New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter II - Administrative Rules and Regulations › Subchapter H - Family Health › Part 69 - Family Health › Subpart 69-4 - Early Intervention Program › Section 69-4.5 - Approval of service coordinators, evaluators, and service providers

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Individuals and
					 agencies shall apply to the Department for approval to provide evaluations,
					 service coordination services, or early intervention services. The Department
					 may reapprove providers, but no more frequently than every five years from the
					 date of approval or subsequent reapproval. Upon receipt of notification from
					 the Department, an agency or individual shall apply for reapproval if the
					 agency or individual wishes to continue providing services in the early
					 intervention program. The Department shall consider applications for approval
					 and reapproval utilizing the criteria set forth in subdivision (4) of this
					 section.
(1) Payee providers shall be
					 enrolled and, as applicable, recertified as providers in the medical assistance
					 program in accordance with the procedures for such enrollment and
					 recertification established by the department, and shall provide documentation
					 of the provider's enrolled and, if applicable, recertification status upon the
					 department's request.
(2) Approved
					 agency providers shall submit on a periodic basis consolidated fiscal reports
					 to the department upon request. Approved individual providers shall submit
					 information on revenues and expenses upon request of and on a form developed by
					 the department.
(3) All approved
					 providers shall be in compliance with the criteria set forth in paragraph (4)
					 of this subdivision.
(4) Approval
					 and reapproval of individuals and agencies shall be based on the following
					 criteria:
(i) character and competence of the
					 individual, or for agency providers, the owners, officers, including the chief
					 executive officer and chief financial officer, members, shareholders who own 10
					 percent or more of the voting shares in the agency, directors or sponsors, the
					 program director and other key employees, and the board of directors of a
					 not-for-profit entity as determined by the department;
(ii) documented fiscal viability of the
					 agency;
(iii) for individual
					 providers, proof of current certificate, license, or registration in one of the
					 disciplines set forth in subdivision (al) of section
					 69-4.1  and documentation of a
					 minimum of 1,000 clock hours prior to the date of application to the Department
					 for approval, delivering such service to children under five years of age in an
					 early intervention, clinical pediatric, early childhood education program,
					 which may include relevant experience obtained as part of a supervised
					 educational program and/or clinical internship as a prerequisite for
					 professional licensure, certification, or registration, and provided that such
					 experience must have included direct experience in delivering services to
					 children with disabilities and their families:
(iv) for agency providers, identification of
					 all employees who will provide Early Intervention Program services, and where
					 applicable, the employees' licenses, registrations, certifications, national
					 provider identification numbers and expiration dates and such other information
					 as may be required by the department;
(v) for agency providers, identification of
					 all State-approved agency and individual contractors who will be utilized to
					 provide services and where applicable, the persons' licenses, registrations,
					 certifications, national provider identification numbers and expiration dates
					 and other information as may be required by the department;
(vi) for agency providers, a comprehensive
					 quality assurance plan that is approved by the Department for all service s
					 offered by the agency, including evaluations, early intervention services, and
					 service coordination. The quality assurance plan shall include, but not be
					 limited to, ensuring qualified personnel have appropriate and current
					 licensure, registration, and certification as applicable; ensuring continuing
					 education and training requirements are met; and addressing how the agency will
					 ensure that all documentation requirements to support billing and claiming for
					 early intervention services are met. The agency program director shall be
					 responsible for developing a quality assurance plan that is approved by the
					 Department, for implementing such plan, and for monitoring that quality
					 assurance requirements are met.
(vii) for agency providers, documentation
					 that the agency has in its employment, or in accordance with this sub
					 paragraph, will have in its employment, the following personnel:
(a) a professional employed on a full time
					 basis who shall serve as the program director for the agency whose duties may
					 include early intervention program service delivery and shall include
					 administration and oversight responsibilities, including submission and
					 oversight of the quality assurance plan pursuant to subparagraph (vi) of this
					 paragraph. The program director shall have a minimum of two years of full-time
					 equivalent experience in an early intervention, clinical pediatric, or early
					 childhood education program serving children ages birth to five years of age,
					 provided that:
(1) such experience shall have
					 included direct experience in delivering services to children with disabilities
					 and their families; and
(2) at
					 least one year of such experience shall have been in the delivery of services
					 to children less than three years of age and their
					 families.
(b) a minimum
					 of two qualified personnel or service coordinators who meet qualifications
					 established in section
					 69-4.4  of this s ubpart, in
					 addition to the Early Intervention Program director, each of whom provides
					 evaluations, service coordination, or services to individuals with disabilities
					 for a minimum of twenty hours each per week.
(c) an agency applying for reapproval shall,
					 at the time of application, submit documentation that it has in its employment
					 the personnel required in this sub paragraph;
(viii) adherence to, and for purposes of
					 reapproval, evidence of demonstrated compliance with all applicable Federal and
					 State laws, regulations, standards and guidelines;
(ix) delivery of services on a twelve-month
					 basis and flexibility in the hours of service delivery, including weekend and
					 evening hours in accordance with eligible children's IFSPs;
(x) agreement to participate and, for
					 purposes of reapproval, evidence of participation in continuing professional
					 and clinical education relevant to early intervention services, including
					 services and clinical issues unique to children less than three years of age,
					 and in-service training on state and local policies and procedures of the Early
					 Intervention Program, including department-sponsored training;
(xi) adherence to, and for purposes of
					 reapproval, demonstrated compliance with the confidentiality requirements
					 applicable to the Early Intervention Program as set forth in Federal and State
					 law and regulations;
(xii)
					 provision of copies of all organizational documents requested by the department
					 and documentation of licensure or approval granted to the individual or agency
					 by other regulatory agencies;
(xiii) for the purposes of reapproval,
					 documentation that corrective actions required by the department have been
					 implemented and non-compliance corrected to the satisfaction of the
					 department;
(xiv) provision of such
					 additional pertinent information or documents necessary for approval or
					 reapproval, as requested by the department.
(5) In addition to the criteria set forth
					 above, for reapproval of an agency or individual, the department may also
					 consider:
(i) any actions taken against the
					 provider's license, certification, or registration, any criminal convictions,
					 or any actions taken pursuant to section
					 69-4.24  of this Subpart;
(ii) the results of any investigations
					 performed by the department pursuant to section
					 69-4.17(i)  of
					 this Subpart;
(iii) the results of
					 monitoring reviews, complaint investigations and fiscal audits performed by the
					 department, municipalities or either of their agents; and
(iv) other information and documents
					 pertinent to the provider's character and
					 competence.