**May 10, 2001**

Honorable Mavis Matthew

Acting Commissioner

Department of Health

P.O. Box 9965

St. Thomas, Virgin Islands 00801

Dear Commissioner Matthew:

The staff from the Office of Special Education Programs (OSEP), U.S.
Department of Education appreciates having the opportunity to meet with
you, former Acting Commissioner Moolenaar, Ms. Hairston, Ms. Kim Gomez
and Ms. Nona McCray on December 7, 2000. Per our agreement, we are
providing a written summary of issues of concern and possible solutions
recommended by you and your staff to ameliorate the extremely serious
problems with the implementation of the infant and toddler program under
Part C of the Individuals with Disabilities Education Act (IDEA).

The purpose of our visit was to obtain information on whether the
Special Conditions imposed on the Part C Federal Fiscal Years 1999 and
2000 grants to the Virgin Islands Department of Health (VIDH) have had a
positive impact on the provision of early intervention services to
infants, toddlers and their families. The Special Conditions required
VIDH to: (1) establish a separate bank account used solely for the Part
C funds to ensure that these funds are not commingled with other local,
territory or federal funds; (2) drawdown a limited amount of Federal
funds only after providing details and a certification by an authorized
VIDH official to the Department of Education to show that funds are
being spent on allowable purposes and are spent in a timely manner; and
(3) complete outstanding audits and resolve audit findings.[^1] The
primary purpose for the Special Conditions on the Part C grants were to
ensure: (1) prompt reimbursement to all vendors for appropriate
expenditures; and (2) no interruption of early intervention services to
eligible infants and toddlers with disabilities and their families.

During the week of December 4-8, 2000, OSEP staff met with parents,
service providers, one service coordinator, members of the Virgin
Islands Interagency Coordinating Council, the Virgin Islands Protection
and Advocacy Organization, and Ms. Kim Gomez and Ms. Nona McCray from
the Virgin Islands Part C office. OSEP also reviewed pertinent financial
records and other information.

OSEP obtained very consistent data from all interviewees. With the
exception of opening a separate bank account for the Part C grant, the
problems that existed prior to the imposition of Special Conditions on
the Part C grant in September 1999, remain unresolved. The Part C
program is not being implemented in accordance with the federal
requirements. The provision of early intervention services, including
specialized equipment and devices for children, parent and provider
training, and the smooth operation of the early intervention
infrastructure are all severely inhibited because of lack of timely
payments to providers and vendors, and personnel hiring procedures that
make it difficult to recruit and retain qualified personnel.

Interviewees identified additional problems that they believe are having
a negative impact on the delivery of services to infants and toddlers.
These are: (1) service coordination is not available on St. Croix,
affecting one-half of all children and families under Part C; (2) early
intervention services are not being provided due to use of Part C
grant-purchased vehicles by unauthorized personnel; (3) the St. Croix
Part C office where parents, at times, receive services and have IFSP
meetings, is in extremely poor physical condition prompting an inquiry
by VIDH staff into alternative space.

Despite the enormous difficulties in the implementation of the Part C
program, parents, providers, one service coordinator and Interagency
Coordinating Council members relayed their strong support for the
leadership provided by Ms. Kim Gomez and her administrative staff. They
stated that Ms. Gomez is an excellent problem solver, team builder,
interagency collaborator, and is always available to parents and the
Part C staff. In addition, she attempts to increase the amount of
training for parents and staff. Ms. Gomez has been instrumental in
developing a physicians outreach program to ensure families are referred
to the Part C program, training child care providers to include young
children with disabilities in their child care centers, and developing
innovative public awareness methods. Recently, Ms. Gomez established two
other innovative projects: (1) A \"Parent to Parent Program: Parents as
Service Coordinators\" whereby a cadre of parents are trained and paid
for providing support and service coordination to parents whose children
are enrolled in early intervention, and (2) An Infant Mental Health
Project, consisting of community awareness training, Part C staff
training, parent training, and direct services, to promote the well
being of infants and toddlers and their families.

Supporting Ms. Gomez and her staff, the members of the VI Interagency
Coordinating Council are integral and active partners in the VI Part C
system. The Council meets quarterly, has nine standing committees and
works closely with the VI Part C staff to bring ongoing issues and
concerns to the forefront. It is in the process of developing a self
-assessment procedure for the VI Part C system.

***[Lack of Timely Pavments Results in Early Intervention Services Not
Being Pro]{.underline}***

OSEP staff reviewed current procurement and payment procedures with
Virgin Islands\' VIDH Part C staff. Based on interviews with VIDH Part C
staff, it appears that: (1) VIDH personnel are not drawing down Part C
funds in a timely manner; and (2) when drawdowns occur and appropriate
documentation is forwarded for payment, the VI Department of Finance
does not transmit checks to the intended recipients in a timely manner.

VIDH staff reported that once the paperwork leaves the VIDH and is sent
to the central government Finance Department, that they have no means to
track the payments to vendors and providers. The lack of personnel in
the Virgin Islands\' Department of Finance appears to be a barrier to
timely payments to service providers and other vendors.[^2]

Moreover, the VIDH Part C staff stated that they do not have access to
financial information they need to monitor federal drawdowns, deposits
and withdrawals from its Part C bank account. The VIDH staff reported
that they do not have \"control\" over when the central government
Finance system pays the Part C providers and vendors and it is extremely
difficult to \"track down\" where their payment request is in the
system.

VIDH Part C staff attempted to institute procedures that would provide a
means to track Part C fund drawdowns and withdrawals from the Part C
bank account by requesting electronic \"read only\" access to
information related to their Part C bank account so that the program
could monitor when bills were paid, the status of monthly drawdowns from
the U .S. Department of Education, and deposits and withdrawals from the
Part C bank account. In September 2000, the former Acting Commissioner
requested this access but as of April 2001, the VIDH had not received a
response from the VI Finance Department to this request.

Parents, providers, administrators, a service coordinator, and State
Interagency Council members reported that up to 100 infants and toddlers
are on waiting lists for early intervention services, primarily speech
and language therapy, special instruction, occupational therapy, and
physical therapy. These interviewees also reported that Individualized
Family Service Plans (IFSPs) are written to provide only services that
are available rather than including services to meet the individualized
needs of infants, toddlers and their families. Having waiting lists for
needed services and developing IFSPs based only on available services
mean VIDH is not in compliance with IDEA because Part C requires that
each eligible child receive services based on individualized need.

The Part C staff reported that it is constantly attempting to create
solutions to problems with implementation of IFSPs. For example, the
Part C program employs therapists who are on leave from other agencies
to implement IFSP services for the summer or during holidays. The Part C
program continuously advertises for staff \"off-island.\" However, as
described below, these service providers remain for only a few months
because they do not receive reimbursement for services, resulting in
gaps in IFSP services.

Interviewees told OSEP that qualified personnel under contract with the
Part C program are not reimbursed for services in a timely manner and
resign after a few months due to nonpayment. Two contractors reported to
OSEP that they wait up to 5 months to be reimbursed for their services.
One contractor who provides special instruction for the Part C program
reported that they only contract for services for 6-7 children because
they cannot afford to wait for reimbursement for additional numbers of
children. Interviewees also stated that the Part C program has extreme
difficulty in recruiting qualified contractors or staff to meet IFSP
needs because they must inform potential providers that it is likely
that reimbursement for services will be delayed, that hiring new staff
usually takes 8-12 months or longer, and that cost of living raises are
rarely instituted.

Providers stated that \"parents are quite discouraged because they are
not obtaining consistent therapy.\" Parents reported to OSEP that they
experience a great deal of confusion and many stop advocating for their
child due to their frustration that \"nothing changes\" despite their
complaints to high level governmental officials.

***[Difficulties in maintaining administrative operations, such as
obtaining specialized equipment and providing parent
information]{.underline}***

Parents, service providers, a service coordinator, Interagency
Coordinating Council members, and administrators reported that access to
materials, supplies, equipment and other infrastructure items cannot be
obtained without enormous difficulty. Most vendors will not accept the
Virgin Islands government requisitions and this interferes greatly with
the ongoing operation of the program. The administrators must \"beg\"
vendors to accept government requisitions for any materials or supplies.
These problems have resulted in: (1) Infants and toddlers waiting up to
one year to obtain assistive technology devices or orthopedic devices in
accordance with their IFSPs; (2) Parents not receiving timely
information on procedural safeguards, IFSP processes, and transition;
(3) Administrators not able to obligate allowable operational expenses
in a timely manner due to the cumbersome procurement and vendor
reimbursement processes. For example, even obtaining a round trip ferry
ticket (cost \$6.00) for a physical therapist to provide direct services
on the island of St. John is extremely difficult.

***[Personnel Issues]{.underline}***

Parents, administrators, providers, a service coordinator and
Interagency Coordinating Council members reported to OSEP that the
infants and toddlers on St. Croix have not received service coordination
services for a year and a half. This has occurred because of the
extended process to terminate employment of an employee and to hire a
qualified service coordinator. The Part C program offered the job to a
qualified person on September 12, 2000, but due to delays in obtaining a
\"Notice of Personnel Action\" from the VI Government, that person was
not yet employed as of April 2001. OSEP was told that the applicant is
already an employee of the VI Government and only requires a transfer.
The Governor must approve \"Notices of Personnel Actions\".

***[Distribution of Services Due to Vehicle Misuse]{.underline}***

Parents, administrators, providers, the service coordinator and
Interagency Coordinating Council members reported to OSEP that vehicles
purchased for the sole use of the Part C program are being utilized by
unauthorized users. The Part C staff reported that during the past four
years, the program has had persistent difficulties providing direct
services to families because: (1) The vehicles are not available for
providers when they have appointments with families; (2) The vehicles
are returned with no gasoline, with spoiled food, and insect-infested;
(3) The vehicles are returned by unauthorized users with flat tires; (4)
Just prior to OSEP\'s visit, one vehicle was recently returned by an
unauthorized user with major physical damage. Between October 1999 and
January 15, 2000, unauthorized users put almost 5,000 miles on the
vehicle purchased with Part C funds. One service provider relayed to
OSEP that she was to make a home visit recently and the Part C vehicle
had no gasoline due to an unauthorized user taking the vehicle and not
replenishing the gasoline. Because of a VI government policy that
gasoline could not be purchased on Fridays and that was the day she
needed the vehicle, she had to go through numerous steps to try to get a
few gallons of gasoline to provide the early intervention services.

OSEP also learned that the Part C vehicles are often seen around the
islands over the weekend parked at restaurants and shops. Recently at
least one vehicle was used for state officials to attend a funeral
during the week when providers needed it to provide services. The former
Acting Commissioner commented that the Virgin Islands attorney
general\'s interpretation is that these vehicles, once purchased, became
the property of the Virgin Islands government and therefore, could be
used by all government officials. He asked that OSEP provide guidance on
the use of these vehicles.

Attached is applicable federal regulation, 34 CFR §80.32(c), which
provides that equipment must be used for the project for which it was
acquired, and can be used for other programs supported with Federal
funds only if such use will not interfere with the work on the intended
project. Thus, a vehicle purchased with Part C funds must be used for
the Part C program. Other uses that interfere with the use by the Part C
program can not be permitted. In addition, under the equipment
management requirements, the grantee must keep the property in good
condition and maintain a control system to prevent damage or theft. See
34 CFR §80.32(d), also attached. The U. S. Department of Education is
available for additional guidance on this matter.

***[Unsafe and Insufficient Facilities for Part C Program Site on St.
Croix]{.underline}***

Because of the extremely poor and dangerous conditions in the State
owned building on St. Croix[^3], the Part C Coordinator investigated
obtaining commercial space on St. Croix and learned that it would cost
approximately \$5,000 per month to pay rent, utilities, phone lines,
maintenance, etc. The VIDH Deputy Commissioner asked whether the State
could charge rent to the Part C grant. This depends on several factors.
If the VIDH wishes to pursue this matter by providing details, we would
be happy to provide feedback.

***[Solutions proposed by VIDH]{.underline}***

The Acting Commissioner will follow up with appropriate Virgin Islands
Government officials to obtain the \"read-only\" access to the Part C
accounts. In addition, the VIDH Federal Programs Director agreed to work
with the Virgin Islands Part C staff to establish a tracking system for
requisitions and other payment requests within the VIDH system to ensure
that the required procedures are expedited. For example, the VIDH
Federal Programs Director could provide the federal drawdown report two
times a month to the Part C program staff.

VIDH staff mentioned that VIDH currently has several federally funded
programs that are successfully operating under a third party agent. They
suggested that using a third party agent to expedite certain operations
of the Part C program could be a ***temporary*** action to resolve
urgent concerns to ensure that infants, toddlers and families receive
the services to which they are entitled under the Part C program. For
example, the VIDH could contract with a third party for contract service
providers, provision of materials and supplies, training activities,
consultants, and vehicle maintenance.

VIDH staff stated that the Virgin Islands government has formed a
partnership with the University of Virgin Islands to plan and develop
improved procurement and financial procedures and the VIDH will be the
\"model demonstration site\" for this new system as soon as it is
developed. The recommendations to revise the system will probably be
completed in the spring of 2001.

The Acting Commissioner also agreed to expedite the \"Notice of
Personnel Action\" for the person that has been offered the service
coordinator position on St. Croix.

The Office of Special Education Programs wants to thank you, Dr.
Matthew, as well as the former Acting Commissioner Moolenaar, Ms.
Hairston, and the Part C staff for the cooperation you demonstrated to
our staff prior to and during our site visit. Everyone was extremely
interested in outlining the serious problems and creating possible
solutions to solve them. This Office wants to work in collaboration with
VIDH to improve the situation in the Virgin Islands so that infants and
toddlers with disabilities and their families receive the services to
which they are entitled. We will be reviewing the results of our site
visit with other officials within the U.S. Department of Education
shortly so that concurrence can be obtained between our Department and
yours on probable avenues to resolve the very serious problems outlined
in this report.

> Sincerely,
>
> Patricia J. Guard
>
> Acting Director
>
> Office of Special Education Programs

Enclosures

cc: Ms. Kim Gomez

Part C Coordinator

[^1]: See correspondence from U.S. Department of Education to VIDH dated
    September 23,1999 and March 30, 2000.

[^2]: OSEP learned that the Virgin Islands Department of Finance has
    three staff who are responsible for processing paperwork and sending
    out payments for the entire Virgin Islands government that includes
    retirement, vendor payments, travel, public assistance checks,
    electric bills for facilities, port authority etc. The system is not
    automated.

[^3]: Parents, administrators, providers, a service coordinator and
    Interagency Coordinating Council members reported to OSEP that the
    location in St. Croix where Part C staff is housed is unacceptable.
    One parent stated \"The place is so ugly. I\'m afraid to put my
    child on the floor because the lead paint is peeling off the walls,
    the building is extremely dirty, and asbestos is in the building\".
    Another parent stated that it is difficult for children in wheel
    chairs to gain entry into the building because a wheel chair must be
    pushed over an extended graveled area to access the building. All
    stated that there is no area available to hold confidential IFSP
    meetings or discussions. One provider told OSEP that it is
    demoralizing to work in the facility because the roof is constantly
    leaking, the telephones do not always work, lead paint is peeling
    off the walls, the air conditioning does not work, and there are no
    adequate bathroom facilities. Other state health and social service
    programs use this facility.