Source: https://hhs.texas.gov/doing-business-hhs/provider-portals/assistive-services-providers/early-childhood-intervention-programs/eci-compliance-guide
Timestamp: 2019-07-17 14:29:50
Document Index: 620738991

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This compliance guide addresses requirements of the ECI program that apply to all Texas contractors that receive IDEA, Part C funds and provide early childhood intervention services. The purpose of this compliance guide is to provide a list of authorities by topic in a useful format. Administrators must comply with IDEA, the Code of Federal Regulations, the Texas Medicaid Provider Procedures Manual, and other authorities. The Compliance Guide is a support for understanding your requirements, rights and duties as a contractor under federal statutes, regulations and the relevant portions of the Texas Administrative Code.
The guide also references related regulations, Medicaid requirements, data entry requirements, and required forms. For standardized and required elements forms, see the HHS ECI Provider Forms page. You will find the links to each specific form on that page.
This guide does not cover all state and federal requirements, nor does it cover local regulations. Please be aware that there are additional regulations that you must follow, including those for funding sources such as private insurance. State, federal and other requirements may change after the publication of this guide. HHS ECI will update the guide as needed, but the updates may not keep pace with the changes. You are responsible for keeping up-to-date on any changes to the requirements. This guide is part of a broader group of technical assistance materials provided by HHS ECI to promote compliance and performance.
Throughout this guide, the word "you" means the administrator, program director or supervisor of ECI services.
Note that live links to federal statutes and regulations go to the most specific portion of the citation possible, depending on the specificity of the coding of the citation on the original page. In cases of a citation that is more specific than the link it connects to, be sure to scroll down on the link page and find the specific requirement that is cited. In a few cases, the link may move to the citation table of contents first before moving to the specific cited requirement.
United States Code, Title 20, Chapter 33: Individuals with Disabilities Education Act (IDEA).
20 USC §§1431-1444: Subchapter III – Infants and Toddlers with Disabilities.
§1401(1) Assistive technology device.
§1401(2) Assistive technology service.
§1401(3) Child with a disability.
§1401(16) Infant or toddler with a disability.
§1401(23) Parent.
§1401(36) Ward of the State.
§1431 Findings and Policy.
§1432 Definitions.
§1435 Requirements for statewide system.
Code of Federal Regulations, Title 34, Part 303: Early Intervention Program for Infants and Toddlers with Disabilities.
§300.201 Designation of lead agency.
§303.501 Permissive use of funds by the lead agency.
Texas Administrative Code, Title 40, Part 2, Chapter 108, Division for Early Childhood Intervention Services.
Subchapter A: General Rules.
§108.101 Purpose.
§108.102 Legal Authority
§108.103 Definitions.
§108.105 Safety Regulations.
§108.107 Health Standards for Early Childhood Intervention Services.
General Provisions, A, B and C
Attachment No. 1, Section II Measurable Outputs and Outcomes, B
4201 Surrogate Parent Identification of Need and Assignment
4201-S Identificación de necesidad y asignación de padres
§1439 Procedural safeguards.
Code of Federal Regulations, Title 34, Part 99: Family Education Rights and Privacy.
§303.320 Screening Procedures.
§303.342(e) Procedures for IFSP development, review, and evaluation.
§303.345(a) Interim IFSPs—provision of services before evaluations and assessments are completed.
§303.421 Prior written notice and procedural safeguard notice.
§303.436 Parent rights in due process hearing proceedings.
§303.437 Convenience of hearing and timelines.
§303.520 Policies related to use of public benefits or insurance or private insurance to pay for Part C services.
§303.521(b) and (e) System of payments and fees.
§303.721(c) Annual report of children served—report requirement.
Subchapter B: Procedural Safeguards and Due Process
§108.201 Purpose.
§108.202 Procedural Safeguards.
§108.203 Responsibilities.
§108.204 Prior Written Notice.
§108.205 Prior Written Notice and Procedural Safeguards Notice.
§108.206 Written Parental Consent.
§108.207 Parental Consent.
§108.209 Parent Rights in the IFSP Process.
§108.211 Parent.
§108.213 Surrogate Parents.
§108.215 Early Childhood Intervention Procedures for Filing Complaints.
§108.217 Procedures for Investigation and Resolution of Complaints.
§108.218 Mediation.
§108.219 Confidentiality Notice to Parents.
§108.221 Access Rights.
§108.223 Fees for Records.
§108.225 Amendment of Records at Parent's Request.
§108.227 Opportunity for a Hearing.
§108.229 Minimum Requirements for Conducting a Hearing.
§108.231 Results of Hearing.
§108.233 Release of Personally Identifiable Information.
§108.235 Safeguards.
§108.237 Record Retention Period.
§108.239 Destruction of Information.
§108.241 Release of Records.
Code of Federal Regulations, Title 34, Part 99: FERPA.
Use of Electronic Signatures and Consents
4205 Consent by Foster Parent or Medical Consenter for Health
4205-S Permiso de los Padres Temporales u Otorgantes de Consentimiento Médico para el Pasaporte de Salud
United States Code, Title 20, Chapter 33: Individuals with Disabilities Education Act (IDEA)
§1435(a) (8) A comprehensive system of personnel development...
§1435(a) (9) Policies and procedures relating to the establishment and maintenance of qualifications...
§303.118 Comprehensive System of Personnel Development.
Subchapter C: Staff Qualifications.
§108.301 Purpose
§108.302 Legal Authority
§108.303 Definitions.
§108.305 Employment Records.
§108.307 Personnel Grievances.
§108.309 Minimum Requirements for All Directed Service Staff.
§108.310 Criminal Background Check.
§108.311 Licensed Professionals.
§108.312 Licensed Practitioner of the Healing Arts (LPHA)
§108.313 Early Intervention Specialist (EIS).
§108.315 Service Coordinator.
§108.317 Staff Who Do Not Hold a License or EIS Credential and Provide Early Childhood Intervention Services to Children and Families.
§108.319 EIS Code of Ethics.
General Provisions A.3
Certifications, A
Attachment No. 1, Section I Early Childhood Intervention Services - Scope of Work
§1436(d) (7) the identification of the service coordinator…
§303.344(g) Content of an IFSP.
§303.521(b) System of payments and fees.
Subchapter D: Case Management for Infants and Toddlers with Developmental Disabilities.
§108.403 Definitions.
§108.404 Recipient Eligibility for Early Childhood Intervention (ECI) Case Management Services.
§108.405 Case Management Services.
§108.406 Parent Refusal.
§108.407 Medicaid Service Limitations.
§108.409 Conditions for Case Management Provider Agency Participation.
§108.411 Assignment of Service Coordinator.
§108.415 Documentation.
§108.417 Due Process.
Texas Medicaid Provider Procedures Manual, Volume 1, Section 1: Provider Enrollment and Responsibilities
Texas Medicaid Provider Procedures Manual, Volume 1, Section 2: Texas Medicaid Fee-for-Service Reimbursement
Texas Medicaid Provider Procedures Manual, Volume 1, Section 3: TMHP Electronic Data Interchange (EDI)
Texas Medicaid Provider Procedures Manual, Volume 1, Section 4: Client Eligibility
Texas Medicaid Provider Procedures Manual, Volume 1, Section 6: Claims Filing
Texas Medicaid Provider Procedures Manual, Volume 1, Section 7: Appeals
Texas Medicaid Provider Procedures Manual, Volume 1, Appendix A: State, Federal and TMHP Contact Information
Texas Medicaid Provider Procedures Manual, Volume 2: Children's Services Handbook
Section 2: Medicaid Children's Comprehensive Care Program (CCP)
General Provisions A.3, A.9
Standards for Program and Financial Management, A.3, A.4
Reporting Requirements and Inspections
Attachment No. 2, Section I Respite Services – Scope of Work
Use the TKIDS Manual Table of Contents to locate the following sections:
Case Management and Targeted Case Management (CM/TCM)
§303.13(b) (14) Special Instruction includes.
Subchapter E: Specialized Skills Training.
§108.501 Specialized Skills Training (Developmental Services).
§108.503 Recipient Eligibility.
§108.505 Conditions for Provider Agency Participation.
§108.507 Due Process.
Standards for Program and Financial Management, A.3
Search these topics within the TKIDS Manual Table of Contents:
Appendix A – Planned Service
Appendix B – Edit, Logical Consistency and Validation Checks
Required Data Fields Tables
F. Public Outreach
United States Code, Title 20, Chapter 33, Individuals with Disabilities Education Act (IDEA)
§1435(a)(5) In general; A comprehensive child find system…
§1435(a)(6) In general; A public awareness program focusing on early identification of infants and toddlers with disabilities…
§1435(a)(7) In general; A central directory that includes information on early intervention services…
Subchapter F: Public Outreach.
§108.601 Purpose.
§108.603 Legal Authority.
§108.605 Definitions.
§108.607 Public Outreach.
§108.609 Child Find.
§108.611 Public Awareness.
§108.613 Publications.
§108.615 Interagency Coordination.
§108.617 Public Outreach Contact, Planning, and Evaluation.
General Provisions, A.8, A.9
Copyrights, Publications, and Patents, C
Use the TKIDS Manual Table of Contents to locate the following section:
G. Referral, Pre-Enrollment and Developmental Screening
§1435(a)(5) A comprehensive child find system.
§1435(a)(6) A public awareness program focusing on early identification of infants and toddlers with disabilities.
Subchapter G: Referral, Pre-Enrollment, and Developmental Screening.
§108.701 Purpose.
§108.702 Legal Authority.
§108.704 Referral Requirements.
§108.705 Child Referred before Birth.
§108.706 Child Referred with an Out-of-State IFSP.
§108.707 Pre-Enrollment Activities.
§108.709 Optional Developmental Screenings.
Attachment No. 1, Section II Measurable Outputs and Outcomes, C and E
Case Pre-Enrollment/Screening
H. Eligibility, Evaluation and Assessment
§1434 Eligibility.
§1435(a)(3) A timely, comprehensive, multidisciplinary evaluation…
Subchapter H: Eligibility.
§108.801 Purpose.
§108.803 Legal Authority.
§108.805 Definitions.
§108.807 Eligibility.
§108.809 Initial Eligibility Criteria.
§108.811 Eligibility Determination Based on Medically Diagnosed Condition That Has a High Probability of Resulting in Developmental Delay.
§108.813 Determination of Hearing and Auditory Status.
§108.815 Determination of Vision Status.
§108.817 Eligibility Determination Based on Developmental Delay.
§108.819 Age Adjustment for Children Born Prematurely.
§108.821 Qualitative Determination of Developmental Delay.
§108.823 Continuing Eligibility Criteria.
§108.825 Eligibility Statement.
§108.828 Medical Review for ECI Services.
§108.829 Review of Nutrition Status.
§108.831 Assistive Technology.
§108.833 Autism Screening.
§108.835 Contractor Oversight.
§108.837 Needs Assessment.
HHSC Monitoring
Payment and Advances, F
J. Individualized Family Service Plan (IFSP)
§1435(a)(8) Requirements for statewide system, A comprehensive system of personnel development…
§1435(a)(9) Requirements for statewide system, Policies and procedures relating to the establishment and maintenance of qualifications…
Subchapter J: Individualized Family Service Plan (IFSP).
§108.1001 Purpose.
§108.1002 Legal Authority.
§108.1003 Definitions.
§108.1004 IFSP.
§108.1007 Interim IFSP.
§108.1009 Participants in Initial and Annual Meetings to Evaluate the IFSP.
§108.1011 Participants in Meetings for a Child with Auditory or Visual Impairments.
§108.1015 Content of the IFSP.
§108.1016 Planning for Services to be Delivered with the Routine Caregiver.
§108.1017 Periodic Reviews.
§108.1019 Annual Meeting to Evaluate the IFSP.
Attachment No. 1, Section II Measurable Outputs and Outcomes, C, D, E, F and H
4205 Consent by Foster Parent or Medical Consenter for Health Passport
4207 Individualized Family Services Plan (IFSP) Services Page
4207-S Hojas de servicios del IFSP
Required Elements for the IFSP
Required Elements for Annual Review of the IFSP
K. Service Delivery
§1436(d)(8) Content of plan, the steps to be taken to support the transition…
§303.32 Scientifically based research.
Subchapter K: Service Delivery.
§108.1101 Purpose.
§108.1102 Legal Authority
§108.1104 Early Childhood Intervention Services Delivery.
§108.1105 Capacity to Provide Early Childhood Intervention Services.
§108.1106 Routine Caregiver.
§108.1107 Group Services.
§108.1108 State Funded Respite Services.
§108.1111 Service Delivery Documentation Requirements.
Texas Medicaid Provider Procedures Manual, Volume 1, General Information, Section 6: Claims Filing and Volume 2, Behavioral Health and Case Management Services Handbook, Section 4: Outpatient Mental Health Services, Section 9: Claims Resources
Texas Medicaid Provider Procedures Manual, Volume 2: Medicaid Managed Care Handbook
Section 4: STAR Kids Program
Section 5: STAR+PLUS Program
Section 6: NorthSTAR Program
Section 7: STAR Health Program
Section 11: Other State Health-Care Programs
Payments and Advances, F
L. Transition
§1436(d)(8) Content of plan, the steps to be taken to support the transition of the toddler with a disability to preschool or other appropriate services.
§303.344(h) Content of an IFSP.
Subchapter L: Transition.
§108.1201 Purpose.
§108.1202 Legal Authority.
§108.1203 Definitions.
§108.1205 Transition Education and Information for the Family.
§108.1207 Transition Planning.
§108.1209 SEA Notification.
§108.1211 LEA Notification of Potentially Eligible for Special Education Services.
§108.1213 LEA Notification Opt Out.
§108.1215 Reporting Late LEA Notifications.
§108.1217 LEA Transition Conference.
§108.1219 Transition to LEA Services.
§108.1221 Transition Into the Community.
M. Child and Family Outcomes
§1435(a) (14) Requirements for statewide system.
Subchapter M: Child and Family Outcomes.
§108.1301 Purpose.
§108.1303 Legal Authority.
§108.1307 Child Outcomes.
§108.1309 Family Outcomes.
N. Family Cost Share System
§303.521 System of payments and fees.
Subchapter N: Family Cost Share System.
§108.1401 Purpose.
§108.1403 Legal Authority.
§108.1405 Definitions.
§108.1407 Family Cost Share System Administration.
§108.1409 Parent Rights Related to the Family Cost Share System.
§108.1411 Early Childhood Intervention Services Provided with No Out-of-Pocket Payment from the Parent.
§108.1413 IFSP Services Subject to Out of Pocket Payment from the Family.
§108.1417 Family Cost Share Agreement.
§108.1419 Private Insurance.
§108.1421 Insurance Premiums.
§108.1423 Co-pays, Co-Insurance, and Deductibles.
§108.1425 Public Benefits and Insurance.
§108.1427 Maximum Charge.
§109.1429 Family Size and Adjusted Income.
§108.1431 DARS ECI Sliding Fee Scale.
§108.1432 DARS ECI Sliding Fee Scale for Families Enrolled Before September 1, 2015
§108.1433 Billing Families for IFSP Services.
§108.1435 Suspension of Services for Nonpayment.
§108.1437 Extraordinary Circumstances.
§108.1439 Program Fiscal and Recordkeeping Policies.
Texas Human Resources Code §117.078 Family Cost Share Provision In Early Childhood Intervention Program.
General Provisions, A.6, A.7, A.10, A.11, A.12
Program Income and Other Third Party Revenue
Reporting Requirements and Inspections, B, C
Attachment No. 2, Section V Budget
Required Elements for the FCS Agreement
Required Elements for FCS Reconsideration
P. Contract Requirements
Texas Administrative Code, Title 1, Part 15, Chapter 392, Purchase of Goods and Services for Specific Health and Human Services Commission Programs.
Subchapter A: Purpose and Applicability.
Subchapter B: Early Childhood Intervention (ECI) Services
Subchapter D: DARS Contract Management Requirements
Texas Human Resources Code §117.077(c) Data Analysis In Family Cost Share Provisions In Early Childhood Intervention Program.
See Your Current Contract Copy, Including Attachments, for Contractor Information and Contractor Requirements
4202 Contractor Notice of Appeal Rights