
         14.6.3 Refusal to Consent ................................................................................................ 92
       14.7 Surrogate Parents ......................................................................................................... 93
         14.7.1 Duty to Assign a Surrogate Parent...................................................................... 93
         14.7.2 Criteria for Selecting a Surrogate Parent ........................................................... 93
         14.7.3 Responsibilities of the Surrogate Parent ............................................................ 94
       14.8 State-Level Complaint, Mediation, and Administrative Due Process Hearings .. 94
         14.8.1 Complaints Procedures ......................................................................................... 94
         14.8.2 Mediation ................................................................................................................. 95
         14.8.3 Administrative Due Process Hearings Concerning Individual Child Rights .. 96
       14.9 Confidentiality of Child and Family Records ............................................................. 97
        14.9.1 Parent’s Rights Related to Child and Family Records ..................................... 98
        14.9.2 Contractor Responsibility Related to Child and Family Records .................... 98
        14.9.3 Fee for Records...................................................................................................... 99
        14.9.4 Disputed Records................................................................................................... 99
        14.9.5 Release of Information with Written Parental Consent ..................................100
        14.9.6 Release of Information without Written Parental Consent.............................101
        14.9.7 Release of Information to School Districts .......................................................101
        14.9.8 Release or Exchange of Information with other Agencies.............................102
        14.9.9 Record Retention .................................................................................................102
    Chapter 15: Eligibility ...............................................................................................................103
      15.1 Overview of Eligibility Criteria ....................................................................................103
       15.2 Determining Child Eligibility .......................................................................................104
       15.3 Medically Diagnosed Condition .................................................................................105
         15.3.1 Children Who Are HIV Positive ..........................................................................105
         15.3.2 Continuing Eligibility Based on a Medically Diagnosed Physical or Mental
         Condition............................................................................................................................105
       15.4 Developmental Delay..................................................................................................106
           15.4.1 Expressive Language Delay...............................................................................106

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         15.4.2 Determining Developmental Delays for Infants Born Prematurely...............107
         15.4.3 Continuing Eligibility Based on Developmental Delay ...................................107
       15.5 Atypical Development .................................................................................................108
        15.5.1 Continuing Eligibility Based on Atypical Development...................................108
    Chapter 16: Referrals and the Pre-enrollment Process .....................................................109
      16.1 Referrals and the Pre-Enrollment Process Requirements....................................109
       16.2 Special Referral Circumstances................................................................................109
         16.2.1 Referrals Received before the Child’s Birth .....................................................109
         16.2.2 Child Protective Services (CPS) Involved ........................................................109
         16.2.3 Referrals from the Texas Department of State Health Services (DSHS),
         Texas Early Hearing Detection and Intervention (TEHDI) Online System ..............110
         16.2.4 Referrals Received for Children at Least 45 Days before the Third Birthday
         .............................................................................................................................................110
       16.3 Ensuring Family Rights...............................................................................................111
       16.4 Initial Assignment of Service Coordinator ...............................................................111
       16.5 Pre-enrollment Process ..............................................................................................112
       16.6 Enrolling Children Served by Two Contractors .......................................................112
    Chapter 17: Screening.............................................................................................................113
      17.1 Screening Overview ....................................................................................................113
       17.2 The Screening Process ..............................................................................................113
       17.3 Provider Qualification to Conduct Screenings ........................................................114
       17.4 Required Nutrition Screening ....................................................................................114
         17.4.1 The Nutritional Screening Process....................................................................114
         17.4.2 Follow-Up to a Failed Nutritional Screening ....................................................114
       17.5 Required Hearing Screening .....................................................................................115
         17.5.1 When to Defer Hearing Screening ....................................................................115
         17.5.2 Follow-Up to a Failed Hearing Screening ........................................................115
       17.6 Required Vision Screening ........................................................................................116
         17.6.1 When to Defer Vision Screening .......................................................................116
         17.6.2 Follow-Up to a Failed Vision Screening ...........................................................116
       17.7 Required Assistive Technology Screening ..............................................................116
         17.7.1 The Assistive Technology Screening Process ................................................116
       17.8 Optional Developmental Screening ..........................................................................117
    Chapter 18: Evaluation and Assessment .............................................................................117
      18.1 Overview of Comprehensive Evaluation and Assessment to Determine Eligibility
      .................................................................................................................................................117
       18.2 Comprehensive Evaluation and Assessment Procedures ....................................118
       18.3 Initial and Annual Evaluations and Assessments of Nutritional Status, Hearing,
       Vision, and Assistive Technology ......................................................................................119


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       18.4 For Children with Diagnosed Auditory Impairment (A I) or Vision Impairment (VI)
       .................................................................................................................................................119
       18.5 The Assistive Technology Evaluation and Assessment Process ........................120
       18.6 Identifying Concerns, Priorities, and Resources (CPRs) ......................................121
       18.7 Assessment for Referral for Velo-Cardio-Facial Syndrome (VCFS) ...................121
       18.8 Autism Spectrum Disorder Screening ......................................................................122
    Chapter 19: Individualized Family Service Plan (IFSP) .....................................................122
      19.1 Individualized Family Service Plan (IFSP) General Requirements .....................122
       19.2 Scheduling IFSP Meetings.........................................................................................123
       19.3 Responsibilities in the IFSP Process .......................................................................123
         19.3.1 IFSP Interdisciplinary Team ...............................................................................124
         19.3.2 Child with Auditory or Visual Impairments .......................................................124
         19.3.3 Other Team Members .........................................................................................124
       19.4 Parent Rights in the IFSP Process ...........................................................................125
       19.5 Content of the IFSP.....................................................................................................125
         19.5.1 Integrated Summary ............................................................................................126
         19.5.2 Family Concerns, Priorities, and Resources (CPRs) .....................................126
         19.5.3 Outcomes, Criteria, and Strategies ...................................................................126
         19.5.4 Early Intervention Services .................................................................................127
         19.5.5 Other Non-ECI Supports and Services.............................................................128
       19.6 Initial IFSPs ..................................................................................................................128
       19.7 Periodic Review of the IFSP ......................................................................................129
         19.7.1 Complete Review of the IFSP ............................................................................129
         19.7.2 Partial Review of the IFSP ..................................................................................130
       19.8 Annual IFSP .................................................................................................................131
       19.9 Continuation IFSP .......................................................................................................131
       19.10 Interim IFSP ...............................................................................................................132
    Chapter 20: Required Early Intervention Services and Service Delivery ........................133
      20.1 Early Intervention Services in Natural Environments ............................................133
         20.1.1 Exceptions to Early Intervention Services in Natural Environments ............133
       20.2 Service Delivery Accommodations ...........................................................................134
       20.3 Service Delivery System Requirements ..................................................................134
         20.3.1 Operating Hours ...................................................................................................136
       20.4 Covisits..........................................................................................................................136
       20.5 Early Intervention Services for Autism Spectrum Disorders.................................136
    Chapter 21: Transition .............................................................................................................137
      21.1 Transition Overview ....................................................................................................137
       21.2 Transition Activities .....................................................................................................137


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       21.3 LEA Notification for All Children ................................................................................139
       21.4 Transition to Community Settings .............................................................................140
         21.4.1 Referral Requirements ........................................................................................140
         21.4.2 Transition Meetings .............................................................................................140
       21.5 Transition to the LEA ..................................................................................................141
        21.5.1 LEA Transition Meetings .....................................................................................141
        21.5.2 LEA Referral Requirements ...............................................................................141
    Chapter 22: Follow-Along Services .......................................................................................142
      22.1 Follow-Along Overview ...............................................................................................142
       22.2 Eligibility ........................................................................................................................142
       22.3 Follow-Along Requirements.......................................................................................143
       22.4 Dismissal from Follow Along .....................................................................................143
       22.5 Referrals to Early Intervention Services ..................................................................143
    Chapter 23: Health, Safety, and Reporting Abuse, Neglect, and Exploitation ...............144
      23.1 Child Health Standards...............................................................................................144
       23.2 Review of Medical Information ..................................................................................144
       23.3 Immunizations ..............................................................................................................145
         23.3.1 Unimmunized Children ........................................................................................145
       23.4 Children with Chronic Infectious Diseases ..............................................................146
       23.5 Abuse, Neglect, or Exploitation Reporting Requirements .....................................146
         23.5.1 How to Report Abuse, Neglect, or Exploitation ...............................................146
         23.5.2 Emergency Situations .........................................................................................147
       23.6 Working with the Child and Family ...........................................................................147
    Chapter 24: Case Management Services ............................................................................147
      24.1 Service Coordinator Qualifications ...........................................................................147
         24.1.1 Parent Rights Related to Assigned Service Coordinator...............................147
       24.2 Case Management Services Requirements ...........................................................149
       24.3 The Case Management Care Plan (CMCP) and Case Management Activities 149
         24.3.1 Assess and Reassess the Child’s Needs.........................................................150
         24.3.2 Develop and Update the Child’s CMCP ...........................................................150
         24.3.3 Provide Referrals and Related Activities to Help the Eligible Child and Family
         Obtain Needed Services .................................................................................................150
         24.3.4 Monitor and Follow Up on All Case Management Activities .........................151
       24.4 Children in Foster Care ..............................................................................................151
       24.5 Children in Institutions and Permanency Plans ......................................................152
       24.6 Case Management Documentation ..........................................................................152
       24.7 Conditions for Billing Case Management Activities to Medicaid under the
       Targeted Case Management (TCM) Program .................................................................153


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        24.7.1 Case Management Activities Not Billable to Medicaid under the TCM
        Program .............................................................................................................................154
    ECI Standards Manual for Contracted Programs Glossary...............................................156




    Chapter 0: Introduction
    The ECI Standards Manual for Contracted Programs performs two major functions. It
    points out or summarizes most of the standards imposed on contracted programs by
    federal statute, federal regulation, OMB circular, Texas statute, DARS or HHSC rule,
    the Governor’s Uniform Grant Management Standards (UGMS) or the contract itself
    (those sources are collectively referred to as ―source documents‖). The manual also
    imposes additional standards to which the contracted program agrees when it signs the
    contract. The standards manual should be a useful tool, but it must not be treated as the
    only source for knowing about or for understanding obligations. Following are some of
    the ways in which the manual is not and can never be definitive.
         Contracted programs must comply with all applicable federal and state statutes,
           rules, and regulations whether or not the manual specifically points them out. In
           most cases those that are not directly referenced in the manual are directly
           referenced in the source documents cited by the manual.
         Although there are references in the manual to requirements in a source
           document, there may be many specific requirements or conditions in a specific
           source document that are not described in the manual. The contracted program
           must still comply with all applicable requirements in the source document.
         Because of the brevity of a summary or ambiguities or misinterpretations in the
           summary, or because of later amendment of a source document, there may
           appear to be an irreconcilable conflict between the manual and the source
           document. The contracted program should contact DARS ECI for guidance about
           any apparent conflict, but if the conflict cannot be reconciled, the program should
           follow the source document.
         When a difference is reconcilable by interpreting the standard in the standards
           manual as being a requirement over and above the requirements in a source
           document, then that higher standard is one which the contracted program agrees
           to meet when it signs the contract.

    Chapter 1: DARS ECI Contract
    1.1 DARS ECI Contract Overview
    DARS enters into a written agreement with the contractor to identify the duties,
    responsibilities, and other terms and conditions between the parties.




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    1.2 Contract Award Process
    Authority: Texas Human Resources Code, Section 73.011

    DARS ECI has established a consistent and fair contract award process for contractors
    delivering services to eligible children and families. The contractor receives an
    application to request funding for the next fiscal year when the contract is eligible for
    renewal and the contractor’s service area is not being competitively procured.
    Notification of availability of DARS ECI funding is published in the Texas Register in the
    following circumstances:
          the DARS ECI assistant commissioner determines that it is not feasible to
            consolidate open service areas between current contractors, or
          a service area is being procured under a competitive process.



    1.3 Contract Execution and Content
    Following the contract award, DARS sends the contract to the contractor for signature.
    The contractor must return the contract signed by an authorized official of the contrac tor
    to DARS before the authorized DARS representatives sign the contract. The contract is
    not fully executed until it has been signed by DARS and the contractor.
    The contract specifies the counties to be served by the contractor and the contract
    number of children. The contract number of children equals the total number of children
    eligible for early intervention services with written individualized family service plans that
    the contractor has the capacity to serve at any one time. The contract runs concurrent
    with the state fiscal year unless partial year funding has been approved. The contract
    may be renewed if the contract provides for renewal and the contractor meets the
    criteria. The contractor must comply with all applicable laws, regulations, and poli cies.
    This includes fiscal requirements on the administration, accounting, auditing, and
    recovery of funds as authorized by the Uniform Grant and Contract Management Act,
    Uniform Grant Management Standards (UGMS), and applicable federal Office of
    Management and Budget (OMB) Circulars.


    1.4 Service Area Designation
    DARS assigns every contractor to a service area that can be identified for parents and
    primary referral sources. Only one contractor is assigned to serve each designated
    service area of the state. Only the assigned contractor provides services to families who
    reside in the contractor’s designated service areas.


    1.4.1 Service Area Agreements in Shared Counties
    Contractors that share counties must jointly develop a service area agreement for those
    counties and submit the agreement to the DARS ECI assistant commissioner for
    approval. The agreement must include
        effective dates of the agreement;



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          a description of each contractor's assigned service area in each shared county
           (that is, designated school districts, ZIP codes, or other distinguishable
           boundaries);
          exceptions to service area assignments (see 1.4.2 Exceptions to Service Area
           Assignments in Shared Counties);
          a description of the system for receiving referrals; and
          a dated signature of an authorized representative from each contractor.


    1.4.2 Exceptions to Service Area Assignments in Shared Counties
    The local plan must define consistently applied exceptions that are acceptable to all
    area contractors. Contractors must review service area agreements annually. A new
    service area agreement must be submitted if changes in service area designations or
    exceptions are determined necessary, or if requested by DARS. Requests for changes
    in service area assignments must be approved by the DARS ECI assistant
    commissioner before implementation.

    Exceptions in service area assignments must be included as part of the service area
    agreement developed by contractors in shared counties. Exceptions are allowed only
    for individual families for the following reasons:
         a child is in day care in a service area that is different from where the child lives;
         a child is in foster care in an area that is different from where the child is
            expected to return;
         a child in foster care changes to a foster care placement in a different service
            area;
         a family residence changes frequently but remains within a limited distance (set
            forth in the local plan approved by DARS) from the current contractor’s service
            area; or
         within six months of the participating child turning three, the family moves to
            another contractor’s service area that is within a distance designated (in the local
            plan approved by the DARS ECI assistant commissioner) from the current
            contractor’s service area.

    Exceptions cannot be made for the convenience of the contractor. Exceptions must
    result in improved access to services. Local contractors must jointly develop and submit
    with their service area assignments a plan that includes the proposed criteria by which
    local contractors will allow exceptions to the approved service area assignments. Other
    exceptions require the DARS ECI assistant commissioner’s approval.


    1.4.3 Notifying DARS of Changes to Contract and Program
    Information
    When changes occur to contract or program information, the ECI contractor must notify
    DARS ECI of the change by email at ecipomailbox@dars.state.tx.us.


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    For any change in chief executive officer, chief financial officer, or program director, the
    ECI contractor must notify DARS ECI immediately, but no later than two working days
    following the change. Changes in the ECI financial contact, TKIDS contact, or public
    outreach/child find coordinator must be reported to DARS ECI within seven working
    days of the change. The ECI contractor must report changes in any of the following for
    the positions addressed in this section:

          name,
          physical and mailing addresses,
          telephone and fax numbers, and
          email address.

    For address changes, including the location of the agency’s office or the physical and
    mailing business addresses (including for satellite offices), the ECI contractor must
    notify DARS ECI within 10 calendar days of the change. Changes in the agency’s
    telephone number or Web site address must be reported to DARS ECI within seven
    working days of the change.

    The ECI contractor must notify DARS ECI within 10 calendar days of any change in
    legal status with the Texas Secretary of State.


    1.5 Contract Amendments
    The contract may be amended by mutual agreement between DARS and the contractor
    during the contract period to change the terms and conditions. Except for reductions to
    the contract amount based on applicable contract provisions, the amendment must be
    in writing and signed by an authorized official of the contractor and the authorized
    DARS representatives. DARS will not pay for the performance of services or work not
    authorized by a properly executed contract amendment.

    DARS develops a written contract amendment when contract changes are determined
    necessary. A contract amendment may be necessary for reasons including
        sanctions (noncompliance or failure to meet program requirements);
        changes to the contract amount as a result of increases or decreases in the
          number of children enrolled in comparison to the established contract number of
          children;
        changes in federal or state law that make continued fulfillment of the contract, on
          the part of either party, unreasonable or impossible;
        changes to the assigned service area; or
        awards or adjustments for other reasons.

    Requests from contractors for additional funds related to awards or adjustments for
    other reasons must be
        based on documented need after subtracting any expected revenue gains,
           including funds from other sources such as Medicaid and private insurance;


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          necessary to prevent or correct the disruption or discontinuance of services
           required under the Individuals with Disabilities Education Act (IDEA) Part C; and
          in compliance with all federal regulations, state rules, and policies that govern
           operations.


    1.6 Budget Revisions
    Authority: Uniform Grant and Contract Management Act, Texas Government Code,
    Chapter 783

    The contractor may submit a request to DARS to revise its approved ECI budget d uring
    the contract period in order to use the funds in the most efficient and effective manner
    and to meet the overall program objectives.

    All requests for revisions among budget categories equaling 10 percent or more of the
    total contract amount require a contract amendment. Such requests must be submitted
    in advance of any budget changes, and no later than 90 days before the end of the
    contract period. Requests for a budget revision requiring a contract amendment must be
    submitted on a Revised Contract Budget form (GC-9a).

    The contractor may make cumulative budget transfers among approved DARS contract
    budget categories, excluding equipment, for approved budget line items for up to 10
    percent of the total contract amount without prior approval. Additiona l equipment
    purchases not previously included in the contract year budget require submission of a
    Revised Contract Budget form no later than 90 days before the end of the contract
    period. Controlled asset purchases require prior approval from DARS unless noted
    otherwise in Chapter 3: ECI Costs, 3.9.3 Controlled Assets.


    1.7 Remedial Actions
    Authority: 34 CFR Section303.501, 40 TAC Sections105.1017, 105.1301, and 105.1315

    DARS has established remedial actions to ensure the enforcement of the contractor’s
    contractual obligations to deliver early childhood intervention services and to correct
    deficiencies identified through oversight and monitoring.

    The remedial actions that DARS may impose on the contractor for noncompliance with
    the contract are
         adverse actions, which may be appealed;
         nonadverse actions, which may not be appealed; or
         a combination of adverse and nonadverse actions.

    DARS may impose remedial actions when the contractor fails to
       follow the terms of the contract; or
       comply with program rules, policies, and procedures.



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    DARS may take remedial actions for reasons that include
       DARS’ determination that consumer health and safety is jeopardized;
       the contractor’s failure to
            o comply with its corrective action plan;
            o follow an agreed-upon audit resolution payment plan;
            o submit an acceptable cost report, if applicable;
            o comply with the contract or program requirements; or
            o maintain any required license or certification;
       the contractor’s relocation to a new facility address that does not have the
         appropriate license, if applicable;
       the contractor’s exclusion from contracting with DARS or with any other Health
         and Human Services agency or program;
       the contractor’s exclusion from contracting with the federal government; or
       validated report(s) of abuse, neglect, or exploitation when the perpetrator is an
         owner, employee, or volunteer of the contractor who has direct access to
         consumers.


    1.7.1 Adverse Actions
    The following remedial actions are considered adverse actions and may be appealed in
    writing:
         recoupment;
         vendor hold;
         denial of all or part of a claim;
         suspension of a subcontractor's participation or payments, in which DARS directs
           a contractor to suspend a subcontractor's participation or payments;
         termination of a subcontract, in which DARS directs a contractor to terminate a
           subcontract;
         reduction of the contract amount for failure to
               o achieve or maintain the proposed level of service,
               o expend funds appropriately, or
               o provide services as set out in the contract;
         involuntary contract termination for cause, in which DARS ends a contract before
           its expiration date and cites instances of failure to comply with the contract or
           DARS program rules, policies, and procedures;
         suspension, in which DARS temporarily suspends a contractor’s right to conduct
           business with DARS; and
         debarment, in which DARS does not allow a contractor to conduct business with
           DARS, in any capacity, for a specified period of time.

    A contractor has the right to appeal any adverse action imposed by DARS. DARS
    attaches DARS1309, Notice of Appeal Rights, to any notice of adverse action. The
    DARS1309 includes all the information necessary to file a correct and timely appeal.

    In the written request for an appeal, the contractor may also request a meeting with
    DARS. DARS provides a written decision to the contractor


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          within 30 days after conclusion of the meeting, if the contractor requests a
           meeting; or
          within 45 days after DARS receives the appeal, if no meeting is held.

    After DARS issues a decision on an appeal, the contractor may submit a written request
    for reconsideration if
         the contractor’s request for an appeal meets DARS requirements, and
         the contractor is not satisfied with DARS' appeal decision.

    Requests for reconsideration must be
       addressed to DARS Legal Services, and
       received by DARS within 20 days after DARS issues the decision of the appeal.

    The contractor must ensure that the request for reconsideration
        clearly states that the purpose of the letter is to request reconsideration of a
          DARS decision on an appeal,
        specifically points out any errors in the appeal decision,
        specifies all relief requested,
        states all reasons the relief should be granted, and
        is received by DARS within 20 days after DARS issues the decision on the
          appeal.

    DARS issues a decision on the request for reconsideration no later than 45 days after
    the receipt of the request for reconsideration. DARS’ decision on the request for
    reconsideration is final.


    1.7.2 Nonadverse Actions
    The following remedial actions are considered nonadverse actions and may not be
    appealed:
        corrective action,
        designation of high-risk status,
        nonrenewal of contract after the contract term,
        establishing additional prior approvals for expenditure of funds by the contractor,
        certain revisions of contract terms and provisions, and
        suspension of consumer referrals.

    DARS may impose adverse action, nonadverse action, or both, such as
       allowing the contractor to submit a corrective action plan and correct deficiencies
         before imposing adverse action;
       imposing adverse action in conjunction with requiring a corrective action plan (for
         example, DARS recoups overpayment from a contractor as part of a corrective
         action plan); or
       imposing only adverse action (for example, contract termination and debarment).



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    1.8 Claims for Breach of Contract
    Authority: Texas Government Code, Chapter 2260, 40 TAC, Section 105.1405

    Most claims for breach of contract initiated by a contractor are resolved in accordance
    with Texas Government Code, Chapter 2260. A contractor may make a claim for breach
    of contract against DARS. DARS may make a counterclaim against the contractor.

    The contractor’s notice of claim for breach of contract must be delivered to the DARS
    commissioner or the designee who signed the contract within 180 days from the date of
    the event giving rise to the claim. The notice must clearly describe the
         nature of the alleged breach of contract,
         amount the contractor seeks in damages, and
         legal theory of recovery.

    DARS has 60 days from receipt of the contractor’s notice of claim to deliver the
    counterclaim notice to the contractor. The DARS commissioner or designee must begin
    negotiations to resolve the claim and counterclaim no later than 120 days after DARS
    receives the contractor’s notice of claim.

    The parties may agree to mediate the claim before
        the 120th day after DARS receives the claim notice, or
        the expiration of any extension for negotiations to which the parties have agreed.

    DARS and the contractor must resolve the claim for breach of contract within 270 days
    after DARS receives the claim notice unless DARS and the contractor agree in writing,
    on or before the 270th day, to extend the time for negotiations.

    The contractor may file a request with DARS for a contested case hearing before the
    State Office of Administrative Hearings (SOAH) if a claim for breach of contract is not
    entirely resolved
         on or before the 270th day after DARS receives the notice of claim, or
         after any extension expires.

    No party is obligated to settle as a result of negotiations or mediation. If a settlement is
    not reached and the claim is escalated to a SOAH hearing, no information discovered or
    discussed during mediation is binding.

    DARS may proceed with an adverse action if the contractor does not request a hearing
    or fails to take any action to come into compliance. Adverse actions may include
         recoupment,
         termination of the contract, and
         debarment.




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    1.9 Contract Termination for Noncompliance
    Authority: 40 TAC Section 105.1301

    DARS may initiate termination of the contract with a contractor for noncompliance.
    DARS may terminate a contract, in whole or in part, after determining that a contractor
    is not or has not been in substantial compliance with
         DARS ECI policies;
         the contract provisions; or
         applicable federal or state laws or regulations (for example, UGMS and OMB
            circulars).

    If DARS proposes to terminate a contract, DARS must notify the contractor in writing by
    regular mail and certified mail of the reasons for the proposed termination and give the
    contractor an opportunity to contest the proposed action through an appeal process.
    Form DARS1309, Notice of Appeal Rights, containing written instructions on filing a
    correct and timely appeal, is attached to the written notification. The contractor must
    submit a written request for appeal to DARS Legal Services in accordance with the
    instructions contained in DARS1309.

    The contractor must ensure that DARS receives the request for appeal within 30 days of
    the contractor’s receipt of the notice of proposed termination. If the contractor does not
    request an appeal in writing within the 30-day period, the contractor is considered to
    have waived the right to appeal, and DARS proceeds to terminate the contract.

    Any proposed termination of a contractor’s contract may be in addition to a decision to
    withhold funds or apply any other sanction under the provisions of 1.7 Remedial
    Actions.

    No contract will be terminated before the final decision of DARS Legal Services
    following the appeal process provided under these sections, if an appeal is requested.

    Between the date a contractor files a request for appeal and the final decision of DARS
    Legal Services, any funds eligible for distribution may be retained at the sole discretion
    of DARS Legal Services. If the final decision of DARS Legal Services is favorable to the
    contractor, the eligible funds are promptly distributed to the contractor. If the final
    decision is adverse to the contractor, the funds may be withheld.


    1.9.1 Time Frames for Appeal Decisions
    When the contractor requests a meeting with DARS, the appeal decision must be
    completed within 30 days after conclusion of the meeting. If no meeting is held, the
    appeal decision must be completed within 45 days after DARS receives the appeal.




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    1.9.2 Role of the DARS ECI Staff
    When a contractor has appealed a DARS adverse action, DARS ECI staff members
    must have no further contact with the contractor or the contractor’s representatives
    about any issues related to the appeal. The contractor or contractor’s representatives
    should contact DARS Legal Services with any questions or concerns about the appeal.


    1.9.3 Request for Reconsideration
    After DARS issues a decision on an appeal, the contractor may submit a written request
    for reconsideration if the contractor has met DARS’ appeal requirements and is not
    satisfied with the appeal decision.

    The contractor must ensure that the request for reconsideration
        clearly states that the purpose of the letter is to request reconsideration of a
          DARS decision on an appeal,
        specifically points out any errors in the appeals decision,
        specifies all relief requested,
        states all reasons the relief should be granted, and
        is addressed to DARS Legal Services.

    DARS Legal Services must receive the request for reconsideration within 20 days after
    issuing the decision on the appeal. DARS issues a decision on the request for
    reconsideration no later than 45 days after the receipt of the request for reconsideration.
    DARS’ decision on the request for reconsideration is final.


    1.9.4 Contract Closeout

    When a contract expires and there is no intent to renew or extend the contract or the
    contract is terminated, contract closeout procedures must be completed to ensure that
    the terms of the contract have been accomplished.

    A DARS performance manager coordinates with the contractor to develop a plan for
    reaching a settlement. The performance manager reviews all documents and contract-
    related activities and begins discussions to resolve any outstanding claims or issues
    with the contractor. A settlement agreement is developed giving consideration to the
    following issues and any additional issues necessary:

          the contractor’s obligation under the contract’s termination clause;
          a schedule for resolving any issues, including
               o any contractor performance issues, and
               o the contractor’s submission of any outstanding claims, inventory
                  schedules, and necessary accounting information;
          arrangements to transfer title and deliver any materials, supplies, and equipment
           that must be returned to DARS, as well as procedures to protect, preserve, and
           dispose of inventories;

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          arrangements to cancel any goods or services ordered but not delivered, if
           possible;
          the point at which work is stopped and the status of any services, goods, plans ,
           and information that would have been delivered had the contract been
           completed;
          arrangements for transferring consumer caseloads and records to a new
           contractor, if applicable; and
          the contractor’s obligation to terminated subcontracts and the general principles
           to be followed in settling subcontractors’ claims.


    1.9.4.1 Resolving Performance Issues

    DARS may determine that an on-site closeout monitoring review is required. If contract
    performance is deficient, DARS may take corrective actions. The contract will not be
    considered closed until all outstanding monitoring findings or other performance issues
    are resolved.


    1.9.4.2 Disposal of Inventories

    Equipment and controlled assets purchased through the contract are subject to an
    equitable claim by the state and the federal government. The equitable claim amount is
    determined by establishing the percentage of monetary interest DARS has in the
    equipment or controlled asset (that is, what percentage of the cost of the purchase did
    DARS fund). Once the percentage of DARS’ monetary interest is determined, the
    method of allocation or return is decided.

    Disposition of the equipment generally involves the contractor’s doing one of the
    following:

          compensating DARS for the state’s equitable claim on the property;
          returning to DARS the proceeds from sale of the property;
          transferring the property according to DARS’ instructions;
          returning the property to DARS; or
          using another method of disposition determined reasonable by DARS.

    Settlement arrangements may also be made to have the contractor return, transfer, or
    compensate DARS for any inventories of unused materials and supplies, if considered
    appropriate. The contractor must immediately cance l any services or goods ordered but
    not delivered.


    1.9.4.3 Transfer of Consumer Caseloads and Records

    The contractor must complete documentation and any necessary follow-up on all
    consumer files and must transfer consumer caseloads and files for currently enrolled

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    children to the new contractor, if applicable. Failure to fulfill these requirements may
    result in payments being decreased or reduced by DARS.

    Generally, the original contractor should retain the original files, and copies should be
    sent to the new contractor. However, there may be times when it is critical that certain
    original documents be transferred with the consumer. The contractor should coordinate
    with the DARS performance manager on these decisions.


    1.9.4.4 Final Report Submission

    By the due date established by DARS, the contractor is required to submit the following
    final financial reports:

                 Financial Status Report (FSR), 269a (4 th quarter version);
                 Program Income Attachment;
                 FSR, 269a Respite (if applicable);
                 Expenditure Summary by Funding Source; and
                 Nonexpendable Personal Property Report.

    DARS determines if there are any financial discrepancies and assists in determining
    any overpayment or underpayment.


    1.9.4.5 Settlement of Subcontractors’ Claims

    The contractor accepts liability and retains responsibility for the performance of any of
    its subcontractors providing services under the terms of this contract. The contractor is
    responsible for settling its subcontractors’ claims. The contractor should apply the same
    general principles used by DARS to ensure that the obligations of the contractor’s
    subcontracts have been fulfilled. Some differences may exist because a subcontractor
    is paid on a fixed amount or fee-for-service basis rather than on a cost reimbursement
    basis.

    The contractor’s subcontractors have no contractual rights against DARS when the ECI
    contract is terminated. DARS does not pay the contractor any amount for anything
    resulting from the termination of any subcontract, and certainly not for the loss of
    anticipated profits or for consequential damages. DARS staff members may inspect a
    subcontractor’s records if the records are necessary to the settlement between DARS
    and the contractor.


    1.9.4.6 Submission of Outstanding Financial Claims

    The contractor must promptly settle any outstanding claims, including claims from
    employees, vendors, and subcontractors. A final date is established for the contractor to


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    submit its final State of Texas Purchase Voucher and Billing Attachment, and if
    applicable, reimbursement check as needed to reconcile reported costs and payments.

    The contractor may submit bills, records, affidavits, audit reports, and other documents
    to support contract claims within a reasonable period of up to 90 days. DARS may
    request the contractor to submit additional documents and data, as required to verify
    claims. If original documentation is unavailable, DARS, at its discretion, may accept
    photocopies or other copies of documents and records .


    1.9.4.7 Contract Closure

    To close the contract, DARS must be reasonably certain that the terms of the contract
    have been accomplished and that the following have occurred:

          all required services have been rendered;
          all report data and other requirement documentation have been delivered and
           accepted by DARS;
          any payment owed to DARS has been received;
          all administrative actions have been completed; and
          any final payment owed to the contractor has been made.

    DARS provides written notification to the contractor when the contract is determined
    closed.



    Chapter 2: Financial Management
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133

    2.1 Financial Management Systems
    Authority: 40 TAC §108.709
    The contractor must maintain a financial management system that
        provides accurate, current, and complete disclosure of the financial status of the
           program; and
        contains enough safeguards to protect against loss or serious error.

    The contractor must
        maintain a self-balancing set of accounts for the program;
        prepare all claims for reimbursement and financial reports directly from this set of
          accounts;
        document all costs charged to the contract or reported as maintenance of effort,
          including in-kind contributions;
        reconcile costs with reimbursements and financial reports;


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          maintain a separate accounting (cost center, account number, etc.) for early
           intervention services and respite services;
          maintain cost controls over program expenditures; and
          take action in a timely and appropriate manner to resolve budgetary overages.

    The contractor must develop and maintain internal controls to the following objectives:

          transactions are properly recorded and accounted for to

                 o permit the preparation of reliable financial statements and reports;
                 o maintain accountability over assets; and
                 o demonstrate compliance with laws, regulations, and other compliance
                   requirements;

          transactions are executed in compliance with

                 o laws, regulations, and the provisions of contracts or grant agreements
                   that could have a direct and material effect on the ECI program; and
                 o any other laws and regulations that are identified by DARS; and

          funds, property, and other assets are safeguarded against loss from
           unauthorized use or disposition.

    2.2 Financial Report Submission
    Authority: Texas Government Code, Chapter 783, Uniform Grant and Contract
    Management Act

    The contractor must submit all required financial reports according to the due dates
    established by DARS. If an established due date falls on a weekend or a holiday,
    reports must arrive at DARS ECI by the last business day before the weekend or
    holiday. The following chart shows how the financial report receipt is determined based
    on the method of submission. Financial reports may be mailed, faxed, emailed, or hand
    delivered.

      Submission Type               Receipt Date
      postal mail                   DARS ECI received date stamp
      hand delivery or courier      DARS ECI received date stamp
      service
      fax                           faxed transmittal date
      email                         email transmittal date

    All financial reports must be signed by an authorized person such as
          the executive director,
          the financial officer, or

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          another contractor staff member who is authorized by the contractor to sign such
           documents.

    DARS is authorized to withhold payment or return unprocessed State of Texas
    Purchase Vouchers to the contractor if the required reports are not received timely.


    2.3 Cost Allocation Plans
    Authority: Texas Government Code, Chapter 783, Uniform Grant and Contract
    Management Act; 1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation
    Plans


    The contractor must develop written procedures to ensure an appropriate method for
    distributing allowable costs between the ECI program and other programs or activities
    benefiting from the same costs.

    The contractor must develop and maintain a current cost allocation plan to support
    requests for funding of expenditures that are joint costs or have a common benefit to
    more than one program or activity.



    The cost allocation plan, at minimum, must

              identify each specific cost allocated;
              describe the method used to allocate each specific cost; and
              include the calculation used to determine the rate or percentage developed
               for each specific cost, if known.


    The contractor must submit a cost allocation plan by the date specified by DARS. DARS
    must approve the cost allocation plan and any changes to the plan before
    implementation. The contractor must maintain and make available a copy of the
    approved cost allocation plan for an audit or monitoring review.


    2.4 Property Management
    Authority: Texas Government Code, Chapter 783, Uniform Grant and Contract
    Management Act

    2.4.1 Equipment and Controlled Assets
    The contractor must
        account for all equipment and controlled assets used in ECI program activities;


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          ensure that these items are used only to benefit the ECI program or that costs
           are properly allocated;
          maintain title to the items during the contract period;
          maintain complete, accurate, and detailed records of the items it possesses;
          complete an annual physical inventory of all equipment and controlled assets
           having a current per unit fair market value of $500 or more; and
          submit a Nonexpendable Personal Property Report form with the status or
           disposition of these items to DARS ECI. Equipment and controlled asset items
           allocated to and used by multiple agency programs, such as servers, are
           exempted from reporting.


    2.4.2 Loss or Disposal of Equipment or Controlled Assets
    The contractor must immediately notify DARS ECI of any missing, destroyed, or
    damaged equipment or controlled assets (except for items damaged through ordinary
    wear and tear). The contractor must report stolen equipment to local law enforcement
    authorities and to DARS ECI as soon as possible after it is discovered missing. The
    contractor must keep a copy of a police report to support the final disposition of the item
    from theft or vandalism.

    The contractor must follow guidelines in the American Hospital Association's (AHA)
    Estimated Useful Lives of Depreciable Hospital Assets for disposing of equipment and
    controlled assets except when federal or state requirements supersede, or as otherwise
    provided by the contract. An abbreviated list of some "useful lives" is available from
    DARS ECI or in the Health and Human Services Commission 2007 Texas Nursing
    Facility Cost Report, Schedule A. If an item of equipment or a controlled asset is not
    contained in the AHA’s Estimated Useful Lives of Depreciable Hospital Assets,
    governed by contract, or superseded by federal or state requirements, Uniform Grant
    Management Standards must be followed.

    When an ECI contractor has usable surplus equipment or controlled assets that it no
    longer needs, other ECI contractors may be able to use the items for ECI activities and
    should be notified that the items are available for their use. The ECI contractor
    possessing the surplus items notifies its assigned performance manager of the
    availability of the items and obtains approval, as required, to dispose of the items.

    The contractor must submit a written request to DARS ECI to dispose of equipment or a
    controlled asset before the end of the item’s useful life, or as otherwise required by the
    contract. This written request must include the
        condition of the equipment,
        estimated value, and
        reason for the disposal.

    The performance manager coordinates notification to other ECI contractors , indicating
    the items that are available and providing the possessing ECI contractor’s contact
    information. Interested ECI contractors contact the possessing ECI contractor directly to

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    get details about the items and to arrange the purchase or transfer of the items, if
    agreed. The possessing and transferring ECI contractor notifies its assigned
    performance manager of the disposition and copies the recei ving ECI program director
    in the notification.

    The transferring and receiving ECI contractors must comply with the DARS ECI
    property management requirements found in 2.4.1 Equipment and Controlled Assets.

    Any compensation from the sale, loss, or appro ved disposal of equipment or controlled
    assets must be used to offset the cost of replacement items or as program income.

    Contractors may retain, sell, or dispose of equipment and controlled assets that have
    reached the end of their useful lives with no further obligation to DARS.

    If approval for disposition has been obtained or is not required, the contractor must
    ensure that disposition of any equipment or controlled asset is in accordance with the
    terms of the contract, such as compliance with the Federal Accounting Standards
    Advisory Board’s Generally Accepted Accounting Principles and any applicable federal
    guidance.


    2.5 Annual Audit Reports
    Authorities:
        1 TAC Section 5.167, State of Texas Single Audit Circular, Uniform Grant
           Management Standards (UGMS)
        19 TAC Section 89.1040(c)(3) and (12)
        OMB Circular A-133, Audits of States, Local Governments, and Non-Profit
           Organizations
        OMB Circular A-102, Grants and Cooperative Agreements with State and Local
           Governments
        2 CFR, Parts 215, 220, 225, and 230

    The contractor must comply with established audit requirements to receive funds from
    DARS to provide early intervention services.


    2.5.1 Requirements for Complying with Annual Audit
    On an annual basis, the contractor must submit the following to the Health and Human
    Services Commission (HHSC) Office of Inspector General (OIG):
        a Single Audit Determination form, and
        an independent audit report, if applicable.

    Contractors expending $500,000 or more of state or federal funds must
       obtain a single audit report in accordance with OMB Circular A-133, Audits of
          States, Local Governments, and Non-Profit Organizations; and


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          submit the audit report to DARS Contract Oversight and Support (COS) and the
           HHSC OIG.

    The audit report, including the management letter, must be sent to DARS COS and
    HHSC OIG within the earlier of 30 days after receipt from an independent CPA, or nine
    months after the end of the audit period, unless a longer period is agreed to in advance
    by HHSC OIG or a different period is specified in a program specific audit guide.

    2.5.2 Applicable Laws and Regulations
    Office of Management and Budget (OMB) Circular A-133 and UGMS define audit
    requirements under the Single Audit Act of 1984. They require each subrecipient
    expending more than $500,000 or more of state or federal funds to have an audit
    conducted in accordance with OMB Circular A-133. In addition, OMB Circular A-133
    exempts a subrecipient from compliance with the Single Audit Act of 1984 and other
    federal audit requirements if a subrecipient expends less than $500,000 in any
    combination of federal or state funds.

    To audit in compliance with OMB Circular A-133 and UGMS, the independent CPA
    must meet the requirements of the government auditing standards and be familiar with
    the following documents:
         Generally Accepted Government Auditing Standards
         OMB Circular A-102, Grants and Cooperative Agreements with State and Local
            Governments
         2 CFR, Part 215, Uniform Administrative Requirements for Grants and
            Agreements with Institutions of Higher Education, Hospitals and Other Non-Profit
            Organizations
         2 CFR, Part 220, Cost Principles for Educational Institutions
         2 CFR, Part 225, Cost Principles for State, Local, and Indian Tribal Governments
         2 CFR, Part 230, Cost Principles for Non-Profit Organizations
         Texas Government Code, Chapter 783, Uniform Grant and Contract
            Management Act (UGCMA)
         1 TAC Section 5.167, State of Texas Single Audit Circular, Uniform Grant
            Management Standards (UGMS)


    2.5.3 UGCMA and UGMS
    The UGCMA and UGMS apply as terms and conditions of the contract and are adopted
    by reference in their entirety. If a conflict arises between the provisions of the contract
    and the provisions of UGCMA and UGMS, the provisions of UGCMA and UGMS prevail
    unless stated otherwise in the contract.


    2.5.4 OMB Circular A-133, Compliance Supplement for State, Local
    Governments, and Non-profit Organizations
    The compliance supplement specifies the following for federal financial assistance
    programs:

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          the general and specific program compliance requirements, and
          suggested audit procedures.


    2.5.5 Schedules of Expenditures of Federal and State Awards
    In accordance with UGMS and OMB Circular A-133, the audit report must include
    separate schedules of expenditures of federal and state awards for the period covered
    by the contractor’s financial statements. While not required, the contractor may choose
    to provide information requested by state awarding agencies and pass-through entities
    to make the schedule of state awards easier to use. For example, when a state program
    has multiple award years, the contractor may list the amount of state awards expended
    for each award year separately.

    At a minimum, the schedules must do the following:
         Present separately, in different sections or schedules, state awards expended
           and federal awards expended, eve n if the state funds were awarded with the
           federal funds as one program. Federal awards and state awards must be totaled
           separately.
         List individual federal programs by federal agency and state programs by state
           agency. For federal or state programs included in a cluster of programs, list
           individual federal or state programs within the cluster.
         For federal or state awards received as a subrecipient, include the
              o name of the pass-through entity, and
              o identifying number assigned by the pass-through entity.
         Provide total federal awards expended for each individual federal program and
           the Catalog of Federal Domestic Assistance (CFDA) number or other identifying
           number when the CFDA information is not available. Provide total state awards
           expended for each individual state program and the state program name and
           state program number, if applicable, or other relevant identifier when the state
           program number is not available.
         Include notes that describe the significant accounting policies used in preparing
           the schedules.

    To the extent practical, pass-through entities should identify in the schedules the total
    amount provided to subrecipients from each federal or state program.




    Chapter 3: ECI Costs
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133




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    3.1 Reimbursement of Allowable Costs
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783

    In order for fringe benefits to be allowable, they must comply with all applicable statutes,
    regulations, rules, and cost principles.

    The contractor must ensure that all reimbursements are in accordance with the
    approved contract budget and corresponding expense line items and attributed to the
    proper contract period. All ECI program charges must comply with the standards
    provided in the UGMS.

    The contractor must
        submit requests for reimbursement on a State of Texas Purchase Voucher and
          Monthly ECI Expenditures—Billing Attachment no later than 30 days following
          the end of the month for which reimbursement is requested;
        submit a final request for reimbursement no later than November 15, following
          the end of the fiscal year to settle outstanding claims;
        ensure that requests for reimbursement represent allowable expenses incurred
          as specified in the approved ECI budget. If the expense is incurred but not yet
          paid at the time reimbursement is requested, payment should be dispersed within
          three days after it is received from DARS. If payment is not dispersed within
          three days, the contractor may be asked to explain why the drawdown was made
          prematurely;
        ensure that requests for reimbursement are necessary and reasonable for proper
          and efficient performance and administration of the ECI program;
        ensure that requests for reimburseme nt are prepared directly from the
          contractor's self-balancing set of accounts; and
        ensure that cumulative requests for reimbursement do not exceed the contract
          amount.

     The contractor must submit purchase vouchers with billing attachments according to
    the instructions and by the due dates established by DARS. The following chart shows
    how the purchase voucher and billing attachment receipt dates are determined based
    on the method of submission.


      Submission Type                   Receipt Date
      postal mail                       DARS ECI received date stamp
      hand delivery or courier          DARS ECI received date stamp
      service
      fax                               faxed transmittal date
      email                             email transmittal date

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    All requests for reimbursement must be signed by an authorized person such as the
    contractor’s
         executive officer,
         financial officer, or
         another contractor position authorized by local policy to sign such documents.


    3.2 Personnel Compensation
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Manageme nt Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may expend funds to employ staff members necessary to administer the
    ECI program, if the position types have been approved in the budget. All personnel
    charges must comply with the standards provided in the UGCMA.



    3.3 Fringe Benefits
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783

    The contractor may expend funds to secure fringe benefits for employees of the ECI
    program, if approved in the budget.

    Contractors must support fringe benefit charges with documentation such as
       invoices,
       canceled checks,
       payroll records, and
       insurance policies.



    3.4 Travel
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783

    The contractor may expend funds to pay employees for travel expenses while on official
    ECI business and to ensure consistency between charges, if approved in the budget.


    Costs must be supported by documentation, such as
       the contractor’s written travel policy,

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          a signed travel voucher submitted by the employee and approved by the
           supervisor (electronic signatures are acceptable if allowed by the contractor’s
           policies),
          receipts and invoices,
          debit or credit card statements, and
          canceled checks.

    The travel voucher must include the following :
        the date;
        the origination;
        the destination;
        mileage from point to point;
        the child identified by case number (if applicable); and
        the purpose of the trip (for example, to provide direct services or to work on some
           project or objective for the contractor).

    If the contractor has no written travel policy, the reimbursement rate must not exceed
    federal travel reimbursement rates in effect; or if directed by state law (for example, for
    MHMR Centers), it must not exceed the Texas state rates in effect.

    If the contractor has a written travel policy, the reimbursement rate must not exceed the
    state rates in effect if directed by state law; or if not directed by state law, the contractor
    may use federal or other established rates, as long as the rates are reasonable as
    determined by DARS. The travel rates used by the contractor must be applied
    consistently.

    If the travel is for both ECI and non-ECI purposes, the costs must be appropriately
    allocated.


    3.5 Contractor-Owned and -Leased Vehicles
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    Contractors are authorized to use contractor-owned and -leased vehicles for travel on
    official ECI business, if approved in the budget.

    If the vehicles are used for both ECI and non-ECI purposes, the costs must be
    appropriately allocated.


    3.5.1 Contractor-Owned Vehicles
    For contractor-owned vehicles, the contractor must use one of the following methods to
    document costs:

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          1. apply the State of Texas mileage rate approved for personal vehicles;
          2. apply depreciation using the straight-line method over the estimated useful
             life of the vehicle. The straight-line method must be a minimum of three years
             for new cars and minivans and five years for light trucks and vans. The
             purchase price of the vehicle and the period of useful life must be submitted;
          3. apply a fixed rate, not to exceed the current State of Texas mileage rate,
             calculated by dividing the total expenditures for vehicle insurance,
             maintenance, and operations by the total miles driven during the same period.
             This average cost per mile may then be applied to the ECI mileage to
             determine the amount to bill. Payments for the vehicle purchase cannot be
             included in the calculation of the fixed rate;
          4. bill actual costs for ECI program use based on receipts for insurance,
             maintenance, and operations. Payments for the vehicle purchase cannot be
             included in the calculation of actual vehicle costs; or
          5. use a combination from above of 2. and 3., or 2. and 4.

    Contractor-owned vehicle costs must be supported by documentation such as
       the agency travel policy;
       mileage reports, including the sites visited and the purpose of trips;
       receipts for insurance;
       gas and maintenance receipts;
       maintenance logs; and
       a description of the method selected to calculate costs.


    3.5.2 Leased Vehicles
    Leased vehicle costs must be supported by documentation such as
        the lease agreement;
        mileage reports, including the sites visited and the purpose of trips;
        receipts for insurance; and
        gas and maintenance receipts.

    Leased vehicle costs cannot include interest or other unallowable costs.


    3.6 Consumer Transportation
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles a nd Cost Allocation Plans

    The contractor may expend funds to obtain transportation necessary for consumers to
    access ECI services or training, if approved in the budget. These expenses may include
        bus fare,
        taxi fare, and

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          personal vehicle mileage reimbursement at a rate not to exceed the contractor’s
           established mileage reimbursement rate.

    If consumer transportation is provided, the contractor must develop written guidelines
    for reimbursement of consumer transportation costs. Consumer transportation
    expenses must be supported by documentation such as
         receipts and invoices,
         debit or credit card statements,
         canceled checks, and
         travel vouchers.

    The contractor must assist the family in seeking reimbursement from third-party sources
    when appropriate.


    3.7 Seminars, Meetings, and Conferences
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may expend funds for staff members to attend seminars, meetings, and
    conferences to benefit them in ECI program activities, if approved in the budget.

    The following information must be on file to justify attendance:
        the contractor’s written travel policy, if applicable;
        the employee's written request containing a description of the seminar, course, or
           conference; and
        an explanation of how the successful completion of the course or attendance at
           the conference enhances the employee's job performance.

    The following information must be on file to support the cost of attendance:
        the names and titles of staff members attending;
        the title, date, and location of the seminar, meeting, or conference;
        a signed travel voucher submitted by the employee and approved by the
           employee's supervisor;
        receipts for authorized and allowable travel expenses;
        receipts for registration fees; and
        an agenda, or a brief description of meeting topics if an agenda is unavailable.



    3.8 Equipment
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;

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    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may expend funds to purchase equipment needed to administer the ECI
    program, if approved in the budget.

    Equipment is nonexpendable, tangible personal property having a useful life of more
    than one year and an acquisition cost that equals or exceeds the lesser of
        the capitalization level established by the contractor for financial statement
           purposes, or
        $5,000.

    Equipment purchases from DARS contract funds during the fiscal year must have
    documented prior approval and be included in the ECI funding application or on an ECI
    Revised Contract Budget form (see Chapter 2: Financial Management, 2.5 Annual Audit
    Reports).
    When requesting to purchase equipment, contractors must include the following
    information:
         justification of need;
         a complete description of the item including brand name and specifications;
         the vendor’s name;
         quantity and unit price; and
         total cost of purchase.

    Equipment costs must be supported by documentation such as
        copies of vendor bids,
        receipts and invoices,
        debit or credit card statements, and
        canceled checks.

    The contractor must have written procedures for procuring equipment that include
    requirements to
        seek bids from at least three vendors, and
        make a selection based on best value.

    The contractor must establish and follow specific inventory procedures for all equipment
    purchased for ECI program activities. The contractor must conduct inventories of
    equipment used in ECI program activities annually. The status or disposition of
    equipment must be reported on a Nonexpendable Personal Property Report form. This
    report must be submitted to DARS ECI by the date specified in the contract following
    the end of each contract period (see Chapter 2: Financial Management, 2.4 Property
    Management.)

    Permanently affixed equipment items, such as items that are secured to an object, are
    unallowable.


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    3.9 Supplies
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may expend funds to purchase supplies needed to administer the ECI
    program, if approved in the budget. Supplies are items costing less than $5,000 per
    unit, or the capitalization level established by the contractor for financial statement
    purposes, and customarily having a useful life of less than one year.


    3.9.1 Direct Service Supplies
    The contractor may purchase direct service supplies necessary for service delivery, if
    approved in the budget.

    Direct service supplies include
        evaluation and assessment tools;
        educational materials;
        expendable medical supplies; and
        positioning, mobility, and assistive technology devices if identified as a need in
           the IFSP.

    For direct service supplies costing more than $500 per item, contractors must seek
    reimbursement from applicable third-party sources before billing DARS ECI.
    Reimbursement from third parties should be attempted in the following order:
        private insurance or Children’s Health Insurance Program (CHIP),
        Medicaid,
        Children with Special Health Care Needs (CSHCN), and
        the DADS In-Home and Family Support Program.

    Most third-party sources require documentation of medical necessity. Third-party
    providers might use different terms than DARS ECI for determining funding eligibility of
    direct service supplies. For example, a third party may define a communication device
    such as a touch talker as ―medically necessary‖ because people who are nonspeaking
    must be able to communicate medical needs to their physicians and primary caregivers,
    while DARS ECI defines it as ―developmentally necessary.‖ Contractors making direct
    service supply requests of third parties should write the requests in accordance with
    third-party requirements and terminology.

    If the contractor is unsuccessful in receiving approval from third-party sources, it may
    use ECI program funds to purchase, rent, or lease direct service supplies. The
    contractor must maintain documentation verifying unsuccessful attempts for
    reimbursement from third-party sources.



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    Contractors must maintain documentation for purchases of direct service supplies,
    showing that the supplies are being used for the benefit of the ECI program.


    3.9.2 Office and Janitorial Supplies
    The contractor may expend funds to purchase office and janitorial supplies necessary to
    administer the ECI program from an outside vendor or from a contractor-owned central
    store, if approved in the budget.

    Requests for reimbursement for office and janitorial supplies must be supported by
    documentation such as
        purchase orders,
        copies of requisitions,
        supply order requests,
        receipts and invoices,
        debit or credit card statements,
        canceled checks, and
        accounting records detailing the transfer of funds if purchased from a contractor -
         owned central store.

    The contractor must maintain financial records to support its central store charges to
    individual programs.


    3.9.3 Controlled Assets
    The contractor may expend funds to purchase controlled assets needed to administer
    the ECI program, if approved in the budget.

    Controlled assets are items from the following list that have a unit cost greater than
    $500, but less than $5,000, or a unit cost greater than capitalization level established by
    the contractor for financial statement:
         copiers;
         medical and laboratory equipment;
         emergency management equipment;
         media equipment such as video recorders, cameras, CD players, TVs, VCRs,
           camcorders, and DVD players;
         desktop and laptop computers;
         printers (not portable); and
         communication devices and systems such as fax machines, cellular and mobile
           telephones, hand-held radios, wireless handheld devices, pagers, and
           telecopiers.

    DARS may modify this list of controlled assets based on guidance from the Comptroller
    of Public Accounts.




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    Controlled assets not listed as an approved budget line item may be purchased without
    prior approval if the following requirements are documented and maintained by the
    contractor:
         justification for the purchase;
         approval from the agency information technology or information resource
           department, if applicable;
         a copy of the quote and specifications;
         the quantity and unit price;
         the total cost of purchase;
         assurance of security of equipment a nd confidentiality of consumer data; and
         application of the purchase to the appropriate fiscal year.

    The contractor must follow its purchasing policies and procedures and confirm before
    purchase that the controlled assets are compatible with its current systems.
    Controlled asset expenses are included in the ―Supplies‖ category of the funding
    application and quarterly Financial Status Reports.

    Controlled asset costs must be supported by documentation such as copies of
       vendor bids,
       receipts and invoices,
       debit or credit card statements, and
       canceled checks.

    Specific inventory procedures must be established and followed for all controlled assets
    purchased for ECI program activities. Inventories of controlled assets used in ECI
    program activities must be conducted annually. The status or disposition of controlled
    assets must be reported on a Nonexpendable Personal Property Report form. This
    report must be submitted to DARS ECI by the date specified in the contract (see
    Chapter 2: Financial Management, 2.4 Property Management).



    3.10 Contractual Services
    Authorities: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    34 CFR Section 80.36(b)–(i); 2 CFR Sections 215.40 through 215.48; Historically
    Underutilized Businesses, Texas Government Code, Chapter 2161; 1 TAC Section
    5.150, Uniform Cost Principles and Cost Allocation Plans; and 40 TAC Section 108.306,
    Criminal Background

    For all subcontracts, the contractor must comply with the requirements in this section.
    The contractor must also comply with the requirements in either 3.10.1 Consumer -
    Related Contractual Services or 3.10.2 Nonconsumer Contract Services, depending on
    whether the contract is for consumer services or non-consumer services.


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    All contractors must comply with UGMS. The contractor uses its own procurement
    procedures that must reflect applicable state and local laws and regulations, as well as
    applicable federal law and the standards identified below.
         State agencies (also applicable to Mental Health and Mental Retardation centers
           and Education Service Centers) must follow 34 CFR Section 80.36(a).
         Local governmental entities (including independent school districts) must follow
           34 CFR Subsections 80.36(b) through (i).
         Institutions of higher education and other nonprofit organizations must follow 2
           CFR Sections 215.40 through 215.48.

    The contractor must purchase contractual services based on best value. In determining
    best value, contractors should evaluate potential subcontractors for the following:
        cost;
        ability to provide the required services;
        quality and reliability of services;
        indicators of probable performance under a contract such as past performance,
           experience, or demonstrated capability and responsibility; and
        other factors relevant to determining the best value in the context of a particular
           purchase.

    The contractor must maintain documentation of bids or proposals, subcontractor
    selection based on best-value factors, subcontracts, and letters of agreement for a
    period of five years. Documentation must also include evidence that there was no
    conflict of interest in hiring the subcontractor. Reimbursement of costs may be
    disallowed if the contractor does not maintain adequate docume ntation.

    Subcontracts or letters of agreement for contractual services must include, at a
    minimum, the following:
        services to be performed and the recipients of those services;
        provisions outlining requirements for criminal background checks equivalent to
          those required for contractor employees;
        provisions outlining the responsibility for the cost of criminal background checks if
          the subcontract is for a consumer service;
        dates of service or subcontract period;
        the amount to be paid to the subcontractor per unit of service provided;
        the total amount of the subcontract;
        the amount to be paid for personal vehicle mileage and for other approved
          allowable costs; and
        the dated signature of the subcontractor and the authorized contractor
          representative before provision of services.

    The subcontract may be amended only in writing, and the amendment must be signed
    by persons with authority to bind all parties.

    Contractual services must be supported by documentation such as


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          a copy of the signed subcontract agreement,
          receipts and invoices, and
          canceled checks.


    3.10.1 Consumer-Related Contractual Services
    The contractor may expend funds to contract with qualified professionals to provide ECI
    services, if approved in the budget.

    Contractual services must be supported by documentation such as
       a copy of the signed subcontract agreement,
       receipts and invoices, and
       canceled checks.

    Documentation of completed contractual services must show the following:
       the date of service;
       a description of the service provided;
       the recipients of the service;
       the amount of time spent providing the service and quantity of service provided;
       results of the service, such as an evaluation or progress report on file in the
         child's folder;
       payment for travel time or expenses, such as personal vehicle mileage, if
         applicable, with payment based on the reasonable and actual miles traveled;
       other costs authorized in the subcontract; and
       evidence showing that the terms of the subcontract were carried out before
         payment to the subcontractor.

    The contractor must maintain copies of current licenses for the subcontractor, or the
    subcontract must state that the subcontractor agrees to continuously maintain current
    licensure and provide proof upon request.

    The contractor must obtain a criminal background check on a subcontractor who is an
    individual professional. The contractor or the subcontractor entity must perform criminal
    background checks on all employees that have contact with or provide services to
    children and families. Specific responsibility for criminal background checks, including
    who pays for them, must be included in the subcontract.


    3.10.2 Nonconsumer Contract Services
    The contractor may expend funds to subcontract for administrative support services
    related to the ECI program, if approved under the category of ―Other‖ in the budget.

    The contractor may incur expenses for contractual services that are not directly
    consumer-related, such as
        clerical services,
        accounting or bookkeeping,

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          auditing,
          data processing,
          janitorial services,
          exterminating, and
          information technology services.


    3.11 Space Rental
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may expend funds to rent space for the ECI program, if approved in the
    budget. See 3.12 Building Use Reimbursement.

    Contractors renting space for the ECI program must doc ument and maintain the
    following information:
          the monthly cost of the space;
          total square footage of the space;
          the agency or person to whom rent is paid;
          the facility address; and
          justification for renting space.

    The contractor must notify DARS if the amount of space or rental charge changes in
    any way, or if the program moves to a new location.

    The rental cost must not exceed the cost of comparable space and facilities in a
    privately owned building in the same locality. The cost of space rental cannot be
    charged for periods of nonoccupancy by the ECI program.

    Space rental costs must be supported by documentation such as
        lease agreements,
        floor plans, and
        canceled checks.



    3.12 Building Use Reimbursement
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215, in particular
    2 CFR Sections 215.40–48; the applicable cost principles of 2 CFR Parts 220, 225, and
    230; OMB Circular A-133; Uniform Grant and Contract Management Act, Texas
    Government Code, Chapter 783; 1 TAC Section 5.150, Uniform Cost Principles and
    Cost Allocation Plans


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    The contractor may receive compensa tion for costs of the use of contractor-owned
    buildings, if approved in the budget. The costs of contractor-owned building space may
    be reimbursed through depreciation or use allowance.

    The following information must be submitted for approval before the expense is
    incurred:
        the name of the owner of the facility;
        a statement of whether the building was purchased with federal funds in full or in
           part;
        the original acquisition cost plus the cost of any improvements;
        the date of purchase and the useful life of the building; and
        the total square footage of the building, as well as the square footage used by
           the ECI program.

    Building use costs must be supported by documentation such as
        floor plans, and
        acquisition cost documents.

    The total cost of space may not exceed the rental cost of comparable space and
    facilities in a privately owned building in the same locality.




    3.13 Interest and Financing Costs
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may expend funds for interest and financing costs related to the use of
    contractor-owned buildings, if approved in the budget.


    3.14 Building Maintenance, Repairs, and Alterations
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may expend funds to maintain buildings and grounds and to make
    necessary building repairs, rearrangements, and alterations, if approved in the budget.

    These costs are allowable to the extent that they
        keep property in an efficient operating condition;


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          do not add to the permanent value of the property or appreciably prolong its
           intended life; and
          are not otherwise included in rental or other charges for space.

    In cases where the contractor rents space in a building, the responsibility for these costs
    should be specified in the lease agreement, and payment should be handled
    accordingly.

    Maintenance may include
        exterminating services,
        janitorial services,
        security services, and
        grounds upkeep.

    Building repairs may include
        air conditioning and heating,
        electrical, and
        plumbing.

    The contractor must request prior approval from DARS ECI for any repairs,
    rearrangements, or alterations costing over $2,000 each, regardless of the source of
    funds to be used.

    Building and grounds maintenance and building repairs, rearrangements, and
    alterations must be supported by documentation such as
         copies of bids,
         receipts and invoices,
         debit or credit card statements, and
         canceled checks.

    These costs must be based on best value. In determining best value, the following
    factors should be considered:
         cost,
         ability of the vendor to provide the required services,
         quality of services,
         reliability of services,
         indicators of probable performance under a contract such as past performance,
         experience or demonstrated capability and responsibility, and
         other factors relevant to determining the best value in the context of a particular
           purchase.

    Costs for building maintenance, repairs, and alterations must be appropriately allocated.




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    3.15 Utilities
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may expend funds for utilities, if approved in the budget.

    Utility costs must be supported by documentation such as
          receipts and invoices,
          debit or credit card statements, and
          canceled checks.

    If utilities are used for both ECI and non-ECI purposes, the costs must be appropriately
    allocated.


    3.16 Communications
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may expend funds for communications, if approved in the budget.

    Communication costs may include, but are not limited to
       telephone and cell phone services,
       paging services, and
       Internet access.

    Communication costs must be supported by documentation such as
       long distance logs,
       receipts and invoices,
       debit or credit card statements, and
       canceled checks.



    3.17 Equipment Leasing, Maintenance, and Repairs
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans



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    The contractor may expend funds to lease, maintain, and repair equipment needed for
    ECI program operations if the maintenance and repair neither adds to the permanent
    value of the equipment nor appreciably prolongs its intended life, but keeps it in efficient
    operating condition, if approved in the budget.

    Equipment leasing, maintenance, and repairs must be supported by documentation,
    such as
        copies of bids,
        receipts and invoices,
        debit or credit card statements, and
        canceled checks.



    3.18 Reproduction and Printing Expenses
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may expend funds for the use of reproduction equipment and supplies
    necessary for printing and copying materials used in ECI activities, if approved in the
    budget.

    Reproduction and printing charges must be supported by documentation such as
       the cost per copy rate,
       copy logs,
       receipts and invoices,
       debit or credit statements, and
       canceled checks.


    3.19 Postage and Shipping
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may expend funds to purchase postage and shipping necessary to
    administer the ECI program, if approved in the budget.

    Postage and shipping must be supported by documentation such as
        postage logs,
        statements from the post office for meter usage,
        receipts and invoices,

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          debit or credit card statements, and
          canceled checks.


    3.20 Insurance
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may expend funds to acquire insurance coverage for facilities, vehicles,
    and personal or professional liability necessary to carry out operations of the ECI
    program, if approved in the budget.

    Contractors requesting insurance coverage must submit the following information:
       the type of insurance coverage requested,
       the monthly or annual cost to the ECI program, and
       justification of need.

    The type, extent, and cost of coverage must be in accordance with general local
    government policy and sound business practices.

    Insurance costs must be supported by the following:
        copies of insurance policies,
        billing statements,
        receipts and invoices,
        debit or credit card statements, and
        canceled checks.


    3.21 Membership Fees, Subscriptions, and State
    Licensing Fees
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may be reimbursed for expenses related to authorized fees and
    subscription costs, if approved in the budget. The contractor may incur expenses for
    memberships, state licensing fees, and subscriptions that benefit the ECI program such
    as
        memberships to professional organizations;
        subscriptions to professional newsletters, periodicals, and magazines; and
        state licensing renewal fees for contractor employees.


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    Costs of membership fees in professional organizations must be supported by
       purchase orders,
       receipts and invoices,
       debit or credit card statements, and
       canceled checks.

    Membership must be in the name of the contractor or one staff representative if agency
    membership is not allowed. Contractors may not use funds to pay for memberships in
    chambers of commerce or organizations that employ lobbyists.

    Costs of the contractor organization for subscriptions to professional newsletters,
    magazines, or periodicals are allowable. Membership must be in the name of the
    contractor and not in the name of a person. These costs must be supported by
    documentation such as
        purchase orders,
        receipts and invoices,
        debit or credit card statements, and
        canceled checks.

    Costs for state licensing renewals for individual employees as well as the cost of
    required exams are allowable if
        the exam is a prerequisite to receive a state license,
        the license is required for the employee’s current position,
        the fee or cost of exam is allowed under the contractor’s written policies, and
        adequate funding is available in the budget.

    If the licensed employee leaves employment with the ECI program before the expiration
    of the licensure term, the employee must reimburse the ECI program a prorated share
    of the license renewal fee.


    3.22 Advertising
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may expend funds to advertise for public awareness and child find
    activities and recruitment of qualified staff persons, if approved in the budget.

    Advertising expenses must be supported by documentation such as
        copies of ads,
        receipts and invoices,
        debit or credit card statements, and
        canceled checks.

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    Allowable advertising costs for public awareness and child find include items for
    distribution to referral sources and the general public including but not limited to
         posters,
         calendars,
         magnets,
         pens, and
         pencils.

    Allowable recruitment expenses include printing for special fliers and brochures and
    advertising costs for newspapers and trade journals. Apparel items, such as T-shirts,
    caps, and other apparel for use by contractor staff members or others for public
    awareness and child find advertisement are unallowable.


    3.23 Employee Educational Expenses
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may reimburse ECI program employees for educational expenses
    incurred while pursuing job-related or job-enhancing course work at institutions of higher
    education or other accredited institutions, if approved in the budget.

    Educational expenses may include the following:
        tuition,
        laboratory fees,
        books, and
        other related costs required for satisfactory completion of the course.

    Educational expenses must be supported by
        the contractor’s written education policy;
        a written request submitted by the employee and approved by the employee’s
          immediate supervisor;
        course schedule or course syllabus;
        receipts and invoices;
        debit or credit card statements;
        canceled checks; and
        evidence of successful completion of the course (for example, grade report).

    The employee's request must contain a narrative description of the course, as well as
    an explanation of how the course is job-related and how the successful completion of
    the course will affect or enhance the employee's future job performance. Meals and


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    travel costs are not considered essential for successful completion of the course and
    therefore are unallowable.

    ECI program employees who are part of an agency that does not have a written
    educational policy cannot be reimbursed for educational expenses.


    3.24 Food
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor may expend funds to purchase food for children in the ECI program to
    implement strategies or achieve IFSP outcomes to enhance the nutritional and
    occupational therapy feeding components of the ECI program, if approved in the
    budget.

    Purchase of food must be supported by documentation such as
        receipts and invoices,
        debit or credit card statements, and
        canceled checks.

    Proper documentation must be maintained to support allocation of food costs for ECI
    children when non-ECI-eligible children are included.

    For food purchases for meals of employees on travel status, see 3.4 Travel.


    3.25 Indirect Costs
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    No cost may be charged as an indirect cost if it is also charged as a direct cost, and
    vice versa.

    The contractor may expend funds for administrative activities that support the ECI
    program and recover costs based on an approved indirect cost rate.

    With prior written approval from DARS, the contractor may charge indirect costs based
    on one of the following methods:
        approved rate agreement from its federal or state cognizant agency,
        indirect cost rate verified by its independent auditors and included as a schedule
           of indirect costs in the annual independent audit report, or

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          indirect cost rate negotiated with DARS based on the administrative costs
           applicable to the ECI program and lower than the approved rate from the
           cognizant agency or the schedule of indirect costs.

    The contractor must submit the following information when requesting to charge indirect
    costs to the ECI program:
       a copy of the current approved rate agreement from the federal or state cognizant
          agency;
       schedule of indirect costs from the most recent annual independent audit report;
          or
       supporting documentation of the calculation for any indirect cost rate, lower than
          the approved rate from the cognizant agency or the schedule of indirect costs,
          based on the administrative costs applicable to the ECI program.

    The indirect cost method approved by DARS must be applied throughout the fiscal year.
    Indirect costs must not be applied to in-kind volunteer and in-kind noncash
    contributions. Documentation must be maintained to support the indirect cost rate,
    including the indirect cost allocation base and a list of joint costs included in the indirect
    cost pool.

    The most recently approved indirect cost rate must be used to calculate indirect charges
    in cases where a rate has not been established for the contract period. In cases where
    a new indirect cost rate becomes effective during the contract period, the contractor
    must apply the new rate starting with the date the new rate becomes effective.


    3.26 Unallowable Costs
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783;
    1 TAC Section 5.150, Uniform Cost Principles and Cost Allocation Plans

    The contractor must conform to cost principles as specified in UGMS and ECI rules and
    regulations.

    The contractor may not incur expenses for unallowable costs such as
        bad debts,
        contingency funds,
        construction or renovation of buildings,
        entertainment expenses,
        fines and penalties,
        legislative expenses,
        under-recovery of costs under grant agreements,
        fund-raising expenses,
        investment management costs,

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          purchases of land or buildings,
          purchases of vehicles,
          lobbying,
          food for purposes other than those defined in 3.4 Travel or 3.24 Food, and
          other costs not included in the approved ECI budget.

    Exclusion of a particular item from the list of unallowable costs above does not
    necessarily mean it is allowable. The contractor should consult with DARS ECI for
    questions about eligibility of costs. DARS ECI refers to the approved ECI budget and
    applicable federal and state regulations when further clarification is needed.


    3.27 Advance Payment on Contracts
    Authority: Uniform Grant Management Standards (UGMS); 2 CFR Part 215; the
    applicable cost principles of 2 CFR Parts 220, 225, and 230; OMB Circular A-133;
    Uniform Grant and Contract Management Act, Texas Government Code, Chapter 783

    A contractor in good standing may submit a written request and receive up to one-
    twelfth of its contract amount in advance funds to meet immediate operating expenses,
    based on justified need.

    Advance payment may be requested only to meet immediate cash needs and must be
    disbursed within three business days of receipt and in accordance with 3.1
    Reimbursement of Allowable Costs. DARS may monitor the contractor’s daily cash
    balances to verify timely disbursement of the advance.

    The contractor must
        submit its request for advance payment to DARS ECI using the Request for
          Advance Payment form;
        demonstrate immediate need and provide a description of how the disbursement
          will occur within three business days of receipt;
        submit a voucher for the amount of the advance payment requested;
        establish a current signed contract before an advance pa yment can be
          processed;
        demonstrate proper justification based on the following criteria to be considered
          for an advance:
          o be in good standing with DARS as determined by a minimum of two years’
               contract history with DARS, unless the contractor can show sufficient and
               proper historical documentation that would suggest that the contractor’s need
               is legitimate (for example, annual audits, program certification, financial
               statements);
          o not have outstanding obligations to DARS from
                questioned or unallowable costs in an annual audit,
                past due monitoring findings, or
                prior year closeout of contract expenditures;
          o not currently be under sanctions imposed by DARS;

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           o not be classified as a state agency under interagency law; and
           o not have access to other funds, including deposited funds, that would be both
             appropriate and sufficient to cover the amount requested.

    DARS determines the contractor’s cash position based on an analysis of year-end fund
    balance, assets, and liabilities. The review may also include an evaluation of the
    contractor’s
        debt service history,
        credit rating,
        financial statements, and
        reports of financial position.

    DARS responds to a request for an advance no later than 30 days after receipt of the
    request.



    Chapter 4: Maintenance of Effort (MOE)
    4.1 State and Local Funds
    Authority: 20 USC Sections 1413, 1416, and 1440; 34 CFR Section 80.25; 34 CFR
    Sections 303.124 and 303.527; UGMS, and 40 TAC Section 108.709

    State and local funds include:
        collections from family cost participation, including the following third-party
           sources:
              o private insurance,
              o public insurance and benefits, and
              o the parent’s maximum monthly fee (MMF);
        local funds;
        private funds;
        in-kind contributions; and
        unsolicited cash.

    State and local funds must be collected by the contractor and must be reported and
    used for allowable ECI program expenditures.


    4.1.1 Family Cost Participation
    The contractor must establish a system of payments for early intervention services in
    compliance with 40 TAC, Chapter 108, Subchapter F. As part of the system, the
    contractor must include the collection of private insurance, public insurance and
    benefits, and the maximum monthly fee (MMF) assessed to the family, for each child
    enrolled in ECI comprehensive services.

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    4.1.1.1 Private Insurance

    The contractor must pursue reimbursement for eligible services and attempt to secure
    contracts with private insurance companies in its service delivery area through all
    appropriate means. When unable to secure a contract, documentation must be
    maintained which supports actions taken to obtain a contract.

    The contractor must obtain written parental consent before billing private insurance and
    must attempt to bill private insurance for all covered services on the IFSP. If a family
    has both Medicaid and private insurance, the contractor must bill private insurance for
    physical therapy, occupational therapy, and speech therapy services which qualify for
    Medicaid as Developmental Rehabilitation Services (DRS). For developmental services
    (DS) that qualify as DRS, the contractor does not bill private insurance because DARS
    ECI bills these services. For other Medicaid-eligible services on the IFSP, the contractor
    does not bill private insurance, but instead bills Medicaid THSteps—CCP.
    4.1.1.2 Children's Health Insurance Program (CHIP)

    The contractor must pursue reimbursement for eligible services and secure contracts
    with CHIP managed care organizations in its service delivery area. ECI services
    covered by CHIP provided by the contractor or a subcontractor must be billed to the
    appropriate third-party payers for children enrolled in CHIP.

    4.1.1.3 TRICARE

    TRICARE is a U.S. Department of Defense health care entitlement for active duty,
    Guard and Reserve, and retired members of the military, and their eligible family
    members and survivors. The contractor must pursue reimbursement for eligible services
    and attempt to secure contracts with TRICARE in its service delivery area through all
    appropriate means. When unable to secure a contract, the contractor must maintain
    documentation of actions taken to obtain a contract.

    4.1.1.4 Texas Health Steps—Comprehensive Care Program (THSteps—CCP)
    The contractor must pursue reimbursement for eligible services and secure contracts
    with Medicaid health maintenance organizations in its service delivery area. ECI
    services covered by THSteps—CCP provided by the contractor or a subcontractor must
    be billed to the appropriate third-party payers for children enrolled in Medicaid. The
    contractor should refer to the Texas Medicaid Provider and Procedures Manual for
    additional information. Permission to bill for any Medicaid service is not needed. The
    contractor should refer to the Texas Medicaid Provider and Procedures Manual for
    additional information.

    The contractor must also secure a contract with the managed care organization (MCO)
    contracted with HHSC to administer the STAR Health program, which provides health
    care services for Texas children in the conservatorship of the Department of Family and
    Protective Services, including children in foster care and kinship care. Eligible services


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    provided by the ECI contractor, or its subcontractor, must be billed to the STAR Health
    MCO.

    Services must be performed by qualified staff members and subcontractors who meet
    qualifications as required by the STAR Health program, and are enrolled as service
    providers in the program.
    4.1.1.5 Case Management and Targeted Case Management (TCM)
    The ECI contractor is required to bill case management services to the appropriate
    third-party payer, including private insurance, CHIP, TRICARE, and Medicaid. For
    children and families that meet the requirements of the Texas Medicaid State Plan, case
    management services must be billed to the Texas Medicaid Claims Administrator.
    4.1.1.6 Family Maximum Monthly Fee (MMF)
    The ECI contractor must determine if the parent must pay a n MMF for ECI services in
    accordance with 40 TAC Section108.604. The DARS ECI attestation form must be used
    to determine if the family is subject to an MMF or does not have the ability to pay an
    MMF.


    4.2 Other Funds for Support of the ECI Program
    The ECI contractor is required to contribute other funds to the operation of its ECI
    program using other funds, including but not limited to
        Local Funds—federal, state, county, and city funds received directly by the
          contractor at the local level including MAC;
        Private Funds—funds received directly by the contractor from United Way and
          other private agencies, foundations and fund raisers;
        In-Kind Contributions—volunteer services furnished by professionals, technical
          consultants, and other skilled and unskilled labor directly benefiting and
          specifically identifiable to the ECI program; noncash contributions such as
          charges for real property, nonexpendable personal property, or the value of
          goods directly benefiting and specifically identifiable to the ECI program; and
        Unsolicited Cash—unsolicited money donations or contributions for use by the
          ECI program.


    4.2.1 Medicaid Administrative Claiming (MAC)

    ECI contractors recognized by the state of Texas as governmental entities must
    participate in the Texas Medicaid Administrative Claiming (MAC) program, which is
    operated by the Health and Human Services Commission (HHSC). To participate in
    MAC, the contractor must have an interagency agreement with HHSC and meet all
    participation requirements.

    All ECI contractors must participate in the Random Moment Time Study (RMTS) for
    purposes of establishing rates for Targeted Case Management services and the
    Developmental Rehabilitation Services.

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    4.2.2 In-Kind Contributions
    Authority: Texas Government Code, Chapter 783, Uniform Grant and Contract
    Management Act

    The contractor may use in-kind contributions in the operation of the ECI program if the
    use and valuation of the contributions are approved by DARS ECI.

    The contractor must document volunteer time in the same manner as personnel
    compensation (see Chapter 3: ECI Costs, 3.2 Personnel Compensation). In addition,
    the ECI contractor must document and an hourly rate comparable to salaries in the
    community for like services. Staff members who are compensated for their time by the
    contractor agency are not considered volunteers.

    Contributions in agency-owned buildings for space, utilities, etc., are not considered in-
    kind contributions when there is a cost incurred by the contractor. However, when
    property is paid for and fully depreciated, the value of the space in contractor-owned
    buildings can be reported as an in-kind contribution. Contractors must estimate and
    report the value of in-kind contributions, including donated space, volunteer time, and
    other noncash contributions on financial reports submitted to DARS ECI.

       

    4.3 Billing for ECI Services
    Authority: 34 CFR Sections 303.520 and 303.522

    The contractor must establish and maintain a system billing of all available third-party
    sources, including private and public insurance, and MMFs assessed to families for ECI
    services.

    The contractor must

          ensure that all third-party benefits are entered timely into the Texas Kids
           Intervention Data System (TKIDS) a nd updated when a change in coverage
           occurs;
          identify all potential third-party sources and make appropriate claims for
           reimbursements;
          establish financial systems for documentation of third-party reimbursements in
           order to provide a proper audit trail and report claims, collections, and
           uncollectible amounts;
          track aged accounts receivable to ensure that claims submitted are received or
           that follow-up actions are initiated and documented; and
          have written policies and procedures for billing third-party sources, and
           determining, collecting, and writing off MMFs assessed to families, in accordance
           with 40 TAC Section 108.611.
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    The contractor must establish a process to follow up with third-party sources if claims
    are denied or not paid timely. The contractor must also have written policies that
    address management oversight of third-party procedures, as well as policies for writing
    off unpaid claims and reviewing the aging of accounts for billings to third-party sources
    and to parents for MMF. The contractor must have management oversight of billing
    procedures and related financial reporting.

    The contractor must pursue reimbursements for eligible services from third-party
    sources through all available means. In addition, the contractor's billing policies should
    include procedures to

          obtain provider numbers from third-party sources for applicable direct service
           providers;
          apply for enrollment as a provider with HMOs, insurance companies, and other
           provider networks covering consumers in their service areas;
          verify and document third-party coverage of services;
          contact third-party sources to resolve issues;
          file and appeal claims with third-party sources;
          file complaints and appeals in a timely manner; and
          maintain documentation of the above.



    4.3.1 Verification of Medicaid Eligibility

    Medicaid eligibility must be verified monthly for each child that is enrolled in Medicaid or
    who may be eligible for Medicaid. For a child enrolled in a Medicaid HMO, the child’s
    enrollment with the identified HMO must be verified before submitting claims for
    evaluations, nutritional assessments, and other services. For services other than
    developmental rehabilitation services (DRS) provided to a child who is enrolled in a
    Medicaid HMO, the ECI contractor located in a non-managed-care area of the state
    must contact the Medicaid HMO before delivering services.

    Responses from TMHP must be on file at the contractor’s office (either paper or
    electronic). If eligibility verification is completed for each individual child by telephone or
    through the TMHP Web site, the contractor must document the following:

          the   date the verification was completed;
          the   name and Medicaid number of the child, if applicable;
          the   outcome of the verification (eligible or not eligible);
          the   call ticket number (for telephone verification); and
          the   name or initials of the staff person who completed the verification.

    A signed screen print is acceptable as long as it includes all the information listed
    above.


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    4.3.2 Claims for Reimbursement

    Documentation of medical necessity is required by most third-party sources. Some
    services may be considered "developmentally necessary" by ECI definition, but qualify
    as "medically necessary" by third-party standards. A request for third-party
    reimbursement must be made in accordance with third-party payer guidelines.

    A claim should be filed if, after verifying the third-party coverage, the contractor has
    reason to believe that the service will be paid by the third -party source. If after
    contacting the third-party source the contractor does not believe that the service will be
    reimbursed, the contractor is not required to submit a claim. The following must be
    documented and maintained as verification of third-party coverage:

          means of verification (for example, telephone or Web site);
          date the verification was completed;
          outcome of the verification (that is, covered or not covered); and
          name or initials of the staff person who completed the verification.



     4.4 Financial Reporting Requirements
    Current year third-party and MMF claims, collections, uncollected amounts, and prior
    year collections as well as other state and local funds collected must be reported
    cumulatively by source on quarterly and annual financial reports. State and local funds
    reported must reconcile to third-party billing records.

    4.4.1 Claims
    For purposes of ECI financial reporting, a claim is defined as a request for payment
    submitted to a third-party source for reimbursement of services provided, or to the
    family for its maximum monthly fee.

    Current year claims are based on the dollar amount of claims submitted for services
    provided during the current fiscal year. Current year uncollected claims is the difference
    in the current year claims and the current year collections (that is, the amount claimed
    but not received).

    Third-party sources include

          private insurance,
          Medicaid,
          CHIP,
          TRICARE, and

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          other public insurance.

    4.4.2 Collections

    Current year collections are distinguished from prior year collections, as defined in the
    ECI contract. Under the ECI contract, collections performance targets have been
    established for third-party sources. Adjusted claims are total claims less ineligible write-
    offs for reimbursement, as reported on the fourth quarter Financial Status Report and
    defined in the Financial Status Report instructions. Failure to meet these targets may
    require one or more of the following actions:

          technical assistance from DARS ECI,
          a corrective action plan or improvement plan,
          revision of contract terms and provisions,
          reduction or withholding of payments, or
          additional sanctions as allowed in the contract.



    4.4.3 Uncollected Claims

    Uncollected claims for each third-party payer source and the family maximum monthly
    fee must be reported on quarterly and a nnual Financial Status Reports, with further
    delineation into the following categories:

          Valid accounts receivable
              o For quarterly or annual Financial Status Reports, valid accounts
                  receivable are the portions of claims submitted that are presumed eligible
                  for reimbursement, but not received by the end of each quarterly or annual
                  reporting period, including those in the appeals process.

          Ineligible write-offs include
              o the 5 percent administrative fee deducted by DARS for MAC claims;
              o any amount billed in excess of the payment for Medicaid THSteps—CCP,
                  STAR Health, private insurance, CHIP, or TRICARE claims;
              o claims submitted for reimbursement that are not payable because of
                  consumer ineligibility or lack of service coverage;
              o the amount of deductibles, co-payments, and coinsurance for private
                  insurance and TRICARE claims; and
              o uncollected MMFs assessed to the family, if the family completed a written
                  attestation affirming its inability to pay.

          Other write-offs
           All claim write-offs that do not fall into the above categories are considered other
           write-offs including claims that have been determined to be uncollectible and
           have been removed from the accounts receivable.

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    The total of valid accounts receivable, ineligible write-offs, and other write-offs must
    equal the total uncollected claims, as reported on Form 269a (MOE). Total uncollected
    claims added to the current year cumulative collections must equal the total current year
    claims reported on Form 269a (MOE).

    The breakdown of uncollected claims must be submitted to DARS ECI on Form 269a
    (MOE) Attachment for the quarterly reporting period and reported on Form 270
    (Request for Advance or Reimbursement) for the annual reporting period.


    4.5 In-Kind Contributions
    Authority: Texas Government Code, Chapter 783, Uniform Grant and Contract
    Management Act
    The contractor may use in-kind contributions in the operation of the ECI program if the
    use and valuation of the contributions are approved by DARS ECI.
    The contractor must document volunteer time in the same manner as personnel
    compensation (see Chapter 3: ECI Costs, 3.2 Personnel Compensation). In addition,
    the ECI contractor must document an hourly rate comparable to salaries in the
    community for like services. Staff members who are compensated for their time by the
    contractor agency are not considered volunteers.
    Contributions in agency-owned buildings for space, utilities, etc., are not considered in-
    kind contributions when there is a cost incurred by the contractor. However, when
    property is paid for and fully depreciated, the value of space in agency-owned buildings
    must be reported as an in-kind contribution.
    ECI contractors must estimate and report the value of in-kind contributions, including
    donated space, volunteer time, and other noncash contributions, on financial reports
    submitted to DARS ECI.




    Chapter 5: Reserved
    Chapter 6: Reserved
    Chapter 7: Respite
    7.1 Respite Services under the State Initiative
    Authority: Texas General Appropriations Act, 80th Texas Legislature, Regular Session
    HB 1


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    Respite care needed by a family for reasons not directly related to outcomes on the
    Individualized Family Service Plan (IFSP) is offered as a project funded by the Texas
    Legislature. The contractor must follow the policies listed below in administering the
    state respite initiative.

    DARS ECI monitors the contractor’s compliance with the respite policy and contract
    requirements.


    7.1.1 Service Requirements
    The contractor must identify existing respite resources within the community, including
    potential respite service providers and additional funding sources. If funding is available,
    the contractor offers respite services as defined in this chapter to families enrolled in
    ECI. If respite funds are not available when requested, the contractor places the eligible
    family on a waiting list for respite funding.

    The contractor may provide funds for respite services to a family for up to 20 hours of
    respite per month, based on the individual needs of the family. The contractor may
    provide funds for respite services to a family for more than 20 hours per month when
        the family has more than one child enrolled in the ECI program, and
          the IFSP team determines that the children cannot be cared for by a single
           respite service provider.


    Respite service providers must
          be 18 years of age or older; and
          not live in the same household as the eligible child, even if they are a member of
           the child’s family.


    The contractor’s service coordinator must inform the family that
          the amount of funding available for respite is limited;
          the family is responsible for
              o selecting a respite provider,
              o scheduling the respite,
              o providing the contractor with the documentation that respite was delivered,
              o requesting reimbursement from the contractor, and
              o paying the provider;
          the family assumes liability for the selection and use of specific providers; and

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              there may be potential tax implications from receiving respite funds.


    The contractor’s service coordinator a nd the family must cooperate to determine the
    level of care needed by the child and the ECI rate of reimbursement. If they cannot
    agree, the contractor’s program director determines the reimbursement rate.
    The Respite Funding Agreement must be completed and signed by the parent, the
    contractor’s service coordinator or other assigned staff member, and the contractor’s
    program director before a respite voucher is issued. The contractor must use a voucher
    system to authorize and process payment for respite services to each family as follows:
           1. The contractor authorizes the number of hours and the level of care needed
                   and issues separate vouchers to the family for each month of authorized
                   respite care.
               2. The family schedules respite services directly with the respite service
                   provider.
               3. The respite service provider must sign the respite voucher after providing the
                   services.
               4. At the end of the calendar month in which respite services are received, the
                   family must return the voucher to the contractor. All portions of the voucher
                   must be completed and signed by the respite service provider, parent, and
                   the contractor staff member.
               5. The family returns the voucher to the contractor within one month of the
                   voucher’s expiration date.
               6. The contractor must expedite reimbursement to the family.


    The contractor must collect respite-related data and submit a Quarterly Respite Report
    to DARS ECI.


    7.1.2 Financial Requirements
    The contractor may receive funds from DARS ECI to provide respite services for
    families of children enrolled in the ECI program.
    A contractor receiving respite funds must
       administer and manage the funds in accordance with established DARS ECI
              policy;
             make every effort to expend 100 percent of the funds awarded;



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         maintain a financial management system for the respite initiative in accordance
          with the requirements of DARS ECI policy (see Chapter 1: DARS ECI Contract);
         submit requests for reimbursement no later than 30 days following the end of the
          month for which reimbursement is requested;
         submit a final request for reimbursement by the due date established in the DARS
          ECI contract for the settlement of outstanding claims; and
         submit quarterly or annual respite reports in accordance with established due
          dates specified in the DARS ECI contract.

    Failure to meet reporting deadlines may result in DARS ECI returning unprocessed
    vouchers or withholding payment to the contractor until the required reports are
    received.

    Respite funds cannot be used to pay for the following:
      insurance co-payments,
         insurance deductibles,
         insurance premiums,
         payment to a parent to provide respite services to his or her own child, or
         costs for the care of siblings of the eligible child.

    The contractor may request reimbursement for applicable indirect costs within the total
    respite services contract amount.
    Contractors may collaborate within their respective consortium to administer respite
    funds.

    7.2 Respite Services under Part C of IDEA
    Respite services under Part C of the IDEA are limited to those needed by the parent in
    order to participate in ECI services. Funding for these respite services is provided
    through the DARS ECI contract. See also Chapter 19: Individualized Family Service
    Plan (IFSP).




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    Chapter 8: Transfers
    8.1 In-State Transfers
    8.1.1 Responsibilities of the Transferring Contractor
    When a family moves from one Texas service area to another, the child is considered
    dismissed from the transferring contractor on the date the family moves from the service
    area, or the date the contractor becomes aware that the family has moved, whichever is
    earlier.
    Upon learning of a planned move, the transferring contractor must provide to the
    receiving contractor on the day of the transfer

          contact information;
          the family’s planned move date;
          the complete, current IFSP;
          necessary medical information; and
          the printed case detail report from TKIDS, including the transfer -out date.

    The receiving and transferring contractors discuss the child’s record and determine if
    any additional information is needed. If additional information is needed, the transferring
    contractor sends all necessary information to the receiving contractor in a timely
    manner.

    8.1.2 Responsibilities of the Receiving Contractor

    Upon receiving a transfer referral from another ECI contractor in Texas, the receiving
    contractor must

          designate a service coordinator; and
          contact the family to
              o verify the planned move date to the service area, and
              o attempt to schedule an IFSP revision meeting and deliver services.

    If the family has not notified the transferring contractor of a move or the family contacts
    the receiving program before the transferring program, the receiving contractor contacts
    the transferring contractor to communicate information about the family’s move.


    Every child transferred from another Texas ECI contractor must have a revised IFSP
    before services can be initiated. At a minimum, the revised IFSP must assign a new
    service coordinator. Complete the revised IFSP as follows:

          comprehensive periodic review of the IFSP—if one is due within one month;

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          annual IFSP—if one is due within two months; or
          revised IFSP—if a 6-month or annual IFSP is not due within the above-stated
           timeframes or the parent does not want this meeting to serve as the 6-month or
           annual IFSP.


    If the receiving contractor cannot contact the family within 30 days of the planned move
    date or if the family requests that the revised IFSP and initiation of services be delayed
    more than 30 days after the transfer-in date, the receiving contractor

          determines whether ECI eligibility procedures must be repeated and documents
           the reasons for the decision,
          completes a new IFSP, and
          coordinates with the previous contractor to ensure appropriate communication.




    8.2 Transfers to Texas from Another State
    When a family moves to Texas with an IFSP from another state, the contractor must

          immediately designate a service coordinator;
          not require an evaluation unless there is a question about the child's eligibility in
           Texas;
          within 15 days, initiate all the early intervention services in the IFSP until a new
           one is developed;
          within 45 days, develop a new IFSP in compliance with Chapter 19:
           Individualized Family Service Plan (IFSP); and
          provide early intervention services in the natural environment, unless the existing
           IFSP includes a justification.

    If the child’s eligibility is in question, the contractor must
          provide the early intervention services in the existing IFSP until completing
            eligibility determination, and
          complete the eligibility determination within 15 days.

    If the child is found not eligible, the contractor must offer follow-along services to the
    family.




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    Chapter 9: Outcomes
    9.1 Outcomes Overview
    The goal of early intervention is to enable young children to be active and successful
    participants during the early childhood years and in the future in a variety of settings—in
    their homes with their families; in child care, preschool, or school programs; and in the
    community. For families, the ultimate goal is to enable families to provide care for their
    children and have the resources they need to participate in their own desired family and
    community activities.

    Outcomes are used to measure progress toward these goals. These outcomes are not
    IFSP outcomes. IFSP outcomes are individualized based on the needs of the child and
    family, and fit within these overarching outcomes. The achievement of an outcome is
    the result of a variety of factors, only one of which is early intervention services. Though
    it is not likely that all families or children will achieve all the outcomes, early intervention
    should strive to achieve them for all the families and children they serve.

    All contractors must collect information on child and family outcomes as directed by
    DARS ECI and use that information to improve results for children and families.


    9.2 Child Outcomes
    Child outcomes address three areas of child functioning necessary for each child to be
    an active and successful participant at home, in the community, a nd in other places like
    a child-care program or preschool. These three outcomes are that children will
        have positive social relationships;
        acquire and use knowledge and skills; and
        take appropriate action to meet their own needs.

    These outcomes are functional outcomes, which place an emphasis on ―how‖ the child
    is able to carry out meaningful behaviors in the context of everyday living. Functional
    outcomes refer to behaviors that integrate skills across developmental domains.

    Child outcomes are assessed by an interdisciplinary team of at least two members.
    Teams must agree on the ratings for each child during the child’s enrollment. The
    contractor must ensure that ratings are entered into TKIDS at entry, annual evaluation,
    and exit. Ratings at six-month intervals are optional.

    Entry ratings must be completed
        for every newly enrolled child who is 30 months of age or younger at the time of
           the initial IFSP, or at the first IFSP if the child is transferring from another state;
        within two weeks of the initial IFSP; and
        on each of the three child outcomes for each child.


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    Subsequent ratings must include the progress item for each outcome
    and be completed
        on each of the three child outcomes for each child;
        independently of the entry ratings;
        at the time of each annual evaluation or IFSP; and
        when a child transfers out of or exits from services. Exit ratings must be
          completed
             o for each child exiting the Texas ECI system who had an entry rating and
                 was enrolled in services for at least six months, and
             o within two weeks of the dismissal date in order to reflect the child’s
                 progress throughout his or her time in se rvices.

    Ratings must be recorded on the Texas Child Outcomes Summary Form (COSF) or a
    program version that includes the following required elements:
        the names of the two IFSP team members who determined the ratings;
        the rating questions 1a, 2a, and 3a at all rating times; and
        the progress questions 1b, 2b, and 3b for all ratings except entry.

    Documentation must
       support the rating decisions of the team;
       be included either on the COSF or in another section of the child’s record as
         identified by the contractor;
       include information related to the child’s functional skills across settings,
         situations, and people; and
       note the source(s) of information (for example, evaluation, observation, or parent
         report).


    9.3 Family Outcomes
    Family outcomes and indicators of family capacity are measured using a family survey.
    Family outcomes address the extent to which early intervention supports families in
    caring for their children.
    The desired outcomes for families who participate in early intervention are that famili es
         understand their children’s strengths, abilities, and special needs;
         know their rights and advocate effectively for their children;
         help their children develop and learn;
         have support systems; and
         are able to use desired services, programs, and activities in their communities.

    Family indicators, as required by OSEP, measure the extent to which early intervention
    services have helped families
        know their rights,
        effectively communicate their children’s needs, and
        help their children develop and learn.


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    All contractors are required to deliver the family survey as directed by DARS ECI to
    measure family outcomes and indicators.



    Chapter 10: Performance Management
    10.1 Performance Management Introduction
    Performance management is the ongoing monitoring and management of contractor
    services in accordance with ECI policy (programmatic and financial) and contract
    requirements. Performance management includes oversight procedures completed by
    DARS ECI for all contractors. These procedures identify areas of nonco mpliance and
    ensure that necessary corrective actions are implemented.

    DARS ECI monitors each contractor’s performance throughout the contract period for

          contract terms and conditions, including any amendments;
          program rules, policies, and procedures;
          other requested contractor reporting;
          identified areas of associated risk; and
          other issues that require special attention and monitoring as determined by
           DARS ECI.

    DARS ECI may implement a variety of performance management activities, including
    desk reviews of provider data, policies, and consumer records, as well as on-site visits
    and other activities determined necessary.

    The contractor must fully participate in the performance management process by

          timely submitting requested information,
          implementing corrective actions or system changes when requested,
          participating in on-site reviews, and
          participating in technical assistance and training activities.

    As determined through the performance management process, if the contractor’s level
    of compliance or performance indicates a need, the program may be subject to adverse
    and nonadverse actions (see Chapter 1: DARS ECI Contract, 1.7 Remedial Actions.)

    The contractor may be immediately recommended for contract termination or
    discontinuation of funding if there is evidence of

          violation of state or federal law,
          abuse or neglect of consumers,
          compromised consumer safety,
          fraud,
          fiscal or program mismanagement,

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          intentional misrepresentation of material issues,
          any real or apparent conflict of interest,
          lack of cooperation with monitoring activities, or
          violation of the terms of the contract.

    DARS ECI reports evidence of illegal acts to the HHSC Office of Inspector General
    (HHSC OIG) and determines whether to contact law enforcement.


    10.2 Desk Review Monitoring
    DARS ECI performance and oversight staff members conduct ongoing desk reviews of
    program and financial data, consumer records, and other pertinent information as
    determined necessary to ensure appropriate contract performance and compliance, and
    to address reported complaints or concerns. As part of the desk review process, the
    contractor may be required to participate in conference calls and submit additional
    supporting documentation to ensure compliance with contract and policy requirements.
    Desk review activities may result in remedial actions, improvement plans, required
    technical assistance, or specified training by DARS ECI or provider management staff
    members.

    Contractors must redact the last name of the child and family from consumer
    information before submitting it to ECI as part of the desk review process.


    10.3 On-Site Visits
    Authority: 34 CFR Section 303.501

    There are three types of on-site visits:
        comprehensive on-site monitoring visits,
        follow-up to comprehensive on-site monitoring visits, and
        focused on-site visits.


    10.3.1 Comprehensive On-Site Monitoring Visits

    Comprehensive on-site monitoring visits are led by the DARS Contract Oversight and
    Support (COS) section and may be announced or unannounced. For announced visits,
    the contractor receives written notice indicating the date and time of the visit,
    expectations of the contractor, and the contact information for the lead monitor.

    To receive an overview of the monitoring process and preliminary results after
    completion of the visit, the contractor’s executive director and chief financial officer (or
    designees), and the program director, must participate in the entrance and exit
    conferences.

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    The contractor must make available the following for all on-site monitoring visits:
        service delivery documentation,
        program and agency financial documentation,
        requested reports,
        work space for the monitoring team, and
        ECI program and financial staff members for interview.

    After a comprehensive on-site monitoring visit, the ECI contractor receives an initial
    monitoring report that outlines findings that must be corrected. The contractor must
    return the draft monitoring report electronically with proposed cor rective actions that
    address each area identified with a finding.

    The contractor receives a letter attached to the initial report that includes timelines and
    contact information to submit the corrective actions. If the contractor disagrees with any
    of the findings, the contractor must respond to DARS in writing within 20 business days
    of receipt. The contractor must indicate its disagreement with any finding and provide
    any required supporting documentation.

    The contractor receives a final report that includes all findings, the contractor’s
    corrective actions, and notification by DARS that the corrective actions are approved.


    10.3.2 Follow-up to Comprehensive Monitoring Visits
    DARS ECI performs follow-up to comprehensive monitoring visits to ensure corrective
    actions approved in the final comprehensive monitoring report are implemented and
    result in improvements to the service delivery system. On-site follow-up to
    comprehensive monitoring visits are led by either COS or ECI state office staff members
    and may be announced or unannounced. For announced visits, the contractor receives
    written notice indicating the date and time of the visit, expectations of the provider, and
    the contact information for the lead monitor.

    The contractor’s executive director, program director, and chief financial officer, if
    requested, must participate in the entrance and exit conferences to receive an overview
    of the monitoring process and preliminary results after completion of the visit.

    The contractor must make available the following for all on-site monitoring visits:
        service delivery documentation,
        program and agency financial documentation,
        requested reports,
        work space for the monitoring team, and
        ECI program and financial staff members for interview.

    After follow-up to a comprehensive on-site monitoring visit, the ECI contractor receives
    a monitoring report that outlines the initial findings and results of the follow-up visit. The

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    report indicates whether the corrective action was successfully implemented and the
    monitoring process completed or requires additional corrective actions to be submitted.
    If additional corrective actions are required, the contractor must return the monitoring
    report with additional proposed corrective actions. DARS ECI issues a final report,
    including information about the status of the monitoring visit, when additional corrective
    actions are submitted and approved.


    10.3.3 Focused On-site Visits
    The contractor must participate in an on-site focused review when requested by the
    assigned performance manager. Focused visits are not compliance visits but may result
    in the need for a corrective action plan or required technical assistance or training to be
    provided by DARS ECI or provider management staff members. Focused visits are
    scheduled immediately and may be unannounced if DARS ECI receives information or
    allegations about possible serious performance or compliance issues about service
    delivery or program and fiscal management. DARS ECI prioritizes these visits based on
    the nature of the issue.

    The contractor may be requested to make the following available during a focused on-
    site visit:
         service delivery documentation,
         program and agency financial documentation,
         requested reports,
         work space for the monitoring team, and
         ECI program and financial staff members for interview.

    After a focused visit, the contractor receives a letter outlining any required actions.



    10.4 Determinations
    Authority: 20 USC Sections 1416(b) and 1442

    DARS ECI makes determinations annually about the performance of each ECI program
    in meeting the requirements of Part C of the Individuals with Disabilities Education Act
    (IDEA). DARS ECI analyzes the performance of each contractor based on a set of
    indicators established in the State Performance Plan and the DARS ECI contract.
    DARS ECI reviews the contractor’s performance and assigns determinations as follows:
         meets the requirements and purposes of Part C,
         needs assistance in implementing the requirements of Part C,
         needs intervention in implementing the requirements of Part C, or
         needs substantial intervention in implementing the requirements of Part C.



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    Considerations for local determination, as indicated by OSEP for local entities that
    implement Part C services include
       performance on compliance indicators;
       whether data submitted by local ECI contractors are valid, reliable, and timely;
       timely correction of noncompliance;
       history, nature, and length of time of any noncompliance or other performance
         issues;
       any audit findings;
       performance on performance indicators; and
       other pertinent information.

    The contractor receives written notice of its annual determination.

    10.4.1 Meets Requirements

    A determination status of ―meets requirements‖ signifies that there are no major
    performance issue trends identified.

    10.4.2 Needs Assistance

    A determination status of ―needs assistance‖ indicates low performance on ECI contract
    performance measures. In this case, the contractor’s CEO must submit an Improvement
    Plan addressing the areas of deficiency. If the contractor receives a determination
    status of ―needs assistance‖ or a combination of ―needs assistance‖ and ―needs
    intervention‖ for three consecutive years, at DARS’ discretion, the determination for the
    third year may be lowered to ―needs intervention.‖

    10.4.3 Needs Intervention

    A determination status of ―needs intervention‖ indicates significantly low performance on
    ECI contract performance measures or low performance over multiple contract periods.
    If a contractor receives a ―needs intervention‖ determination status, the contractor’s
    CEO must submit a corrective action plan addressing the areas of deficiency. If the
    contractor receives a determination status of ―needs intervention‖ for three consecutive
    years, at DARS’ discretion, the determination for the third year may be lowered to
    ―needs substantial intervention.‖

    10.4.4 Needs Substantial Intervention
    A determination status of ―needs substantial intervention‖ represents ongoing and
    significant low performance on ECI contract performance measures with little or no
    improvement shown or failure to comply with DARS improvement and intervention
    requirements. The contractor’s CEO must submit a corrective action plan to address the
    areas of deficiency. If an ECI contractor receives a determination status of ―needs
    substantial intervention‖ for two consecutive years and has not demonstrated
    improvement resulting in a determination status of ―needs assistance‖ or higher in the
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    following contract period, DARS will conduct a focused monitoring visit. DARS, at its
    discretion, may not renew the ECI contract at the end of the contract term. Other actions
    may be taken at the discretion of DARS.

    10.5 Local Reporting
    DARS ECI reports annually to the public on the performance of each ECI program using
    indicators specified in the State Performance Plan. These reports present the
    performance of each ECI program in relation to state targets and the state’s
    performance. DARS provides the local reporting data to the contractor. The contractor
    should review the data and notify DARS of any discrepancies by the due date
    determined by DARS.

    10.6 TKIDS Ad Hoc Data Requests
    To request an ad hoc TKIDS or TRAD report or revisions to an existing TKIDS or TRAD
    report, complete the following basic steps:

       1. initiate a request,
       2. review the request and determine the timeline, and
       3. finalize the report.



    10.6.1 Initiating a Request
    To request a new or modified report, the program director must email an ECI Data
    (External) Request Form.

    The program director
       1. completes all applicable parts of the form, including
           requester’s contact information,
           the date the report is needed,
           a description of the report or modification being requested and how it will be
             used,
           parameters of the data to be included, and
           documentation to illustrate the type of report requested, if applicable.

              Documentation might include copies of proposed report layouts, a copy of an
              existing report with annotations to show changes, an Excel spreadsheet
              made to look like a report, or a hand-drawn report. The requester must
              provide any additional information that is needed by the developer.

       2. submits the completed and signed request form to the DARS TKIDS Mailbox
          (Tkids@dars.state.tx.us), copying the assigned DARS ECI performance
          manager.


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    10.6.2 Reviewing the Request and Determining the Timeline
    Upon receipt of the approved request, DARS ECI conducts an initial review of the
    request to determine if sufficient information has been provided and to estimate
    resources to help prioritize the request.

    Printed or scanned copies of proposed report layouts may be helpful to the developer.
    These could include a copy of an existing report with annotations to show changes, an
    Excel spreadsheet made to look like a report, or a hand-drawn report. The requester
    must provide any additional information that is needed by DARS ECI.

    A minimum of two weeks should be expected for completing data requests, and a
    longer time frame may be required depending on the complexity of the request and the
    workload of the DARS ECI staff.

    10.6.3 Finalizing the Report
    During the development phase, DARS ECI may identify issues that must be addressed
    with the requester The DARS ECI staff communicates any identified issues or additional
    considerations to the requester as soon as possible. The requester must provide any
    additional information needed as timely as possible to minimize delays in completing the
    report.

    An initial draft of the report may be forwarded to the requester for review, along with the
    request form (including any identified issues noted in the Developer Notes section).
    Based on feedback from the requester, DARS ECI makes any needed adjustments,
    finalizes the report, and forwards it to the requester.

    Once the data request has been satisfied, the requester electronically signs and dates
    the form in the Verification and Approval section and forwards it back to DARS ECI.



    Chapter 11: Public Outreach
    11.1 Public Outreach Overview
    Authorities: 34 CFR Sections 303.320 and 303.321; 34 CFR Section 303.522; Texas
    Human Resources Code, Section 73.007–008

    Public outreach comprises public awareness, child find, and interagency coordination.
    The purpose of public outreach is to
        identify, locate, and screen or evaluate infants and toddlers, birth to 36 months of
           age, who have or are suspected of having disabilities or developmental delays;
        ensure access to services, as early as possible, for eligible children and their
           families;
        promote coordination of services;
        promote access to existing community resources; and

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          promote interagency coordination.


    11.2 Public Outreach Plan Development and
    Implementation
    Each fiscal year, the contractor must develop and implement a written public outreach
    plan that incorporates child find, public awareness, and interagency coordination. The
    public outreach plan must be submitted to DARS ECI with the contractor’s annual
    funding application.

    The purpose of the public outreach plan is to identify and implement specific strategies
    and activities for informing parents, the general public, the media, and referral so urces
    about ECI’s philosophy, the importance of early identification, eligibility criteria, the
    referral process, and access to ECI services.

    The contractor (in coordination with adjacent ECI program contractors) must inform all
    potential referral sources in its service area about the system for receiving referrals.

    Public outreach plans and activities must address the diversity of people within the local
    service area, and must be designed and conducted to reach all segments of the service
    area population.


    11.3 Public Outreach Plan Requirements
    11.3.1 Public Outreach Target Audiences
    Public outreach plans must target specific audiences including the general public and
    primary referral sources listed below:
        parents and families, including those with child ren birth to 36 months who are
              o born premature,
              o homeless,
              o wards of the state,
              o part of a tribe or tribal organization,
              o involved in a substantiated case of abuse or neglect,
              o identified as affected by illegal substance abuse or withdrawal symptoms
                  resulting from prenatal exposure,
              o residents of a colonia, or
              o infants with other physical risk factors associated with learning or
                  developmental complications;
        medical referral sources, including
              o hospitals, including prenatal and postnatal facilities;
              o physicians and other health care providers;
              o public health facilities and Maternal and Child Health programs under Title
                  V of the Social Security Act;
              o Children’s Health Insurance Program providers; and

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              o Medicaid’s Texas Health Steps providers;
          social service agencies, including
              o Texas Department of Family and Protective Services;
              o Women, Infants, and Children (WIC);
              o programs funded under the Developmental Disabilities Assistance and Bill
                  of Rights Act, such as Advocacy, Inc., "Family to Family Network," etc.;
                  and
              o programs funded by Supplemental Security Income under Title XVI of the
                  Social Securities Act; and
          educational referral sources, including
              o school districts and charter schools,
              o Head Start and Early Head Start, and
              o child-care programs.


    11.3.2 Public Outreach Plan Structure and Requirements
    The public outreach plan structure must clearly identify the following information:
        goals, objectives, strategies, and actions;
        timelines for activities;
        the person(s) or position(s) responsible for conducting the activities; and
        specific performance measures to determine the effectiveness of strategies and
          activities.

    For interagency coordination strategies, the following information should be provided in
    the plan:
         specific agencies, organizations, and local and regional planning and
           coordination groups affecting services to young children with whom the
           contractor will coordinate; and
         coordination strategies and activities to
              o increase effectiveness and efficiency of training and service provision,
              o prevent duplication of assessments and services, and
              o ensure that families have access to services for which they are eligible.


    11.4 Interagency Coordination
    11.4.1 Memoranda of Understanding
    Interagency coordination plans and activities must be coordinated and consistent with
    all DARS ECI memoranda of understanding (MOUs).

    11.4.2 ECI Statewide Coordination
    The contractor must coordinate public outreach plans and activities with other ECI
    contractors and with the ECI Statewide Public Outreach Plan.




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    Interagency Coordination Groups
    The contractor must specify in the Public Outreach Plan how the contractor will work
    with these local or regional partners:
         child care parent advisory council, if applicable;
         Community Resource Coordination Groups (CRCG);
         colonias workgroups, as applicable; and
         other interagency coordination groups that address issues of families with
           children.


    Medical Child Find
    Contractors must coordinate with other ECI contractors that share the medical service
    area to
        conduct child-find activities in all service area hospitals, neonatal intensive care
           units, and medical clinics serving infants and toddlers;
        ensure that child find efforts are not duplicated;
        facilitate referrals to the correct ECI contractor;
        provide the medical community the list of medical diagnoses that a utomatically
           qualify a child for ECI services; and
        promote the involvement of physicians and other health care professionals in
           early identification, referral, and service provision.


    Texas Information and Referral Network (2-1-1 Texas) and Community Information
    and Referral Providers
    The contractor must provide a description of ECI services to all information and referral
    programs. The description must include
        enough detail about the ECI program to ensure appropriate referrals;
        the contractor’s current program name, address, telephone, and fax number;
        the DARS Inquiries phone number; and
        the service area assignments for each contractor.

    The contractor must provide current and correct information to the local Texas I&R
    Network (2-1-1 Texas) area information center.
    Media Public Outreach
    The contractor must maintain documentation that demonstrates the coordination of
    public outreach efforts by DARS ECI contractors that share television-viewing areas,
    radio-listening areas, and/or newspaper-distribution areas.

    11.5 Coordination of ECI Services with LEA Special
    Education Services
    The contractor communicates with local school district personnel to
        review eligibility requirements for public school placement,
        review state and local early transition memoranda of understanding, and

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          facilitate the transition of ECI-enrolled children into public school programs.



    11.6 Performance Evaluation
    The contractor must maintain documentation of public outreach activities and identify
    and apply performance measures to evaluate the effectiveness of efforts. The
    contractor must use the information from this evaluation to guide the development and
    implementation of subsequent efforts and plans.

    11.7 Marketing of Local ECI programs
    11.7.1 Promotional Materials
    The contractor must meet requirements listed in the ECI Graphic Standards Manual,
    including the ECI logo, for all materials published locally and used for public outreach,
    such as publications, promotional items, and program correspondence.

    Distribution of promotional items must be addressed in the contractor’s Public Outreach
    Plan. The plan must identify the target audience and how all promotional materials are
    used to promote awareness of ECI. See Chapter 3: ECI Costs, 3.22 Advertising.

    11.7.2 Telephone Directory Listing
    The contractor must list local ECI programs in the white and yellow pages of the primary
    telephone directory in the service area. If an area of the state is served by more than
    one contractor and that area has a single designated ECI referral line or area-wide toll-
    free contact number, then that number must be listed in the white pages and the yellow
    pages of the telephone book.

    11.7.3 Program Identity
    The contractor must use "ECI" as part of its program name.



    Chapter 12: Directory of Community
    Resources

    12.1 Authorities
    Contractors must provide information about community resources to families of infants
    and toddlers with developmental delays in compliance with 34 CFR Section 303.301.


    12.2 Directory Scope
    The contractor must maintain a directory of state, county, city, and local resources that
    includes information about

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          public and private early intervention services,
          research and demonstration projects, and
          professional or other groups that provide assistance to eligible children and their
           families.

    12.3 Directory Content
    Information about resources must include
         a telephone number,
         the address,
         scope of services,
         eligibility requirements, and
         the type of assistance available.

    12.4 Directory Availability
    The directory of local resources available in each geographic region, including rural
    areas, must be updated annually and be accessible to the general public, including
    persons with disabilities.

    12.5 Nonduplication of Efforts
    The contractor must coordinate with the Texas Information and Referral Network
    regional Area Information Center to prevent duplication of effort in gathering,
    maintaining, and publishing information about community resources



    Chapter 13: Early Childhood Intervention
    Providers
    13.1 Who Can Provide Early Intervention Services?
    DARS contracts with local entities to provide early intervention services. The contractors
    must employ or contract with appropriate early intervention providers to implement the
    required array of services in the Individuals with Disabilities Education Act, Part C (20
    U.S.C. Sections 1431–1444).

    An early intervention provider must
        have professional credentials that meet the entry-level degree required for his or
          her discipline;
        maintain current licensure (with appropriate renewals) and qualifications; and
        abide by the requirements of his or her license, registration, or certification.

    13.1.1 Criminal History Search
    Authority: 40 TAC Section 108.306 Criminal Background



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     When conducting a criminal background check, the contractor must
        provide notice to the person that a criminal history search will be conducted, and
        maintain documentation that a criminal history search was completed.


    13.1.2 Job Descriptions for Each Position
    The contractor must maintain written job descriptions for all positions. Each job
    description must include
        a current description of assigned responsibilities; and
        the requirements for employment, including
              o experience,
              o licensure, and
              o second language proficiency.
    The contractor must submit a job description to DARS ECI for any new or revised
    position type.


    13.1.3 Individualized Professional Development Plan (IPDP)
    The contractor must develop an annual individualized professional development plan
    (IPDP) for all providers who work directly with families, excluding subcontractors. The
    IPDP must address the overall needs of the contractor as well as the person’s
    professional development.

    The IPDP must
        include required trainings (see the table below),
        include training events and activities to address professional development, and
        document all completed training.


    Required Trainings by ECI Provider Type
    The following table shows training required for each type of ECI provider.




                              Providers   Providers
                             with Access  Who Work
                               to Child     Directly
                              Records1       with
                                            Children
                                              and
                                           Families2
                     Completed upon initial employment. Repeat as needed.


    Recognition of                                X

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    Common Childhood
    Illnesses

                                            Due Annually
    Procedural
    Safeguards                    X             X
    for Confidentiality
    Universal Precautions
    Training for the Texas
                                                X
    Early Childhood
    Intervention Program
           Update certification according to the requirements of the certifying agency.
    Cardiopulmonary
    Resuscitation (CPR)                         X           X
    of infants and toddlers
    First Aid including
    emergency care of                           X           X
    seizures.

                 Complete after six months, but before two years of employment.
    CORE                                       X

    1
     Includes subcontractors, interns, and volunteers who have access to consumer
    records.
    2
     Includes subcontractors, interns, and volunteers who work directly with children and
    families except for CORE.

    The contractor must have written policies or procedures for implementing the DARS
    Making It Work curriculum for all direct service providers.

    13.1.4 Provider Health Standards
    Authority: 34 CFR Part 85 and Texas Health and Safety Code, Chapter 81.

    The contractor must have written policies and procedures to address
        exposure to a communicable disease, and
        a drug-free workplace.

    The contractor’s written policies and procedures that address returning to work following
    exposure to communicable disease must either
        implement the Texas Department of State Health Services Communicable
          Disease Chart for Schools and Child-Care Centers, or
           require documentation of clearance by a physician to return to work.




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    If required by local health officials or public school officials, all providers must provide
    written evidence of tuberculosis screening within six months of beginning employment
    and follow-up as required by the local health department.

    13.2 Early Intervention Specialists
    Early intervention specialist (EIS) is a professional occupational category established by
    DARS ECI. It is specific to direct-service providers employed by DARS ECI contractors.
    To function as an EIS or to use the occupational title EIS, a person must be participating
    in or credentialed through the ECI Competency Demonstration System (CDS).

    The early intervention specialist
        may serve as one of the two required professionals on an interdisciplinary team,
        represents the discipline of early intervention,
        conducts pre-enrollment activities,
        conducts screenings,
        participates in eligibility determination and assessment,
        participates in the development of the IFSP,
        provides family education services and developmental services,
        provide transition services, and
        may serve as service coordinator.

    13.2.1 Entering the ECI Competency Demonstration System (CDS)
    To enter the CDS, a person must hold at least a bachelor's degree from an accredited
    institution. If the degree is from an institution outside the United States, documentation
    must be provided from an accrediting agency that verifies that the degree is comparable
    to a degree from a United States institution. The bachelor’s degree must be in one of
    the following areas of study:
         adaptive physical education (with or without teacher certification),
         child development,
         child life,
         communication sciences and disorders,
         early childhood education (with or without teacher certification),
         elementary education (with or without teacher certification),
         family studies,
         health,
         psychology,
         social work,
         sociology,
         special education (with or without teacher certification), or
         rehabilitation services or rehabilitation counseling.

    Alternately, a person may enter the CDS with a bachelor’s degree in another area of
    study. Eighteen hours of college credit must be directly related to early intervention and
    be verified by an official transcript with passing grades. Courses that directly relate to
    early intervention are found in any of the departments mentioned above.

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    13.2.2 Early Intervention Specialist Requirements
    The entry-level EIS must
        participate in one hour per week of documented, direct supervision until the CDS
          is completed;
        document progress in the CDS by nine months from the hire date;
        complete all competencies and required activities in the CDS by two years from
          the hire date;
        abide by the Early Intervention Specialist Code of Ethics found in the Texas
          Administrative Code; and
        have one designated EIS supervisor but may have multiple mentors.

    The fully qualified EIS must
        abide by the Early Intervention Specialist Code of Ethics;
        submit to DARS ECI documentation of 10 hours of continuing professional
           education (CPE) annually;
        submit to DARS ECI documentation of three additional hours of ethics training
           every two years along with the 10 hours of CPE; and
        have one designated EIS Supervisor.
    EIS Mentors and Supervisors
    The responsibilities of EIS mentors and supervisors are shown in the following table.

                                                                              EIS
    Responsibility                                       EIS Mentor
                                                                           Supervisor
    Holds an ECI-approved license or credential that          X                 X
    authorizes supervisory responsibilities ,
     Follows requirements of professional licensure           X                 X
     authority
     Attends the DARS ECI CDS Manual Training
     For New Supervisors and Mentors within 6                                   X
     months of assuming EIS supervisory duties
     Receives training in the requirements of the
                                                              X                 X
     CDS
     Documents weekly supervision for the entry
     level EIS

     Documentation of EIS supervision includes the            X                 X
     EIS’s name, the date, the length of the
     supervision meeting, a short description of what
     was discussed, and the signature of the
     supervisor or mentor.
     Approves completion of CDS competencies                  X                 X
     Ensures competence of the EIS before the EIS
     independently implements any service to                                    X
     children and families
     Completes 3 hours of training in supervision                               X

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     and/or leadership skills annually



    13.2.3 Documentation Requirements and Timelines for the CDS
    Information and documentation in the EIS Registry and the EIS Registry files are
    subject to the requirement and restrictions of the Public Information Act.
    EIS Required Documentation
    The EIS must submit required documents to DARS ECI by the designated deadline.
    Failure to do so will result in the EIS losing professional status. If extenuating
    circumstances exist, the EIS may submit a written request to extend any deadline
    before the due date. The program director must sign or otherwise approve the
    extension.


    Documentation                  Due Date                Additional Information
    Application to enter the       30 days from the        A signed EIS Code of Ethics
    CDS and a signed EIS           EIS’s date of hire      must be submitted with the
    Code of Ethics                                         application.

                                                           A person does not have
                                                           professional status as an E IS
                                                           until his or her application to
                                                           enter the CDS is approved by
                                                           DARS ECI.
    9-Month Review                 9 months from the
                                   EIS’s date of hire

    Completion of the CDS          24 months from the      Once approved, DARS ECI
    individualized professional    EIS’s date of hire      issues a certificate of recognition
    development plan                                       to verify that the person has
                                                           attained the status of a fully
                                                           qualified EIS.
    Annual continuing              annually on the         10 hours of continuing
    professional education         anniversary of the      professional education is required
    (CPE)                          EIS’s fully qualified   annually.
                                   certificate date
                                                           Three hours of ethics training is
                                   Documentation           required every two years in
                                   cannot be submitted     addition to the 10 hours of CPE.
                                   more than 8 weeks
                                   before the due date     CPE does not include ECI
                                                           required trainings (CPR, First Aid,
                                                           Universal Precautions, etc.) or
                                                           the ECI static Web-based
                                                           trainings found on the ECI Web

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                                                            site.
    Change of Information for       within 30 days of
    any of the following            change
    changes:
        name change,
        change in
           supervisor,
        change in program,
           or
        change in status
           (active to inactive or
           inactive to active)



    13.2.4 Loss of Professional EIS Status
    An EIS who fails to submit the required documentation by the designated deadline may
    not perform activities requiring EIS professional status.

    Professional status is reinstated after DARS ECI receives and approves the required
    documents.

    If an EIS’s professional status is lost, all evaluations, assessments, and IFSPs that were
    performed by an interdisciplinary team of only two providers that included the EIS must
    be reviewed and approved by another licensed or credentialed professional. This
    professional ensures that the activities were performed correctly and that appropriate
    services are in place for the child and family.

    13.2.5 EISs Returning from Inactive Status
    Fully-qualified EISs may return to active status from inactive status by submitting 10
    hours of CPE for every year of inactive status.
    EIS Returning from Inactive Status Actions
    To return from inactive to active status, an EIS must comp lete the application actions in
    the following table.

    Status                          Required Action
    The fully qualified EIS was     The EIS must submit the required ethics training in
    due for ethics training while   addition to the required CPE.
    on inactive status.
    The fully qualified EIS does    The EIS returns to active status as an entry-level EIS and
    not have the appropriate        participates in documented weekly one-hour direct
    number of CPE or ethics         supervision sessions until the appropriate number of
    training hours.                 training hours are submitted to DARS ECI; or
                                    completes the CDS again instead of submitting the
                                    necessary training hours.


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    The entry-level EIS is        The EIS starts over in the CDS unless he or she is able to
    returning to active status    complete the CDS by his or her original final IPDP
    from inactive status.         deadline.

    13.2.6 Early Intervention Specialist Code of Ethics
    The EIS must abide by the standards of conduct in the EIS Code of Ethics found in the
    Texas Administrative Code.
    If the EIS violates the EIS Code of Ethics, the EIS’s supervisor must
          complete and sign an EIS Code of Ethics Incident Report; the EIS Code of Ethics
            Incident Report must also be signed by the program director;
          submit the incident report to DARS ECI within 30 days of knowledge of the
            violation; and
          document on the incident report the reason that the EIS information is missing, if
            the EIS did not document his or her version of the violation or sign the EIS Code
            of Ethics Incident Report form.

    Documentation of the EIS Code of Ethics Incident Report is maintained in the EIS’s
    registry file, which is maintained by DARS ECI.


    13.3 Service Coordinators
    Each family must have a service coordinator who acts as a single point of contact for
    the program and the community. Service coordinators must
         have a high school diploma or GED;
         meet qualifications to carry out all applicable responsibilities;
         complete training on
              o infants and toddlers who are developmentally delayed, or are at risk of
                  delay;
              o Part C of IDEA; and
              o services available in the community or from state-funded programs.
                  Training includes eligibility and cost information;
         complete the ECI Family-Centered Service Coordination module before providing
           any service coordination activities; and
         effectively communicate in the family’s primary language or use an interpreter
           and translator unless it is clearly not feasible to do so.


    13.4 Paraprofessional Supervision Requirements
    A paraprofessional with a discipline-specific license or credential must adhere to the
    specific supervision requirements of that license or credential. A paraprofessional
    without a discipline-specific license or credential who provides services to children and
    families must participate in one hour per week of direct supervision with a degreed
    professional.


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    A paraprofessional who serves as a service coordinator must receive supervision from a
    degreed ECI service coordinator who has 18 hours of college credit directly related to
    early intervention. The college credit must be verified by an official transcript with
    passing grades.

    Supervision includes consultation, record review, and observation.

    13.4.1 Eligible Activities for Paraprofessionals
    A paraprofessional must complete the appropriate training before providing the following
    activities:
         screenings,
         pre-enrollment,
         service coordination,
         parent education,
         nonclinical behavior services, and
         other discipline-specific activities that fall under the scope of the
            paraprofessional’s license or credential.


    13.4.2 Ineligible Activities for Paraprofessionals
       A paraprofessional is not qualified or allowed to
        serve as one of the two required team members on an interdisciplinary team for
          evaluations and assessments or for developing the IFSP,
        supervise other paraprofessionals, or
        supervise or mentor entry-level EISs in the CDS.

       A paraprofessional without a discipline-specific license or credential is not qualified
       or allowed to provide developmental services.


    13.5 Provider Qualifications for Developmental
    Services
    Developmental services consist of general intervention across all developmental
    domains.

    Developmental services include
        providing developmentally appropriate individualized skills training and support to
          promote the child’s engagement in daily activities, functional independence, and
          social interaction;
        assisting caregivers in identifying and using opportunities to incorporate
          therapeutic intervention strategies into daily life activities that are natural and
          normal for the child and family; and



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         continually monitoring the child’s progress in acquiring and mastering functional
           skills to reduce or overcome limitations resulting from disability or developmental
           delays.

    When developmental services are planned on the child’s IFSP, the following
    professionals, practicing within the scope of their license or certification, are authorized
    to both provide and supervise the provision of developmental services:
         licensed occupational therapists,
         licensed physical therapists,
         licensed speech language pathologists,
         licensed professional counselors,
         licensed clinical social workers,
         registered nurses, and
         other persons authorized in the Texas Medicaid State Plan.

    The following professionals are authorized to provide developmental services only when
    the IFSP is reviewed and supervised by one of the professionals authorized to
    supervise the provision of developmental services (listed above):
         licensed therapists (COTA, PTA, SLP assistant, SLP-CFY);
         licensed counselors (LMFT);
         licensed social workers (LBSW, LMSW);
         Early Intervention Specialist (EIS) professionals participating in or certified
           through the ECI Competency Demonstration System;
         licensed psychological associates, and
         other persons authorized in the Texas Medicaid State Plan.

    Supervision of developmental services on the IFSP includes
        participating in the child and family’s initial and annual comprehensive
          assessments by being present at or reviewing them,
        attending revision meetings or reviewing and signing the IFSP for any
          subsequent revisions of the plan that result in service changes,
        providing a face-to-face visit with the child at least once a year, and
        monitoring the child’s progress through
              o ongoing provision of services,
              o consultations, or
              o assessment at a frequency determined to be necessary by the
                 interdisciplinary team.

    Supervision of developmental services on the IFSP does not imply that the professional
    is responsible for personnel supervision duties for the employee who is providing
    developmental services.



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    13.6 Provider Qualifications for Autism Spectrum
    Disorders (ASD)
    The contractor must provide appropriate teams to perform assessment and evaluation
    and provide services to children diagnosed with or displaying signs or symptoms of
    autism spectrum disorders (ASD). Any staff member who provides assessment and
    evaluation or services to the family of a child suspected of having an ASD must
    demonstrate proficiency in recognizing the signs of ASD and early intervention
    modalities for ASD.

    Others who may provide ASD early intervention services include
        Board Certified Behavior Analysts (BCBA),
        family members,
        friends, and
        others selected by the family.

    ECI staff members or subcontractors authorized to provide clinical support of the ASD
    early intervention services are limited to
        BCBAs,
        Psychologists,
        psychologist associates,
        LPCs, and
        LCSWs.

    Any staff members who provide oversight of an IFSP for a child suspected of having an
    ASD must have documented training and expertise in autism and infant-toddler
    development.



    Chapter 14: Procedural Safeguards
    14.1 Procedural Safeguards Overview
    With few exceptions, the procedural safeguards required in this chapter are summaries
    of requirements found in statutes and federal regulations. In case of conflict between
    these standards and the federal authorities, the interpretation must be in favor of higher
    safeguards for children and families.

    Federal Authorities: Individuals with Disabilities Education Act, Part C (20 U.S.C.
    Sections 1431–1444); Family Educational Rights and Privacy Act of 1974 (20 U.S.C.
    Section 1232g); Title VI of the Civil Rights Act of 1964 (42 U.S.C. Sections 2000d–
    2000d-7) and their implementing regulations, in particular 34 C.F.R. Part 99 and 34
    C.F.R. Sections 303.170, 303.172, 303.342, 303.400–303.406, 303.419–303.425,
    303.460, 303.510, and 303.512.


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    DARS Rules: 40 T.A.C. Sections, 108.3, 108.7, 108.101–108.139, and 101.8011–
    101.8015.

    The contractor must

          ensure that families are informed of and understand the legal rights and
           protections available to the child, the family, and their advocates; and
          develop local policies and procedures to effectively implement all procedural
           safeguards in accordance with DARS ECI policies and standards, and federal
           and state requirements.

    14.2 Informing Parents of Procedural Safeguards
    The contractor must

          provide oral and written explanation to the parent about safeguards during the
           pre-enrollment process and at other times when parental consent is required,
          provide the family an ECI Handbook (developed by DARS ECI) that informs
           parents of their rights under the Individuals with Disabilities Education Act (IDEA)
           and the Family Educational Rights and Privacy Act (FERPA), and
          explain the ECI Handbook to the parent at the
              o beginning of the pre-enrollment process,
              o initial IFSP meeting before the parent signs the IFSP, and
              o annual IFSP meeting before the parent signs the IFSP.

    14.2.1 Limited English Proficiency
    The contractor must

          provide all information to the parent in clear language that is understandable to
           the general public and omits or clarifies technical and professional terms;
          make every reasonable effort to ensure that the parent understands all
           information provided;
          make reasonable accommodations for limited English proficiency and the literacy
           level of the family;
          make reasonable efforts to ensure that information is provided orally (if the
           parent's primary language or other mode of communication cannot be written) or
           by other modes of communication normally used by the parent (for example, sign
           language or braille);
          make reasonable efforts to communicate in the parent’s and child’s primary
           language or other mode of communication unless clearly not feasible;
          provide appropriate interpreter or translator services when necessary;
          use a certified interpreter and translator to meet the individual needs of the child
           and family unless clearly not feasible;


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          use people who are proficient to provide interpreter or translator services when a
           certified interpreter or translator is not available;
          never use a minor as an interpreter to interpret or translate information, even if
           requested;
          ensure that the interpreter or translator is effective, accurate, and impartial;
          provide interpreter and translator service at no cost to the family; and
          ensure that communication with the family is accurate, effective, and impartial.

    The contractor must document in the child’s record
        offers to provide interpreter services, and
        the parent’s response.

    14.3 Child and Parent Rights
    The child’s and parent’s rights begin immediately when the contractor receives the
    referral or is otherwise contacted about the child or family. The parent has the right to

          expect confidentiality of personally identifiable information;
          receive prior written notice before the contractor proposes to evaluate the child,
           or initiate or change early intervention services;
          receive a comprehensive evaluation of the child;
          provide prior written consent before all assessments, evaluations, and early
           intervention services;
          choose how they will participate in the child’s evaluation, assessment, and early
           intervention services;
          refuse some or all evaluations, assessments, and early intervention services;
          receive prior written notification before the contractor refuses to evaluate or
           initiate early intervention services;
          receive prior written notice before a contractor proposes to change eligibility for
           early intervention services;
          receive prior written notice in a reasonable time to plan and prepare before the
           IFSP meeting;
          report concerns to DARS ECI;
          request mediation or a due process hearing;
          file a complaint with DARS ECI;
          bring a civil action in state or federal court;
          receive prompt and unbiased dispute resolution;
          continue to provide the child previously agreed-upon, appropriate early
           intervention services during any complaint proceeding;
          review and inspect the child’s records;
          request that information in the child’s record be corrected if the information is
           incorrect or violates the child’s or family’s privacy; and
          have information provided in their primary language unless clearly not feasible.


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    The contractor must ensure that any additional procedural safeguards required at the
    local level do not conflict with state or federal procedural safeguards.

    14.4 Prior Written Notices to Parents
    The contractor must ensure that the family is given adequate notice to participate in
    assessments, evaluations, and the planning and development of early intervention
    services.

    The contractor must provide prior written notice to the parent within a reasonable time
    before the contractor

           proposes or refuses to evaluate the child,
           proposes or refuses to initiate or change the eligibility status of the child,
           proposes or refuses to initiate or change early intervention services,
           proposes to discontinue early intervention services to the child and family, or
           schedules an IFSP meeting.

     All prior written notices must be given within reasonable time before the meeting date
     to ensure that participants can attend and must include

           the date of the notice;
           the name of the child;
           the names and disciplines of the persons on the team;
           the location, date, and time of the meeting;
           the purpose of the meeting;
           a statement that consent is voluntary and may be revoked at any time;
           an explanation of the consequences of the parent’s refusal;
           an explanation of the rights of the parent to choose how he or she wishes to be
            involved in the process;
           a statement that the parent may give consent for some parts of the assessment,
            evaluation, early intervention services, or the plan and not for others;
           information about the parent’s right to disagree;
           a statement that the child’s records are kept by the contractor, the parent may
            review the child’s records, the child’s records are confidential, and the contractor
            will destroy the child’s records five years after the child exits;
           information about the parent’s right to file a complaint; and
           enough detail to inform the parent about
                 o the actions or issues to be considered;
                 o each record or report used as a basis for consideration; and
                 o applicable procedural safeguards, including rights of confidentiality, rights
                    to refuse consent, and rights to appeal.

    The contractor must maintain in the child’s record the original prior written notice
    provided to the family.

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    14.4.1 Prior Written Notice Related to Evaluation
    In addition to the requirements in 14.4 Prior Written Notices to Parents, the prior written
    notice for assessments or evaluations must also contain

          the developmental areas to be assessed or evaluated,
          the assessment or evaluation instrument to be used,
          the purpose of the assessment or evaluation, and
          how the results will be used.

    The parent has the right to decide whether to proceed to evaluation after screening. The
    contractor must provide prior written notice before the team recommends an evaluation
    not be performed for a child, based on screening results. This notice must also contain

          the reason for not evaluating the child, and
          information about the parent's right to disagree with the screening results and
           receive an evaluation.

    14.4.2 Prior Written Notice Related to IFSP

    The contractor must provide prior written notice before all IFSP meetings. In addition to
    the requirements in 14.4 Prior Written Notices to Parents, the prior written notice for an
    IFSP meeting must also include statements that the

          parent will receive a copy of the IFSP,
          contractor will keep a copy of the IFSP in the child's record, a nd
          IFSP is confidential.

    14.5 Informed Consent
    Before obtaining the parent’s written consent, the contractor must fully inform the parent
    and explain

          the activity for which consent is sought;
          all information related to the assessment, evaluation, early i ntervention service,
           or activity for which consent is sought;
          that granting consent is voluntary and may be revoked at any time;
          the right to consent to some assessments, evaluations, early intervention
           services, or activities;
          the right to refuse other assessments, evaluations, early intervention services, or
           activities;
          the right to accept or decline any assessments, evaluations, early intervention
           services, or activities;
          the right to decline a service at any time without jeopardizing other early
           intervention services described in the IFSP;
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          any financial responsibility or other burdens that the family will bear as a result of
           giving consent; and
          any adverse consequences that could result from denying consent.

    14.6 Written Parental Consent
    The contractor must ensure that the parent is fully informed and has agreed in writing to
    all activities before the child participates. All documents must be completed (including
    blank lines or boxes requiring choices) before they are signed.

    The contractor must obtain written parental consent before
        screening, except in cases of referral by DFPS of a child in the conservatorship
          of DFPS;
        conducting any assessments or evaluations;
        providing early intervention services as described in the IFSP;
        changing the frequency, intensity, location, method, or payment arrangements for
          early intervention services;
        adding or discontinuing early intervention services;
        releasing personally identifiable information;
        seeking exchange of information with another agency, organization, or provider;
          and
        billing private insurance.

    14.6.1 Written Parental Consent for Screening, Assessment, and
    Evaluation
    Written parental consent must be obtained before conducting any screening,
    assessment, or evaluation and must include

          the name of the child;
          the time and location of the meeting;
          the names and disciplines of the team members;
          the tool or process to be used;
          a description of the activity;
          a description of the records (if any) that will be released and to whom they will be
           released;
          the developmental areas to be addressed;
          the purpose of the activity and how the results will be used;
          the parent’s involvement in the process;
          a statement that consent is voluntary and may be revoked at any time;
          a statement that consent may be given for some parts of the assessment or
           evaluation and not for others;
          an explanation of the consequences of the parent’s refusing the early
           intervention services;

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          a statement that the parent may review the results, the contractor will keep the
           results, and the results are confidential;
          information about the parent's right to file a complaint;
          a statement about financial arrangements (if applicable);
          a parental signature and date of consent; and
          information about applicable procedural safeguards.

    14.6.2 IFSP Procedural Safeguards
    The IFSP must contain the following procedural safeguards:

          a statement that consent is voluntary and may be revoked at any time,
          a statement that consent may be given for some early intervention services and
           not for others,
          an explanation of the consequences of the parent’s refusing early intervention
           services, and
          an explanation that the parent's signature grants permission for the child to
           receive early intervention services.

    14.6.3 Refusal to Consent

    If the parent does not give written consent, the contractor must make reasonable efforts
    to ensure that the parent

          is fully aware of the nature of the available assessments, evaluations, or early
           intervention services;
          understands that the child may receive the assessment, evaluation, or early
           intervention services only if consent is given; and
          understands the possible adverse consequences of not consenting to the release
           of personally identifiable information, if refusing to release the information results
           in early intervention services being denied.

    The contractor must not

          employ any form of coercion in attempting to persuade parents to consent to
           recommended assessment, evaluation, or early intervention services; or
          limit or deny a specific assessment, evaluation, or early intervention service
           because the parent has refused consent for another assessment, evaluation, or
           early intervention service.

    If a referral is made by DFPS of a child in the conservatorship of DFPS, consent for a
    screening may be given by a DFPS caseworker or child placing agency, and it may be
    given orally. For assessment or evaluation of the child, written consent by a parent or
    surrogate parent is necessary.


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    14.7 Surrogate Parents
    The contractor must ensure that all rights of an eligible child are protected if

          no parent can be identified;
          the contractor, after reasonable efforts, cannot discover the whereabouts of a
           parent; or
          the child is a ward of the state under the laws of Texas (A child who has an
           individual foster parent is not a ward of the state).

       The contractor must ensure that the child’s rights are protected by assigning a
       surrogate parent to represent the child’s interests in matters pertaining to
       assessment, evaluation, IFSP development, and early intervention services.

    14.7.1 Duty to Assign a Surrogate Parent

    The contractor must assign an individual to act as a surrogate parent if the child's parent
    cannot be located. This must include a method for

          determining whether the child needs a surrogate parent,
          assigning a surrogate parent to the child at the beginning of the pre-enrollment
           process, and
          providing training to ensure that the surrogate parent fully understands the role
           and responsibility to represent the best interests of the child.

    Assignment of the surrogate parent and training, as appropriate, must be documented
    in the child's record.

    If a child has a parent who meets the definition of parent in federal law and who is
    willing and able to serve, the contractor may not assign a surrogate parent, but the
    contractor may request that the parent attend surrogate parent training.

    14.7.2 Criteria for Selecting a Surrogate Parent
    To be assigned as surrogate parent, the person must

          have no interest that conflicts with the interests of the child represented;
          not be an employee of any state agency or a person or an employee of a person
           providing early intervention services to the child or to any family member of the
           child; and
          have knowledge and skills that ensure adequate representation of the interests of
           the child.

    Note: A person who otherwise qualifies to be a surrogate parent is not an employee
    solely because he or she is paid by a public agency to serve as a surrogate parent.

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    14.7.3 Responsibilities of the Surrogate Parent
    The contractor must ensure that the assigned surrogate parent

         represents the child and gives consent in all matters related to the

              o assessment and evaluation of the child;
              o development and implementation of the child's IFSP, including annual
                evaluations and periodic reviews; and
              o ongoing provision of early intervention services to the child;

         participates in the child’s early intervention services; and
         reports additional needs of the child.

    If the assigned surrogate parent fails to fulfill these responsibilities, the contractor must
    consider assigning a new surrogate parent.

    14.8 State-Level Complaint, Mediation, and
    Administrative Due Process Hearings
    The contractor must ensure that the parent a nd other people have the opportunity to
    resolve complaints and disagreements at the state level.

    The contractor must provide an explanation of the ECI Handbook and the parent’s right
    to file a state-level complaint, request mediation, or request an administrative due
    process hearing at the

                 beginning of the pre-enrollment process,
                 initial IFSP meeting before the parent signs the IFSP, and
                 annual IFSP meeting before the parent signs the IFSP.

    14.8.1 Complaints Procedures
    Any individual or organization may file a complaint with DARS ECI alleging that DARS
    or a contractor has violated requirements of IDEA, Part C or any related regulations or
    policies. The complaint must be in writing and state the facts on which the complaint is
    based. The complaint may be submitted by mail, fax, or email to the DARS ECI
    assistant commissioner.

    The complainant may submit additional information, either orally or in writing, about the
    allegations in the complaint. All relevant information will be reviewed.

    Within 60 days, the DARS ECI assistant commissioner issues a letter of findings and
    conclusions resolving the complaint, including the

         findings for each allegation;
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        reasons for the final decision; and
        corrective actions the contractor must take, if necessary.

    An extension of the 60-day time limit to resolve a complaint may be granted only in
    exceptional circumstances.

    To ensure the effective implementation of the final decision, the DARS ECI assistant
    commissioner assigns a staff member to provide technical assistance and appropriate
    follow-up.

    In resolving a complaint resulting in a finding of failure to provide appropriate early
    intervention services, the DARS ECI assistant commissioner may remediate the denial
    of those services, including, as appropriate, reimbursement or other corrective action
    appropriate to the needs of the child and the child's family.

    14.8.2 Mediation
    An individual or organization filing a complaint or requesting an administrative due
    process hearing is offered mediation to resolve the dispute. Participation in mediation is
    voluntary, and both parties to the dispute must agree to participate in mediation. The
    parent has the right to request that a neutral mediator be assigned, at DARS ECI’s
    expense, to help resolve the disagreement between the parent and the contractor. The
    request for mediation may be submitted by mail, fax, or email to the DARS ECI
    assistant commissioner.

    If both parties agree, the DARS ECI assistant commissioner contacts and assigns a
    qualified mediator who is knowledgeable in laws and regulations relating to the
    provision of early intervention services from a list maintained at DARS. DARS develops
    and implements a contract with the mediator and bears the cost of the mediation
    process.

    Mediation sessions must be scheduled in a timely manner and held in a location that is
    convenient to both parties in the dispute. All discussions that occur during the mediation
    process are confidential and may not be used as evidence in any subsequent
    administrative due process hearings or court actions. The parties to the mediation
    process may be required to sign a confidentiality pledge before beginning the process.

    If an agreement to the dispute is reached, a written mediation agreement is developed
    and signed by both parties. The agreements are enforceable in any state court of
    competent jurisdiction or in federal district court.

    The parent's right to a complaint investigation or administrative due process hearing
    must not be denied or delayed because the parent chose to participate in mediati on.
    The complaint investigation continues and is resolved within 60 days, even if a
    mediation agreement is reached.



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    While in mediation, unless both parties agree otherwise, the contractor must continue to
    provide the child previously agreed-upon, appropriate early intervention services.


    14.8.3 Administrative Due Process Hearings Concerning Individual
    Child Rights
    Authority: Texas Government Code, Chapter 2001, Administrative Procedure Act

    The parent or the contractor may request an administrative due process hearing on any
    matter related to identification, evaluation, placement, or provision of early intervention
    services. The request for a hearing must be in writing and submitted to the DARS ECI
    assistant commissioner. The request for a hearing is considered filed on the date
    received by the DARS ECI assistant commissioner’s office.

    While the hearing is pending, unless the parties agree otherwise, the child must
    continue to receive previously agreed -upon early intervention services. If the due
    process hearing involves an application for admission, the child must receive those
    services not in dispute.


    Rights Related to Administrative Due Process Hearings
    Any party to a hearing has the right to
        be accompanied and advised by counsel and by people with special knowledge
          or training in early childhood intervention services;
          present evidence and confront, cross-examine, and compel the attendance of
           witnesses pursuant to the Texas Government Code, Chapter 2001,
           Administrative Procedure Act;
          prohibit the introduction of any evidence at the hearing that has not been
           disclosed to the other party at least five days before the hearing;
          obtain a written or electronic verbatim record of the hearing; and
          obtain written findings of fact, conclusions of law, and a decision.


    Hearing Officers
    Due process hearings must be conducted by an impartial hearing officer. The hearing
    officer must
         be licensed to practice law in Texas,
         be knowledgeable about the provision of early intervention services,
          not be an employee of
               o the DARS ECI, or
               o any contractor involved in providing services or care to the child or the
                  child's family ;and,
          not have a personal or professional interest that would conflict with objectivity in
           the hearing.

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    Note: A person who qualifies to be an impartial hearing officer is not an employee of an
    agency solely because the person is paid to implement the complaint resolution
    process.


    Administrative Due Process Hearing Procedures
    The following hearing procedures are required:
        The hearing officer must give the parties an opportunity for hearing after
           reasonable notice of not less than ten days, unless the parties have agreed
           otherwise.
        Each hearing must be conducted at a time and place that is reasonably
           convenient to the parties involved.
          The rules of evidence and the rights to have a court reporter or other forms of an
           official record as provided for in the Texas Government Code, Chapter 2001,
           Administrative Procedure Act apply in these hearings.
          The hearing officer may issue subpoenas and commissions to take depositions
           pursuant to the Texas Government Code, Chapter 2001, Administrative
           Procedure Act. Subpoenas and commissions to take depositions must be issued
           in the name of DARS.
          The hearing officer must issue a final decision no later than 30 days after a
           request for a hearing is filed. The decision must be in writing and include findings
           of fact and conclusions of law, separately stated. Findings of fact must be based
           exclusively on the evidence and on matters officially noticed pursuant to Texas
           Government Code, Chapter 2001, Administrative Procedure Act. The hearing
           officer transmits the final decision to each party.
          A due process hearing is closed to the public unless the parent requests that the
           hearing be open.

    Any party who disagrees with the findings and decision from an administrative hearing
    has the right to bring a civil action in state or federal court after the hearing officer
    issues a final decision (see 20 U.S.C. Section 1439(a)(1).


    14.9 Confidentiality of Child and Family Records
    The contractor must ensure the confidentiality of personally identifiable information
    (paper or electronic) concerning each child and family. The child’s and parent’s rights
    begin as soon as the contractor receives the referral or is otherwise contacted about the
    child or family. The contractor may presume that the parent has authority to inspect and
    review records relating to the child unless advised that the parent does not have the
    authority under applicable state law governing such matters as guardianship,
    separation, and divorce
    Local policies and procedures must comply with the confidentiality requirements of 34
    C.F.R. Part 99; Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. Section
    1232g); and the Texas Communicable Disease Prevention and Control Act, Texas
    Health and Safety Code, Chapter 81.

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    The contractor must ensure that FERPA and IDEA requirements for confidentiality are
    met. The contractor must work with the local agency legal counsel and information
    technology personnel to ensure that security contro ls are in place to protect any
    information that is transmitted electronically.


    14.9.1 Parent’s Rights Related to Child and Family Records
    The parent has the right to
        receive a description of what personally identifiable information is maintained, the
          types of information sought, the methods used in gathering information (including
          the sources from whom information is gathered), and how the information will be
          used;
        receive a description of how personally identifiable information is stored,
          disclosed to third parties, maintained, and destroyed;
        inspect and review the child's records (paper or electronic);
          receive a response from a contractor to reasonable requests for explanations
           and interpretations of the records;
          receive, upon request, copies of the records containing the child’s information;
          have a representative of the parent inspect and review the records; and
          receive upon request, copies of the contractor’s policies and procedures on
           confidentiality.

    If any record includes information on more tha n one child, the parent has the right to
          inspect and review only information relating to his or her child; or
          be informed only of information specific to his or her child.


    14.9.2 Contractor Responsibility Related to Child and Family Records
    The contractor must
        protect the confidentiality of personally identifiable information at the collection,
          storage, disclosure, and destruction stages;
          designate one official (for example, administrator or records officer) to assume
           responsibility for ensuring the confidentiality of any personally identifiable
           information;
          upon request, provide the parent a list of the types and locations of service
           records collected, maintained, or used by the agency;
          maintain, for public inspection, a current list of the names and positions of those
           employees within the agency and other authorized personnel who may have
           access to personally identifiable information and records;
          maintain in the child's record a list of parties obtaining access to records
           collected, maintained, or used. Each record of access must include the name of
           the party, the date access was given, and the purpose for which the party is

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           authorized to use the record. This list must be provided to the parent upon
           request; and
          provide training or instruction about the state's policies and procedures to all
           persons collecting or using personally identifiable information.

    The contractor must maintain confidentiality of the HIV status of the child or any family
    member in a manner that is consistent with all state and federal statutes, regulations,
    and rules.


    14.9.3 Fee for Records
    If a fee for copies of records is charged to parents, the fee must not prevent the parent
    from exercising his or her right to inspect and review those records.

    The contractor must not charge a fee to search and retrieve child records.


    14.9.4 Disputed Records
    A parent who believes that information in the child’s record is inaccurate or misleading
    or violates the privacy or other rights of the child may request that the record be
    amended.
    The contractor must decide whether to amend the information as requested within a
    reasonable period after receiving the request, not to exceed 30 days.


    The Contractor Determines That Disputed Information Will Be Changed

    If the contractor decides that information in the record is inaccurate, misleading, or
    otherwise in violation of the privacy or other rights of the child, the contractor must
    amend the record and provide the parent written confirmation.



    The Contractor Determines That Disputed Information Will Not Be Changed
    If the contractor reviews the record and decides to refuse to amend the information in
    accordance with the request, the contractor must inform the parent of the refusal and
    advise the parent of the right to a hearing.

    The contractor must, upon request, provide an opportunity for a hearing to challenge
    information in the child’s records to ensure that the information is not inaccurate,
    misleading, or otherwise in violation of the privacy or other rights of the child. The
    contractor must give the parent an opportunity to present evidence relevant to the
    issues including, but not limited to, FERPA.

    The hearing must meet the following minimum requirements:



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          The contractor must hold the hearing within a reasonable time, not to exceed 30
           days, after it has received a hearing request from the parent.
          The contractor must give the parent notice of the date, time, and place
           reasonably in advance of the hearing.
          The hearing must be conducted by an individual who does not have a direct
           interest in the outcome of the hearing. This may be an official of the contractor.
          The contractor must give the parent a full and fair opportunity to present
           evidence relevant to the issues including, but not limited to FERPA. The parent
           may, at his or her own expense, be assisted or represented by one or more
           people of his or her choice, including an attorney.
          The contractor must make its decision in writing within a reasonable period after
           the hearing, not to exceed 30 days.
          The decision must be based solely on the evidence presented at the hearing and
           must include a summary of the evidence and the reasons for the decision.

    If the hearing results in a decision that the information is inaccurate, misleading, or
    otherwise in violation of the privacy or other rights of the child or family, the contractor
    must amend the information accordingly and inform the parent in writing.

    If the hearing results in a decision that the information is not inaccurate, misleading, or
    otherwise in violation of the privacy or other rights of the child or family, the contractor
    must inform the parent of the right to place a statement in the record commenting on the
    contested information or any reasons for disagreeing with the decision.

    Any explanation placed in the child’s record under this policy must be maintained by the
    contractor as part of the record according to child record retention requirements.

    If the contractor discloses the contested information to any party, the explanation must
    also be disclosed.
    Changes to Records
    Any changes to any information documented in a child's record must be lined through
    with a single line, initialed, and dated by the individual making the change. Using
    correction fluid or any other method to make corrections in a child's record is not
    allowable.


    14.9.5 Release of Information with Written Parental Consent
    The contractor may release a copy of the child's record, including medical information,
    to a designated party with informed written parental consent. The contractor must
    maintain documentation in each child's record of all disclosures of confidential
    information made as a result of parental consent to release information.

    Unless authorized to do so under FERPA and 34 C.F.R. Section 99.31, informed written
    parental consent must be obtained before personally identifiable information is

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          disclosed to anyone other than officials, employees, or subcontractors of ECI-
           contracted agencies and public school child find personnel; or
          used for any purpose other than meeting a requirement under this policy.

    The contractor must have procedures that are used if a parent refuses to provide
    consent.

    14.9.6 Release of Information without Written Parental Consent
    The contractor may share personally identifiable information without parental consent in
    some circumstances. These circumstances include
        compliance with a judicial order;
        health or safety emergencies such as child protective situations;
        DARS monitoring and audits or monitoring and audits of a funding agency;
          disclosing information to other officials, employees, or subcontractors of other
           ECI contractors to facilitate referrals, coordinate efforts, or prevent duplication;
          ECI reporting systems such as T-KIDS;
          sending personally identifiable information to authorized representatives o f state
           or local educational authorities to comply with child find requirements; and
          other reasons as allowed by law.


    14.9.7 Release of Information to School Districts
    The contractor may release information to local school districts only in the specific
    conditions listed in the situations below.
    Referrals from School Districts
    The contractor must report the disposition of a referral from a school district to an
    authorized school district official when requested. This disclosure is to help the school
    district comply with the data collection requirements under Part B of IDEA. This
    information may be shared with school districts without parental consent, according to
    FERPA and 34 C.F.R. Section 99.31. A school district must initiate data collection
    efforts.
    School District Child Find
    Written parental consent is not required to disclose personally identifiable information to
    authorized representatives of state or local educational authorities to comply with child-
    find requirements.

    During the pre-enrollment process, the contractor must inform the parent that the
    contractor will notify (not refer) public school child-find personnel of the names of all
    enrolled children to ensure a continuum of services for children after they reach the age
    of three. The contractor must tell the parent that the information provided to the public
    school child-find personnel will include personally identifiable information (see Glossary
    for definition of "Personally Identifiable Information") and will occur between the child's
    second and third birthday if the child is potentially eligible for the PPCD.

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    Transition to School Districts
    Informed parental consent must be obtained before confidential ECI records are
    released to a school when a child is making the transition from an ECI program to a
    public school setting. If the parent refuses consent, confidential ECI records must not be
    intermingled with public school records, including records relating to special education.
    This consent is not required for personally identifiable information that must be shared
    with public school child-find personnel under the requirements for notification. .



    14.9.8 Release or Exchange of Information with other Agencies
    Exchange of information with entities outside ECI occurs only for legitimate reasons.
    Except as provided in 14.9.6 Release of Information without Written Parental Consent,
    the parent must provide prior written consent to release records, and the following
    requirements must be met:
         The parent must be informed of his or her right to refuse to sign the consent for
           release of information. Notice of the right to refuse must appear on the Consent
           to Release Information form.
         The form must
               o list the agency or agencies and/or persons to whom the information will be
                   disclosed, and
               o specify the type of information that will be given.
         The parent must be given the opportunity to limit the informa tion released and to
           limit the agencies and persons with whom information will be shared. The form
           must provide ample space for parents to express such limitations in writing.
         The form must contain a statement that consent is revocable at any time.
         The consent must be time-limited. The form must reflect a time limitation not to
           exceed one year.

    If a contractor requests information from another provider, such as the child's physician,
    and receives records that were not specifically requested, the contrac tor must
          mail the unrequested records back to the originator, or
          give them to the parent.

    The contractor must obtain informed parental consent before disclosing confidential
    information obtained from another agency, organization, or provider, unless the
    redisclosure is permitted under the terms of the original disclosure made to the agency
    or program.


    14.9.9 Record Retention
    Unless a longer period is required by state or federal law, the contractor must retain
    records for five years after the child exits early intervention services. The contractor
    must not destroy records before the normal record retention schedule.

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    The contractor must provide the parent written notice during the pre-enrollment and exit
    processes that the child’s records are destroyed five years after the child exits.

    The contractor must inform the parent when personally identifiable information
    collected, maintained, or used is no longer needed to provide early intervention services
    to the child and family and that the records will be destroyed.

    The contractor must destroy information upon request of the parent; however, it is
    permissible to maintain a permanent record of a child's
        name,
        address,
          telephone number,
          attendance record,
          early intervention services received, and
          years completed and dismissed.



    Chapter 15: Eligibility
    15.1 Overview of Eligibility Criteria
    Early intervention services are provided to families and their children in Texas once they
    have been determined eligible. This includes those who are
        Native Americans who reside on a reservation located in Texas,
        homeless,
          wards of the state,
          involved in a substantiated case of abuse or neglect, and
          identified as affected by illegal substance abuse or withdrawal symptoms
           resulting from prenatal exposure.

    The contractor must serve all eligible children and families regardless of
        gender,
          race,
          ethnicity,
          color,
          religion,
          national origin,
          sexual orientation,
          political affiliation,
          socioeconomic status, or

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          disability.

    Child eligibility criteria are standardized for all contractors. If a child is determined
    eligible for early childhood intervention in one area of Texas, the same eligibility criteria
    are applied if the family moves to another part of the state.


    15.2 Determining Child Eligibility
    To be eligible for early intervention services, a child must be under 36 months of age
    and
        have a medically diagnosed physical or mental condition that has a high
          probability of resulting in developmental delay and have a documented need for
          early intervention services,
        have a developmental delay, or
          exhibit atypical development.

    The contractor must
        establish a system of management oversight to ensure consistent eligibility
          determination;
        determine the child’s eligibility for early intervention services
              o at no cost to the family, and
              o based on the decision of an interdisciplinary team that includes the parent
                   and at least two professionals from different disciplines;
        include in the child’s record an eligibility statement from the interdisciplinary team
          that
              o verifies medical eligibility,
              o summarizes developmental delay, or
              o describes atypical development;
        maintain all test protocols used to determine eligibility in the child’s record;
        redetermine child eligibility for early intervention services at least annually;
        include in the child’s record the annual updated eligibility statement;
        dismiss from early intervention services any child who does not continue to meet
          eligibility criteria;
        provide written notice to the parent when the child is determined to be ineligible
          for early intervention services because the child no longer meets eligibility
          criteria; and
        consider enrolling the child in follow-along services based on the decision of the
          interdisciplinary team and parental consent. See Chapter 22: Follow-Along
          Services.




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    15.3 Medically Diagnosed Condition
    The contractor must determine eligibility for early intervention services based on a
    child’s having a medically diagnosed condition that
         has a high probability of resulting in developmental delay; and
          results in a documented need for early intervention services.

    For an approved list of eligible diagnoses, see ECI Medical Diagnoses.

    The contractor must ensure that the child’s record contains written verification of the
    medically diagnosed condition such as
        a physician’s statement,
          a hospital discharge summary, or
          other medical record.

    If eligibility is based on a medically diagnosed condition, the contractor must conduct an
    assessment
          to document the need for early intervention services; and
          to plan for intervention.


    15.3.1 Children Who Are HIV Positive
    The contractor must use the following procedure to determine eligibility for a child who
    is HIV Positive.

                                             Requirements for the Early Childhood
                 Child’s Age
                                                       Intervention Provider
     less than 15 months                    determine if the child is otherwise eligible
                                            for early intervention services. A child less
                                            than 15 months of age is not eligible
                                            based on a diagnosis of HIV alone.
     15 months through 35 months            obtain a physician’s statement of positive
                                            HIV testing.


    15.3.2 Continuing Eligibility Based on a Medically Diagnosed Physical
    or Mental Condition
    A child remains eligible for comprehensive early intervention services as long as
        the qualifying medical diagnosis is present; and
        the child continues to need early intervention services.

    The contractor must discontinue early intervention services when
        a change in medical diagnosis results in the c hild’s no longer having a qualifying
          medical diagnosis; or

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          resolution of the symptoms results in the family and child no longer
           demonstrating a need for early intervention services as determined by the
           interdisciplinary team.

    The contractor must ensure that the child’s record contains written documentation of
    any change in medical diagnosis.


    15.4 Developmental Delay
    The contractor determines eligibility for early intervention services based on a delay in
    one or more of the following developmental areas:
        cognitive;
        motor;
        communication;
        social-emotional; or
          adaptive skills.

    The contractor must determine the child’s specific level of delay by the child’s
    performance on an evaluation tool designated by DARS ECI and informed clinical
    opinion. No single procedure is to be used as the sole criterion for determining the
    child’s eligibility. The contractor assigns the highest age in the range to determine the
    months of delay when using an inventory or test that results in an age-range score.

    The contractor must use the following levels of delay to determine eligibility.

                 Child’s Age                                Requirements
    2 months* through 12 months                 A documented delay of 2 months or
                                                more in any one developmental area
    13 months through 24 months                 A documented delay of 3 months or
                                                more in any one developmental area
    25 months through 35 months                 A documented delay of 4 months or
                                                more in any one developmental area
    *For a child under 2 months of age, eligibility must be determined based on atypical
    development or a medically diagnosed condition.



    15.4.1 Expressive Language Delay
    For a child under age 18 months whose only delay is in the area of expressive
    language, use the following criteria.

         Level of Delay                             Requirements
    Less than 4 months           a speech-language pathologist must assess and
                                 determine atypical development in order for the child

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                                 to be eligible for early intervention services.

    4 months or more             the delay is documented, and the child is eligible for
                                 early intervention services.


    For a child ages 18 through 35 months whose only delay is in the area of expressive
    language, use the following criteria.

         Level of Delay                               Requirements
    Less than 6 months           a speech-language pathologist must assess and
                                 determine atypical development in order for the child
                                 to be eligible for early intervention services.

    6 months or more             the delay is documented, and the child is eligible for
                                 early intervention services.



    15.4.2 Determining Developmental Delays for Infants Born
    Prematurely
    When determining eligibility for an infant born prematurely (less than 37 weeks
    gestation),
        the developmental age must be measured against the adjusted age rather than
           chronological age until the child is 12 months old; and
        the adjusted age may not be adjusted for more than 2 months’ prematurity.


    15.4.3 Continuing Eligibility Based on Developmental Delay
    The contractor must determine the child’s continuing eligibility based on the child’s
    performance on an evaluation tool designated by DARS ECI and informed clinical
    opinion. No single procedure is to be used as the sole criterion for determining the
    child’s eligibility. The contractor assigns the highest age in the range to determine the
    months of delay when using an inventory or test that results in an age-range score.

    Use the following levels of delay to determine continuing eligibility.

                 Child’s Age                                Requirements
    0 through 24 months                         A documented delay of 1 month or
                                                more in any one developmental area
    25 months through 35 months                 A documented delay of 2 months or
                                                more in any one developmental area




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    15.5 Atypical Development
    The contractor determines eligibility for early intervention services based on responses
    or patterns that are qualitatively different, even if the child performs within the
    appropriate age range on test instruments.

    Atypical development includes, but is not limited to, the following:
        abnormal or questionable sensory-motor response;
        unusual or irregular patterns of language or cognition;
          problematic emotional or social patterns; and
          auditory or visual impairments as defined by the Texas Educatio n Agency rule at
           19 TAC Section 89.1040.

    The contractor must
        convene an interdisciplinary team that includes
              o the parent,
              o a professional with knowledge and expertise in the primary developmental
                 area of concern, and
              o at least one other professional from another discipline;
        use a testing instrument designated by DARS ECI and informed clinical opinion;
          and
          ensure that the child’s record includes the
              o documentation of observation and informed clinical opinion,
              o parent report, and
              o test protocol of the administered testing instrument.


    15.5.1 Continuing Eligibility Based on Atypical Development
    Continuing eligibility based on atypical development is determined by the
    interdisciplinary team that includes
         the parent,
          a professional with knowledge and expertise in the primary developmental area
           of concern, and
          at least one other professional from another discipline.

    The contractor must discontinue early intervention services when the child
        no longer exhibits atypical development, based on informed clinical opinion; and
        meets no other continuing eligibility requirements.




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    Chapter 16: Referrals and the Pre-
    enrollment Process
    16.1 Referrals and the Pre-Enrollment Process
    Requirements
    The contractor must develop and implement written policy or procedures for accepting
    referrals and initiating the pre-enrollment process that require that
         referral sources be informed that the family will be contacted within 5 business
           days,
         referral sources be informed that early intervention services strengthen the
           family’s ability to access resources and improve the child’s development through
           daily activities,
         a staff member contact every family by phone or face-to-face within five business
           days of the initial referral,
         a service coordinator conduct a face-to-face meeting with the family within 10
           business days of the initial referral,
         the referral source and date be documented in the child's record,
         referral information be transferred to the appropriate contractor within two
           business days if the family resides in another ECI service area,
         referrals be forwarded to the correct agency or organization if the referral is not
           appropriate for ECI,
         families be referred to other appropriate community resources if the child is
           ineligible for early intervention services, and
         records of referrals be appropriately maintained.


    16.2 Special Referral Circumstances
    Certain referral types have additional requirements .

    16.2.1 Referrals Received before the Child’s Birth
    When the contractor receives a referral before the birth of a child who is expected to be
    eligible for early intervention services based on medical diagnosis, the child is not
    considered referred until birth.


    16.2.2 Child Protective Services (CPS) Involved
    The contractor must
        offer developmental screening or evaluation services to children referred by CPS
          with open cases involving substantiated abuse or neglect, and
        use a developmental screening instrument designated by DARS ECI.




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    Referrals from the Texas Department of Family and Protective Services Child Protective
    Services (CPS) Division are handled according to the following chart.

    Reason for Referral               Provider Requirements
    CPS has placed the child in       If the contractor receives a completed developmental
    foster care.                      screening from the child’s physician indicating a
                                      developmental delay, the contractor must conduct a
                                      comprehensive evaluation to determine eligibility for
                                      early intervention services.
                                      If the contractor does not receive a completed
                                      developmental screening from the child’s physician, the
                                      contractor must offer a developmental screening to
                                      determine the need for a comprehensive evaluation.
                                      The contractor may use professional judgment to
                                      conduct a comprehensive evaluation without a
                                      developmental screening.
    CPS has found a reason to         The contractor must offer a developmental screening to
    believe that abuse or neglect     determine the need for a comprehensive evaluation.
    has occurred, but the child is    The contractor may use professional judgment to
    not placed in foster care.        conduct a comprehensive evaluation without a
                                      developmental screening.
    CPS suspects a disability or      The contractor must offer a comprehensive evaluation
    developmental delay.              to determine eligibility.


    16.2.3 Referrals from the Texas Department of State Health Services
    (DSHS), Texas Early Hearing Detection and Intervention (TEHDI)
    Online System
    Contractors must
       receive referrals from the TEHDI system and report how the referrals are handled
          to DSHS through the TEHDI system;
       consider the email notification of a referral as the date of referral;
       follow procedures in the TEHDI-ECI training manual; and
       obtain written parental consent before reporting the disposition of the referral.
          See Chapter 14: Procedural Safeguards.

    16.2.4 Referrals Received for Children at Least 45 Days before the
    Third Birthday
    When a contractor receives a referral for a child at least 45 days before the third
    birthday, if the parent requests, the contractor must
         complete eligibility determination procedures with written parental consent;
         develop an IFSP with transition steps and strategies; and
         provide notification of the child’s personally identifiable information to the ISD if
           the child is potentially eligible.



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    The parent has the option to decline evaluation and assessment, but still receive case
    management and transition services. The contractor must document in the child’s
    record
        if the parent declines evaluation and assessment from ECI, and
        the case management and transition activities offered to the family until the child
           turns three.


    16.3 Ensuring Family Rights
    During the pre-enrollment process, the contractor must
        provide appropriate interpreter services or communication assistance to the
          parent or child with limited English proficiency or sensory or speaking
          impairments at no cost;
        assign a surrogate parent if necessary (see Chapter 14: Procedural Safeguards,
          14.6 Surrogate Parents);
        provide the family with a copy of the ECI Handbook;
        explain the ECI Handbook to the family and allow an opportunity to ask
          questions;
        document that the following were explained to the family:
              o the family’s rights,
              o the steps in early childhood intervention, and
              o the early childhood program and services available;
        file the signed acknowledgement form from the ECI Handbook in the child’s
          records;
        notify the family that personally identifiable information will be sent to public
          school child-find personnel between the child’s second and third birthdays if the
          child is potentially eligible for the PPCD; and
        obtain written consent from the parent before
              o beginning all screening procedures,
              o contacting medical professionals and other outside sources to coordinate
                  and gather information about the child and family, and
              o releasing personally identifiable information to other community resources
                  to coordinate services or to refer the child for other appropriate services.

    For more information, see Chapter 14: Procedural Safeguards.


    16.4 Initial Assignment of Service Coordinator
    At the first face-to-face contact with the family and a service provider, the contractor
    must
         document the assignment of a service coordinator; and


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          explain to the family that the service coordinator is the point of contact for the
           contractor.

    16.5 Pre-enrollment Process
    The pre-enrollment process begins at the point of referral and ends when the team
    begins to develop the IFSP or some other final disposition is reached. The contractor
    begins collecting information on the child and family when the referral is received and
    continues to collect information throughout the pre-enrollment process.


    During the pre-enrollment process, the contractor must
        gather information from the family about their concerns and needs as well as
          daily routines, tasks, and responsibilities;
        assist the family in identifying their capabilities and strengths related to
          enhancing their child’s development;
        gather information about the family’s formal and informal supports;
        discuss with the family ECI’s commitment to providing early intervention services
          in a natural environment in order to support the parent’s efforts to help the child
          function where he or she lives and plays;
        explain to the parent that the assessment and evaluation must capture the most
          accurate picture of the child’s ability to function in his or her natural environment,
          including the child’s behavior and interactions with others;
        assist the family in determining the most appropriate setting and circumstances
          for evaluation and assessment, including
              o time of day,
              o who should be present, and
              o who will participate; and
        assist the family in identifying the natural environment where the child will receive
          early childhood intervention services, such as
              o at home,
              o in the neighborhood,
              o at daycare, and/or
              o in other community settings.


    16.6 Enrolling Children Served by Two Contractors
    A child who lives part-time with two parents not in the same ECI service area can
    receive ECI services from both contractors. The IFSP team must determine that the
    services are needed, and both parents must agree to participate. The contractor who
    enrolls the child should be the one in whose area the child spends a majority of the
    time.

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    The contractor that enrolls the child retains the overall responsibility for the delivery of
    ECI services and must
        assume all administrative duties;
        have a process for determining if the parent has exclusive or shared rights to
          make health care and educational decisions for the child that would impact the
          ability of either or both contractors to provide ECI services; and
        establish a provision with the other contractor for implementing the IFSP in both
          settings with one of the following arrangements:
          o a formal contract for direct services with the second contractor;
          o an agreement with the second contractor for staff members from the enrolling
              contractor to provide direct services in the service area of the second
              contractor; or
          o a contract for direct services between the enrolling contractor and a private
              provider, with the agreement of the second contractor.

    The second contractor sends all documentation required by ECI to the enrolling
    contractor.




    Chapter 17: Screening
    17.1 Screening Overview
    Initial screenings must take place before eligibility determination to identify specific
    areas that require further evaluation and assessment. See Chapter 14: Procedural
    Safeguards, 14.6 Written Parental Consent.
    Screening packets may be done before or after the comprehensive evaluation.
    However, the eligibility determination is not complete until required screening packets
    are completed.

    The contractor must ensure that screening instruments are
        not used to determine eligibility for early intervention services, and
        maintained in the child’s record.


    17.2 The Screening Process
    All screenings, including vision, hearing, nutrition, and assistive technology, must
         be conducted in the setting chosen by the child’s parents ;
         be conducted by persons trained to use appropriate methods and procedures ;
         be administered after obtaining informed written parental consent, except in
            cases of referral by DFPS of a child in the conservatorship of DFPS;
         include the name(s) of the evaluator(s) and the date the screening was
            administered;


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          be reviewed on an ongoing basis and updated at the frequency recommended by
           the interdisciplinary team; and
          include informed clinical opinion and parent input.

    17.3 Provider Qualification to Conduct Screenings
    The contractor must ensure that the DARS ECI screening packet is administered only
    by professional or paraprofessional personnel (see also Chapter 13: Early Childhood
    Intervention Providers) who are
         trained in the administration of the DARS Early Childhood screening packet,
           which includes the administration of the Texas Early Childhood Intervention
           nutrition, hearing, and vision screening forms; and
         licensed or registered professionals in the area of screening, or have experience
           or education in recognizing impairments and the medical conditions related to the
           area of screening.

    The contractor must maintain documentation in staff members’ personnel files of
    completed training on using the Texas Early Childhood Intervention nutrition, hearing,
    vision, and assistive technology screening packet and forms.


    17.4 Required Nutrition Screening
    Before eligibility determination, the contractor must use the DARS Early Childhood
    Intervention screening packet, which includes the Texas Early Childhood Intervention
    Nutrition Screening form, to determine current nutritional status and the need for further
    nutrition evaluation and assessment. See also Chapter 18: Evaluation and Assessment,
    18.3 Initial and Annual Evaluations and Assessments of Nutritional Status, Hearing,
    Vision, and Assistive Technology.


    17.4.1 The Nutritional Screening Process
    Before eligibility determination, the contractor must
        plot the child’s head circumference, weight, length, and height on the growth
          chart, current within 30 days; and
          sign and date the completed growth chart.

    Once the child is enrolled, the contractor must screen and update the child’s nutrition
    status at a frequency recommended by the interdisciplinary team.


    17.4.2 Follow-Up to a Failed Nutritional Screening
    If the child fails the Texas ECI nutrition screening, the contractor must refer the child to
    a licensed or registered dietitian for a nutritional assessment, with parental consent and
    within five working days. A referral for a nutritional assessment is not required if the
    child has received a nutritional assessment within six months of the screening process.


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    17.5 Required Hearing Screening
    Before eligibility determination, the contractor must use the DARS Early Childhood
    Intervention screening packet, which includes the Texas Early Childhood Intervention
    Hearing Screening form, to determine the need for further hearing evaluation and
    assessment.

    The contractor must rescreen and update a child’s hearing status at a frequency
    recommended by the interdisciplinary team. See also Chapter 18: Evaluation and
    Assessment, 18.4 For Children with Diagnosed Auditory Impairment (AI) or Vision
    Impairment (VI).

    17.5.1 When to Defer Hearing Screening
    If any of the following conditions are identified, the contractor is not required to complete
    the Texas Early Childhood Intervention hearing screening but must refer the child, with
    parental consent, to the local education agency (LEA).
         The child has failed a diagnostic auditory brainstem response (ABR) or
            otoacoustic emissions (OAE) test, or other diagnostic evaluations.
         The child’s record includes an otological examination that reports the child has a
            serious hearing loss after corrective medical treatment.
         The child uses amplification.
         The child is being followed by an otologist.
          The child has an audiological evaluation that indicates a hearing loss or a
           progressive condition resulting in hearing loss.


    17.5.2 Follow-Up to a Failed Hearing Screening
    If the child fails the Texas ECI hearing screening and has not already had an
    audiological evaluation within the previous six months immediately before the Texas
    ECI hearing screening is conducted, then the contractor must refer the child to a state
    licensed audiologist within five business days.

    If the contractor receives an audiological evaluation that indicates the child has an
    auditory impairment, the contractor must refer the child within five business days
          to an otologist, an otolaryngologist, or an otorhinolaryngologist for an otological
            examination. An ontological exami nation may be completed by any licensed
            medical physician when an otologist is not reasonably available. The child record
            must include documentation that an otologist, an otolaryngologist, or an
            otorhinolaryngologist was not reasonably available to complete the examination;
            and
          to the LEA to complete the communication e valuation and participate in the
            eligibility determination process as part of the interdisciplinary team.

    See also Chapter 14: Procedural Safeguards, 14.9.5 Release of Information with
    Written Parental Consent.

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    17.6 Required Vision Screening
    Before eligibility determination, the contractor must use the DARS Early Childhood
    Intervention screening packet, which includes the Texas Early Childhood Intervention
    Vision Screening form, to determine the need for further vision evaluation and
    assessment.

    The contractor must rescreen and update a child’s vision status at a frequency
    recommended by the interdisciplinary team. Chapter 18: Evaluation and Assessment,
    18.4 For Children with Diagnosed Auditory Impairment (AI) or Vision Impairment (VI).

    17.6.1 When to Defer Vision Screening
    If any of the following conditions are identified, the contractor is not required to complete
    the Texas Early Childhood Intervention vision screening but must refer the child, with
    parental consent, to the LEA. The referral must be accompanied by the DARS2006E,
    State of Texas Interagency Eye Examination Report form completed by an
    ophthalmologist or an optometrist.
         The child appears to have no vision.
         The child has a serious visual loss after correction.
         The child has a progressive visual condition.


    17.6.2 Follow-Up to a Failed Vision Screening
    The contractor must refer a child who fails the Texas ECI vision screening and has not
    had a vision evaluation within nine months of the vision screening to an ophthalmologist
    or optometrist for an examination, with parental consent and within five working days. If
    the results of the examination indicate a vision impairment, the contractor must refer the
    child to the LEA and to the local office of the DARS Division for Blind Services, with
    parental consent and within five days of receiving the report.

    17.7 Required Assistive Technology Screening
    The contractor must complete an assistive technology screening before eligibility
    determination unless the child will receive a comprehensive evaluation from an
    interdisciplinary team that includes a therapist (physical therapist, occupational
    therapist, or speech-language pathologist). See also Chapter 18: Evaluation and
    Assessment, 18.5 The Assistive Technology Evaluation and Assessment Process.

    17.7.1 The Assistive Technology Screening Process
    The contractor must
        maintain documentation of screening and evaluation results in the child’s record,
          screen and update a child’s assistive technology needs at a frequency
           recommended by the interdisciplinary team, and



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          include an appropriate professional such as a motor therapist or a
           speechlanguage pathologist on the interdisciplinary evaluation team if screening
           determines a need for further testing.


    17.8 Optional Developmental Screening
    Developmental screenings must not be used to determine eligibility but may be used to
    identify potential areas of delay. The results of the developmental screening can be
    used to determine which disciplines may be needed on the interdisciplinary team during
    the evaluation and/or the assessment process.

    Contractors must meet the following requirements for developmental screening:
        ensure that developmental screening tools are standardized or norm-referenced;
          and
        train providers administering the screening tool according to the parameters
         required by the selected tool (See also Chapter 16: Pre-enrollment Process,
         16.2.2 Child Protective Services (CPS) Involved).

    The parent has the right to decide whether to proceed to evaluation after screening. If a
    child passes all areas of the developmental screening, the contractor must
        provide written documentation to the parent that further evaluation is not
           recommended, and
        offer the parent the option of completing a comprehensive evaluation.



    Chapter 18: Evaluation and Assessment
    18.1 Overview of Comprehensive Evaluation and
    Assessment to Determine Eligibility
    The contractor must complete an initial and annual comprehensive needs evaluation of
    the child’s functioning and a family-directed identification of the needs of the child and
    family.

    If the child does not have a medically qualifying condition, an interdisciplinary team
    consisting of a minimum of two professionals from two different disciplines and the
    child’s parent, must determine eligibility for early intervention services by completing an
    initial and annual comprehensive evaluation that

          identifies the child’s unique needs and strengths;
          determines the nature, extent, and need for early intervention services; and
          assists the family in identifying their concerns, priorities, and resources.


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    The contractor must maintain all documentation of eligibility determination and needs
    assessment in the child’s record, including all assessment reports, associated test
    protocols, and medical reports (See also Chapter 15: Eligibility).

    The procedures in Chapter 14: Procedural Safeguards for parental notification and
    consent apply to the evaluation and assessment process.


    18.2 Comprehensive Evaluation and Assessment
    Procedures
    At initial and annual comprehensive child evaluations and assessments, the
    interdisciplinary team must
         get prior written parental consent before obtaining records or child and family
             information from outside entities;
         review the child’s health and medical history;
         administer test protocols designated by DARS ECI to determine eligibility and
             months of delay across the following domains:
                 o cognitive development;
                 o physical development including vision, hearing, nutritional status, and
                    gross and fine motor skills;
                 o communication development;
                 o social and emotional development; and
                 o adaptive and self-help skills development;
         assess the child’s unique strengths and functional abilities related to each
             developmental domain;
         consider informed clinical opinion;
         document input from the parent and others selected by the parent (for example,
             grandparents, day care providers, and other family members) about the
                 o child’s functional skills, strengths, and behaviors;
                 o child’s functional ability to participate in everyday routines and activities;
                    and
                 o people, places, and things that interest and motivate the child to
                    participate in everyday routines and activities.
         ensure that assessments are conducted by persons trained to use appropriate
             methods and procedures; and
         ensure that settings and circumstances have been selected by the family as
             being the most appropriate for the child.

    The contractor must
        provide evaluations and assessments at no cost to the family;
        ensure that any costs of evaluations or assessments the family chooses for a
          second opinion are not incurred by the contractor or DARS ECI; and
        document in the child’s record the reason, if a discipline-specific evaluation is
          needed, but it is not completed before the IFSP meeting.

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    The contractor must consider other evaluations performed by outside entities and
        determine whether evaluations used to determine eligibility are consistent with
          ECI policies,
        determine if the information in evaluations reflects the child’s current status, and
        consider implications for planning the IFSP.


    18.3 Initial and Annual Evaluations and Assessments
    of Nutritional Status, Hearing, Vision, and Assistive
    Technology
    At the initial evaluation, the interdisciplinary team must
         gather information about the child’s
                o typical diet and eating habits,
                o functional use of vision and hearing, and
                o assistive technology supports; and
         complete the Texas Early Childhood screening packet to evaluate the child’s
                o nutritional status,
                o hearing, and
                o vision.

    If the child fails one or more of the areas of the screening packet, the contractor must
          make and document all necessary referrals for further evaluation within five days
            of a failed screening (A referral to the WIC program is not considered a referral
            for a nutrition assessment); and
          invite other professionals who have expertise in the area of the failed screening
            and are involved with the child to participate in the evaluation and assessment
            process.

    At the annual evaluation, the interdisciplinary team must assess the child’s nutritional
    status, hearing, and vision. The team refers to the appropriate professional for further
    evaluation as needed.


    18.4 For Children with Diagnosed Auditory Impairment
    (AI) or Vision Impairment (VI)
    For children with diagnosed AI or VI, the contractor must ensure effective and timely
    collaboration with the Local Education Agency (LEA).

    The contractor must



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          provide the LEA and/or the auditory specialist a 10-day written notice of the initial
           and annual comprehensive evaluations and assessments;
               o the parent may request or permit the contractor to proceed sooner than
                   the 10 days' required notice to LEA (see also Chapter 14: Procedural
                   Safeguards, 14.4 Prior Written Notices to Parents);
          maintain current contact information where notices can be sent;
          document the LEA’s notification in the child’s record; and
          coordinate the time of the comprehensive evaluation and assessment with the
           appropriate LEA-certified teacher of deaf and hard of hearing or certified teacher
           of the visually impaired so that he or she is able to participate;

    If the certified teacher of the deaf and hard of hearing or certified teacher of the visually
    impaired is not able to participate in the comprehensive evaluation and assessment,
    another meeting is scheduled to conduct the Auditory Impairment (AI) evaluation or the
    Visual Impairment (VI) evaluation. See also Chapter 17: Screening, 17.5 Required
    Hearing Screening and 17.6 Required Vision Screening.



    18.5 The Assistive Technology Evaluation and
    Assessment Process
    The contractor must ensure that assistive technology evaluations are performed by
    personnel with the appropriate education and experience:
        occupational therapists,
        physical therapists,
        speech-language pathologists, and
        certified teachers of the
              o deaf and hard of hearing, and
              o visually impaired.

    The contractor must ensure that assistive technology evaluations

          include a review of the child’s development in the areas of cognition; motor,
           language, social, and emotional development; and self-help skills;
          include a review of the child’s functioning and needs for assistance in positioning,
           mobility, communication, and play;
          consider all of the child’s activities that occur over a 24-hour period and over a
           variety of important life events such as holidays and vacations;
          take place in the child’s home and places of familiarity for the child and include
           environmental factors, such as transportation, home environment, and family
           routines;
          provide the parent with information about the availability of assistive technology
           services and devices and the possible positive outcomes; a nd


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         are documented and maintained in the child’s record. See also Chapter 17:
          Screening, 17.7.1 The Assistive Technology Screening Process.

    18.6 Identifying Concerns, Priorities, and Resources
    (CPRs)
    The contractor must assist the family to identify concerns, priorities, and resources.
    The contractor documents information obtained from the parent related to
       the parent’s ability to enhance the child’s development;
       concerns the parent considers to be a priority; and
       resources (supports and services) already in place that help to address co ncerns
          the parent has identified as a priority.

    The contractor must ensure that the process of gathering CPRs
        is based on information obtained through a parent interview,
        assists the family in identifying supports and services to help them support their
          child’s development and ability to fully participate in his or her natural
          environment,
        includes a discussion with the family about a need or interest in participating in a
          parent support group, and
        informs families that CPRs can be filed separately from the child’s record.

    18.7 Assessment for Referral for Velo-Cardio-Facial
    Syndrome (VCFS)
    The contractor must ensure that the interdisciplinary team considers seven specified
    characteristics of VCFS during evaluation and assessment for every child who is not
    already identified as having VCFS. The seven characteristics are
         hypotonicity;
         communication delay;
         articulation disorder;
         resonance disorder;
         nasal regurgitation during feeding of an infant with no history of cleft palate;
         recurrent ear infections combined with cardiac anomaly, feeding disorder, cleft
          palate, or submucosal cleft palate; and
         fine motor or gross motor delay.

    If a child has two or more of the seven characteristics and is not already under the
    treatment of a physician for VCFS, then the inte rdisciplinary team must
          provide the family with an introduction and overview of VCFS,
          recommend that the family follow up with the child’s health care provider,
          give the family the DARS ECI VCFS brochure, and
          provide and document any needed follow-up.

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    18.8 Autism Spectrum Disorder Screening
    Although the contractor does not diagnose autism, early screening and identification for
    autism is critical. Three indicators are
         atypical speech or language delay;
         social, emotional, or behavioral concerns; or
         cognitive delay.

    If an enrolled child over the age of 18 months has two of the above indicators and has
    not been screened by another entity for autism, then the contractor must
         explain the importance of early screening for autism,
         provide case management to assist the parent with having an autism screening
           done by the child’s physician,
         complete the Modified Checklist for Autism in Toddlers (M-Chat) if the child is not
           screened by the physician or is unable to receive the screening from the
           physician in a timely manner, and
         complete the M-Chat follow-up interview for children who fail the M-Chat
           screening.



    Chapter 19: Individualized Family Service
    Plan (IFSP)
    19.1 Individualized Family Service Plan (IFSP) General
    Requirements
    The contractor must develop a written Individualized Family Service Plan (IFSP) for the
    eligible child. An interdisciplinary team that includes the parent develops the IFSP. The
    plan must be based on shared assessment information, support a collaborative
    partnership with the family, meet the unique needs of the child and family, and be
    written in functional language. The parent may choose how to participate in the IFSP
    process. The child is considered enrolled in ECI on the date the parent signs the IFSP.

    The written plan must document

          discussions with the family about the evaluations and assessments results,
          information from parent interviews,
          information from other sources such as child-care or medical providers;
          the child and family needs;
          the child's participation in family and community activities; and
          family routines and interests.




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    19.2 Scheduling IFSP Meetings
    The contractor must schedule IFSP meetings
        with prior written notice;
        at times convenient for the family;
          in settings convenient for the family;
          including other persons requested by the family;
          with adequate notice to all participants requested by the family to attend;
          using necessary translation or interpreter services; and
          coordinating, with parental consent as needed, with other service providers
           working with the family.

    If the child has auditory or visual impairments, a certified teacher of the deaf and hard of
    hearing and/or a teacher of the visually impaired must be on the interdisciplinary team.
    The contractor must
          provide the teacher at least a 10-day written notice before the meeting, and
          keep documentation of the notice in the child's record.

    If operating in a Medicaid-managed care region, the contractor must provide, with
    parental consent, adequate notice of the IFSP meeting to the child's primary care
    physician and, if applicable, the child's medical or HMO case manager.


    19.3 Responsibilities in the IFSP Process
    The IFSP team must
        make decisions about early intervention services on an individualized basis for
          the child and family,
        comply with all applicable procedural safeguards,
          not plan early intervention services in excess of the frequency and intensit y the
           team determines the child needs, and
          make every effort to reach consensus when there is a dispute.

    The contractor must keep the original IFSP in each child’s record. See also Chapter 14:
    Procedural Safeguards.

    The contractor must review the child’s IFSP at a meeting or by other means acceptable
    to the parent
         upon parental or team member request, and
         any time conditions warrant a review.




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    19.3.1 IFSP Interdisciplinary Team
    The contractor must ensure that an interdisciplinary team is designated for each child
    for the child’s entire period of enrollment. If a member of the initial team becomes
    unavailable, the contractor must designate and document in the progress notes a
    replacement. The interdisciplinary team must include
         the parent;
          at least two fully qualified professionals from different disciplines. An early
           intervention specialist and a certified teacher may not compose an
           interdisciplinary team (except a certified teacher o f deaf and hard of hearing or a
           teacher of the visually impaired);
          the service coordinator who has worked with the family since the initial referral or
           is responsible for implementing the IFSP;
          a professional directly involved in conducting the evaluations and assessments;
           and
          a medical professional who meets the requirements of Chapter 13: Early
           Childhood Intervention Providers. If the medical professional on the team cannot
           attend the meeting, and the interdisciplinary team determines that developmental
           services are necessary, the medical professional must review all pre-enrollment
           information and review and sign the IFSP.


    19.3.2 Child with Auditory or Visual Impairments
    If the child has auditory or visual impairments, a certified teacher of the deaf and hard of
    hearing and/or a teacher of the visually impaired must be on the interdisciplinary team.
    The contractor must
          provide the teacher at least a 10-day written notice before the initial IFSP, annual
            IFSP, or complete review meetings, and
          keep documentation of the notice in the child's record.

    If the certified teacher of the deaf and hard of hearing and/or teacher of the visually
    impaired cannot attend the initial IFSP, annual IFSP, or complete review,
          the IFSP team cannot make any decisions or changes about auditory or vision
            services; and
          the IFSP must be routed to the certified teacher of the deaf and hard of hearing
            and/or teacher of the visually impaired for review and signature.

    If a teacher disagrees with any portion of the IFSP, the teacher must request within five
    days that another IFSP meeting be held to discuss the concerns.


    19.3.3 Other Team Members
    With parental consent, the contractor must also invite to the IFSP meeting
        Early Head Start and Migrant Head Start staff members, if the family is jointly
          served;

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          representatives from other agencies serving the child or family, such as the
           DARS Office for Deaf and Hard of Hearing Services or the DARS Division for
           Blind Services; and
          other family members, advocates, or persons outside the family, as requested by
           the parent.


    19.4 Parent Rights in the IFSP Process
    The contractor must explain the contents of the IFSP to the parents and obtain informed
    written consent from the parent before providing any early intervention services. The
    parent has the right to
         be present and participate in the development of the IFSP;
         have decisions about early intervention services made on the individualized
           needs of the child and family;
         receive a full explanation of the IFSP;
          receive a review of the ECI Handbook;
          consent to some, but not all, early intervention services;
          receive all early intervention services in the IFSP for which the parent gives
           consent;
          request an administrative hearing or file a complaint if the parent does not agree
           with the team;
          indicate disagreement with a part of the IFSP, even though the parent consents
           to early intervention services;
          have the IFSP developed in the parent’s primary language or mode of
           communication; and
          receive a copy of the IFSP.

    See also Chapter 14: Procedural Safeguards.

    19.5 Content of the IFSP
    Each written IFSP must be dated and include
        the name of the service coordinator;
        identified appropriate steps and strategies to support the transition when the child
          exits the program (see Chapter 21: Transition);
        an integrated summary (see 19.5.1 Integrated Summary);
        the child’s strengths and needs;
        concerns, priorities, and resources of the family;
        individualized outcomes, criteria, and strategies; and
          planned early intervention services.



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    19.5.1 Integrated Summary
    The IFSP must include a summary of
        the child’s level of functioning across all developmental domains (cognitive,
          social-emotional, communication and gross motor, adaptive/self-help skills, and
          fine motor development);
        the child’s functional skills, strengths, and behaviors;
        the child’s functional ability to participate in everyday routines and activities;
        people, places, and things that interest and motivate the child to participate in
          everyday routines and activities;
        the child’s pertinent health and medical history;
        the child’s current health status, including physical development, hearing, and
          vision;
        the child’s nutritional status; and
        any assistive technology the child currently uses.


    19.5.2 Family Concerns, Priorities, and Resources (CPRs)
    The IFSP team must address with the family the importance of identifying family
    concerns, priorities, and resources (CPRs). CPRs include information related to the
    family's ability to enhance their child's development, including any assistance they need
    to promote their child's ability to fully participate in his or her natural environments. The
    discussion includes identifying the natural supports and resources in the child’s
    environment and people who can facilitate the child’s acquisition and mastery of skills.

    The family may decline to develop CPRs. The family may choose to have their CPRs
    documentation maintained in a separate location from the IFSP.

    If the parent declines to develop CPRs, the IFSP team must document that the family
    was given the opportunity to identify and address their CPRs.



    19.5.3 Outcomes, Criteria, and Strategies
    Outcomes must
        be individualized for the child and family’s specific needs;
          use active language to describe a measurable desired end result;
          include criteria and timelines to describe the routines or activities;
          include strategies the family chooses to use to enhance the child’s
               o functional developmental skills and behaviors, and
               o ability to participate in everyday family and community routines and
                  activities;
          include where, when, and with whom the routines or activities will occur;




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           incorporate strategies for achieving each outcome that provide the necessary
            supports and resources for parents to enhance their child’s learning. These
            strategies include
                o assisting the family as needed in accessing other (non-ECI) services and
                   resources for which the child and family may be eligible;
                o assisting the family to use toys and materials found in the home to
                   enhance the child’s learning;
                o identifying activities in the child’s daily routine that offer opportunities for
                   the child to learn new skills; and
    addressing preliteracy and language skills, as developmentally appropriate for the child.
    The IFSP team must address outcomes and strategies before making decisions about
    early intervention services. If new outcomes are developed during service delivery, they
    must be dated and added to the IFSP. Early intervention services must not be listed as
    strategies.


    19.5.4 Early Intervention Services

    The IFSP must include the specific early intervention services needed to reach the
    identified outcomes, based on peer-reviewed research to the extent practical. The IFSP
    team must

          discuss how much support and assistance the family needs to implement the
           strategies in the IFSP;
          identify one team member to
               o meet with the family on a regular basis to support it in carrying out the
                   planned strategies developed by the team,
               o focus on what is necessary to achieve all functional outcomes, and
               o directly engage other team members with appropriate expertise as
                   needed; and
          identify and document in the IFSP the disciplines of staff members to provide
           needed services through consultation or joint visits to assist the family in
           implementing the strategies in the IFSP.

    Documentation of IFSP services must include

          the natural environments in which the early intervention services will be provided,
           or a justification if an early intervention service cannot be provided in the natural
           environment (see also Chapter 20: Required Early Intervention Services and
           Service Delivery);
          early intervention services to
               o enhance the child’s functional developmental skills and behaviors, and
                   ability to participate in everyday family and community routines and
                   activities;


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              o strengthen the capacity of the family to meet the child’s unique needs and
                  implement the strategies in the IFSP; and
              o provide all necessary supports from team members;
          dates for starting and ending each service;
          the frequency, intensity, location, and method of delivery for each service on the
           IFSP (the intensity of the service must be a specific amount of time, not a range );
          the discipline of the person responsible for implementing each individual service;
          payment arrangements for all early intervention services identified on the IFSP;
          the dated signature of the parent designating informed consent to early
           intervention services (see also Chapter 14: Procedural Safeguards);
          assurance that the child’s medical record has been reviewed for e ligibility for the
           Medicaid Developmental Rehabilitation Services (DRS) program [see also
           Chapter 8: Developmental Rehabilitation Services (DRS)];
          steps to be taken to support the transition of the child two years of age or older to
           other appropriate services;
          an indication if assistive technology strategies are included in the IFSP; and
          dated signatures of all team members, including those who
               o conducted evaluations and assessments,
               o participated in developing the IFSP, and
               o will provide early intervention services.


    19.5.5 Other Non-ECI Supports and Services
    The IFSP documentation must also include
        medical and any other services that the child needs but are not required early
          intervention services;
        the funding sources to be used to pay for those services; and
        the steps to be taken, if necessary, to secure public or private resources.

    19.6 Initial IFSPs
    The contractor must ensure that the initial IFSP meets the requirements in 19.5 Content
    of the IFSP for all IFSPs and is
         written within 45 days of referral;
         based on information gathered during
              o the pre-enrollment process, and
              o the comprehensive evaluation and assessment; and
          signed by all team members, including those who
              o conducted evaluations and assessments,
              o participated in developing the IFSP, and
              o will provide early intervention services.

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    The interdisciplinary team must develop the initial IFSP in a face-to-face meeting.

    Any professional directly involved in conducting the evaluation and assessment who
    cannot attend the IFSP meeting must provide input through other means acceptable to
    the parent and team.

    19.7 Periodic Review of the IFSP
    There are three types of periodic reviews:
        complete IFSP review with no changes,
        complete IFSP review with changes, and
        partial IFSP review.


    19.7.1 Complete Review of the IFSP
    A complete review of the IFSP must be conducted every six months at a minimum,
    more frequently if conditions warrant, or whenever the family or another member of the
    interdisciplinary team requests a review.

    If a complete review due date falls within 60 days of the due date for the annual IFSP,
          both the complete review and the annual IFSP are completed according to their
           due dates; or
          the annual IFSP is completed by the due date of the complete review and fulfills
           the requirement for complete review.

    A complete review must document discussion by the entire team of the entire IFSP
    including
         the current needs of the child and family,
         the effectiveness of strategies,
         progress toward achieving outcomes,
          any additional needs, and
          any needed modification of the outcomes or early intervention services.

    If at any time an original member of the team becomes unavailable, the contractor must
    designate a replacement interdisciplinary team member.


    Complete IFSP Review with No Changes
    If during the complete IFSP review the team determines that no changes to the type,
    intensity, or frequency of services are required, this determination is documented on the
    IFSP Periodic Review form.


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    If a change to an outcome does not result in changes to the type, intensity, or frequency
    of services, the team must
          develop and date new outcome pages,
          note the new outcome pages in the progress notes, and
          add the new pages to the IFSP.

    The contractor must ensure that a complete review with no changes is conducted in a
    face-to-face meeting with the parent and other team members, or b y another means
    acceptable to the parent. If a face-to-face meeting is conducted, the parent must receive
    prior written notice. All discussions with team members and the family must be
    documented in the child’s record.


    Complete Review with Revision to the IFSP

    If during the complete IFSP review the team determines that changes to the type,
    intensity, or frequency of services is required, the team must revise the IFSP.

    The contractor must ensure that a complete review with revision to the IFSP is
    developed by the service coordinator in a face-to-face meeting or other means
    acceptable to the parents and other participants. Other team members must be present
    as needed.

    The revision must be documented on the IFSP Periodic Review form, which

          assigns the revision date as the start date to all early intervention services unless
           a later start date is identified for a new service;
          identifies the service coordinator;
          includes the parent’s written consent to the changes (see Chapter 14: Procedural
           Safeguards); is provided in written form to the parent; and
          includes signatures of the entire team, signifying their agreement with the
           changes.


    19.7.2 Partial Review of the IFSP
    If, at any time other than the complete review the team determines that revision to the
    type, intensity, or frequency of the early intervention services is required, but a complete
    review is not necessary, the interdisciplinary team conducts a partial IFSP review. A
    partial review of the IFSP is also the procedure used to change the service coordinator
    at any time other than during the complete IFSP review.

    A partial IFSP review does not have the same requirements as a complete review, but
    is a review of limited portions of the IFSP.



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    The partial review and changes must be documented on an IFSP Periodic Review form,
    which
        assigns the revision date as the start date to all early intervention services unless
          a later start date is identified for a new service;
        identifies the service coordinator;
        includes the parent’s written consent to the changes (see Chapter 14: Procedural
          Safeguards); and
        is provided in written form to the parent.

    The contractor must provide and bill for all early intervention services not affected by the
    change while the IFSP team develops the revision or new service grid and gathers all
    required signatures.


    19.8 Annual IFSP
    The contractor must ensure that the child’s annual IFSP
        meets the requirements for all IFSPs,
        is written no later than one year after the initial IFSP,
        is developed at a face-to-face meeting of the interdisciplinary team including the
          parent,
          is based on information gathered during the annual reevaluation and
           assessment,
          includes an updated Family Cost Share Agreement, and
          is signed by all team members.

    At the time of the annual review, the IFSP team must
         review the ECI Handbook with the family,
          obtain the parent’s signature on the acknowledgement form,
          file the acknowledgement form in the child’s record, and
          provide a new handbook to the family if needed.

    If an annual IFSP due date falls within 60 days of the due date for a complete review,
         both the annual IFSP and the complete review are completed according to their
           due dates; or
         the annual IFSP is completed by the due date of the complete review.


    19.9 Continuation IFSP
    A continuation IFSP extends an IFSP beyond 12 months.

    A contractor may use a continuation IFSP without violating ECI rules, policy, or
    standards in the following circumstances:

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          when family circumstances prevent developing the annual IFSP within the one-
           year time frame. The contractor must
            o continue to implement the last agreed-upon IFSP;
            o document the reason for delay in the child's record; and
            o develop the annual IFSP as soon as possible, but within 60 days of the
               original due date.
          when, after a formal IFSP review meeting, there is a disagreement between the
           family and the rest of the IFSP team and no new agreement can be reached
           concerning the IFSP. (See Chapter 14: Procedural Safeguards, 14.3 Child and
           Parent Rights and 40 TAC Section 108.113.) The contractor must
            o continue to implement the last agreed-upon IFSP;
            o document the reason for delay in the child's record; continue attempts to
               reach agreement; and
            o if no complaint, mediation, or administrative proceeding is pending and no
               agreement has been reached within 60 days, seek DARS formal or informal
               assistance in reaching an agreement.

    In other circumstances not caused by one of the two circumstances above, the
    contractor has violated the requirement to review the IFSP annually. The contractor
    must continue the services of the previous IFSP until proper agreement to a new IFSP
    may be reached or until parents refuse services in whole or in part. This is not
    considered a continuation IFSP and does not excuse the lack of timely review.


    19.10 Interim IFSP
    In limited circumstances, the contractor has the option to develop an interim IFSP
    before completing the evaluation and assessment if all of the following are documented:

          a serious family circumstance, such as the child’s prolonged illness, precludes
           the completion of evaluation and assessment within 45 days of referral;
          the child is expected to be eligible for early intervention services; and
          the parent consents in writing.

    The contractor must ensure that the interim IFSP

          is developed implementing all procedural safeguards;
          includes the services the IFSP team and family agree are needed immediately;
          identifies the service coordinator responsible for implementing the interim IFSP;
           and
          includes one or more outcomes and a services grid page.

    Comprehensive evaluation and needs assessment and the IFSP must be completed as
    soon as family circumstances permit.

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    Chapter 20: Required Early Intervention
    Services and Service Delivery
    The contractor must provide early intervention services that meet the needs of the
    eligible child, in settings that the family has identified as natural or normal including the
    home, neighborhood, and community settings in which children without disabilities
    participate.

    The contractor must not choose service settings based solely on type or severity of
    disability, age, availability of services or space, or administrative convenience. Early
    intervention services cannot be denied based on the family’s inability to pay.

    20.1 Early Intervention Services in Natural
    Environments
    The contractor must
        plan and provide early intervention services to support the child and family in
          their natural environment, and
        determine and provide the supplemental supports in the natural environment that
          the family needs to assist the child in meeting the outcomes in the IFSP.

    If the IFSP team plans a service in a group setting that does not include typically
    developing children, a justification must be written in the IFSP that includes how
          the child and family will benefit from the group setting,
          participation in the group will assist the family in helping the child reach the
             outcomes in the IFSP, and
          the child will interact with the other children in the group.


    20.1.1 Exceptions to Early Intervention Services in Natural
    Environments
    The contractor must provide written justification in the IFSP for any early intervention
    services provided outside the child’s natural environment. Justification must include
        how and why the IFSP team determined that the child's outcomes cannot be met
           in the child's natural environment, even with supplementary supports;
        how early intervention services provided in this location can be generalized to
           support the child's ability to function in his or her natural environment; and
        a plan indicating timelines and the supports necessary to allow the child's
           outcomes to be generalized to his or her natural environments.
    The contractor must reconsider exceptions and document justification in the child’s
    IFSP every six months.
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    20.2 Service Delivery Accommodations
    The contractor must design early intervention services to accommodate the family by
        allowing variable degrees of family involvement, as determined by the family;
        not denying services based on the family's decision about their level of
          involvement;
        assisting the family in arranging for the child to participate in a community setting
          to interact with other children to achieve an outcome such as socialization or
          language development;
        providing flexible scheduling, including outside normal business hours, that
          allows time for the family to participate; and
        providing respite child-care services when necessary to enable a family to
          participate in or receive other early intervention services (see Chapter 7:
          Respite).

    ECI funds must not be used to provide early intervention services in settings other than
    those specified in the IFSP.

    20.3 Service Delivery System Requirements
    The contractor must provide the full array of required early intervention services,
    including
         assistive technology services and devices;
         audiology;
         developmental services (DS);
          early identification, screening, and assessment;
          family counseling;
          family training;
          home visits;
          health services necessary to enable the child to benefit from the other early
           intervention services;
          medical services, only for diagnostic or evaluation purposes;
          nursing services;
          nutrition services;
          occupational therapy;
          physical therapy;
          psychological services;
          service coordination or case manageme nt;
          social work services;
          speech-language pathology, sign language, and cued language services;

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          transportation and related costs; and
          vision services.

    The contractor must provide early intervention services that are
        individualized;
        determined by the interdisciplinary team;
          provided under public supervision; and
          designed to meet the developmental needs of the child and family, related to
           enhancing the child's development.

    All early intervention services needed by the child must be listed in the IFSP and
    provided within 28 days of the parent signature. Early intervention services needed by
    the family may be addressed in the IFSP with agreement of the family.

    The child’s progress in meeting objectives must be monitored monthly. The planned
    services must be reviewed and revised or updated if progress in meeting the objectives
    is not being achieved.

    The contractor must document the provision of all early intervention services in the
    child's record. Documentation must include
         the date, time, duration, and place of the service;
          the nature of the service;
          the names of recipients;
          the signature of the service provider; and
          a description of family involvement in the service.

    Documentation must also be provided following a service delivery visit and include
       what progress the child has made since the last service delivery visit;
       what happened during the service delivery visit; and
       strategies the family agrees to implement before the next visit.

    The contractor must assist family members with accessing counseling or parent support
    services when the need is indicated.

    The contractor must provide respite child care services when necessary to enable a
    family to participate in or receive other early intervention services, for example, child
    care to allow a parent to receive counseling (see Chapter 7: Respite).

    Early childhood intervention contractors must ensure that developmental services are
    provided and supervised by qualified staff members (see also Chapter 13: Early
    Childhood Intervention Providers).




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    20.3.1 Operating Hours
    At a minimum, the contractor must have staff available to process referrals and meet
    service delivery needs of families between the hours of 8:00 a.m. and 5:00 p.m.,
    Monday through Friday. Each year the contractor may select up to ten days from the
    official state or federal holidays to close business.

    This policy does not eliminate the requirement for the contractor to also offer services to
    families in the evening or at other times outside 8:00 a.m. through 5:00 p.m. when
    appropriate to meet individual family needs.


    20.4 Covisits
          A covisit is a home visit conducted by more than one service provider at the
           same time. Covisitation may occur when:each service must be listed on the
           IFSP, and documentation includes a justification of how the child and family
           received greater benefit from one service if the other is provided at the same
           time; or
          only one of the services is listed on the IFSP, and the second service provider is
           in the home for
               o staff training or supervision,
               o team collaboration, or
               o staff safety as determined by the program director and reviewed on a
                   regular basis.

    20.5 Early Intervention Services for Autism Spectrum
    Disorders
    The team must address the following areas when developing an IFSP for a child with a
    diagnosis of an autism spectrum disorder (ASD) or who has failed the M-CHAT Follow-
    Up Interview (see also Chapter 18: Evaluation and Assessment, 18.8 Autism Spectrum
    Disorders Screening):

          functional spontaneous communication,
          social skills in various settings,
          cognitive development,
          play skills and appropriate use of toys, and
          motor skills.

    The team must use one of the following interventions, which have been established as
    effective when developing the IFSP:
         joint attention,
         proactive approaches to behavior problems (CBTYC intervention),
         naturalistic teaching strategies, and
         behavioral intervention.



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     The team must plan and deliver individualized services at a frequency that can improve
     the parent’s learning and the child’s progress, so that individual objectives can be
     achieved. Services must begin as soon as possible after the enrolled child is suspected
     of having an ASD.



    Chapter 21: Transition
    21.1 Transition Overview

    All transition activities must reflect the parent’s desire for the child. The IFSP team must
    begin discussing the transition process at the initial IFSP meeting and continue to
    discuss transition options with the family during the child’s enrollment in ECI.

    The contractor must develop steps (how) and strategies (what) before the child’s
    second birthday to assist the child and family to effectively transition from early
    intervention services to activities, places, or programs the family would like the child to
    participate in after he or she exits ECI.

    Throughout the child’s enrollment in ECI, the parent may also request that the
    contractor develop steps and strategies to assist the child and family to transition
        from one contractor to another contractor,
        from one family setting to another family setting, or
        from one state to another when the family is moving out of state.

    The contractor must obtain prior written parental consent before sharing child or family
    information with other entities. See also Chapter 14: Procedural Safeguards.

    Personally identifiable information (the child’s and parent’s names, address, phone
    numbers, and the child’s date of birth) is provided to the Local Education Agency (LEA)
    for child-find purposes. Parental consent is not required for LEA notification. However,
    the parent has the option to opt out of the LEA notification upon request.



    21.2 Transition Activities
     IFSP documentation must include

          the parent’s general transition outcomes and goals for the child at the initial IFSP;
          any changes to transition outcomes and goals on future IFSPs;
          the specific transition steps and strategies identified when the child is two years
           old to support the transition when the child exits the program;


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    The transition steps and strategies developed when the child is two must evolve
    throughout the time before the child exits ECI. The child’s record must include
    documentation of:
         the parent’s choice for the child to transition into a community or educational
           program or for the child to remain in the home;
         all transition-related activities;
         all transition related discussions;
         assistance provided to the child and family to smoothly transition from early
           intervention services to activities, places, or programs the family would like the
           child to participate in at age three.


    Information the Contractor Must Provide the Parent
    The contractor must provide the parent
         information and training regarding options for the child’s future settings;
         information regarding IDEA Part B services;
         information regarding advocacy and resources for parent support;
         a copy of Beyond ECI, a booklet that explains the transition process;
         a copy of the ECI Resource Guide;
         information on legislation and rights appropriate to the child and family’s needs ;
         information about Medicaid waiver programs, child-care subsidies, the DARS
          Autism Program, and other state-funded programs; and
         information about the use of assistive technology to meet the child’s needs.


    Assistance the Contractor Must Provide the Parent
    The contractor must assist the parent to
        understand the dynamic, ongoing process of transition, and the option to update
          the transition steps and strategies as needed;
        prepare the child for changes in service delivery, including steps to help the child
          adjust to and function in a new setting;
        identify appropriate future settings, such as community rehabilitation programs,
          child care, Head Start, prekindergarten public school programs, and early
          childhood special education in the public school to address educational and
          developmental needs;
        identify and address any future medical needs;
        identify naturally occurring opportunities in the community for continued learning;
        plan opportunities for children who have reached developmentally appropriate
          milestones and no longer need intervention services;
        identify and address any needs of the parent and family for ongoing support; and
        identify and address the needs of the family and child for case management.

    Referral Activities in Which the Contractor Must Participate
    The contractor must

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          refer to and convene meetings with appropriate settings according to the parent’s
           interest;
          provide information (with parent consent) about the child to the next service
           provider;
          plan assessments and evaluations jointly with receiving service providers to
           avoid duplication;
          participate in planning and transition meetings with community providers as
           appropriate; and
          participate in LEA planning meetings, Admission Review and Dismissal (ARD)
           meetings, and other LEA meetings.


    21.3 LEA Notification for All Children
    Personally identifiable information (child and parent’s names, address, and phone
    numbers and child’s date of birth) is provided to the Local Education Agency (LEA) for
    child-find purposes. Parental consent is not required for LEA notification. However, the
    parent has the option to opt out of the LEA notification upon request.

    By the time the child reaches 24 months, the contractor must send the child’s personally
    identifiable information to the LEA in which the child resides unless the parent opts out
    of the early notification requirement.

    The contractor must
        notify the parent at enrollment that the child’s personally identifiable information
          will be sent to the LEA in which the child resides unless the parent opts out of the
          LEA notification;
        give the parent the option to opt out of the LEA notification either in writing or
          verbally;
        notify the parent in writing 30 days before the personally identifiable information
          is scheduled to be sent to the LEA;
        include in the notification that the personally identifiable information will be sent
          to the LEA unless the parent contacts the program to opt out of the LEA
          notification before the scheduled LEA notification date;
        file the parent’s request to opt out of early notification in the child’s record; and
        not send the child’s personally identifiable information to the LEA if the parent
          opts out of early notification at any time before the notification is scheduled to be
          sent.

    The following table shows requirements for notification.
    Status of Child                            Notification Requirement
    The child is enrolled in ECI 90 to 45      Immediate notification to LEA unless the
    days before the child’s third birthday     parent opts out.
    and is determined potentially eligible for
    the PPCD.

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    The child is referred to ECI fewer than       Notification is not required.
    45 days before the child’s third birthday.


    21.4 Transition to Community Settings
    The contractor must obtain prior written parental consent before sharing child or family
    information with other community programs or settings.


    21.4.1 Referral Requirements
    With written parental consent, the contractor must facilitate referrals to community
    services.

    With written parental consent, the contractor sends the community setting or program
    the child’s

          personally identifiable information,
          screening,
          assessment,
          evaluation,
          medical information, and
          IFSP.


    21.4.2 Transition Meetings
    With parental consent, the contractor must convene a face-to-face meeting at least 90
    days before the child’s third birthday with
        the family;
        ECI program staff;
        representatives of the future setting or program;
        the DARS Division for Blind Services specialist if a child has a vision impairment
          or the DARS Office for Deaf and Hard of Hearing Services regional specialist if a
          child has a hearing impairment; and
        case managers from other programs, if available, for families needing case
          management services after exiting ECI services.

    The contractor must
        share information about the child’s use of assistive technology to participate in an
          inclusive setting, if appropriate, and
        identify accommodations needed for the child to participate in the new se tting(s).

    The contractor is not required to conduct a transition meeting for a child referred to the
    ECI program less than 90 days before the child’s third birthday but should facilitate the
    transition activities with the parent and other program or setting.

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    21.5 Transition to the LEA
    The contractor must continue to provide early intervention services to the child until the
    child’s third birthday even if the Admission, Review, and Dismissal (ARD) meeting has
    occurred and the Individualized Education Pla n (IEP) has been signed. However, the
    contractor must not provide services to the child when
         the child reaches his or her third birthday;
         the parent requests to no longer receive early intervention services; or
         the child begins receiving the same services from the LEA.


    21.5.1 LEA Transition Meetings
    For children potentially eligible for the Preschool Programs for Children with Disabilities
    (PPCD,) the contractor must
        convene a transition meeting with representatives from the LEA;
        invite the LEA to the meeting at least 14 days before the meeting. This timeline
           may be changed by written local agreement;
        conduct the meeting, even if LEA representatives do not attend, and in doing so,
           provide parents information about preschool special education and related
           services, including a description of the Part B eligibility definitions, timelines, and
           process for consenting to an evaluation and eligibility determination and
           extended year services;
        document that the setting, if the meeting is conducted in a group setting, is
           acceptable and appropriate to the family; and
        conduct the meeting for children enrolled in ECI who also attend the Regional
           Day School for the Deaf.

    The contractor is not required to conduct a transition meeting for children referred to the
    ECI program less than 90 days before the child’s third birthday.


    21.5.2 LEA Referral Requirements
    With written parental consent, the contractor must
        complete the referral for a child enrolled in the Regional Day School Program for
          the deaf;
        refer the child to the LEA at least 90 days before the child’s third birthday
          (invitation to the transition meeting may be considered the referral to the LEA or
          may occur at the transition meeting if included in a local MOU with the LEA); and
        complete a late referral to the LEA for potentially eligible children aged 33–36
          months.

    Late referrals must include documentation of one of three reasons for the delay:
        the parent previously declined referral,


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          enrollment in ECI occurred when the child was between 33 and 36 months o f
           age, or
          program reasons delayed the referral.

    With written parental consent, the contractor sends the LEA the referral, which consists
    of the child’s
         personally identifiable information,
         screening,
         assessment,
         evaluation,
         medical information, and
         IFSP.

    If the parent declines referral to the LEA or the child is determined ineligible for the LEA,
    the contractor must assist the family with transition activities for the child into another
    appropriate setting by the child’s third birthday.

    The contractor must document in the child’s record if the
        parent declines referral to the LEA,
        parent declines LEA services and is referred to another setting, or
        child is determined ineligible for LEA services and is referred to another setting.



    Chapter 22: Follow-Along Services
    22.1 Follow-Along Overview
    The follow-along program is intended to track the progress of the child who is
    determined ineligible for, or whose parent declines, early intervention services, but who
    according to clinical opinion may be at risk for developmental delay. See 34 C.F.R.
    303.300.

    The contractor must obtain prior written parental consent before providing follow-along
    services (see Chapter 14: Procedural Safeguards).


    22.2 Eligibility
    To be eligible for follow-along services, the child must meet one of the following criteria:
        demonstrates developmental proficiency at evaluation, but is still at risk for
          developmental delay according to clinical opinion;
        passes the initial DARS ECI screenings and was not evaluated, but is still at risk
          for developmental delay according to clinical opinion;
        is born weighing less than 1,000 grams (extremely low birth weight) but is
          determined ineligible for early intervention services.

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          is determined eligible for early intervention services, but the parent declines
           comprehensive services; or
          transferred to Texas with a current IFSP from another state, but is determined
           ineligible for early intervention services in Texas.

    If the interdisciplinary team believes that the child is at risk for developmental delay
    based on clinical opinion, i ncluding biological or environmental risk factors (one or
    more), follow-along services must be offered. The child's record must contain
    documentation of the basis for determining the risk for developmental delay.

    The contractor may offer follow- along when the child is referred by CPS even if the
    child passes the developmental screening.


    22.3 Follow-Along Requirements
    The contractor must ensure that follow-along services include
        providing contact information for local early childhood intervention contractors
          and suggesting the family contact the contractor at any time with concerns;
        contacting the family at least every six months to determine the child’s
          developmental status as measured by a
              o developmental questionnaire conducted by telephone;
              o developmental questionnaire, such as Ages and Stages, mailed to the
                 family with instructions on how to check the child's development and what
                 to do if they have any concerns; or
              o combination of telephone contact and a mailed questionnaire;
        providing age-appropriate developmental materials to the family when the child is
          determined ineligible for early intervention services to assist the family in
          monitoring the child’s development; and
        providing information about transition to other available services on the child’s
          second birthday if the child is eligible for early intervention services, but the
          parent declines comprehensive services.

    22.4 Dismissal from Follow Along
    If the family has not responded for a period of one year to follow-along efforts, the
    contractor must dismiss the child and family from follow-along services. Before
    dismissal, the contractor must send the parent a letter of intent to discontinue follow-
    along services.

    22.5 Referrals to Early Intervention Services
    If the contractor receives a referral for early intervention services on a child enrolled in
    follow along, the contractor must comply with all timelines required for new referrals.



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    Chapter 23: Health, Safety, and Reporting
    Abuse, Neglect, and Exploitation
    23.1 Child Health Standards
    The contractor must
        follow Universal Precautions as defined in Section 85.202, Texas Health and
          Safety Code;
          comply with the Texas Communicable Disease Preventio n and Control Act,
           Chapter 81, Texas Health and Safety Code;
          ensure confidentiality of information on the health status of the child or family
           member and release this information only to persons designated in writing by the
           parent or for other reasons allowed by law;
          follow all child health guidelines in 25 TAC Sections 97.61–97.72 when providing
           early intervention services in group settings; and
          prohibit smoking in facilities funded by ECI where services are provided to
           children.

    The provider must
        wash or otherwise sanitize hands thoroughly after entering a home, child-care
          center, or other service setting; and
        wash, or otherwise sanitize, toys or other items that may have been handled by a
          child before using them with another child.

    23.2 Review of Medical Information
    If the child enters ECI without a current physical examination according to the periodicity
    schedule of the American Academy of Pediatrics, the contractor must
          inform the family of the importance of obtaining a physical examination, and
          assist the family as needed in obtaining a physical examination.

    The interdisciplinary team must
        determine what information related to the child’s physical health status and
           medical history is necessary to develop an appropriate plan of services for the
           child;
          review all pertinent medical information, including the current physical exam if
           available, before developing the Individualized Family Service Plan (IFSP);
          determine if the child has a primary care physician (PCP) or medical home. If the
           child does not have a PCP or medical home, the service coordinator must
               o encourage the family to establish a relationship with a PCP or medical
                  home, and
               o assist the family as needed in locating and accessing a PCP or medical
                  home;

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          discuss any additional medical records that become available at any time during
           enrollment that could affect early intervention services; and
          document all review and discussion of medical information.

    If a member of the IFSP team believes, based on a lack of medical information, that
    implementing a strategy or service could jeopardize the health or safety of the child, the
    team may
          delay implementing the strategy or service; or
          implement, but adjust the strategy or service.

    Any delay or adjustment must
        continue until the necessary medical information is obtained, and
        be documented in the child’s record.

    If the IFSP team determines that additional medical information is needed to implement
    early intervention services and no other funding source is available, the contractor may
    use ECI funds to pay for the needed medical service.


    23.3 Immunizations
    Contractors must
       assist the family in accessing immunizations when needed; and
       document
              o that the child has received immunizations according to the schedule
                 recommended by the American Academy of Pediatrics (AAP), or
              o efforts to obtain the immunizations.


    23.3.1 Unimmunized Children
    The parent may choose not to immunize the child. In those cases, the contractor must
        provide early intervention services regardless of noncompliance with the AAP-
          recommended immunization schedule,
        inform the parent that the child could be at risk for contracting a contagious
          disease, and
        inform the parent that the child may be excluded from group activities in times of
          emergency or epidemic declared by the commissioner of the Texas Department
          of State Health Services. See
              o DSHS home page, and
              o 40 TAC Section 746.3601, What type of illness would prohibit a child from
                 being admitted for care?




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    23.4 Children with Chronic Infectious Diseases
    The contractor must follow all federal and state laws and regulations regarding providing
    services and maintaining records for families and children with HIV or other
    communicable diseases.

    For children with infectious diseases (such as HIV, AIDS, CMV, or Hepatitis B), the
    contractor must, with the parent’s prior written consent,
        communicate with the PCP before assessment,
        involve the physician in decisions related to early intervention services, and
        maintain communication with the physician througho ut the child’s enrollment.

    If the child has an immunosuppressed condition (such as HIV or AIDS) or other chronic
    infectious disease, the contractor must inform the child’s parent and physician (with the
    parent’s prior written consent) when there is an outbreak of a contagious illness that
    could pose a health threat to the child (such as mumps, chicken pox, or measles).


    23.5 Abuse, Neglect, or Exploitation Reporting
    Requirements
    The contractor, its staff members, and subcontractors must report the following acts to
    the Texas Department of Family and Protective Services (DFPS): abuse, neglect, or
    exploitation of

          a child by a parent, family member, or caregiver. Providers must make reports
           within 48 hours from the time they first suspect a child has been abused or
           neglected;
          a child in licensed child-care facilities or treatment centers for the state of Texas;
          an elderly person or adult with a disability; or
          a client served by the Texas Department of State Health Services (DSHS) or
           Texas Department of Aging and Disability Services (DADS) employees in state
           hospitals or state schools.


    A person making a report to DFPS in good faith is immune from civil or criminal liability.
    The name of the person making the report is kept confidential by the department.
    However, the name can be released in certain circumstances (that is, by order of the
    court or at the specific request of law enforcement if they are conducting a criminal
    investigation). Any person who fails to report abuse, neglect, or exploitation is liable for
    a Class B misdemeanor.


    23.5.1 How to Report Abuse, Neglect, or Exploitation
    Reports can be made to DFPS 24 hours a day, seven days a week by
       calling the DFPS statewide abuse intake number toll-free at 1-800-252-5400, or

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          filing an electronic report by creating an account at www.txabusehotline.org.

    A person with knowledge of abuse or neglect may not delegate the responsibility of
    reporting suspected abuse to another person.

    The contractor must maintain documentation separate from the child’s record of the
        date and time the report was made,
        name of person making the report, and
        DFPS call ID number.


    23.5.2 Emergency Situations
    In a life-threatening or emergency situation, call your local law enforcement agency or
    9-1-1 immediately.

    23.6 Working with the Child and Family
    All employees, volunteers, and other persons working under the auspices of a
    contractor must always involve the parent or regular caregiver present when screening,
    evaluating, or providing services to a child. If the parent or regular caregiver is not
    available, the appointment must be rescheduled.


    Chapter 24: Case Management Services
    24.1 Service Coordinator Qualifications
    An ECI service coordinator must meet all qualifications and complete all required
    training as specified in Chapter 13: Early Childhood Intervention Providers.

    The assigned service coordinator must be from the profession most immediately
    relevant to the child’s and family’s needs or who is otherwise qualified to carry out al l
    applicable responsibilities.

    24.1.1 Parent Rights Related to Assigned Service Coordinator
    The contractor must assign only one service coordinator to each child. One service
    coordinator must be assigned at the time of the referral. A new service coordinator may
    be assigned at the time the IFSP is developed or the original service coordinator may
    be retained. The parent must be given the assigned service coordinator’s name and
    contact information. The contractor must
        assign a new service coordinator at the parent’s request,
        allow the parent to share case management responsibilities with assistance from
           and documentation by the assigned ECI service coordinator,
        not condition the receipt of case management services on the receipt of other
           services,

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          not restrict the receipt of other services on the receipt of case management
           services, and
          allow the parent to refuse ECI case management services.



    The Parent Refuses ECI Case Management Activities

    If the parent decides to share case management responsibilities with the assigned ECI
    service coordinator or refuses ECI case management activities, the ECI service
    coordinator must
          provide the IDEA Part C required case management services during the pre-
            enrollment period, including scheduling and coordinating screenings, evaluations,
            and assessments; and
          schedule and coordinate the development, review, and evaluation of the
            Individualized Family Service Plan (IFSP), including any reviews, revisions, and
            the annual IFSP, and provide and obtain all the accompanying required notices
            and consents.

    If the parent requests that another agency or organization provide case management
    services, ECI must allow the other agency or organization case management provider
    to perform the child’s case management services.


    The Parent Chooses a Service Coordinator from Another Agency or Organization

    If the parent chooses to receive case management activities from another agency or
    organization such as the Department of State Health Services (DSHS) Children with
    Special Health Care Needs (CSHCN) Services Program or Case Management for
    Children and Pregnant Women (CPW), or the DARS Division for Blind Services, the ECI
    service coordinator must coordinate case management services with the other case
    management provider, and
          provide the IDEA Part C required case management services during the pre-
            enrollment period, including scheduling and coordinating screenings, evaluations,
            and assessments;
          schedule and coordinate the development, review, and evaluation of the IFSP,
            including any reviews, revisions, and the annual IFSP, and all the accompanying
            required notices and consents;
          invite the other case management provider to participate in the IFSP
            development process, with the parent’s consent;
          coordinate with the other program’s case management provider, with the parent’s
            consent, to avoid duplication of activities and to determine whether identified
            needs of the child can be met by the other program; and
          provide case management activities for the child and family that are not covered
            by the other case management program, with the parent’s consent. If the other
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           case management program will be covering all the child’s case management
           needs, the monthly contact by the ECI service coordinator is not required.


    24.2 Case Management Services Requirements
    At referral, a service coordinator is assigned who acts as a single point of contact for the
    family. The service coordinator provides case management activities at no cost to the
    family. Case management services are ongoing activities performed by the service
    coordinator who, as the single point of contact,
         assists and enables the ECI eligible child and the child’s family to receive the
            provisions, rights, procedural safeguards, and services that are authorized by
            ECI;
         coordinates and monitors all services across agency lines;
         helps the parent obtain necessary services;
         assists the parent of the eligible child in gaining access to ECI and other services
            identified in the IFSP;
         coordinates the provision of ECI and other services that the child needs;
         facilitates the timely delivery of available services;
         seeks the appropriate services and situations necessary to benefit the
            development of the child being served for the duration of the child’s eligibility;
         coordinates the performance of evaluations and assessments;
         facilitates and participates in the development, review, and evaluation of the
            IFSPs;
         coordinates and monitors the delivery of all available services;
         informs the family of available advocacy services;
         informs the family of complaint procedures;
         coordinates with medical and health providers;
         facilitates the implementation of strategies to transition out of ECI;
         provides all case management activities related to the Case Management Care
            Plan (CMCP); and
         documents case management activities and the parent’s active participation in
            the child’s record.


    24.3 The Case Management Care Plan (CMCP) and
    Case Management Activities
    The contractor must provide case management activities to all referred children. Case
    management activities are performed with the active participation of the parent.




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    24.3.1 Assess and Reassess the Child’s Needs
    The assigned service coordinator must collaborate with the parent and the other IFSP
    team members to
        identify the child’s needs and then determi ne the medical, educational,
          developmental, social, or other necessary services;
        take an applicable history of the child; and
        gather information from other sources, such as family members, medical
          providers, social workers, and educators, as necessary.


    24.3.2 Develop and Update the Child’s CMCP
    The assigned service coordinator must
        specify the needs identified through the needs assessment;
        specify the goals and strategies to address the identified medical, social,
          educational, developmental, and other needs;
        identify any need for coordination with other case management providers outside
          the ECI program;
        establish a timeline for obtaining needed services;
        identify the parent’s or other family members’ case management needs unless
          the parent or family member chooses not to include them or does not want the
          information released without his or her prior written consent;
        reassess the child’s needs when the needs identified on the CMCP are met; and
        modify the CMCP when the child’s needs or status changes.


    24.3.3 Provide Referrals and Related Activities to Help the Eligible
    Child and Family Obtain Needed Services
    The service coordinator gathers information about needed resources and contacts
    providers and agencies by phone or in person to link the child and family with
        medical services for the ECI child including
              o needed prescriptions and immunizations,
              o well-child checkups, and
              o necessary care from other medical and dental professionals;
        transportation for medical services;
        medical equipment and supplies;
        a primary health care provider for the child;
        Medicaid waiver program such as the
              o Home and Community-Based Services—In Home and Family Support;
              o Community Living and Support Services (CLASS); and
              o Medically Dependent Children Program (MDCP), if appropriate;
        social services for the ECI child such as
              o Women, Infants, and Children (WIC);

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              o Supplemental Security Income (SSI);
              o Supplemental Nutrition Assistance Program (SNAP) food benefits (food
                 stamps);
              o food pantries;
              o Temporary Assistance to Needy Families (TANF);
              o housing;
              o utility assistance;
              o translation providers (if needed to gain access to a service for the ECI-
                 eligible child);
              o transportation providers (if needed to gain access to a service for the ECI-
                 eligible child);
              o other nonprofit or charitable organizations that provide a service that
                 meets the needs of the ECI child; and
              o other case management providers; and
          developmental or educational services such as
              o child care (but not a babysitter),
              o Head Start,
              o transition conferences and visits to the local education agency or other
                 service providers, and
              o other opportunities for the child to play and learn with children without
                 disabilities.


    24.3.4 Monitor and Follow Up on All Case Management Activities
    The service coordinator must monitor the implementation of the CMCP and follow up
    with the parent to ensure that the child’s needs are being addressed adequately.
    At least once per month, the assigned service coordinator must
         contact family members, service providers, or other entities or individuals who
           can provide information related to the child’s needs and related services;
         determine if services are being provided in accordance with the child’s CMCP
           including the ECI services stated on the IFSP grid;
         evaluate if the child’s goals are being met and the CMCP is adequately meeting
           the child’s needs;
         determine if there are changes in the child’s needs or status;
         make necessary revisions in the CMCP and service arrangements; and
         seek appropriate services and situations necessary to benefit the development of
           the child for the duration of the child’s eligibility.


    24.4 Children in Foster Care
    If the child is in foster care with the Texas Department of Family and Protective
    Services, the service coordinator must
          complete DARS4005, Consent of Foster Parent or Medical Consenter for Health
            Passport with the foster parent or medical consenter of a foster child in the ECI

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           program to obtain consent to release the DARS4006, Individualized Family
           Services Plan IFSP Grid to the Health Passport or other medical information to
           the Health Passport system;
          send the first page of DARS4006, IFSP Grid to the Health Passport or other
           medical information to the Health Passport if written consent is obtained;
          coordinate services with the STAR Health Program so that services are not
           duplicated;
          participate on behalf of the foster child with the appropriate Community Resource
           Coordination Group (CRCG); and
          document CRCG participation in the child’s record.


    24.5 Children in Institutions and Permanency Plans
    Children living in institutions require a permanency plan as provided in Government
    Code, Section 531.0245 Permanency Planning for Certain Children. The permanency
    plan must be listed as a need on the child’s CMCP.

    Case management activities must support the permanency plan outcomes, and if no
    permanency plan exists, ECI must work cooperatively with the institution’s social
    worker, the parent, other family member with guardianship, or CPS to facilitate the
    development of a permanency plan. This may include involvement with other state or
    local agencies.


    24.6 Case Management Documentation
    Case Management activities must be documented in the child’s record. The child’s
    record must include documentation of
        the name of the assigned service coordinator who will serve as the single point of
           contact for the family;
        the name of the child;
        dates of all case management activities;
        the anticipated completion date;
        the need for and occurrence of coordination of case management activities with
           other case management providers;
        the parent’s active participation in case management activities;
        specific case management activities are provided by ECI when the family
              o refuses ECI case management activities,
              o chooses to serve as his or her own service coordinator, or
              o chooses a case management provider from another agency or
                  organization; and
        the nature and content of case management activity, including


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              o whether the outcomes or goals specified in the CMCP have been
                achieved;
              o whether the child or the child’s family has declined any case management
                services;
              o the time involved in providing the case management activity; and
              o the location of case management activity, if face-to-face.

    Case management documentation must be organized in a manner that allows case
    management activities and follow-up on child and family needs to be clearly identified.

    If the Individualized Family Service Plan (IFSP) has already been developed, much of
    the information required for the CMCP may have already been completed. The
    Concerns, Priorities, and Resources (CPR) section of the IFSP is used to gather much,
    if not all, of the same information. Case management documentation is not required to
    be duplicated in both the IFSP and the CMCP.

    The CMCP or the CPR may include information about the parent’s or other family
    members’ case management needs. The parent or other family members may choose
    where these needs are documented and may choose not to release this information
    without prior written consent.


    24.7 Conditions for Billing Case Management
    Activities to Medicaid under the Targeted Case
    Management (TCM) Program
    All children and families referred to ECI are entitled to receive case management
    services. However, only those activities that meet the requirements of the Texas
    Medicaid State Plan are billable to Medicaid under the TCM Program. The Texas
    Medicaid State Plan ―targets‖ the group of children eligible for case management
    services as those who have been referred to a qualified ECI contractor and who meet
    the criteria of developmental disabilities. Children who are determined eligible for ECI
    meet the criteria for developmental disabilities.

    TCM billable activities fall into four categories:
       assessing child and family needs for the CMCP,
       developing and revising the CMCP,
       providing referral and related activities, and
       monitoring and following up on activities in the CMCP.

    Billable case management activities include
          face-to-face or telephone contact with
               o the parent and child, or
               o the parent, or
          collateral contacts made in the presence of the parent.

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    Case management services are billable to Medicaid under the TCM Program if the
    following conditions are met:
          services are provided during the month the child was eligible for Medicaid;
          services are provided after the child is determined eligible for ECI comprehensive
            services;
          the contractor meets all case management requirements for billing the TCM
            Program as stated in the Texas Medicaid Provider and Procedures Manual
            (TMPPM);
          a qualified service coordinator provided the case management services;
          the contractor meets all case management requirements stated in the ECI rules,
            ECI standards manual, and DARS contract; and
          TCM contacts are billed according to the information provided by DARS ECI, the
            TMPPM, and the Texas Medicaid and Healthcare Partnership (TMHP) Medicaid
            Bulletins.

    If referral and coordination activities benefit the child enrolled in ECI, they are
    considered case management activities that may be billed to the Medicaid TCM
    Program, if the child is eligible for Medicaid when the activity is performed.

    If the Medicaid State Plan is amended concerning TCM for ECI families to allow or
    forbid the billing of certain activities, DARS will provide immediate notice to the
    contractor, and these Standards must automatically be considered amended to allow or
    forbid the billing of such activities to Medicaid.


    24.7.1 Case Management Activities Not Billable to Medicaid under the
    TCM Program
    The contractor must not bill Medicaid for
        any case management activities provided to a family who refuses ECI case
          management,
        any case management activities performed by the parent,
        any case management activities provided before ECI eligibility determination,
        unallowable case management activities,
        duplicate case management activities provided by another entity if the parent
          chooses another case management provider, and
        any case management activities provided during a month the child was not
          eligible for Medicaid.


    Pre-Enrollment Process


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    Case management activities in the pre -enrollment process not billable to Medicaid
    under the TCM Program include
        explaining the ECI program to the family and to referral sources, as needed;
        completing paperwork (for example, consents, notifications, family cost share,
           and insurance billing) with the family;
        scheduling, coordinating, and completing initial screenings, initial evaluations,
           and assessments, including scheduling appointments with the ECI team; and
        scheduling and coordinating the initial eligibility determination process.


    IFSP Process

    Case management activities in the IFSP process not billable to Medicaid under the TCM
    Program include
        scheduling IFSP meetings;
        providing the required prior notices to families;
        obtaining consents from the parent;
        explaining procedural safeguards, the ECI Handbook, and parental rights;
        coordinating the development of the child’s IFSP, except for the Concerns,
          Priorities, and Resources (CPR) portion of the IFSP, which is billable to Medicaid
          under the TCM Program if the child was eligible for Medicaid when the activity
          was performed;
        collecting information that will be used in the reviews or revisions and annual
          IFSP but that cannot be used for the development of the CMCP; and
        documenting information on the IFSP or writing or revising the IFSP.


    Referral and Related Activities

    Case management referral and related activities not billable to Medicaid under the TCM
    program include services that do not directly benefit the ECI child, such as
        coordinating referrals for family members to and from health care services
          including
              o family planning,
              o genetic counseling, and
              o prenatal care;
        assisting a parent with obtaining a GED or higher education goals;
        providing families with information about respite care from community resources;
        providing families with other requested information such as services available in
          the community or at a statewide level;
        assisting with or providing translation services; and
        arranging for or providing transportation services.

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    Collateral Contacts

    Collateral contacts are contacts with other providers, agencies, organizations, or
    persons for the benefit of the child and family. Collateral contacts are integral to
    providing case management, but collateral contacts done when the parent is not
    present are not billable to Medicaid under the TCM Program.



    ECI Standards Manual for Contracted
    Programs Glossary
    The words and terms used in the ECI Standards Manual for Contracted Programs have
    the following meanings unless the context clearly indicates otherwise.

    Assessment
          The ongoing procedures used by appropriately qualified personnel throughout
          the period of a child's eligibility to identify

                 the child's unique needs and strengths;
                 the family's concerns, priorities, and resources and the supports and
                  services necessary to enhance developmental needs of the child; and
                 the nature and extent of intervention services needed by the child and the
                  family in order to resolve the determinations.

    Care Plan
          The plan written to address the child’s case management needs. The Care Plan
          is required in addition to the Individualized Family Service Plan (IFSP), and is
          developed by the service coordinator in consultation with the parent of the child
          determined eligible for ECI services. It must be signed by the service coordinator
          and the parent of the child. It is required for all children eligible for ECI services
          except for children who are enrolled in follow along. (See Chapter 24:
          Case Management Services, Section24.3 The Case Management Care Plan
          (CMCP) and Case Management Activities.)
    Case Management Services
          Services to assist children from birth to 36 months of age with disabilities or
          developmental delays in gaining access to needed medical, social, educational,
          developmental, and other appropriate services. Case management includes the
          following assistance:

                 comprehensive needs assessment and periodic reassessment of a child's
                  need for any medical, educational, developmental, social, or other
                  services;
                 development and periodic revision of a specific Care Plan;

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                 referral and related activities; and
                 monitoring and follow-up activities.

          For purposes of the Early Childhood Intervention (ECI) Program, case
          management includes all the activities defined above and also includes the
          assistance required by IDEA, Part C.

    Code of Federal Regulations (CFR)
           Rules of the federal government. All agencies and programs receiving funds
           under federal law must follow these rules.
    Collateral Contacts
           Contacts that are necessary to help the family access services for the child, such
           as physician services and community resources. Collateral contacts are Targeted
           Case Management (TCM) Program contacts necessary to address a need on the
           Care Plan but only the TCM contacts made with the parent of a child enrolled in
           Medicaid are billable to Medicaid under the Targeted Case Management
           Program. Other collateral contacts may be integral to providing case
           management but may not be billable to Medicaid under the TCM Program.
    Community Resources
           Services available outside the ECI program through such entities as civic,
           educational, health, social service, faith-based, habilitative, and benevolent
           organizations. Resources and services available in the community may be used
           or accessed.
    Comprehensive Services
           Individualized intervention services, as determined by the interdisciplinary team
           and listed in the Individual Family Service Plan (IFSP).
    Contested Case
           A proceeding in which the legal rights, duties, or privileges of a party are to be
           determined by the DARS commissioner after an opportunity for adjudicated
           hearing.
    Contractor
           A local private or public agency with proper legal status and governed by a board
           of directors or governing authority that accepts funds from DARS to administer
           the Early Childhood Intervention (ECI) Program.
    Developmental Proficiency
           Children reach developmental proficiency when they no longer exhibit atypical
           development or they are no longer delayed, as determined by test performance
           on a content validated comprehensive developmental inventory or standardized
           instrument.
    Early Childhood Intervention
           The total effort in Texas directed toward meeting the needs of children eligible
           under federal law (IDEA, Part C) and state law (Chapter 73, Texas Human
           Resources Code).
    Enrollment




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          Enrollment occurs when the child has been determined eligible for services; the
          Individualized Family Service Plan (IFSP) has been completed, signed , and
          dated by the interdisciplinary team.
    Evaluation
          The procedures used by appropriate qualified personnel to determine the child's
          initial and continuing eligibility, consistent with the definition of infants and
          toddlers with developmental delay, including determining the status of the child in
          areas of cognitive development, physical development, communication
          development, social-emotional development, and adaptive or self-help skills.
          Evaluation activities include reviewing all available information prior to eligibility
          determination, including medical information, screening results, assessment
          results, parent input, etc.

    Family Strengths
           Characteristics that family members identify as contributing to the growth and
           development of the child and family. Among the areas of family life that many
           families identify as strengths are coping strategies, nurturing relationships,
           communication, religious or personal beliefs, family competence, and family–
           community interconnectedness.
    Frequency
           The number of days or sessions that a service will be provided within a specified
           period of time.
    High Probability of Resulting in Developmental Delay
           For a medical diagnosis with high probability of delay to qualify a child as eligible
           for an ECI-funded program, it must be known and widely accepted within the
           medical community that the natural course of the diagnosis will result in a
           significant developmental delay.
    Individualized Family Service Plan (IFSP)
           A written plan, developed by the interdisciplinary team, based on all assessment
           and evaluation information, including the family's description of their strengths
           and needs, which outlines the early intervention services for the child and the
           child's family.
    Individuals with Disabilities Education Act (IDEA)
           The federal law (20, U.S. Code, Chapter 33) authorizing and funding services for
           the education of all children and youths with disabilities. Early Childhood
           Intervention Services are authorized under Part C of IDEA.
    Intensity
           The length of time a service is provided during a session.
    Location
           The place where a service is provided (that is, in the child's home, child-care
           centers, hospitals, clinics, or other settings).
    Method
           The manner in which the service is delivered (that is, in a group or on an
           individual basis).
    Other Services



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           Services beyond those specifically defined that must be provided to meet the
           developmental needs of the child and the needs of the family related to
           enhancing the child's development.
    Outcomes
           Statements of the changes that families want to see for their child or themselves
           (family's priorities). An outcome can focus on any area of child development or
           family life that a family feels is related to their ability to help the child. Outcomes
           are functionally stated in terms of what is to occur (process) and what is
           expected as a result of these actions (product).
    Part C
           The section of the federal law known as Individuals with Disabilities Education
           Act (IDEA), which authorizes and allocates funding to states "to develop and
           implement a statewide, comprehensive, coordinated, multidisciplinary
           interagency program of early intervention services for infants and toddlers with
           disabilities and their families."
    Personally Identifiable Information
           Information that includes

                  the name of the child;
                  the name of the child's parent or other family member;
                  the address of the child, parent, or other family member;
                  a personal identifier, such as the child's or parent's Social Security
                   number; or
                  a list of personal characteristics or other information that would make it
                   possible to identify or trace the child, the parent, or other family member
                   with reasonable certainty.

    Physical Examination
           A physical examination entails a review of systems in the body. A systems review
           includes general; skin; head, face and neck; ears; eyes; nose and oral cavity;
           respiratory; heart; gastrointestinal; genitourinary/reproductive; musculoskeletal ,
           and neurological reviews.
    PPCD
           Preschool Programs for Children with Disabilities
    Procedural Safeguards
           The rights provided families and children eligible to receive early intervention
           services under Part C of Individuals with Disabilities Education Act (IDEA).
    Provider
           An individual staff member or professional who provides services to a child and
           family.
    Qualified Professional
           A person who has met state-approved or -recognized certification, licensing,
           registration, or other comparable requirements that apply to the area in which the
           person is providing early intervention services.
    Rate



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           The rate established by ECI used to calculate the cost of services that are
           subject to fees.
    Referral Date
           The date the child's name and sufficient information to contact the family was
           obtained by the receiving program.
    Respite
           ―Respite is a service in which care is provided to children with disabilities to
           provide temporary relief for families. Respite can occur in the child's home or in a
           variety of out-of-home settings, and can occur for any length of time depending
           on the needs of the family and available resources. As a vital part of the
           continuum of services for families, respite reduces family stress and thereby
           helps preserve the family unit, supports family stability, and prevents lengthy and
           costly out-of-home placements and possible abuse and neglect situations." This
           definition for respite was developed by the Access to Respite Care and Help
           (ARCH) National Network and Resource Center.
    Services
           Individualized intervention services, as determined by the interdisciplinary team
           and listed in the IFSP.
    Sliding Fee Scale
           The scale of graduated family fees or cost share amounts adopted by ECI for use
           in determining the family's ability to pay and the maximum cost share a family
           receiving ECI services may be responsible for based on their income and family
           size.
    Strategies
           Family and service-related activities that will be used to bring about the family's
           desired outcomes and focus on mobilizing a family's own resources and support
           networks.
    Targeted Case Management Program
           The Texas Medicaid Targeted Case Management (TCM) Program included in the
           Texas State Plan and defined in the Texas Medicaid Provider and Procedures
           Manual. TCM services are provided to infants and toddlers birth to 36 mo nths of
           age with disabilities or developmental delays who are eligible for ECI services.
    TEA
           Texas Education Agency.
    Texas Administrative Code (TAC)
           The code containing rules and regulations adopted by a state agency under the
           agency's statutory rule-making authority.
    Texas Kids Intervention Data System (TKIDS)
           An electronic database application operated by the ECI State Office that is used
           for reporting of child-level data, including information on referral, eligibility,
           enrollment, family, and service delivery, and service provider information. TKIDS
           data standards, such as data reporting requirements and descriptions of data
           elements and codes, are published in the TKIDS User Manual.
    Texas Human Resources Code
           The state law that establishes the structure and function of the Texas ECI
           program is contained in Chapter 73, Texas Human Resources Code.

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    Vouchers
         Preauthorization and payment forms used to document each respite service and
         request reimbursement.




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