Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 225 - REQUIREMENTS FOR VIRGINIA EARLY INTERVENTION SYSTEM › Part I - Authority and Definitions › Section 12VAC35-225-20 - Definitions

Current through Register Vol. 40, No. 24, July 15, 2024
The following words and terms when used in this chapter
					 shall have the following meanings unless the context clearly indicates
					 otherwise:
"Ability to pay" means the amount a family is able to
					 contribute toward the cost of early intervention services, based on family
					 size, income, and expenses.
"Adjusted age" means an adjustment that is made for
					 premature birth (gestation less than 37 weeks) used to determine developmental
					 status until the child is 18 months of age.
"Administrative complaint" means a written, signed
					 complaint by an individual or organization alleging that the department, local
					 lead agency, or early intervention service provider violated a requirement of
					 Part C or this chapter.
"Assessment" means the ongoing procedures used by
					 qualified early intervention service providers to identify (i) the child's
					 unique strengths and needs and the concerns of the family; (ii) the early
					 intervention services appropriate to meet those needs throughout the period of
					 the child's eligibility under Part C; and (iii) the resources, priorities, and
					 supports and services necessary to enhance the family's capacity to meet the
					 developmental needs of the child.
"Assistive technology device" means any item, piece of
					 equipment, or product system, whether acquired commercially off the shelf,
					 modified, fabricated, or customized, that is used to increase, maintain, or
					 improve functional capabilities of a child. The term does not include a medical
					 device that is surgically implanted, such as a cochlear implant, or the
					 optimization (e.g., mapping), maintenance, or replacement of that
					 device.
"Assistive technology service" means any service that
					 directly assists in the selection, acquisition, or use of an assistive
					 technology device. Assistive technology services include (i) evaluating the
					 needs of the child, including a functional evaluation in the child's customary
					 environment; (ii) purchasing, leasing, or otherwise providing for the
					 acquisition of assistive technology devices; (iii) selecting, designing,
					 fitting, customizing, adapting, applying, maintaining, repairing, or replacing
					 assistive technology devices; (iv) coordinating and using other therapies,
					 interventions, or services with assistive technology devices, such as those
					 associated with existing education and rehabilitation plans and programs; (v)
					 providing training or technical assistance to a child, or, if appropriate, that
					 child's family; and (vi) providing training or technical assistance to
					 professionals, including individuals providing education or rehabilitation
					 services, or other individuals who provide services to or are otherwise
					 substantially involved in the major life functions of the child.
"Atypical development" means one or more of the following
					 conditions or responses:
(i) atypical
				  or questionable sensory-motor responses; (ii) atypical or questionable
				  social-emotional development; (iii) atypical or questionable behaviors that
				  interfere with the acquisition of developmental skills; or (iv) impaired social
				  interaction and communication skills with restricted and repetitive behaviors.
"Audiology" means services that include (i) identifying
					 children with auditory impairments, using at-risk criteria and appropriate
					 audiologic screening techniques; (ii) determining the range, nature, and degree
					 of hearing loss and communication functions by use of audiological evaluation
					 procedures; (iii) referring children with auditory impairment for medical or
					 other services necessary for habilitation or rehabilitation; (iv) providing
					 auditory training, aural rehabilitation, speech reading and listening devices,
					 orientation and training, and other services; (v) providing services for
					 prevention of hearing loss; and (vi) determining the child's individual
					 amplification, including selecting, fitting, and dispensing appropriate
					 listening and vibrotactile devices, and evaluating the effectiveness of those
					 devices.
"Child find" means a comprehensive and coordinated system
					 to locate, identify, refer, and evaluate all children with disabilities in
					 Virginia who may be eligible for early intervention services under Part
					 C.
"Child with a disability" or "infant or toddler with a
					 disability" means an individual who is under three years of age and who needs
					 early intervention services because he is experiencing a developmental delay in
					 one or more areas of development or atypical development or has a diagnosed
					 physical or mental condition that has a high probability of resulting in
					 developmental delay.
"Commissioner" means the Commissioner of the Department of
					 Behavioral Health and Developmental Services.
"Counseling services" means the assessment and treatment
					 of mental, emotional, or behavioral disorders and associated distresses that
					 interfere with mental health, including (i) individual or family group
					 counseling with the parent or parents and other family members; (ii)
					 collaborating with the family, service coordinator, and other early
					 intervention service providers identified on an infant's or toddler's
					 individualized family service plan (IFSP); and (iii) family training,
					 education, and support provided to assist the family of an infant or a toddler
					 with a disability in understanding his needs related to development, behavior,
					 or social-emotional functioning and to enhance his development.
"Day" means calendar day, unless clearly specified
					 otherwise.
"Department" means the Department of Behavioral Health and
					 Developmental Services.
"Developmental delay" means a level of functioning that
					 (i) is at least 25% below the child's chronological or adjusted age in
					 cognitive, physical, communication, social or emotional, or adaptive
					 development or (ii) demonstrates atypical development or behavior even in the
					 absence of a 25% delay. Developmental delay is measured using the evaluation
					 and assessment procedures described in 12VAC35-225-90.
"Developmental services" means services provided to a
					 child with a disability that include (i) designing learning environments and
					 activities that promote the child's acquisition of skills in a variety of
					 developmental areas, including cognitive processes and social interaction; (ii)
					 curriculum planning, including the planned interaction of personnel, materials,
					 time, and space, that leads to achieving the outcomes in the child's IFSP;
					 (iii) providing families with information, skills, and support related to
					 enhancing the skill development of the child; and (iv) working with the child
					 to enhance his development.
"Discipline" or "profession" means a specific occupational
					 category that may provide early intervention supports and services to eligible
					 children under Part C and their families.
"Due process complaint" means a complaint filed by a
					 parent requesting a due process hearing to resolve a disagreement with an early
					 intervention service provider's proposal or refusal to initiate or change
					 identification, eligibility determination, or placement of the child or the
					 provision of early intervention services to the child or family.
"Duration" means the projection of when a given early
					 intervention service will no longer be provided, such as when the child is
					 expected to achieve the results or outcomes in his IFSP.
"Early intervention practitioner" means a person who is
					 qualified to apply for or who holds certification as an early intervention
					 professional, specialist, or case manager. An early intervention practitioner
					 may be employed as an early intervention service provider under Part C.
"Early intervention records" means all records regarding a
					 child that are required to be collected, maintained, or used under Part
					 C.
"Early intervention service provider" means a provider
					 agency, whether public, private, or nonprofit, or an early intervention
					 practitioner that provides early intervention services under Part C, whether or
					 not the agency or individual receives federal Part C funds.
"Early intervention services" means services provided
					 through Part C designed to meet the developmental needs of children and
					 families and to enhance the development of children from birth to age three
					 years who have (i) a 25% developmental delay in one or more areas of
					 development, (ii) atypical development, or (iii) a diagnosed physical or mental
					 condition that has a high probability of resulting in a developmental delay.
					 Early intervention services provided in the child's home and in accordance with
					 this chapter shall not be construed to be home health services as referenced in
					 § 32.1-162.7 of the Code of Virginia.
"Eligibility determination" means the evaluation
					 procedures used by qualified early intervention service providers to determine
					 a child's initial and continuing eligibility under Part C.
"Family fee" means the amount based on the accrued charges
					 and copayments that may be charged to families for services that an infant or a
					 toddler with a disability and his family receive each month. The family fee may
					 not exceed the monthly cap.
"Frequency" means the number of days or sessions a service
					 will be provided.
"Health services" means services necessary to enable a
					 child receiving services under Part C to benefit from other early intervention
					 supports and services he receives and includes (i) providing clean intermittent
					 catheterization, tracheostomy care, tube feeding, the changing of dressings or
					 colostomy collection bags, and other health services and (ii) arranging
					 consultation by physicians with other service providers concerning the special
					 health care needs of the child that will need to be addressed in the course of
					 providing other early intervention services. The term does not include services
					 that are surgical in nature (e.g., cleft palate surgery, surgery for club foot,
					 or the shunting of hydrocephalus); purely medical in nature (e.g.,
					 hospitalization for management of congenital heart ailments or the prescribing
					 of medicine or drugs for any purpose); or related to the implementation,
					 optimization (e.g., mapping), maintenance, or replacement of a medical device
					 that is surgically implanted, including a cochlear implant; devices (e.g.,
					 heart monitors, respirators and oxygen, and gastrointestinal feeding tubes and
					 pumps) necessary to control or treat a medical condition; or medical health
					 services (e.g., immunizations and regular "well-baby" care) that are routinely
					 recommended for all children.
"Homeless children" means children who meet the definition
					 given the term "homeless children and youths" in § 752 (
					 42 USC §
											11434 a) of the McKinney-Vento Homeless
					 Assistance Act, as amended, 42 USC §
											11434 a et
					 seq.
"Inability to pay" means the amount a family is able to
					 contribute toward the cost of early intervention services is zero, resulting in
					 the family's receiving all early intervention services at no cost to the
					 family.
"Indian" means an individual who is a member of an Indian
					 tribe.
"Indian tribe" means any federal or state Indian tribe,
					 band, rancheria, pueblo, colony, or community, including any Alaska native
					 village or regional village corporation.
"Individualized family service plan" or "IFSP" means a
					 written plan for providing early intervention supports and services to a child
					 with a disability or his family that (i) is based on the evaluation for
					 eligibility determination and assessment for service planning; (ii) includes
					 information based on the child's evaluation and assessments, family
					 information, results or outcomes, and supports and services based on
					 peer-reviewed research (to the extent practicable) that are necessary to meet
					 the unique needs of the child and the family and to achieve the results or
					 outcomes; and (iii) is implemented as soon as possible once parental consent is
					 obtained.
"Informed clinical opinion" means the use of professional
					 expertise and experience in combination with information gathered through
					 eligibility determination or assessment for service planning, or both, to
					 determine the child's developmental status and eligibility under Part C.
"Initial early intervention service coordination plan"
					 means a written plan that specifies the activities that will be completed by
					 the service coordinator prior to completion of the individualized family
					 service plan.
"Intensity" means whether a service will be provided on an
					 individual or group basis.
"Length of service" means the amount of time the service
					 will be provided during each session (e.g., an hour or other specified
					 timeframe).
"Local lead agency" means an entity that, under contract
					 with the department, administers a local early intervention system.
"Location of service" means the actual place or places
					 where the early intervention service will be provided.
"Medical services" means services provided by a licensed
					 physician for diagnostic or eligibility determination purposes to determine a
					 child's developmental status and need for early intervention supports and
					 services.
"Monthly cap" means the maximum amount that a family will
					 be required to pay per month for early intervention services regardless of the
					 charge or charges or number of different types, frequency, or length of
					 services a child and family receive.
"Multidisciplinary" means the involvement of two or more
					 separate disciplines or professions.
"Native language" means the language or mode of
					 communication, such as sign language, Braille, or oral communication for
					 persons with no written language, that is normally used by the child or his
					 parents.
"Natural environments" means settings that are natural or
					 typical for a same-aged child without a disability and may include the home or
					 community settings.
"Nursing services" means services that include (i)
					 conducting assessments of health status for the purpose of providing nursing
					 care, including the identification of patterns of human response to actual or
					 potential health problems; (ii) providing nursing care to prevent health
					 problems, restore or improve functioning, and promote optimal health and
					 development; and (iii) administering medications, treatment, and regimens
					 prescribed by a licensed physician.
"Nutrition services" means services that include (i)
					 individual assessments in nutritional history and dietary intake;
					 anthropometric, biochemical, and clinical variables; feeding skills and feeding
					 problems; and food habits and food preferences; (ii) developing and monitoring
					 appropriate plans to address the nutritional needs of children eligible for
					 early intervention supports and services based on the findings of individual
					 assessments; and (iii) making referrals to appropriate community resources to
					 carry out nutritional goals.
"Occupational therapy" means services that are designed to
					 improve the child's functional ability to perform tasks in home, school, and
					 community settings, and include (i) identifying and assessing the child's
					 functional needs and providing interventions related to adaptive development;
					 adaptive behavior; play; and sensory, motor, and postural development; (ii)
					 adapting the environment and selecting, designing, and fabricating assistive
					 and orthotic devices to facilitate development and promote the acquisition of
					 functional skills; and (iii) preventing or minimizing the impact of initial or
					 future impairment, delay in development, or loss of functional ability.
"Parent" means
(i) a biological or adoptive parent of a
				  child; (ii) a foster parent, unless state law, regulations, or contractual
				  obligations with a state or local entity prohibit a foster parent from acting
				  as a parent; (iii) a guardian generally authorized to act as the child's parent
				  or authorized to make early intervention, educational, health, or developmental
				  decisions for the child (but not the state if the child is a ward of the
				  state); (iv) an individual acting in the place of a biological or adoptive
				  parent, including a grandparent, stepparent, or other relative, with whom the
				  child lives or an individual who is legally responsible for the child's
				  welfare; or (v) a surrogate parent, when determined necessary in accordance
				  with and assigned pursuant to this chapter. The term "parent" does not include
				  any local or state agency or its agents if the child is in the custody of said
				  agency.
"Part B" means Part B of the Individuals with Disabilities
					 Education Act, 20 USC §
												1411 et seq.
"Part C" means Part C of the Individuals with Disabilities
					 Education Act, 20 USC §
												1431 et seq.
"Participating agencies" means the Departments of Health,
					 Education, Medical Assistance Services, Behavioral Health and Developmental
					 Services, and Social Services; the Departments for the Deaf and Hard-of-Hearing
					 and Blind and Vision Impaired; and the Bureau of Insurance within the State
					 Corporation Commission.
"Payor of last resort" means a funding source that may be
					 used only after all other available public and private funding sources have
					 been accessed.
"Personally identifiable information" means the name of
					 the child, the child's parent, or other family members; the address of the
					 child or the child's family; a personal identifier, such as the child's or
					 parent's social security number; or a list of personal characteristics or other
					 information that, alone or in combination, could be used to identify the child
					 or the child's parents or other family members.
"Physical therapy" means services that promote the child's
					 sensory or motor function and enhance his musculoskeletal status,
					 neurobehavioral organization, perceptual and motor development, cardiopulmonary
					 status, and effective environmental adaptation. These services include (i)
					 screening, evaluation for eligibility determination, and assessment of children
					 to identify movement dysfunction; (ii) obtaining, interpreting, and integrating
					 information appropriate to program planning to prevent, alleviate, or
					 compensate for movement dysfunction and related functional problems; (iii)
					 adapting the environment and selecting, designing, and fabricating assistive
					 and orthotic devices to facilitate development and promote the acquisition of
					 functional skills; and (iv) providing individual or group services or treatment
					 to prevent, alleviate, or compensate for movement dysfunction and related
					 functional problems.
"Primary referral sources" means those agencies,
					 providers, entities, and persons who refer children and their families to the
					 early intervention system and include (i) hospitals, including prenatal and
					 postnatal care facilities; (ii) physicians; (iii) parents; (iv) child care
					 programs and early learning programs; (v) local school divisions; (vi) public
					 health facilities; (vii) other public health or social service agencies; (viii)
					 other clinics and health care providers; (ix) public agencies and staff in the
					 child welfare system, including child protective services and foster care; (x)
					 homeless family shelters; and (xi) domestic violence shelters and
					 agencies.
"Psychological services" means services that include (i)
					 administering psychological and developmental tests and other assessment
					 procedures; (ii) interpreting assessment results; (iii) obtaining, integrating,
					 and interpreting information about child behavior and child and family
					 conditions related to learning, mental health, and development; and (iv)
					 planning and managing a program of psychological services, including
					 psychological counseling for children and parents, family counseling,
					 consultation on child development, parent training, and education
					 programs.
"Service coordinator" means a person who holds a
					 certification as an early intervention case manager and is responsible for
					 assisting and enabling children with disabilities and their families to receive
					 the services and rights, including procedural safeguards, that are authorized
					 to be provided under Virginia's early intervention program.
"Sign language and cued language services" means
(i) teaching sign language, cued language,
				  and auditory or oral language;
(ii) providing oral transliteration services,
				  such as amplification; and
(iii)
				  providing sign and cued language interpretation.
"Single point of entry" means the single entity designated
					 by the local lead agency in each local early intervention system where families
					 and primary referral sources make initial contact with the local early
					 intervention system.
"Social work services" means services that include (i)
					 making home visits to evaluate a child's living conditions and patterns of
					 parent-child interaction; (ii) preparing a social or emotional developmental
					 assessment of the child within the family context; (iii) providing individual
					 and family-group counseling with parents and other family members, including
					 appropriate social skill-building activities with the child and parents;
(iv) working with
				  identified problems in the living situation (home, community, and any center
				  where early intervention supports and services are provided) that affect the
				  child's use of early intervention supports and services; and
(v) identifying, mobilizing, and coordinating
				  community resources and services to enable the child with a disability and his
				  family to receive maximum benefit from early intervention services.
"Speech-language pathology services" means services that
					 include (i) identifying children with communication or language disorders and
					 delays in development of communication skills and identifying and appraising
					 specific disorders and delays in those skills; (ii) referring children with
					 communication or language disorders and delays in development of communication
					 skills for medical or other professional services necessary for the
					 habilitation or rehabilitation; and (iii) providing services for the
					 habilitation, rehabilitation, or prevention of communication or language
					 disorders and delays in development of communication skills.
"State lead agency" means DBHDS, which is the agency
					 designated by the Governor to receive funds to administer the state's
					 responsibilities under Part C.
"Surrogate parent" means a person assigned by the local
					 lead agency or its designee to ensure that the rights of a child are protected
					 when no parent can be identified; the lead agency or other public agency, after
					 reasonable efforts, cannot locate a parent; or the child is a ward of the
					 state.
"Transportation and related costs" means the cost of
					 travel and other costs that are necessary to enable a child with a disability
					 and his family to receive early intervention supports and services.