November 8, 2005

Joseph Chiaro, M.D.

Deputy Secretary of Health

Florida Department of Health

Children's Medical Services

4052 Bald Cypress Way

Tallahassee, Florida 32399-1707

Dear Deputy Secretary Chiaro:

The purpose of this letter is to respond to the Florida Department of
Health\'s (FDOH\'s) April 1, 2005 submission of its Federal Fiscal Year
(FFY) 2003 Annual Performance Report (APR) for the Individuals with
Disabilities Education Act (IDEA) Part C funds for the grant period July
1, 2003 through June 30, 2004. The APR reflects actual accomplishments
that the State made during the reporting period, compared to established
objectives. OSEP has designed the APR for IDEA to provide uniform
reporting from States and result in high-quality information across
States. The APR is a significant data source in the Continuous
Improvement and Focused Monitoring System (CIFMS) of the Office of
Special Education Programs (OSEP), within the U.S. Department of
Education.

*Background*

OSEP's November 19, 2004 FFY 2002 APR response letter required the State
to submit, in the FFY 2003 APR a final progress report from the
Improvement Plan OSEP accepted on March 26, 2004 demonstrating
correction of the following 9 areas of noncompliance from OSEP's 2001
Monitoring Report:

-   General Supervision: ensuring timely correction of identified areas
    of noncompliance, as required by 34 CFR §303.501(b)(4);

-   Family Centered Services: ensuring that family assessments are
    conducted, with the concurrence of the family, and documented on the
    IFSP, as required by 34 CFR §303.322(d)(1);

-   Early Intervention Services in Natural Environments: (1) ensuring
    ongoing service coordination, including the coordination and
    documentation of other services on the IFSP, as required by 34 CFR
    §§303.23(a)-(d) and 303.344(e); (2) ensuring individualized
    decisions by participants at the IFSP meeting, including the
    decision to determine the provision of services in natural
    environments, as required by 34 CFR §§303.12, 303.18 and
    303.344(d)(1)(i); (3) revising the Service Delivery Policy and
    Guidelines on natural environments; (4) conducting evaluations and
    assessments in all five developmental domains, as required by 34 CFR
    §§303.322(c) and 303.344(a); (5) ensuring timely evaluations and
    assessments and conducting the initial IFSP meeting within 45 days
    of the referral to Part C, as required by 34 CFR §§303.321(e)(2),
    303.322(e)(1) and §303.342(a); and (6) ensuring the provision of
    services in a timely manner as required by 34 CFR §§303.340(c),
    303.342(e) and 303.344(f); and

-   Early Childhood Transition: holding the transition meeting, with
    concurrence from the family, at least 90-days before the child's
    third birthday, as required by 34 CFR §§ 303.148(b)(4) and
    303.344(h).

OSEP's November 19, 2004 FFY 2002 APR response letter also required FDOH
to submit, in the FFY 2003 APR, data and required information to
demonstrate progress towards correcting the two areas of noncompliance
identified in OSEP's November 2004 letter. A final progress report
demonstrating correction of these two areas is not due until December
19, 2005 but may be combined with the State's submission of the State
Performance Plan (SPP):[^1]

-   General Supervision: ensuring parents are informed of their
    procedural safeguards, as required by 34 CFR §303.403; and

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-   Early Childhood Transition: ensuring IFSPs included steps to support
    the transition of the child and family, as required by 34 CFR
    §303.344(h).

OSEP's November 2004 letter also required the State to submit in the FFY
2003 APR data and the required information to demonstrate improved
performance in the three performance areas: (1) General Supervision:
ensure the reporting of timely and accurate data; (2) Family Centered
Services: the extent to which family supports and services enhance the
family's capacity to enhance outcomes for infants and toddlers; and (3)
Early Intervention Services in Natural Environments: the percentage of
children participating in the Part C program who demonstrate improved
and sustained functional abilities in the five developmental areas.

The State's APR should reflect the collection, analysis, and reporting
of relevant data and document data-based determinations regarding
performance and compliance in each of the cluster areas. This letter
responds to the State's FFY 2003 APR**.** OSEP has listed its comments
by cluster area.

### General Supervision

[Identification and timely correction of noncompliance]{.underline}

OSEP's November 19, 2004 FFY 2002 APR response letter required the State
to submit, in the FFY 2003 APR a final progress report demonstrating
timely correction of State-identified areas of noncompliance, as
required by 34 CFR §303.501(b)(4). On pages 2-5 and 22 of the FFY 2003
APR, the State included data and analysis regarding the correction of
noncompliance identified in OSEP's FFY 2002 APR response letter in the
following area to ensure the timely correction of identified areas of
noncompliance, as required by 34 CFR §303.501(b)(4). FDOH reported trend
data to demonstrate that the State completed its three-year monitoring
cycle and a follow-up desk audit in all 16 local service areas. The
results of the State\'s monitoring indicated that, from FFY 2001 to FFY
2003, 13 local service areas, including the remaining four local service
areas identified in FFY 2002, completed the strategies in their
Improvement Plans (IPs). FDOH stated in its FFY 2003 APR that the
timeline for the three remaining local service areas to complete the
strategies in their IP extended beyond this reporting period. In its
October 2005 submission, FDOH reported that the remaining three local
service areas had completed their IPs. OSEP appreciates the State's
efforts in this area and looks forward to reviewing the State's data in
response to Indicator #9 as part of the SPP, due December 2, 2005.

[Dispute resolution]{.underline}

On pages 2, 8 and 22 of the FFY 2003 APR, the State included data and
analysis that demonstrated progress towards correction of noncompliance
identified in OSEP's FFY 2002 APR response letter in the following
areas: (1) to ensure that parents are informed of their procedural
safeguards, as required by 34 CFR §303.403; and (2) revision of the
State\'s complaint procedures to comply with 34 CFR §§303.500 through
303.512.

FDOH presented trend data that indicated all 16 local programs
implemented an IP to ensure that families were given information
regarding the procedures to file a complaint and that procedural
safeguards were explained to families in a manner that they understood.
Evidence of change data indicated that 13 of 16 local service areas
completed the activities in their IP, from FFY 2001 to FFY 2003, to
demonstrate compliance with this requirement. FDOH stated that the
timeline for the three remaining local service areas to complete the
strategies in their IP extended beyond this reporting period. In its
October 2005 submission, the State confirmed that the three remaining
local service areas have implemented the revised notice and procedural
safeguards documents.

FDOH, in the State's FFY 2002 APR, included a copy of the complaint
procedures and reported that the procedures were issued to all local
service areas. OSEP completed its review of the State's complaint
procedures and determined that revisions were needed. OSEP issued its
review of the State's complaint procedures in a letter dated May 18,
2005. With the SPP, due on December 2, 2005 the State must submit a
written assurance under IDEA Sections 635 and 639 that its revised
complaint procedures and revised notice have been implemented and
provide a copy of the memorandum to demonstrate that the complaint
procedures and notice were issued to all local service areas.

On pages 5-10 and in Attachment 1 of the FFY 2003 APR, the State
included data and analysis regarding compliance in this area to ensure
that complaints were resolved in a timely manner as required by 34 CFR
§§303.510-512. FDOH included data and analysis indicating that all
complaints filed during the FFY 2003 reporting period had a decision
rendered within the required timelines. FDOH stated that written
findings of fact identified five allegations in the two investigated
complaints that required corrective action plans. The five allegations
correlated with the systemic issues identified from the State's on-site
monitoring activities and included the development of the IFSP, early
childhood transition, service coordination, procedural safeguards, and
services in the natural environment. The State reported that all
allegations identified in the State complaint during the FFY 2001
through FFY 2003 reporting periods were timely resolved prior to and
during this reporting period. FDOH stated that each local service area
was required to submit a self-assessment to outline the changes to their
service delivery model to maintain compliance with these systemic areas.
FDOH reported that there were no requests for mediations, or due process
hearings. OSEP appreciates the work of the State in ensuring compliance
with this requirement. OSEP looks forward to reviewing the State's data
in response to Attachment 1 to the SPP, due December 2, 2005**.**

#### Personnel 

On pages 11-14 of the FFY 2003 APR, the State included data and analysis
regarding its performance in this area to ensure that sufficient
personnel are available to meet the identified early intervention needs
of all eligible infants and toddlers and their families. FDOH reported
trend data that indicated 98% of the early intervention staff met the
State's credentialing criteria, within the specified timeline as
required by 34 CFR §303.361. FDOH stated that the current number of
personnel employed reflected a decrease during FFY 2001 to FFY 2002;
however, the data represented an actual count since duplicative and
inactive providers were purged from the database. FDOH reported that a
statewide Comprehensive System of Personnel Development training
partnership continued with the Florida Department of Education.
Contracts were in place with nine Universities, and with support from
the General Supervision Enhancement Grant (GSEG), training was
implemented to enhance interagency collaboration, professional
development, early intervention competencies, and standards, and
dissemination and evaluation mechanisms were developed. To standardize
training, on-line training modules were implemented in February 2005. To
ensure the availability of qualified personnel, the Infant Toddler
Development Specialist position became an approved Medicaid provider on
June 30, 2005. OSEP appreciates the work of the State in improving
performance in this area.

#### Collection and timely reporting of accurate data

On pages 2 and 15-16 of the FFY 2003 APR, the State included data and
analysis regarding its performance and compliance in this area to ensure
timely and accurate data consistent with Section 618 of IDEA, as
required by 34 CFR §303.540. FDOH reported in its FFY 2003 APR that 13
of 16 local service areas monitored from FFY 2001 through FFY 2003
completed the strategies in their IP, to demonstrate 100% compliance
with this requirement. The State confirmed in October 2005 that the
remaining three local service areas had completed their implementation.
OSEP appreciates the State's efforts to ensure timely and accurate data
reporting.

[Fiscal responsibility]{.underline}

In Attachment 2 of the FFY 2003 APR, the State included data and
analysis regarding its performance in this area to ensure the
identification and coordination of funding resources within the State
that resulted in the provision of continuous early intervention
services. FDOH reported that Federal Part C funds constituted the single
greatest financial support for Florida's early intervention program. The
other sources of funding included: (1) State general revenue; (2)
Medicaid; (3) Temporary Assistance to Needy Families (TANF); (4) Federal
Part B; (5) State Tobacco Settlement; and (6) GSEG funds. OSEP
appreciates the State's efforts in this area and looks forward to
reviewing data and information demonstrating continued improvement in
this area.

### Comprehensive Public Awareness and Child Find System

On pages 16-19 of the FFY 2003 APR, the State included data and analysis
regarding its performance and compliance to ensure a coordinated child
find and public awareness system as required by 34 CFR §§303.320 through
303.323**.** On pages 16-20 of the FFY 2003 APR**,** FDOH reported that
based on an annual count, the number of infants and toddlers identified
and referred to Part C reflected 5.4% of the general population. The
State also reported the following information. The interagency
collaborative child-find system facilitated referrals from various
sources. The largest number of referrals, 25% came from families, 26%
from hospitals, and 21% from private physicians. Ninety-two percent of
the infants and toddlers identified and referred were determined
eligible due to developmental delays and eight percent, due to
established conditions.

FDOH reported that 21% of the infants and toddlers determined eligible
were under one year of age. The ethnicity of infants and toddlers
receiving Part C services was comparable to the general population with
the exception of Hispanics, that were under-represented and whites that
were over-represented. The State reported that it would continue to
monitor the results of its child find and public awareness efforts in
order to meet the diverse needs of all local service areas. OSEP
appreciates the work of the State in ensuring performance and compliance
with this requirement. OSEP looks forward to reviewing the State's data
in response to the child find indicator in the SPP, due December 2,
2005.

## ***Family Centered Services***

OSEP's November 19, 2004 FFY 2002 APR response letter required the State
to submit, in the FFY 2003 APR, a final progress report from the
Improvement Plan OSEP accepted on March 26, 2004 demonstrating
correction of OSEP's 2001 Monitoring Report finding that family
assessments are conducted under 34 CFR §303.322(d)(1). On pages 2,
20-21and 24 of the FFY 2003 APR, the State included data and analysis
regarding correction of noncompliance and continued performance in the
following areas: (a) ensure that family assessments are conducted, with
the concurrence of the family, and documented on the IFSP, as required
by 34 CFR §303.322(d)(1); and (b) the extent to which family supports
and services enhance the family\'s capacity to enhance outcomes for
infants and toddlers. FDOH reported trend data that indicated all 16
local service areas monitored in FFY 2001 through FFY 2003, including
the four remaining local service areas identified in FFY 2002, completed
the strategies in their IPs and that family assessments were being
conducted as required by the Part C regulations.

FDOH stated that 100% of the families reported that daily routines,
activities, and places identified and services documented on the IFSP
were based on their concerns, priorities, and resources. FDOH provided
data that indicated 100% of the families reported that early
intervention professionals helped them become involved in helping their
child develop to their potential. FDOH stated that a family training
initiative, \"New Star\" was implemented and a family survey would be
administered to further determine the impact of early intervention
services on child and family outcomes. OSEP appreciates the work of the
State in ensuring performance and compliance with this requirement.

***Early Intervention Services in Natural Environments***

OSEP's November 19, 2004 FFY 2002 APR response letter required the State
to submit, in the FFY 2003 APR a final progress report from the
Improvement Plan OSEP accepted on March 26, 2004 demonstrating
correction of the following 5 areas of noncompliance in this cluster are
from OSEP's 2001 Monitoring Report or the State's FFY 2001 or 2002 APR:
(1) ensuring ongoing service coordination, including the coordination
and documentation of other services on the IFSP, as required by 34 CFR
§§303.23(a)-(d) and 303.344(e); (2) ensuring individualized decisions by
participants at the IFSP meeting, including the decision to determine
the provision of services in natural environments, as required by 34 CFR
§303.12, 303.18 and 303.344(d)(1)(i); (3) revising the Service Delivery
Policy and Guidelines on natural environments; (4) conducting
evaluations and assessments in all five developmental domains, as
required by 34 CFR §§303.322(c) and 303.344(a); (4) ensuring timely
evaluations and assessments and conducting the initial IFSP meeting
within 45 days of the referral to Part C, as required by 34 CFR
§§303.321(e)(2), 303.322(e)(1) and 303.342(a); and (5) ensuring the
provision of services in a timely manner as required by 34 CFR
§§303.340(c), 303.342(e) and 303.344(f). On pages 2 and 24-35 of the FFY
2003 APR, the State included data and analysis regarding these five
areas, each of which is discussed below.

## 

## Service Coordination 

OSEP's November 19, 2004 FFY 2002 APR response letter required the State
to submit, in the FFY 2003 APR a final progress report demonstrating
that the State was ensuring the provision of service coordination
services, including the coordination and documentation of other services
on the IFSP, as required by 34 CFR §§303.23(a)-(d) and 303.344(e). On
pages 2, 21 and 24 of the FFY 2003 APR, the State included data and
analysis regarding the progress towards correction of noncompliance
identified in OSEP\'s FFY 2002 APR response letter in the following area
to ensure ongoing service coordination, including the coordination and
documentation of other services on the IFSP, as required by 34 CFR
§§303.23(a)-(d) and 303.344(e). FDOH reported that the caseload for
service coordinators was reduced from 1 to 75 to 1 to 65 to facilitate
service coordinators carrying out their responsibilities. FDOH stated
that the 13 local service areas monitored in FFY 2001 through FFY 2003,
including the remaining four programs identified in FFY 2002, completed
the strategies in their IP to demonstrate 100% compliance with this
requirement. The results of the statewide parent interviews and surveys
conducted in FFY 2003 indicated that 100% of the families reported that
they were satisfied with their service coordinator and their service
coordinator listened to their needs and responded to their requests.
OSEP appreciates the State's efforts to ensure compliance and improve
performance in this area.

## 

## Natural Environments

On pages 2 and 25 of the FFY 2003 APR, the State included data and
analysis regarding its progress in correcting noncompliance identified
in OSEP's November 2004 FFY 2002 APR response letter in the following
area to ensure individualized decisions by participants at the IFSP
meeting, including the decision to determine the provision of services
in natural environments, as required by 34 CFR §§303.12, 303.18 and
303.344(d)(1)(i). FDOH, to ensure compliance relative to services in
natural environments, revised its service delivery model effective March
2004 and disseminated its revised Service Delivery Policy on Natural
Environments on February 2005 (approved by OSEP in its November 2004 FFY
2002 APR letter). Although FDOH reported that the 13 local service areas
with identified noncompliance in FFY 2001 through FFY 2003 completed the
strategies in their IP, FDOH has not yet monitored for the
implementation of its revised Service Delivery Policy to ensure that all
IFSPs identify: (1) that early intervention services are in natural
environments or (2) an appropriate child outcome based justification is
included when early intervention services are not provided in the
child's natural environment. With the SPP, the State must provide
updated data in response to the natural environments indicator regarding
the number of children without appropriate child-outcome based
justifications when they are not receiving services in the natural
environment. If the data is monitoring data, the State must provide as
part of the evidence of its correction, the data from its local service
areas that the State relied upon to determine whether the local service
area is in compliance.

## Evaluation and Identification of needs

On pages 2 and 28 of the FFY 2003 APR, the State included data and
analysis regarding its progress in ensuring correction of noncompliance
identified in OSEP's FFY 2002 APR response letter in the following area
to ensure that evaluations and assessments were conducted in all five
developmental domains, as required by 34 CFR §§303.322(c) and
303.344(a). FDOH reported that the local service areas monitored in FFY
2001 and FFY 2002, including the four remaining local service areas
identified in FFY 2002, completed the strategies in their IP to
demonstrate compliance with this requirement. The State's review of
IFSPs, during FFY 2003, indicated that 83% contained documentation that
evaluations were conducted in all five developmental areas. The State
reported in its FFY 2003 APR that three of the six local service areas,
monitored during FFY 2003 completed the strategies in their IPs and in
its October 2005 submission, the State confirmed that the remaining
three implemented IPs and required corrective actions. OSEP appreciates
the State's efforts in this area.

[Individualized family service plans (IFSPs)]{.underline}

On pages 2 and 25-27 of the FFY 2003 APR, the State included data and
analysis regarding its efforts to correct noncompliance identified in
OSEP's 2001 Monitoring Report in the following areas: (1) ensure timely
evaluations and assessments and conduct the initial IFSP meeting within
45 days of the referral to Part C, as required by 34 CFR
§§303.321(e)(2), 303.322(e)(1) and 303.342(a); (2) ensure the provision
of services in a timely manner as required by 34 CFR §§303.340(c),
303.342(e) and 303.344(f); and (3) ensure the provision of early
intervention services consistent with the IFSP as required by 34 CFR
§303.344.

> [Timely evaluations and assessments]{.underline}

FDOH reported that 62.1 % of initial IFSPs were completed within 45 days
of referral.[^2] FDOH reviewed IFSPs where initial meetings were not
held within the required 45 days and identified that the 47% of these
were delayed due to family- or child-related issues, such as illness or
family cancellation. FDOH reported that the State's database was revised
to better identify and capture the barriers to holding the initial IFSP
meeting within 45 days and the provision of early intervention services.
The State must submit with the SPP due December 2, 2005, data reflecting
compliance with Part C's 45-day timeline requirement. If the data is
monitoring data, the State must provide as part of its evidence of
correction, the data from its local service areas that the State relied
upon to determine whether the local service area is in compliance. If
the data indicate noncompliance, the State must include its analysis and
provide any additional strategies to ensure compliance.

##### Timely provision of early intervention services 

On pages 2 and 25-27 of the FFY 2003 APR, the State included data and
analysis regarding correction of noncompliance identified in OSEP's 2001
Monitoring Report to ensure that services were provided in a timely
manner as required by 34 CFR §§303.340(c), 303.342(e) and 303.344(f).
FDOH reported that 68.5% met the State's timely provision of services
standard. The results from record reviews indicated that delays were
contributed to child- and family-related issues. FDOH stated that
barrier codes would be added to the State's database in order to
identify and track circumstances that may impede the timely provision of
services. The State reported that early intervention services must be
provided in Florida within 22 days after completion of the IFSP. The
State must submit with the SPP data reflecting compliance with Part C's
timely provision of early intervention services requirement. If the data
is monitoring data, the State must provide as part of its evidence of
correction, the data from its local service areas that the State relied
upon to determine whether the local service area is in compliance. If
the data indicate noncompliance, the State must include as part of
Indicator #1 its analysis and provide any additional strategies to
ensure compliance as soon as possible.

#### Provision of early intervention services consistent with the IFSP

On pages 2 and 24 of the FFY 2003 APR, the State included data and
analysis regarding correction of noncompliance identified in OSEP\'s FFY
2002 response letter in the following area to ensure that early
intervention services are provide to eligible children consistent with
the documentation on the IFSP as required by 34 CFR §303.344. FDOH
reported that all 16 local service areas monitored in FFY 2001 through
FFY 2003, including the remaining four local service areas identified in
FFY 2002, completed the strategies in the IP to demonstrate 100%
compliance with this requirement**.** OSEP appreciates the work of the
State in ensuring compliance with this requirement.

#### Early childhood outcomes

On page 34 of the FFY 2003 APR, the State included data and analysis
regarding its continued performance in this area to determine the
percentage of children participating in the Part C system who
demonstrate improved and sustained functional abilities in the five
developmental areas. FDOH provided data indicating that 93% of the local
programs reported that approximately 3,088 children demonstrated
improved/sustained functional status across the five developmental
areas. FDOH reported that with the support from the GSEG, a system
evaluation workgroup was formed to assist the State in developing a plan
to measure the outcomes of early intervention services. The SPP
instructions establish a new indicator in this area, for which States
must provide entry data in the FFY 2005 APR due February 1, 2007.
Absence of this information at that time will be considered in OSEP's
annual determination on the status of the State's performance and
compliance required under section 616(d) of the IDEA. The State should
carefully review the instructions to the SPP in developing its plans for
this collection. OSEP looks forward to reviewing the State's plan for
collecting this data, in the SPP.

### 

### Early Childhood Transition

#### Holding the transition meeting

On pages 2 and 36-38 of the FFY 2003 APR, the State included data and
analysis regarding its effort to correct the noncompliance identified in
OSEP's 2001 Monitoring Report: to hold the transition meeting, with
concurrence from the family, at least 90 days before the child's third
birthday, for children potentially eligible under Part B as required by
34 CFR §303.148(b)(2)(i). FDOH provided data indicating that 67% the
local records reviewed demonstrated compliance in this areas. FDOH did
not provide data to determine the extent to which delays were due to
family, child, or other circumstances. The State must submit with the
SPP data reflecting compliance with Part C's 90-day transition
conference requirement at 34 CFR §303.148(b)(2)(i). If the data is
monitoring data, the State must provide as part of the evidence of its
correction, the data from its local service areas that the State relied
upon to determine whether the local service area is in compliance. If
the data indicate noncompliance, the State must include its analysis and
provide any additional strategies to ensure compliance as soon as
possible

## 

## Steps on the IFSP to support transition

OSEP's November 19, 2004 FFY 2002 APR response letter required FDOH to
submit, in the FFY 2003 APR, data and required information to
demonstrate progress toward correcting the Part C transition requirement
that IFSPs include steps to support the transition of the child and
family, as required by 34 CFR §§303.148(b)(4) and 303.344(h). On pages
36-38 of the FFY 2003 APR, the State included data and analysis
regarding its efforts to ensure that IFSPs included steps to support the
transition of the child and family, as required by 34 CFR
§§303.148(b)(4) and 303.344(h). The State reported that 17% of the
records reviewed demonstrated compliance in this area. FDOH reported
that revisions were made to the State's database to capture the
appropriate data and information. FDOH reported that numerous transition
activities were being implemented across the State, however local
service providers were not documenting the activities on the IFSPs. In a
telephone conference call with the State on May 1, 2005, FDOH reported
that a form would be developed to assist local service areas in
documenting the results of the transition activities. OSEP is concerned
about the limited data available and the low level of noncompliance in
this area. The State must submit by December 19, 2005 (but may submit
with the SPP as part of Indicator #8), a final progress report with data
and information demonstrating that IFSPs included steps to support the
transition of the child and family, as required by 34 CFR
§§303.148(b)(4) and 303.344(h). If the data submitted by the State is
monitoring data, the State must include data by local service area
regarding compliance with the transition planning requirements.

***Conclusion***

As noted above, the State must submit with the SPP, due on December 2,
2005, data and information that demonstrate compliance with the
following four areas of noncompliance from OSEP's 2001 Monitoring Report
(or the State's FFY 01 APR):

-   Early Intervention Services in Natural Environments: ensure
    individualized decisions by participants at the IFSP meeting,
    including the decision to determine the provision of services in
    natural environments, as required by 34 CFR §§303.12, 303.18 and
    344(d)(1)(i) and provide specifically the number of children without
    appropriate child-outcome based justifications when they are not
    receiving services in the natural environment. The State must submit
    with the SPP updated data in response to the natural environments
    indicator regarding the number of children without appropriate
    child-outcome based justifications when they are not receiving
    services in the natural environment.

-   The State must ensure timely evaluations and assessments and conduct
    the initial IFSP meeting within 45 days of the referral to Part C,
    as required by 34 CFR §§303.321(e)(2), 303.322(e)(1) and
    §303.342(a). The State must submit data reflecting compliance with
    Part C's 45-day timeline requirement.

-   The State must ensure the provision of services in a timely manner
    as required by 34 CFR §303.344(f). The State must submit with the
    SPP data reflecting compliance with Part C's timely provision of
    early intervention services requirement. If the data indicate
    noncompliance, the State must include as part of Indicator #1 its
    analysis and provide any additional strategies to ensure compliance
    as soon as possible.

-   Transition: hold the transition meeting, with concurrence from the
    family, at least 90-days before the child\'s third birthday for
    children potentially eligible for Part B services, as required by 34
    CFR §303.148(b)(2)(i).

The State must submit with the SPP data reflecting compliance with Part
C's 90-day transition conference requirement at 34 CFR §§
303.148(b)(2)(i).

If the data in the four areas above is monitoring data, the State must
provide as part of the evidence of its correction, the data from its
local service areas that the State relied upon to determine whether the
local service area is in compliance. If the data in the four areas above
indicate continuing noncompliance, the State must include with the SPP
its analysis and provide any additional strategies to ensure compliance
as soon as possible. Failure to demonstrate compliance in these four
areas may result in the State being considered as a "high risk" designee
for its FFY 2006 Part C grant under the IDEA.

The State must also submit with the SPP a written assurance under IDEA
Sections 635 and 639 that its revised complaint procedures and revised
notice have been implemented and provide a copy of the memorandum to
demonstrate that the complaint procedures and notice were issued to all
local service areas.

The State must submit by December 19, 2005 (but may submit with the
SPP), a final progress report with data and information demonstrating
correction of the following one area of noncompliance identified
initially in OSEP's November 2004 letter (from the State's FFY 2002
APR): Early Childhood Transition: ensuring IFSPs included steps to
support the transition of the child and family, as required by 34 CFR
§§303.148(b)(4) and 303.344(h). If the data submitted by the State is
monitoring data, the State must include data by local service area
regarding compliance with the transition planning requirements.

IDEA 2004, §616, requires each State to submit a State Performance Plan
(SPP) that measures performance on monitoring priorities and indicators
established by the Department. These priorities and indicators are, for
the most part, the same as clusters and probes in the APR. OSEP
encourages the State to carefully consider the comments in this letter
as it prepares its SPP, due December 2, 2005.

OSEP recognizes that the APR and its related activities represent only a
portion of the work in your State, and we look forward to collaborating
with you as you continue to improve results for infants and toddlers
with disabilities and their families. If you have questions, please
contact Alma McPherson at (202) 245-7443.

> Sincerely,
>
> /s/Troy R. Justesen
>
> Troy R. Justesen
>
> Acting Director
>
> Office of Special Education Programs

cc: Janice Kane

[^1]: In an e-mail dated October 25, 2005, FDOH was given a sixty day
    extension to submit its SPP.

[^2]: The State completes the initial IFSP at its initial IFSP meetings.