016.05.22 Ark. Code R. § 003 - Rules for the Division of Developmental Disabilities Services First Connections Program
Under Part C of the Individual with Disabilities Education Act
LAST UPDATED: July 1, 2022
Subchapter 1.
General.
101.
Authority.
(a) These standards are promulgated under the
authority of Ark. Code Ann. §
20-14-503.
(b) The Division of Developmental
Disabilities Services (DDS) is the designated lead agency for the State of
Arkansas, responsible for performing all certification, general supervision,
monitoring, and other regulatory functions involved in the implementation and
administration of Part C of the IDEA.
102.
Purpose.
The purpose of these standards is to:
(1) Serve as the minimum standards for
Service Providers; and
(2) Ensure
that all aspects of the First Connections program are carried out in compliance
with the requirements of Part C of the IDEA.
103.
Definitions.
(a)
(1)
"Assistive Technology and Adaptive Equipment" means an item or product used to
increase, maintain, or improve the functional capabilities of the
child.
(2) "Assistive Technology
and Adaptive Equipment" does not mean a device that must be surgically
implanted, or any therapy equipment typically found in clinics.
(b) "Business Day" means Monday
through Friday, except for any day that is recognized as a holiday by the State
of Arkansas.
(c) "Calendar Day"
means the period from midnight to the following midnight, Monday through Sunday
including without limitation holidays and days schools are closed.
(d) "CDS" means the comprehensive database
system used by First Connections into which Service Providers enter the
information and upload the documentation required by these standards.
(e) "Change in Ownership" means one (1) or
more transactions within a twelve-month period that, in the aggregate, result
in a change in greater than fifty percent (50%) of the ownership, financial, or
voting interests of a Service Provider.
(f) "CMDE" means the comprehensive
multi-disciplinary developmental evaluation of a child that is used to
determine the child's First Connections eligibility and identify the child's
and family's strengths, priorities, resources, and concerns.
(g) "DDS" means the Arkansas Department of
Human Services, Division of Developmental Disabilities Services.
(h) "Evaluation Report" means a written
report about a child's evaluation results that is used to guide the IFSP team
in developing a child's IFSP.
(i)
"Early Intervention Services" means any of the following developmental
services:
(1) Service Coordination
Services;
(2) Assistive Technology
and Adaptive Equipment and Services;
(3) Audiology Services;
(4) Family Training, Counseling, and Home
Visit Services;
(5) Health
Services;
(6) Medical
Services;
(7) Nursing
Services;
(8) Nutrition
Services;
(9) Occupational Therapy
Evaluations and Services;
(10)
Physical Therapy Evaluations and Services;
(11) Psychological Services;
(12) Sign Language and Cued Language
Services;
(13) Social Work
Services;
(14) Specialized
Evaluation Services;
(15)
Speech-Language Pathology Evaluations and Services;
(16) Transportation Services;
(17) Developmental Therapy
Services;
(18) Vision
Services;
(19) Parent Education
Services; and
(20) Any other
developmental, corrective, or supportive services that meet the needs of a
child as determined by the IFSP team and incorporated into the IFSP.
(j) "Employee" means an Employee
or other agent of a Service Provider who has direct contact with a child
participating in First Connections including without limitation any Employee,
contractor, sub-contractor, intern, volunteer, trainee, or agent.
(k) "Family Assessment" means the
family-directed assessment performed by a Service Coordinator using an
assessment tool and conducting a personal interview that identifies the family
resources, priorities, and concerns; the child's Natural Environment; and the
typical child and family community activities that will assist the IFSP team in
developing the IFSP.
(l) "Family
Delay" means the child or Parent is unavailable for any reason.
(m) "First Connections" means the DDS program
that administers, monitors, and carries out all activities and responsibilities
for the State of Arkansas under Part C of IDEA to ensure appropriate Early
Intervention Services are available to all infants and toddlers from birth to
thirty-six (36) months of age (and their families) that are suspected of having
a developmental delay.
(n) "First
Connections Central Intake Unit" means the unit that serves as the single
referral point of entry for First Connections.
(o) "IDEA" means the Individuals with
Disabilities Education Act.
(p)
"IFSP" means an individual family service plan which is a written and
individualized plan that includes Early Intervention Services and other
services necessary to meet the identified unique needs of the child and their
family and to enhance the child's development.
(q) "LEA" or "Local Education Agency" means
the school district, education cooperative, or other State of Arkansas
accredited education agency for the area where a child resides.
(r)
(1)
"Market or Marketing" means the accurate and honest advertisement of a Service
Provider that does not also constitute solicitation.
(2) "Marketing" includes without limitation:
(i) Advertising using traditional
media;
(ii) Distributing brochures
or other informational materials regarding the services offered by the Service
Provider;
(iii) Conducting tours of
the Service Provider's place of practice to interested children and
Parents;
(iv) Mentioning services
offered by the Service Provider in which the child or Parent might have an
interest; and
(v) Hosting
informational gatherings during which the services offered by the Service
Provider are described.
(s) "Native Language" means the language and
primary mode of communication used by an individual.
(t)
(1)
"Natural Environment" means activities in which a same-aged child without a
disability would participate in at appropriate home and community-based
locations, such as the family home, parks, libraries, churches, and grocery
stores.
(2) "Natural Environment"
does not mean:
(i) A clinic, hospital, Service
Provider's office, early intervention day treatment center, or other facility
in which the majority of individuals are not typically developing; or
(ii) Removing a child from an integrated
setting or room to provide Early Intervention Services in an isolated setting
or room.
(u)
"Parent" means one (1) of the following individuals who is responsible for
protecting and representing the child's rights and interests during their
participation in First Connections:
(1) A
natural, adoptive, or foster parent;
(2) A legal guardian;
(3) A relative or other family member with
whom the child lives acting in the place of a Parent;
(4) An individual legally responsible for the
child's welfare; or
(5) A Surrogate
Parent.
(v) "Parental
Consent" means the Parent demonstrating formal, written approval of a proposed
activity.
(w) "Part C Funds" means
the federal grant funds available to First Connections which may be used to
administer, monitor, and carry out all activities and responsibilities under
Part C of IDEA, including without limitation payments to Service Providers for
the delivery of those Early Intervention Services included on a child's
IFSP.
(x) "Personally Identifiable
Information" means any information, written or otherwise, that would make a
child or family member's identity easily traceable including without
limitation:
(1) The name of a child, Parent,
or other family member;
(2) The
address of a child, Parent, or other family member;
(3) A personal identifier number such as a
Social Security or Medicaid identification number;
(4) Photographic images of a child, Parent,
or family member; and
(5) A list of
personal characteristics or other information that would make it possible to
identify the child with reasonable certainty.
(y) "Service Coordinator" means a First
Connections staff member or a Service Provider certified to perform service
coordination services.
(z) "Service
Provider" means an individual or organization that has been certified by First
Connections to provide one (1) or more Early Intervention Services to children
participating in First Connections.
(aa)
(1)
"Solicit or Solicitation" means the initiation of contact with a child or their
family by a Service Provider, when the child is currently receiving services
from another Service Provider, with the purpose of persuading the child or
Parent to switch to or otherwise use the services of the Service Provider that
initiated the contact.
(2)
"Soliciting or Solicitation" includes without limitation inducing a child or
their family by:
(i) Contacting the family of
a child who is currently receiving services from another Service
Provider;
(ii) Offering cash or
gift incentives to a child or their family;
(iii) Offering free goods or services not
available to other similarly situated children or their families;
(iv) Making negative comments to a child or
their family regarding the quality of services performed by another Service
Provider;
(v) Promising to provide
services in excess of those necessary;
(vi) Giving a child or their family the false
impression, directly or indirectly, that the Service Provider is the only
Service Provider that can perform the services desired by the child or their
family; or
(vii) Engaging in any
activity that DDS reasonably determines to be "Solicitation."
(bb) "Surrogate Parent"
means an individual appointed by a judge or First Connections to serve as a
child's Parent for purposes of protecting and representing the child's rights
and interests during the child's participation in First Connections when there
is no other qualifying individual able or willing to serve in that
role.
(cc) "Written Notice" means
delivery of written notice to the Parent or a Service Provider in their Native
Language and in language that is understandable to the general public, of an
action, proposed action, or refusal to act, which must include without
limitation:
(1) The action taken, not taken,
or proposed to be taken or not taken;
(2) The reason for taking or not taking the
action;
(3) All applicable due
process and appeal rights, or instructions on where to find all applicable due
process and appeal rights; and
(4)
Any applicable procedures and timelines for exercising due process or appeal
rights, or where to find any applicable procedures and timelines for exercising
due process or appeal rights.
Subchapter 2.
Certification.
201.
Certification
Required.
(a) An
individual or organization must be certified by DDS to provide any Early
Intervention Service.
(b) A
separate DDS certification is required for each type of Early Intervention
Service.
(c) A Service Provider
must comply with all applicable requirements of these standards to maintain
certification for a particular Early Intervention Service.
(d) An individual or organization that is on
the Medicaid excluded provider list is prohibited from being a Service
Provider.
202.
Application for Certification.
(a)
(1) To
apply for Early Intervention Service certification, an Service Provider must
submit a complete application to First Connections.
(2) A complete application includes without
limitation:
(i.) Documentation demonstrating
the Service Provider's entire ownership, including without limitation all
information on the applicant's governing body as well as financial and business
interests.
(ii.) Documentation of
the Service Provider's management, including without limitation the management
structure and members of the management team;
(iii.) Documentation of the Service
Provider's contractors and the contractors that the Service Provider intends to
use as part of providing First Connections Early Intervention
Services;
(iv.) All documentation
demonstrating compliance with the standards for the Early Intervention Services
for which certification is sought; and
(v.) All other documentation or other
information requested by DDS.
(b) A request for a Change in Ownership is
initiated by a potential new owner submitting a complete application described
in Section 202(a)(2), which must include a detailed description of how the
existing Service Provider's business and children will be transferred to the
new owner if the Change of Ownership application is approved.
Subchapter 3.
Administration.
301.
Organization and
Ownership.
(a) A Service
Provider must be authorized and in good standing to do business under the laws
of the State of Arkansas.
(b)
(1) If the Service Provider is an entity or
organization, it must appoint a single manager as the point of contact for
First Connections matters and provide First Connections with updated contact
information for that manager.
(2)
This manager must have decision-making authority for the Service Provider and
all its Employees as well as the ability to ensure that First Connections
requests, concerns, inquiries, and enforcement actions are addressed and
resolved to the satisfaction of First Connections.
(c)
(1) A
Service Provider cannot transfer any Early Intervention Service certification
to any other person or entity.
(2)
A Service Provider cannot complete a Change in Ownership unless DDS approves
the application of the new ownership pursuant to Sections 202.
(3) A Service Provider cannot change its name
or otherwise operate under a different name than the one listed on the
certification without prior Written Notice to First Connections.
302.
Personnel and Staffing.
(a)
(1) A
Service Provider must comply with all requirements applicable to Employees
under these standards, including without limitation drug screens, criminal
background checks, adult and child maltreatment registry checks, and sex
offender registry searches.
(2.) A
Service Provider must verify that an Employee continues to meet all
requirements upon the request of First Connections or whenever the Service
Provider receives information after hiring that would create a reasonable
belief that an Employee no longer meets all requirements, including without
limitation requirements related to drug screens, criminal background checks,
adult and child maltreatment registry checks, and sex offender registry
searches.
(b)
(1) A Service Provider must conduct criminal
background checks for all Employees as required pursuant to Ark. Code Ann.
§
20-38-101,
et seq.
(2) A
Service Provider must conduct an Arkansas Child Maltreatment Central Registry
check on each Employee prior to hiring and at least every two (2) years
thereafter.
(3) A Service Provider
must conduct an Arkansas Adult Maltreatment Central Registry check on each
Employee prior to hiring and at least every two (2) years thereafter.
(4) A Service Provider must conduct a drug
screen that tests for the use of illegal drugs on each Employee prior to
hiring.
(5) A Service Provider must
conduct an Arkansas Sex Offender Central Registry search on each Employee prior
to hiring and at least every two (2) years thereafter.
(c) Each Employee must successfully pass all
required checks, screens, and searches required in Section 302 (b).
303.
Employee
Records.
(a) A Service
Provider must maintain a personnel file for each Employee in CDS including
without limitation:
(1) Evidence of all
required criminal background checks;
(2) All required Child Maltreatment Registry
checks;
(3) All required Adult
Maltreatment Registry checks;
(4)
Documentation demonstrating that the Employee maintains in good standing all
professional licensures, certifications, or credentials that are required for
the Employee or the Early Intervention Service the Employee is performing;
and
(5) Documentation demonstrating
that the Employee meets all continuing education, in-service, or other training
requirements applicable to that Employee under these standards as well as any
professional licensures, certifications, or credentials held by that
Employee.
(b) A Service
Provider must maintain its own separate and complete electronic or paper
personnel file for each Employee in addition to the personnel file maintained
for each Employee in CDS.
(c) A
Service Provider must make all Employee personnel files available to First
Connections upon request.
304.
Client Service Records
and Personally Identifiable Information.
(a) A Service Provider must maintain a
complete service record for each child in CDS that includes (at a minimum) all
documentation related to a child's eligibility determination, their IFSP,
service delivery, Written Notices, Parental Consents, and any other
documentation related to the child that is required under these
standards.
(b) If a Service
Provider elects to maintain its own set of service records in addition to the
service record maintained for each child in CDS, then the Service Provider must
maintain service records and Personally Identifiable Information in compliance
with the requirements of Part C of IDEA and all applicable state and federal
laws and rules governing the protection of medical, social, personal,
financial, and electronically stored records, including without limitation the
Health Insurance Portability and Accountability Act (HIPAA), the Privacy Act of
1974, and the Family Educational Rights and Privacy Act (FERPA).
(c)
(1) A
Service Provider must provide access to, and at least one (1) no cost copy of,
a child's service record to each of the following individuals within ten (10)
Calendar Days upon request:
(i) First
Connections staff;
(ii) A Parent;
and
(iii) The authorized
representative of a Parent.
(2) A Service Provider must explain and
interpret the contents of a child's service record when requested by a
Parent.
(3)
(i) A Parent has the right to request an
amendment to the child's service record when the Parent believes that the
service record is inaccurate, misleading, or violating the child's privacy or
other rights.
(ii) A Service
Provider must respond to a Parent's child service record amendment request
within ten (10) Calendar Days of receipt of the request.
(iii) If a Parent's child service record
amendment request is denied, the Service Provider must:
(A) Inform the Parent of their right to
include the Parent's statement of facts concerning the amendment request in the
child service record; and
(B)
Provide Parental Notice of the Parent's due process rights to challenge the
denial through First Connections dispute resolution procedures.
305.
First Connections
Referrals.
(a) A Service
Provider must refer to the DDS First Connections Central Intake Unit within two
(2) Business Days of first contact with all infants and toddlers from birth to
thirty-six (36) months of age for whom there is a diagnosis or suspicion of a
developmental delay or disability.
(b) A CMDE and determination of program
eligibility cannot be conducted when a referral to First Connections occurs
less than forty-five (45) days before the child's third birthday. See Section
306 regarding LEA referral.
306.
LEA Referrals and
Notifications.
(a)
(1) If a child is referred to First
Connections forty-five (45) days or less before the child's third birthday,
then the Service Coordinator must make a referral to the child's LEA unless
there is documented refusal of Parental Consent or failure to obtain Parental
Consent despite documented, repeated attempts.
(2) If a child is referred to First
Connections between ninety (90) and forty-six (46) days before their third
birthday, then the Service Coordinator must make a referral to the child's LEA
as soon as possible after the child is determined eligible for First
Connections.
(b) For
every child with an IFSP, the Service Coordinator must send a quarterly LEA
notification to the appropriate LEA no later than ninety (90) days prior to a
child's third birthday.
(c) A
Service Provider is required to enter documentation in CDS evidencing that any
required referral or notification was completed in a proper and timely
manner.
307.
Transition Plan.
(a)
(1)
Each child must have a transition plan developed and included in their IFSP
between nine (9) months and ninety (90) days prior to their third
birthday.
(2) Each transition plan
must include without limitation:
(i) The
transition services and activities necessary to support the child's and
family's transition out of First Connections;
(ii) A minimum of three (3) specific steps
that will be taken to prepare the child for the changes in service delivery and
learning environment;
(iii) A
specific action step that will be taken by the Parent or other caregiver to
prepare the child for the changes in service delivery and learning
environment;
(iv) Documentation
that the Service Coordinator provided the Parent with a copy of the Transition
Guide;
(v) Documentation that the
Service Coordinator provided the Parent with LEA contact information concerning
Part B services; and
(vi)
Documentation that the Service Coordinator referred the child to the DDS
Children with Chronic Health Conditions program or that the Parent declined the
referral.
(b)
The transition plan development process must include:
(1) A Parent;
(2) A Service Coordinator; and
(3) Other individuals requested by the
Parent.
308.
Transition Conference.
(a) A transition conference must be held no
later than ninety (90) days before the child's third birthday.
(b)
(1) The
only justifications for failing to hold the transition conference at least
ninety (90) days before the child's third birthday are:
(i) Family Delay;
(ii) Lack of Parental Consent; or
(iii) The child's referral to First
Connections was received less than ninety (90) days from the child's third
birthday.
(2) The reason
for Family Delay or lack of Parental Consent must be documented in the child's
service record.
(3) The transition
conference must be held as soon as practicable after Parental Consent is
obtained or the circumstances causing Family Delay no longer exist.
(c) The transition conference must
include the following individuals:
(1) A
Parent;
(2) A Service
Coordinator;
(3) A Service
Provider;
(4) An LEA or
representative of any other program to which the child is transitioning;
and
(5) Other individuals requested
by the Parent.
(d) The
transition conference may be held in-person or by any other means that are
acceptable to the Parent and other participants.
(e)
(1) The
transition conference must be held in a setting and at a time convenient to the
Parent.
(2) Written Notice of the
transition conference must be provided to all participants at least fourteen
(14) days in advance.
(3) It must
be documented if the Parent requests that a transition conference be held prior
to receiving Written Notice.
309.
Document
Destruction.
(a) A
Service Provider must retain all child service records for at least five (5)
years from the date the child exits First Connections, or until the conclusion
of all reviews, appeals, investigations, administrative or judicial actions
related to an exited child's service record (if longer than five (5)
years).
(b) A Service Provider must
comply with all applicable state and federal laws and rules governing the
destruction of child service records and Personally Identifiable Information,
including without limitation Part C of IDEA and the General Education Provision
Act.
310.
Written Notice.
(a) If Written Notice involves a proposed
action, meeting, or refusal to act, then unless otherwise stated in these
Rules, the Written Notice must be delivered at least seven (7) Calendar Days
prior to the proposed action, meeting, or refusal to act described in the
Written Notice.
(b) A Service
Provider must upload documentation into CDS demonstrating the delivery and
receipt of all Written Notices in the manner required by these
standards.
311.
Parental Consent.
(a)
(1) A
Service Provider must fully inform a Parent in advance of all relevant
information pertaining to the activity for which Parental Consent is sought,
including without limitation:
(i) A complete
description of the activity for which Parental Consent is sought;
(ii) An explanation that Parental Consent is
voluntary and may be withdrawn at any time, but that any revocation will not be
retroactive;
(iii)
(A) A description of any information that
will be released (if any) and to whom;
(B) The purpose of releasing the information;
and
(C) The duration of time that
the information will be released.
(2) A Service Provider must fully answer all
Parent questions for Parental Consent to be valid.
(3) A Service Provider must communicate in
the Parent's Native Language to fully inform the Parent and answer the Parent's
questions when seeking Parental Consent.
(4) A Service Provider cannot use lack of
Parental Consent as justification for failing to meet a requirement under these
standards unless there is a documented refusal signed by the Parent or
documented repeated attempts to obtain Parental Consent.
(b) A Service Provider must upload
documentation into CDS demonstrating the delivery and receipt of all Parental
Consents in the manner required by these standards.
312.
Marketing and
Solicitation.
(a) A
Service Provider can Market its services.
(b) A Service Provider cannot Solicit a child
or their family.
313.
Third-party Service Agreements.
(a) A Service Provider may contract in
writing with third-party vendors to provide services or otherwise satisfy
requirements under these standards.
(b) A Service Provider must ensure that all
third-party vendors and contractors comply with these standards and all other
applicable laws, rules, and regulations.
314.
System of
Payments.
(a) A Service
Provider must provide any service on the IFSP at no cost to the
Parent.
(b) Part C Funds may only
be used when there are no other federal, state, local, or private resources
available to pay for the Early Intervention Service.
(c)
(1) A
Parent cannot be required to obtain private insurance or enroll in Medicaid
(including TEFRA) to receive the services necessary to reach IFSP
goals.
(2)
(i) A Service Provider must have Parental
Consent to submit a claim for payment for Early Intervention Services through a
child or Parent's Medicaid.
(ii)
Prior to obtaining Parental Consent, a Service Provider must provide the Parent
the approved written notification regarding the use of the child or Parent's
Medicaid and a statement of the no cost protection provisions.
(3)
(i) A Service Provider must have Parental
Consent to submit a claim for payment for Early Intervention Services through a
Parent's private insurance.
(ii)
Prior to obtaining Parental Consent, a Service Provider must provide the Parent
the approved systems of payments information and a statement of the no cost
protection provisions.
(4)
(i)
When a Parent's private insurance or Medicaid is used, the Parent is
responsible for any applicable private insurance or Medicaid
premiums.
(ii)
(A) Any co-payments and deductibles in
connection with Early Intervention Services that are not covered by private
insurance, Medicaid, or other funding may be paid with Part C Funds.
(B) A Parent may be reimbursed using Part C
Funds for any copayments and deductibles in connection with Early Intervention
Services they paid that are not covered by private insurance, Medicaid, or
other funding.
(5) Part C Funds may be used to prevent a
delay in providing Early Intervention Services pending reimbursement from the
insurer or other available funding source that has ultimate responsibility for
payment.
(c) A Service Provider must accept
the Medicaid payment for an Early Intervention Service as payment in full
regardless of amount.
(d) If a
Parent has granted Parental Consent to bill their Medicaid and private
insurance, then the Service Provider must first bill and receive a denial from
the private insurance before billing Medicaid for an Early Intervention
Service.
315.
Exiting
Children.
(a) Upon the
exiting of a child from First Connections, the Service Provider must ensure the
following are entered or uploaded into CDS:
(1) Finalized required service delivery
notes; and
(2) Final goals and
objectives status rating.
(b) Upon the exiting of a child from First
Connections, the Service Coordinator must ensure the following are entered or
uploaded into CDS:
(1) The reason for
exit;
(2) Final Child Outcomes
Summary Rating; and
(3) A complete
Parent family rating unless there is a documented refusal signed by the Parent
or documented repeated attempts to obtain.
(c)
(1) If
a child exits First Connections and does not have a transition conference, then
the Service Coordinator must hold an exit conference.
(2) An exit conference must include the:
(i) Parent;
(ii) Service Coordinator;
(iii) Service Provider; and
(iv) Any other individual the Parent requests
to attend.
(3) The only
justification for failure to hold a transition conference or an exit conference
is Family Delay.
(4) The exit
conference may be held in-person or by any other means that are acceptable to
the Parent and other participants.
316.
Refusal to
Serve.
(a) If a selected
Service Provider is unable or unwilling to serve a child, then the Service
Provider must inform the Service Coordinator within two (2) Business Days of
being notified in CDS of its selection as a Service Provider by a
Parent.
(b) The Service Provider is
responsible for documenting that it has made a timely refusal to serve
election.
(c)
(1) A Service Provider is prohibited from
selecting the children they do or do not serve based on location of the child
(if a teleservices option is available) or the perceived complexity of the
child's needs.
(2) If First
Connections reasonably suspects a Service Provider is electing the children
they do or do not serve based on a prohibited reason, it is the Service
Provider's responsibility to demonstrate that its refusals to serve have been
for permitted reasons.
Subchapter 4.
Physical/Service Setting Requirements.
401.
Natural
Environment.
(a)
(1) All Early Intervention Services listed on
an initial IFSP must be performed in the child's Natural Environment.
(2) All Early Intervention Services listed on
any other IFSP must be performed in the child's Natural Environment unless the
requirements of Section 401(b) below are documented.
(b)
(1) An
Early Intervention Service listed on an IFSP (other than the initial IFSP) can
be performed in a setting that is not Natural Environment only when:
(i) A functional goal of a child has not been
achieved in the Natural Environment;
(ii) There has been a meeting of the full
IFSP team to update the IFSP by modifying goals, adjusting intervention
strategies, and improving Parent implementation of intervention strategies in
an attempt to achieve the functional goals in the Natural Environment
setting;
(iii) There is a summary
describing why the functional goals were not achieved after updating the IFSP
with modified goals, adjusted intervention strategies, and improved Parent
implementation of intervention strategies and implementing Natural Environment
practices for at least a ninety (90) Calendar Day period; and
(iv)
(A)
There is a conversion plan for transitioning the Early Intervention Service
setting back to Natural Environment once the specific functional goals linked
to that Early Intervention Service have been met.
(B) The conversion plan must list:
(I) Specific steps;
(II) Timelines; and
(III) Individuals involved.
(C) A conversion plan cannot
exceed six (6) months.
(2) A meeting of the full IFSP team must be
held to update the IFSP and implement new strategies if unable to transition
any Early Intervention Service setting back to Natural Environment within six
(6) months.
Subchapter 5.
Eligibility
and the Individual Family Service Plan (IFSP).
501.
Eligibility
Generally.
(a) Each of
the following criteria must be met for a child to participate in First
Connections:
(1) The child is under three (3)
years of age.
(2) The child meets
at least one of the following:
(i) A score on
both an age-appropriate standardized norm and criterion referenced
developmental evaluation that indicates a developmental delay of twenty-five
percent (25%) of the child's chronological age or greater in one (1) or more of
the five (5) development domains, in accordance with Section 502;
(ii) A documented developmental diagnosis of
a condition that has a high probability of developmental delay, in accordance
with Section 503; or
(iii) It is
the informed clinical opinion of the IFSP team that the child qualifies for
First Connections, in accordance with Section 504.
(3) The child must be receiving at least one
(1) Early Intervention Service.
(4)
The child is not enrolled with and receiving Tier II or Tier III services
through a Provider-Led Arkansas Shared Savings Entity ("PASSE").
(b) Every child referred to First
Connections must have an individual acting as Parent.
(c)
(1)
(i) Each child referred to First Connections
at least forty-six (46) days prior to their third birthday must have a meeting
to determine eligibility.
(ii) A
CMDE must be completed prior to the meeting to determine eligibility.
(2) The meeting to determine
eligibility must include, at a minimum:
(i)
The Service Coordinator;
(ii) The
evaluator that conducted the age-appropriate standardized developmental
evaluations, or a knowledgeable representative who can also serve as member of
the IFSP team at the initial IFSP meeting;
(iii) The Parent; and
(iv) Any other individual the Parent would
like to attend.
502.
Developmental
Delay.
(a) A qualifying
developmental delay as described in Section 501(a)(2)(i) is demonstrated by a
score on both an age appropriate standardized norm and criterion referenced
developmental evaluation performed within the past six (6) months that
indicates a developmental delay of twenty-five percent (25%) of the child's
chronological age or greater in one (1) or more of the five (5) development
domains:
(1) Physical;
(2) Cognitive;
(3) Communication;
(4) Social or emotional; and
(5) Adaptive or self-help.
(b)
(1) The evaluator must follow the
instrument's protocol for scoring.
(2) If the developmental evaluation scoring
results do not yield a whole number, then the evaluator should round up to the
next whole number for any score ending in five tenths (.5) or higher, and round
down to the next whole number for any score ending in four tenths (.4) or
lower.
(3) The evaluator must
convert scoring results to a percentage of chronological age delay.
(4)
(i) The
evaluator must adjust scoring for prematurity on any developmental evaluation
administered to a child under eighteen (18) months of age who was born
premature.
(ii) When an adjustment
for prematurity is required, the evaluator must use age-appropriate
standardized developmental evaluation instruments that are still valid when
adjusted for prematurity.
503.
Developmental
Diagnosis.
(a) A
qualifying developmental diagnosis as described in Section 501(a)(2)(ii) is
demonstrated by a medical diagnosis of a condition that has a high probability
of resulting in a developmental delay, including without limitation:
(1) Down syndrome and other chromosomal
abnormalities associated with intellectual disability;
(2) Congenital syndromes and conditions
associated with delays in development such as fetal alcohol syndrome,
intra-uterine drug exposure, prenatal rubella, and severe macro and
microcephaly;
(3) Metabolic
disorders;
(4) Intra-cranial
hemorrhage;
(5) Malignancy or
congenital anomaly of brain or spinal cord;
(6) Spina bifida;
(7) Seizure disorder, asphyxia, respiratory
distress syndrome, neurological disorder, and sensory impairments;
and
(8) Maternal Acquired Immune
Deficiency Syndrome.
(b)
The qualifying developmental diagnosis must be from a licensed
physician.
504.
Informed Clinical Opinion.
(a) The informed clinical opinion of the IFSP
team may be used to qualify a child for participation in First Connections.
(1) Informed clinical opinion cannot be used
to negate the results of any developmental evaluation used to establish First
Connections eligibility.
(2)
Informed clinical opinion may be issued only at the meeting to determine
eligibility.
(b) When
informed clinical opinion qualifies a child for First Connections, the IFSP
must either:
(1) Detail the specific
developmental concern that forms the basis of the informed clinical opinion and
describe the rationale, contributing factors, and specific results of the CMDE
that indicate the child qualifies for First Connections, including without
limitation why the CMDE evaluations do not clearly reflect the child's
functional ability; or
(2) Detail
the specific condition and contributing factors that form the basis of the
informed clinical opinion and describe how the specific condition affects the
child's functional ability such that the child qualifies for First
Connections.
505.
Evaluations
Generally.
(a)
(1) Parental Consent is required prior to
scheduling and conducting an evaluation.
(2) Written Notice is required prior to
conducting an evaluation.
(3) A
Parent or other caregiver must be present for the evaluation.
(b)
(1) Any instrument and procedures used as
part of an evaluation must be performed by an individual qualified to
administer the evaluation instrument.
(2) An evaluation must be administered in the
child's Natural Environment with the Parent or other caregivers.
(3) All aspects of an evaluation must be
communicated in the child's and the family's Native Language.
(c)
(1)
(i)
Each evaluation performed must have its own Evaluation Report.
(ii) The Evaluation Report must be prepared
by the individual who conducted the evaluation.
(iii) The Evaluation Report must be written
in a format and using language that is free of jargon and understandable to the
general public.
(2) The
completed Evaluation Report must be uploaded into CDS and the evaluation
results keyed into the child's service record within twenty-one (21) Calendar
Days of the date the Service Provider was notified to perform the evaluation,
unless there is documentation demonstrating Family Delay.
(3) The Evaluation Report must include, at a
minimum:
(i) Child's name, birthdate and
Native Language;
(ii) Name of the
participating Parent or other caregiver and their Native Language;
(iii) Name of the evaluation instrument and
date administered;
(iv) Name and
credentials of individual who conducted the evaluation;
(v) Date and location where the evaluation
was administered;
(vi) Referral
source and why the child was referred;
(vii) Complete child and family social
history, which should include:
(A) All
individuals living in same household as child;
(B) Observation of the child in their Natural
Environment engaged in typical child and family routines and
activities;
(C) Information about
the child, including without limitation birth and development;
(D) The family's concerns about the
child;
(E) The child's educational
history; and
(F) The child's
medical history, including without limitation a health, vision, and hearing
summary.
(viii) Complete
child developmental history, including without limitation the child's
interests, abilities, strengths, and developmental needs;
(ix) Recommendations that support the family
in assisting in the child's learning and development, which should include:
(A) Solutions to family issues, such as
activities and routines in which the family would like the child to participate
more fully;
(B) The skills needed
for the child to successfully participate in the family identified activity or
routine;
(C) Skills that the family
could benefit from learning that would assist the child's development and
participation in everyday routines and activities;
(D) Assistive Technology devices, adaptations
of existing equipment, or acquisition of other materials that will support the
child's participation in everyday family routines and activities;
(E) Information that would enhance the
family's capacity to assist the child's development and participation in
everyday routines and activities; and
(F) Referrals to people and community
resources outside of First Connections that would assist the child and family
in expanding opportunities for involvement in community activities.
(x) The signature, date, and
credentials of individual who conducted the evaluation.
506.
Comprehensive Multi-Disciplinary Developmental Evaluation
(CMDE)
(a)
(1) Every child referred to the First
Connections Central Intake Unit at least forty-six (46) Calendar Days prior to
their third birthday must receive a complete CMDE.
(2) A new CMDE must be conducted annually
prior to the annual IFSP review to determine the child's continued eligibility
for First Connections.
(b) In addition to those requirements
contained in Section 505, each CMDE must also:
(1) Be conducted by a multidisciplinary team
that consists of one (1) or more individuals qualified or certified in two (2)
or more separate disciplines or professions; and
(2) Involve the administration of:
(i)
(A) If
it is an initial CMDE, both an age-appropriate standardized norm referenced
developmental evaluation instrument AND an age-appropriate criterion referenced
developmental evaluation instrument that measure the child's functioning in
each of the five (5) developmental areas; or
(B) If it is an annual CMDE to demonstrate
the child's continued eligibility, either an age-appropriate standardized norm
referenced developmental evaluation instrument OR an age-appropriate criterion
referenced developmental evaluation instrument that measure the child's
functioning in each of the five (5) developmental areas; and
(ii) A Family
Assessment.
507.
Initial IFSP
Meeting.
(a)
(1)
(i) The
initial IFSP meeting to develop the initial IFSP must be held within forty-five
(45) Calendar Days of the referral to the First Connections Central Intake
Unit.
(ii) An initial IFSP meeting
is not required if the referral was received by the First Connections Central
Intake Unit less than forty-six (46) Calendar Days from the child's third
birthday.
(2)
(i) Family Delay is the only justification
for failure to hold the initial IFSP meeting within forty-five (45) Calendar
Days of receipt of the referral by the First Connections Central Intake
Unit.
(ii) The reason for Family
Delay must be documented in the child's record.
(iii) The initial IFSP meeting must be held
as soon as practicable after the circumstances causing Family Delay no longer
exist.
(3) A child must
have a completed CMDE prior to the initial IFSP meeting.
(b) The initial IFSP meeting must include, at
a minimum:
(1) The initial Service
Coordinator;
(2) The evaluator who
conducted the age-appropriate standardized developmental evaluation instrument,
or a knowledgeable representative;
(3) The Parent; and
(4) Any other individuals that the Parent
would like to attend.
(c) An initial IFSP meeting may be held
in-person or by any other means acceptable to the Parent and other
participants.
(d)
(1) Written Notice of the initial IFSP
meeting must be provided to the Parent and any other participants.
(2) It must be documented if the Parent
requests the initial IFSP meeting be held prior to receiving Written
Notice.
508.
Individual Family Service Plan (IFSP).
(a) An IFSP must include, at a minimum:
(1) The child's present level of development
stated in months with the percentage of child's chronological age delay in each
of the five (5) developmental domains, based on professionally acceptable
objective criteria;
(2) The
family's resources, priorities, and concerns related to the development of the
child;
(3) One or more family
outcomes stating what the Parent will accomplish;
(4) A list of at least five (5) specific
child functional outcomes, which must be specific, functional, family-driven,
linked to child and family activities and routines, and measurable in a range
of months not to exceed six (6);
(5) The specific action step(s) that will be
taken by the Parent or other caregivers, within typical child and family
activities, to reach each functional outcome;
(6) The list of Early Intervention Services
and accompanying service delivery information, which must include:
(i) The location for each Early Intervention
Service session, which must be in the child's Natural Environment unless there
is justification meeting the requirements of Section 401(b);
(ii) A schedule of service delivery that
includes the frequency and intensity of each Early Intervention Service session
and whether sessions are on an individual or group basis;
(iii) The Service Provider;
(iv) The specific date by which the child
will be expected to achieve the outcome tied to the Early Intervention Service;
and
(v) Identification of the
funding source for the Early Intervention Service.
(7) A list of other services that the child
or family will need or receive through sources outside of First Connections in
order to achieve the child's outcomes;
(8) The CMDE results;
(9) If a child is within ninety (90) Calendar
Days of their third birthday, a transition plan is required to be included in
the IFSP, unless the child was referred to First Connections Central Intake
Unit between ninety (90) and forty-six (46) Calendar Days prior to their third
birthday; and
(10) The original
date of meeting and signatures of all parties participating in an IFSP
meeting.
(b) An IFSP
expires at the earlier of either the child's third birthday or after twelve
(12) months. The IFSP can only be renewed at an annual IFSP review.
(1) Early Intervention Services must stop
when an IFSP expires.
(2)
(i) Parental choice or Family Delay are the
only justifications for allowing an IFSP to expire before the child's third
birthday.
(ii) The parental choice
or Family Delay must be documented in the child's service record.
(iii) If Family Delay is the cause, then the
annual IFSP review must be held to renew the IFSP as soon as practicable after
the circumstances causing Family Delay no longer exist.
509.
IFSP Reviews.
(a) An annual IFSP review must be held at
least every twelve (12) months after the initial IFSP meeting.
(b) A bi-annual IFSP review must be held
within six (6) months after the initial IFSP meeting and any annual IFSP
review.
(c)
(1) An IFSP review may be requested sooner or
more frequently by the Parent.
(2)
All annual and bi-annual IFSP reviews must include, at a minimum:
(i) The Service Coordinator;
(ii) A Service Provider performing at least
one (1) Early Intervention Service for the child;
(iii) The Parent; and
(iv) Any other individuals that the Parent
would like to attend.
(d) An IFSP review may be held in-person or
by any other means acceptable to the Parent and other participants.
(e)
(1)
Written Notice of an IFSP review must be provided to the Parent and any other
participants.
(2) It must be
documented if the Parent requests a IFSP review be held prior to receiving
Written Notice.
510.
Interim
IFSP.
(a) A child can
begin receiving Early Intervention Services under an interim IFSP prior to
completion of the CMDE when:
(1) There is a
documented need for immediate services at the time of referral that cannot wait
for the completion of the CMDE; and
(2) The available documentation demonstrates
the child is eligible for First Connections pursuant to Section 501; however,
informed clinical opinion cannot be used to demonstrate a child's eligibility
for purposes of an interim IFSP.
(b) An interim IFSP meeting should be
scheduled as soon as possible after the determination of immediate need and
must include the following individuals:
(1)
Parent; and
(2) Service
Coordinator.
(c) The
interim IFSP must include the following, at a minimum:
(1) Name of the Service
Coordinator;
(2) One (1) or more
functional child outcomes and the action steps that will be taken to reach each
functional outcome;
(3) The date by
which the child will be expected to achieve the outcomes tied to the Early
Intervention Service
(4) The Early
Intervention Service(s) determined to be needed immediately to meet the
outcomes;
(5) The name of the
Service Provider selected by the Parent to provide the Early Intervention
Service(s);
(6) A statement that
the Early Intervention Service(s) will be performed in the child's Natural
Environment;
(7) The location for
each Early Intervention Service session;
(8) A schedule of service delivery that
includes the frequency and intensity of each Early Intervention Service session
and whether sessions are on an individual or group basis; and
(9) Funding source for the Early Intervention
Service(s).
(d) The use
of an interim IFSP does not excuse, delay, extend, or toll the forty-five (45)
Calendar Day requirement in Section 501(a)(1).
Subchapter 6.
Early
Intervention Services.
601.
Services
Generally.
(a) Early
Intervention Services included on the IFSP must begin no later than thirty (30)
Calendar Days from the date of Parental Consent.
(b)
(1)
(i) Parental Consent is required prior to the
delivery of any Early Intervention Service.
(ii) A parent may revoke Parental Consent at
any time for any reason.
(iii) A
Parent may decline any Early Intervention Service or any other service or
activity at any time without jeopardizing any other Early Intervention
Service.
(iv) A Parent has the
right to change the Service Provider for any Early Intervention Service at any
time and for any reason with the exception that a Parent cannot switch initial
Service Coordinators without the prior consent of First Connections.
(2) A Parent or other caregiver is
required to attend and participate in each session of Early Intervention
Services.
(3) The Service Provider
must actively consult with and train the participating Parent or other
caregiver on the early intervention strategies described in the child's IFSP
when delivering an Early Intervention Service.
(c) No requirement in these standards will be
considered completed until the required information is entered or the required
documentation uploaded into CDS.
(d)
(1) A
Service Provider must perform all Early Intervention Services at the scheduled
time unless:
(i) There is justifiable reason,
as determined in the reasonable discretion of First Connections
staff;
(ii) There is Family Delay;
or
(iii) Alternative arrangements
have been made with the Parent in advance.
(2) The Service Provider must document one
(1) of the justifications described in Section 601(d)(1) applies.
(e) Any Early Intervention Service
documentation required to be entered or uploaded into a child's service record
must be completed no later than thirty (30) days after the Early Intervention
Service was completed.
602.
Service
Coordination.
(a) Service
coordination services must be performed by a Service Provider who is a
certified Service Coordinator.
(b)
(1) A Service Coordinator must have:
(i)
(A) A
bachelor's (or more advanced) degree in education, social work, or a related
field; or
(B) A high school
diploma, GED, or the equivalent, and have completed the First Connections
targeted case management training with at least seventy percent (70%)
proficiency on the exit exam.
(ii) Two (2) years' experience working with
individuals with developmental disabilities.
(iii) Completed all First Connections
training and professional development requirements.
(2) A Service Coordinator may only provide
service coordination services for one (1) Service Provider
organization.
(3) A Service
Coordinator is limited to a maximum service coordination caseload of fifty (50)
children without prior approval from First Connections.
(c)
(1) An
initial Service Coordinator is assigned at the time of a child's referral to
the First Connections Central Intake Unit.
(2) An initial Service Coordinator is
responsible for:
(i) Making initial contact
with the Parent and initiating the child's file in CDS;
(ii) Discussing with the Parent the parental
rights and procedural safeguards;
(iii) Obtaining Parental Consent;
(iv) Offering the Parent the choice of
evaluators to perform the CMDE; and
(v) Ensuring any required initial IFSP
meeting is held within forty-five (45) Calendar Days of the referral to the
First Connections Central Intake Unit.
(d)
(1) The
Parent will be offered their choice of an ongoing Service Coordinator at the
initial IFSP meeting.
(2) The
ongoing Service Coordinator's responsibilities include without limitation:
(i) Updating the child's service record in
CDS as required, including without limitation completing and uploading the
Family Assessment;
(ii) Assisting
the Parent in obtaining access to Early Intervention Services and other
services identified in the IFSP, including making referrals to providers and
scheduling appointments;
(iii)
Coordinating the provision of Early Intervention Services and other services
that the child needs or is being provided;
(iv) Coordinating evaluations and
assessments;
(v) Ensuring that the
Early Intervention Services and other services identified in the IFSP are
provided in the child's Natural Environment;
(vi) Facilitating and participating in the
development, review, and evaluation of IFSPs;
(vii) Coordinating, facilitating, and
monitoring the delivery of services on the IFSP to ensure that the services are
provided in a timely manner;
(viii)
Conducting follow-up activities to determine that appropriate services are
being provided;
(ix) Informing
families of their rights and procedural safeguards and explaining the Parent
Participation Agreement;
(x)
Coordinating the funding sources for services on the IFSP; and
(xi) Facilitating the development of a
transition plan to preschool, or, if appropriate, to other services.
(3) If through adoption or
otherwise there is a change in the Parent, then the Service Coordinator must
close out the child's service record in CDS under the former Parent and open a
new service record under the new Parent.
(e) A Service Coordinator must maintain the
following documentation in the child's service record for each service
coordination service provided:
(1) The
specific activities performed; and
(2) Recommendations based on the results of
the service coordination service, if any.
603.
Assistive Technology
and Adaptive Equipment and Services.
(a) An Assistive Technology or Adaptive
Equipment service is any service that directly assists a child or their family
in the selection, acquisition, or use of an Assistive Technology or Adaptive
Equipment device.
(b) An Assistive
Technology or Adaptive Equipment device Service Provider must be enrolled as a
Durable Medical Equipment provider with the Arkansas Medicaid
Program.
(c) An Assistive
Technology or Adaptive Equipment Service Provider is required to:
(1) Provide instruction and training on how
to use Assistive Technology or Adaptive Equipment to the child and Parent or
other caregiver, as required;
(2)
Provide ongoing assistance to adjust any Assistive Technology or Adaptive
Equipment as needed by child or Parent;
(3) Assume liability for Assistive Technology
or Adaptive Equipment devices and warranties;
(4) Install, maintain, and replace any
defective parts or devices;
(5)
Research and recoup payment from any third-party sources available to the child
and their Parent prior to billing First Connections; and
(6) Submit the purchase or rental price for
Assistive Technology or Adaptive Equipment within five (5) Business Days from
the date a request is received from the Service Coordinator.
(d) A Service Provider must
maintain the following documentation in the child's service record for each
Assistive Technology or Adaptive Equipment device order:
(1) The date the order was
received;
(2) The name of the
Service Coordinator who placed the order;
(3) The price quoted for the order;
(4) The date the quote was submitted to the
Service Coordinator;
(5) A copy of
the Medicaid or private insurance denial, if applicable;
(6) The date of delivery and installation of
the Assistive Technology or Adaptive Equipment device;
(7) A narrative of the instruction and
training provided to the child and Parent or other caregiver when installed;
and
(8) The Parent or other
caregiver's signature verifying that the delivery, installation, and required
instruction and training were completed.
604.
Audiology
Services.
(a) An audiology
service is any service listed in the IFSP that:
(1) Identifies children with auditory
impairments using appropriate screening techniques;
(2) Measures the range, nature, and degree of
hearing loss and communication function through audiological evaluation
procedures;
(3) Refers a child for
necessary medical, habilitative, or rehabilitative auditory services;
(4) Is an auditory training, aural
rehabilitation, speech reading, listening device orientation or training, or
other auditory service;
(5) Is a
hearing loss prevention service; or
(6) Measures the child's need for
amplification, including the selecting, fitting, and dispensing of appropriate
listening and vibrotactile devices, and the evaluation of the effectiveness of
those devices.
(b)
Audiology services must be performed by an individual with a license in good
standing from the Arkansas Speech-Language-Hearing Association.
(c) A Service Provider must maintain the
following documentation in the child's service record for each audiology
service performed:
(1) The date and beginning
and ending time for each audiology service;
(2) The name(s) of the Parent and any
participants in the audiology service;
(3) The name(s) and credential(s) of the
individual providing the audiology service;
(4) A narrative of the instruction, training,
and interaction provided to the participating Parent or other
caregiver
(5) The relationship of
the audiology service to the goals and objectives described in the child's
IFSP; and
(6) If applicable,
written progress notes on each audiology service session, signed or initialed
by the individual providing the audiology service, describing the child's
status with respect to their goals and objectives.
605.
Family
Training, Counseling, and Home Visits.
(a)
(1)
Family training, counseling, and home visits are support services provided by
social workers, psychologists, and other qualified personnel to train and
assist the Parent or other caregiver of a child in any area related to the
special needs of the child as determined necessary by the IFSP team.
(2) Family training, counseling, and home
visit services exclude the required family training, counseling, and home
visits provided to the child and family in connection with other Early
Intervention Services.
(b) A Service Provider must maintain the
following documentation in the child's service record for each family training,
counseling session, or home visit performed:
(1) The date and beginning and ending time
for each training, session, or visit;
(2) The names of the Parent and other
caregivers that participated in the training, session, or visit;
(3) The name and credentials of the
individual conducting the training, session or visit and, if the individual is
not credentialed, the experience or other knowledge that qualifies them to
conduct the training, session, or visit;
(4) The topics covered and any specific
materials or instruction received during the training, session, or
visit;
(5) The relationship of the
training, session, or visit to the goals and objectives described in the
child's IFSP;
(6) If applicable,
written progress notes on each training, session, or visit signed or initialed
by the individual conducting the training, session, or visit;
(7) If applicable, the receipt for the actual
cost of any materials, training, session, or visit;
(8) If applicable, the receipt for the actual
cost of any reimbursement submitted by the attending Parent or other caregiver;
and
(9) Verification of the Parent
or other caregiver participation such as a certificate of completion, sign-in
sheet, or signature.
606.
Health
Services.
(a) A health
service is a service that enables a child to receive or benefit from other
Early Intervention Services.
(1) Health
services do not include services that are surgical or purely necessary to
control or treat a medical condition.
(2) Health services do not include medical
services such as immunizations or other care that is routinely recommended for
all infants and toddlers.
(b) A Service Provider must maintain the
following minimum documentation in the child's service record for each health
service performed:
(1) The date and beginning
and ending time for each health service;
(2) The name of the Parent and other
caregivers who participated in the health service;
(3) The name and credentials of the
individual providing the health service and, if the individual is not
credentialed, the experience or other knowledge that qualifies them to perform
the health service;
(4) A narrative
of the instruction, training, and interaction provided to the participating
Parent or other caregiver;
(5) The
other Early Interventions Services on the IFSP that the health services enable
the child to receive; and
(6) The
relationship of the health service to the goals and objectives described in the
child's IFSP.
607.
Medical
Services.
(a) A medical
service is a diagnostic service provided by a licensed physician when necessary
to assist the IFSP team in developing and implementing the IFSP.
(b) Medical services must be performed by a
licensed physician in good standing with the Arkansas State Medical
Board.
(c) A Service Provider must
maintain the following documentation in the child's service record for each
medical service performed:
(1) A description,
date, and beginning and ending time for each medical service;
(2) The name of the Parent and other
caregivers who participated in the medical service;
(3) The name of the physician providing the
medical service and the name of their employer;
(4) A narrative of the instruction, training,
and interaction provided to the participating Parent or other
caregiver;
(5) The relationship of
the medical service to the goals and objectives described in the child's
IFSP.
608.
Nursing Services.
(a) Nursing services are assessments,
services, and medication or treatment administrations that are necessary to
enable a child to benefit from other Early Intervention Services.
(b) Nursing services must be performed by a
licensed Registered Nurse in good standing with the Arkansas Board of
Nursing.
(c) A Service Provider
must maintain the following documentation in the child's service record for
each nursing service performed:
(1) The date
and beginning and ending time for each nursing service;
(2) The name of the Parent and other
caregivers who participated in the nursing service;
(3) The name of the Registered Nurse
providing the nursing service and the name of their employer;
(4) A narrative of the instruction, training,
and interaction provided to the participating Parent or other
caregiver
(5) The other Early
Interventions Services on the IFSP that the nursing services enable the child
to receive;
(6) The relationship of
the nursing services to the goals and objectives described in the child's
IFSP.
609.
Nutrition Services.
(a)
(1)
Nutrition services assess the nutritional needs of a child, develop and monitor
plans to address those nutritional needs and refer a child to appropriate home
and community resources to carry out the nutritional goals in their
IFSP.
(2) Nutrition services
exclude feeding services provided in connection with speech pathology and
occupational therapy services.
(b) Nutrition services must be performed by
an individual that is:
(1) A Registered
Dietician in good standing with the American Dietetic Association;
(2) A provisionally certified Registered
Dietician by the American Dietetic Association; or
(3) A licensed physician in good standing
with the Arkansas State Medical Board.
(c) A Service Provider must maintain the
following documentation in the child's service record for each nutrition
service performed:
(1) The date and beginning
and ending time for each nutrition service;
(2) The name of the Parent and other
caregivers who participated in the nutrition service;
(3) The name and credentials of the
individual providing the nutrition service and the name of their
employer;
(4) A narrative of the
instruction, training, and interaction provided to the participating Parent or
other caregiver;
(5) The
relationship of the nutrition service to the goals and objectives described in
the child's IFSP.
610.
Occupational Therapy
Evaluations and Services.
(a)
(1)
Occupational therapy evaluations and services address the functional needs of a
child in their adaptive development, adaptive behavior, and play as well as
sensory, motor, and postural development.
(2)
(i)
Occupational therapy evaluations must be performed by a licensed Occupational
Therapist.
(ii) Occupational
therapy services must be performed by a licensed Occupational Therapist or
Occupational Therapy Assistant.
(3) Occupational therapy evaluations and
services must be performed by an individual who is a certified Occupational
Therapy Service Provider.
(4) Any
occupational therapy evaluation instrument administered must be from the First
Connections approved list.
(b) Each Occupational Therapist and
Occupational Therapy Assistant must:
(1) Hold
an Occupational Therapy or Occupational Therapy Assistant license in good
standing with the Arkansas State Medical Board;
(2) Complete all First Connections training
requirements; and
(3) Enroll with
the Arkansas Medicaid Program.
(c)
(1) An
Occupational Therapy Assistant must be supervised by an Occupational
Therapist.
(2) An Occupational
Therapy Assistant must have their supervising Occupational Therapist's
certification uploaded into CDS.
(d) An Occupational Therapist may supervise a
maximum of three (3) Occupational Therapy Assistants at any time.
(1) An Occupational Therapist must work at
the same Service Provider organization as any Occupational Therapy Assistant
they are supervising.
(2) An
Occupational Therapist must upload into CDS the certification of any
Occupational Therapy Assistant they are supervising.
(3)
(i) An
Occupational Therapist must complete a quarterly written evaluation on each
Occupational Therapy Assistant they are supervising, which must include a
complete evaluation of the Occupational Therapy Assistant's performance based
on the supervising Occupational Therapist's in-person observation of a session
with a child and Parent.
(ii) One
(1) of the four (4) quarterly reports during each twelve (12) month period must
be an annual written evaluation.
(e) Each completed occupational therapy
evaluation and report must be uploaded into CDS. See Section 505.
(f) A Service Provider must maintain the
following documentation in the child's service record for each occupational
therapy service session:
(1) The date and
beginning and ending time for each occupational therapy service
session;
(2) The name of the Parent
and other caregivers who participated in the occupational therapy service
session;
(3) A description of the
consulting and training provided to the participating Parent or other
caregivers on the early intervention strategies described in the child's
IFSP;
(4) The name and credentials
of the Occupational Therapist (if any) and Occupational Therapy Assistant
providing or observing the occupational therapy services each
session;
(5) The relationship of
each occupational therapy session to the goals and objectives described in the
child's IFSP; and
(6) Written
progress notes on each occupational therapy service session describing the
child's status with respect to their goals and objectives, which must be signed
or initialed by the Occupational Therapist or Occupational Therapy Assistant
providing the occupational therapy services.
611.
Physical Therapy
Evaluations and Services.
(a)
(1)
Physical therapy evaluations and services address the sensory motor function of
a child through enhancement of their musculoskeletal status, neurobehavioral
organization, perceptual and motor development, cardiopulmonary status, and
effective adaptation to their Natural Environment.
(2)
(i)
Physical therapy evaluations must be performed by a licensed Physical
Therapist.
(ii) Physical therapy
services must be performed by a licensed Physical Therapist or Physical Therapy
Assistant.
(3) Physical
therapy services must be performed by an individual who is a certified Physical
Therapy Service Provider.
(4) Any
physical therapy evaluation instrument administered must be from the First
Connections approved list.
(b) Each Physical Therapist and Physical
Therapy Assistant must:
(1) Hold a Physical
Therapy or Physical Therapy Assistant license in good standing with the
Arkansas State Medical Board;
(2)
Complete all First Connections training requirements; and
(3) Enroll with the Arkansas Medicaid
Program.
(c)
(1) A Physical Therapy Assistant must be
supervised by a Physical Therapist.
(2) A Physical Therapy Assistant must have
their supervising Physical Therapist's certification uploaded into
CDS.
(d) A Physical
Therapist may supervise a maximum of three (3) Physical Therapy Assistants at
any time.
(1) A Physical Therapist must work
at the same Service Provider organization as any Physical Therapy Assistant he
or she is supervising.
(2) A
Physical Therapist must upload into CDS the certification of any Physical
Therapy Assistant they are supervising.
(3)
(i) A
Physical Therapist must complete a quarterly written evaluation on each
Physical Therapy Assistant they are supervising, which must include a complete
evaluation of the Physical Therapy Assistant's performance based on the
supervising Physical Therapist's in-person observation of a session with a
child and Parent.
(ii) One (1) of
the four (4) quarterly reports during each twelve (12) month period must be an
annual written evaluation.
(e) Each completed physical therapy
evaluation and report must be uploaded into CDS. See Section 505.
(f) A Service Provider must maintain the
following documentation for each physical therapy service session:
(1) The date and beginning and ending time
for each physical therapy service session;
(2) The name of the Parent and other
caregivers who participated in the physical therapy service session;
(3) A description of the consulting and
training provided to the participating Parent or other caregivers on the early
intervention strategies described in the child's IFSP;
(4) The name and credentials of the Physical
Therapist (if any) and Physical Therapy Assistant providing or observing the
physical therapy services each session;
(5) The relationship of physical therapy
session to the goals and objectives described in the child's IFSP;
and
(6) Written progress notes on
each physical therapy service session describing the child's status with
respect to their goals and objectives, which must be signed or initialed by the
Physical Therapist or Physical Therapy Assistant providing the physical therapy
services.
612.
Psychological
Services.
(a)
Psychological services support parents and other caregivers in helping a child
use appropriate behavior to meet needs by using evidence-based practices to
improve the quality of the Parent-child relationship through changing
Parent-child interaction patterns for children with behavioral and emotional
disorders. Psychological services include consultation on child development as
well as Parent training and education programs, including without limitation
Parent-Child Interaction Therapy and coaching Parents in the use of therapeutic
parenting practices proven to decrease problematic behaviors.
(b) A Service Provider of psychological
services must meet one (1) of the following:
(1) A licensed Psychologist in good standing
with the Arkansas Psychology Board; or
(2) A licensed Psychological Examiner in good
standing with the Arkansas Psychology Board.
(c) A Service Provider must maintain the
following minimum documentation for each psychological service performed:
(1) The date and beginning and ending time
for each psychological service;
(2)
The name of the Parent and other caregivers who participated in the
psychological service;
(3) The name
and credentials of the individual providing the psychological service and the
name of their employer;
(4) A
narrative of the instruction, training, and interaction provided to the
participating Parent or other caregiver;
(5) The relationship of the psychological
service to determining the child's eligibility or the goals and objectives
described in the child's IFSP.
613.
Sign Language and Cued
Language Services.
(a)
Sign language and cued language services include auditory and oral language and
transliteration services, as well as formal training and direct support to
families learning sign or cued language.
(b) A Service Provider must maintain the
following documentation for each sign language or cued language service
performed:
(1) The date and beginning and
ending time for each sign language or cued language service;
(2) The name of the Parent and other
caregivers who participated in the sign language or cued language
service;
(3) A description of the
consulting and training provided to the participating Parent or other
caregivers on the early intervention strategies described in the child's
IFSP;
(4) The name and credentials
of the individual providing the sign language or cued language service and, if
the individual is not credentialed, the experience or other knowledge that
qualifies them to perform the sign language or cued language service;
and
(5) The relationship of the
sign language or cued language service to the goals and objectives described in
the child's IFSP.
614.
Social Work
Services.
(a)
(1) Social work services evaluate a child's
living conditions and patterns of family interaction, conduct social and
emotional assessments of a child within the family context, and coordinate
community resources and services to determine eligibility and enable a child to
receive the maximum benefit from Early Intervention Services.
(2) Social work services do not include any
activities that are able to be performed by the Service Coordinator.
(b) Social work services must be
performed by a Licensed Clinical Social Worker in good standing with the
Arkansas Board of Social Work.
(c)
A Service Provider must maintain the following documentation for each social
work service performed:
(1) The date and
beginning and ending time for each social work service;
(2) The name of the Parent and other
caregivers who participated in the social work service;
(3) A description of the consulting and
training provided to the participating Parent or other caregivers on the early
intervention strategies described in the child's IFSP;
(4) The name and credentials of the
individual providing the social work service and the name of their employer;
and
(5) The relationship of the
social work service to determining the child's eligibility or the goals and
objectives described in the child's IFSP.
615.
Developmental Therapy
Evaluations and Services.
(a)
(1)
Developmental therapy evaluations and services provide specialized instruction
to the child and Parent or other caregiver to promote the child's acquisition
of skills in all developmental areas, daily living activities, and social
interactions.
(2)
(i) Developmental therapy evaluations must be
performed by an individual who is a certified Developmental Therapist Service
Provider.
(ii) Developmental
therapy services must be performed by an individual who is a certified
Developmental Therapist or Developmental Therapy Assistant Service
Provider.
(b)
(1)
(i) A
Developmental Therapist must have one (1) of the following:
(A) Early Childhood Special Education
certification;
(B) A Masters of
Developmental Therapy or Early Intervention; or
(C) An Alternate Learning Plan approved by
and filed with the Arkansas Department of Education.
(ii) A Developmental Therapist must have
completed all First Connections training, professional development, and
Developmental Therapy Assistant in-person observation requirements.
(iii) A Developmental Therapist must be
enrolled with the Arkansas Medicaid Program as both a DDS non-Medicaid Service
Provider (type 76) and also as a First Connections Medicaid Service Provider
(type 86).
(2)
(i) A Developmental Therapy Assistant must
have one (1) of the following:
(A) Associates
Degree in Early Childhood Development or a related field;
(B) Two (2) years of documented experience
working with children under five (5) years of age; or
(C) Two (2) years of documented experience
working with children with disabilities.
(ii) A Developmental Therapy Assistant must
be supervised by a certified Developmental Therapist Service Provider and have
the supervising Developmental Therapist's certification uploaded into
CDS.
(iii) A Developmental Therapy
Assistant must have completed all First Connections training and professional
development requirements.
(iv) A
Developmental Therapy Assistant must be enrolled with the Arkansas Medicaid
Program as both a DDS non-Medicaid Service Provider (type 76) and also as a
First Connections Medicaid Service Provider (type 86).
(c) A Developmental Therapist may
supervise a maximum of three (3) Developmental Therapy Assistants at any time.
(1) A Developmental Therapist must work with
the same Service Provider organization as any Developmental Therapy Assistant
they are supervising.
(2) A
Developmental Therapist must upload into CDS the certification of any
Developmental Therapy Assistant they are supervising.
(d) Each completed developmental therapy
evaluation and report must be uploaded into CDS. See Section 505.
(e) A Service Provider must maintain the
following documentation for each development therapy service session:
(1) The date and beginning and ending time
for each developmental therapy session;
(2) The name of the Parent and other
caregivers who participated in the developmental therapy session;
(3) A description of the consulting and
training provided to the participating Parent or other caregivers on the early
intervention strategies described in the child's IFSP;
(4) The name and credentials of the
Developmental Therapist (if any) and Developmental Therapy Assistant providing
or observing the developmental therapy services each session;
(5) The relationship of each developmental
therapy session to the goals and objectives described in the child's IFSP;
and
(6) Written progress notes on
each developmental therapy session describing the child's status with respect
to his or her goals and objectives, which must be signed or initialed by the
Developmental Therapist or Developmental Therapy Assistant providing the
developmental therapy services.
616.
Speech-Language
Pathology Evaluations and Services.
(a)
(1)
Speech-language pathology evaluations and services identify a child's
communication or language disorders and delays in development of communication
skills and any service for the habilitation, rehabilitation, or prevention of a
child's communication or language disorder or delays in the development of a
child's communication skills.
(2)
(i) Speech-Language Pathology evaluations
must be performed by a licensed Speech-Language Pathologist.
(ii) Speech-Language Pathology services must
be performed by a licensed Speech-Language Pathologist or Speech-Language
Pathology Assistant.
(3)
Speech-Language Pathology services can only be performed by an individual who
is a certified Speech-Language Pathology Service Provider.
(b) Each Speech-Language Pathologist and
Speech-Language Pathology Assistant must:
(1)
Hold a Speech-Language Pathologist or Speech-Language Pathology Assistant
license in good standing with the Arkansas State Medical Board;
(2) Complete all First Connections training
requirements; and
(3) Enroll with
the Arkansas Medicaid Program.
(c)
(1) A
Speech-Language Pathology Assistant must be supervised by a Speech Language
Pathologist.
(2) A Speech-Language
Pathology Assistant must have their supervising SpeechLanguage Pathologist's
certification uploaded into CDS.
(d) A Speech-Language Pathologist may
supervise a maximum of three (3) Speech-Language Pathology Assistants at any
time.
(1) A Speech-Language Pathologist must
work at the same Service Provider organization as any Speech-Language Pathology
Assistant they are supervising.
(2)
A Speech-Language Pathologist must upload into CDS the certification of any
Speech-Language Pathology Assistant he or she is supervising.
(3) A Speech-Language Pathologist must upload
into CDS any in-person observation documentation related to a Speech-Language
Pathology Assistant they are supervising.
(e) Each completed speech-language pathology
evaluation and report must be uploaded into CDS. See Section 505.
(f) A Service Provider must maintain the
following documentation for each speech-language pathology service session:
(1) The date and beginning and ending time
for each speech-language pathology session;
(2) The name of the Parent and other
caregivers who participated in the speechlanguage pathology session;
(3) A description of the consulting and
training provided to the participating Parent or other caregivers on the early
intervention strategies described in the child's IFSP;
(4) The name and credentials of the
Speech-Language Pathologist (if any) and SpeechLanguage Pathology Assistant
providing or observing the speech-language pathology services each
session;
(5) The relationship of
speech-language pathology session to the goals and objectives described in the
child's IFSP; and
(6) Written
progress notes on each speech-language pathology session describing the child's
status with respect to their goals and objectives, which is signed or initialed
by the Speech-Language Pathologist or Speech-Language Pathology Assistant
providing the speech-language pathology services.
617.
Transportation Services.
(a) A transportation service involves
covering the costs of travel necessary to enable a child and their Parent or
other caregiver to receive an Early Intervention Service.
(b) A Service Provider must maintain the
following documentation for each transportation service:
(1) The specific Early Intervention Service,
date, location, and beginning and ending time for the Early Intervention
Service session for which the transportation service was necessary;
(2) The name of the Parent and other
caregivers involved in a transportation service;
(3) If applicable, the name of the vendor
that provided the transportation service;
(4) If applicable, the itemized receipt for
any transportation service reimbursement submitted by the Parent or other
caregiver; and
(5) If applicable,
signed verification by Parent or other caregiver of the amount of the
transportation service payment.
618.
Vision
Services.
(a) Vision
services involve the evaluation and assessment of a child's visual
functioning.
(b) Vision services
must be performed by an individual that is one (1) of the following:
(1) A licensed Ophthalmologist in good
standing with the Arkansas Board of Optometry or the Arkansas Board of
Ophthalmology; or
(2) A certified
Orientation Mobility Specialist.
(c) A Service Provider must maintain the
following documentation for each vision service performed:
(1) The date and beginning and ending time
for each vision service;
(2) The
name of the Parent and other caregivers who participated in the vision
service;
(3) The name and
credentials of the individual providing the vision service and the name of
their employer;
(4) A narrative of
the instruction, training, and interaction provided to the participating Parent
or other caregiver;
(5) The
completed evaluation or assessment and accompanying report (See Section 505);
and
(6) The relationship of the
vision service to the goals and objectives described in the child's
IFSP.
619.
Specialized Evaluation Services.
(a)
(1)
Specialized evaluation services relate to the performance of evaluations and
assessments necessary for diagnostic purposes to assist the IFSP team in
developing and implementing the IFSP.
(2) Specialized evaluation services do not
include evaluations related to occupational therapy, developmental therapy,
speech-language pathology, physical therapy, or vision services.
(b) A Service Provider must
maintain the following documentation for each specialized evaluation conducted:
(1) The date and beginning and ending time
for each specialized evaluation;
(2) The name of the Parent and other
caregivers who participated in the specialized evaluation;
(3) The name and credentials of the
individual conducting the specialized evaluation and, if the individual is not
credentialed, the experience or other knowledge that qualifies them to conduct
the specialized evaluation; and
(4)
The diagnostic purpose of the specialized evaluation and how it will assist the
IFSP team in development and implementing the child's IFSP.
620.
Parent Education Services.
(a) Parent education services are third-party
support groups, conferences, and workshops that instruct a Parent or caregiver
on how to enhance the child's development and enable the child to benefit from
other Early Intervention Services.
(b) A Service Provider must maintain the
following documentation for each Parent education service:
(1) The date and beginning and ending time
for each support group, conference, or workshop;
(2) The name of the Parent and other
caregivers who participated in the support group, conference, or
workshop;
(3) The name and
credentials of the individual or organization conducting the support group,
conference, or workshop and, if the individual or organization is not
credentialed, the experience or other knowledge that qualifies them to conduct
the support group, conference, or workshop;
(4) The topics covered, and any specific
materials or instruction received during the support group, conference, or
workshop;
(5) The relationship of
the support group, conference, or workshop to the goals and objectives
described in the child's IFSP;
(6)
If applicable, the registration form and itemized receipt for the actual cost
of any materials, support group, conference, or workshop;
(7) If applicable, the itemized receipts for
the actual cost of any reimbursement submitted by the Parent or other
caregiver; and
(8) Verification of
Parent or other caregiver participation and attendance, such as a certificate
of completion, or sign-in sheet.
621.
Teleservices.
(a) Teleservices are one (1) of the following
Early Interventions Services conducted via a telecommunication device in
accordance with the requirements of this Section 621:
(1) Developmental Therapy Services;
(2) Occupational Therapy Services;
(3) Physical Therapy Services;
(4) Speech-Language Pathology Services;
and
(5) Sign Language and
Cued-Language Services.
(b) Developmental therapy, occupational
therapy, physical therapy, and speech-language pathology evaluations must be
performed through traditional in-person methods.
(c) The child service record must include the
following documentation:
(1) A detailed
assessment of the child that determines they are an appropriate candidate for
teleservices based on the child's age and functioning level;
(2) A detailed explanation of all on-site
assistance or participation that will be used to ensure:
(i) The effectiveness of telemedicine service
delivery is equivalent to face-to-face service delivery; and
(ii) Telemedicine service delivery will
address the unique needs of the child; and
(3) A plan and estimated timeline for
returning service delivery to in-person if a client is not progressing towards
goals and outcomes through telemedicine service delivery.
(d) The Service Provider is responsible for
ensuring teleservices are the equivalent to inperson, face-to-face service
delivery.
(1) The Service Provider is
responsible for ensuring the calibration of all clinical instruments and the
proper functioning of all telecommunications equipment.
(2) All teleservices must be delivered in a
synchronous manner, meaning through realtime interaction between the
practitioner and the child and Parent or other caregiver via a
telecommunication link.
(3) A store
and forward telecommunication method of service delivery where either the child
and Parent or other caregiver or the practitioner records and stores data in
advance for the other party to review at a later time is prohibited.
(e) Teleservices are subject to
all the same limits and requirements as in-person, face-to-face delivery of the
Early Intervention Service.
Subchapter 7.
Incident and
Accident Reporting.
701.
Incidents to be Reported.
(a) A Service Provider must report all
alleged, suspected, observed, or reported occurrences of any of the following
events:
(1) Death of a child;
(2) Serious injury to a child;
(3) Child maltreatment;
(4) Any event where an individual threatens
or strikes a child;
(5)
Unauthorized use of restrictive intervention on a child, including seclusion or
physical, chemical, or mechanical restraint;
(6) Events involving a risk of death, serious
physical or psychological injury, or serious illness to a child; and
(7) Any act or omission that jeopardizes the
health, safety, or quality of life of a child.
(b) Any Service Provider may report any other
occurrences impacting the health, safety, or quality of life of a
child.
702.
Reporting Requirements.
(a) A Service Provider must:
(1) Submit all reports of the following
events within one (1) hour of the event:
(i)
Death of a child;
(ii) Serious
injury to a child; or
(iii) Any
incident that a Service Provider should reasonably know might be of interest to
the public or the media.
(2) Submit reports of all other incidents
within forty-eight (48) hours of the event or the first Business Day if the
accident occurs on weekend or holiday that prevents reporting within
forty-eight (48) hours.
(b) A Service Provider must enter the
incident report in the child's service record in CDS.
(c) Reporting under these standards does not
relieve a Service Provider of complying with any other applicable reporting or
disclosure requirements under state or federal laws, rules, or
regulations.
703.
Notification to Guardians and Legal
Custodians.
(a) If not
present at the time of the incident, a Service Provider must notify the
guardian or legal custodian of a child of any reportable incident involving a
child, as well as any injury or accident involving a child, even if the injury
or accident is not otherwise required to be reported in this Section.
(b) A Service Provider should maintain
documentation evidencing notification required in subdivision (a).
Subchapter 8.
Enforcement.
801.
Monitoring.
(a)
(1) DDS
shall monitor a Service Provider to ensure compliance with these
standards.
(2)
(i) A Service Provider must cooperate with
all monitoring and other regulatory activities performed or requested by
DDS.
(ii) Cooperation required
includes without limitation cooperation with respect to investigations,
surveys, site visits, reviews, and other regulatory actions taken by DDS to
monitor, enforce, or take other regulatory action on behalf of DDS.
(b) Monitoring includes
without limitation:
(1) CDS reviews, on-site
surveys, and other visits including without limitation annual reviews and
Parent surveys;
(2) CDS and on-site
child service record reviews;
(3)
Written requests for documentation and records required under these
standards;
(4) Written requests for
information; and
(5) Investigations
related to complaints received.
(c) DDS may contract with a third-party to
monitor, enforce, or take other regulatory action on behalf of DDS.
802.
Written
Notice of Enforcement Remedy.
DDS shall provide Written Notice of all enforcement remedies taken against the Service Provider to the manager appointed pursuant to Section 301.
803.
Remedies.
(a)
(1) DDS
shall not impose any enforcement remedies unless:
(i) The Service Provider is provided Written
Notice and appeal rights pursuant to this Section 802 and Subchapter 10;
or
(ii) DDS determines that public
health, safety, or welfare imperatively requires emergency action;
(2) If DDS imposes an enforcement
remedy as an emergency action before the Service Provider has notice and appeal
rights pursuant to subdivision (a)(1), DDS shall:
(i) Provide immediate Written Notice to the
Service Provider of the enforcement action; and
(ii) Provide the Service Provider with its
appeal rights pursuant to Subchapter 10.
(b) If a Service Provider fails to comply
with the standards, DDS may impose any of the following enforcement remedies
for the Service Provider's failure to comply with the standards:
(1) Plan of correction;
(2) Directed in-service training
plan;
(3) Removal as choice of
provider;
(4) Transfer;
(5) Monetary penalties;
(6) Suspension of Service Provider
certification;
(7) Revocation of
Service Provider certification;
(8)
Recoupment; and
(9) Any remedy
authorized by law or rule including, without limitation section
25-15-217
of the Arkansas Code.
(c) DDS shall determine the imposition and
severity of these enforcement remedies on a case-by-case basis using the
following factors:
(1) Frequency of
non-compliance;
(2) Number of
non-compliance issues;
(3) Impact
of non-compliance on a child's health, safety, or well-being;
(4) Responsiveness in correcting
non-compliance;
(5) Repeated
non-compliance in the same or similar areas;
(6) Non-compliance with previously or
currently imposed enforcement remedies;
(7) Non-compliance involving intentional
fraud or dishonesty; and
(8)
Non-compliance involving violation of any law, rule, or other legal
requirement.
(d)
(1) DDS shall report any noncompliance,
action, or inaction by the Service Provider to appropriate agencies for
investigation and further action.
(2) DDS shall refer non-compliance involving
Medicaid billing requirements to the Division of Medical Services and the
Arkansas Attorney General's Medicaid Fraud Control Unit.
(e) These enforcement remedies are not
mutually exclusive, and DDS may apply multiple enforcement remedies
simultaneously for a failure to comply with these standards.
(f) The failure to comply with an enforcement
remedy imposed by DDS constitutes a separate violation of these
standards.
804.
Removal as Choice of Provider.
(a) DDS may cease to offer the Service
Provider as a choice for one (1) or more Early Intervention Services.
(b) A Service Provider that is no longer
offered as a choice of Service Provider may continue to provide Early
Intervention Services to children they are already serving.
805.
Transfer.
(a) DDS may require a Service Provider to
transfer a child to another Service Provider if DDS finds that the Service
Provider cannot or is not adequately providing Early Intervention Services to
the child.
(b) If directed by DDS,
a Service Provider must continue providing services until the child is
transferred to their new Service Provider of choice.
(c) A transfer of a child may be permanent or
for a specific term, depending on the circumstances.
806.
Monetary
Penalties.
(a) DDS may
impose a civil monetary penalty on a Service Provider, not to exceed five
hundred dollars ($500) for each violation of the standards.
(b)
(1) DDS
may file suit to collect a civil monetary penalty assessed pursuant to these
standards if the Service Provider does not pay the civil monetary penalty
within sixty (60) days from the date DDS provides Written Notice to the Service
Provider of the imposition of the civil monetary penalty.
(2) DDS may file suit in Pulaski County
Circuit Court or the circuit court of any county in which the Service Provider
is located.
807.
Suspension and
Revocation of Certification.
(a)
(1) DDS
may temporarily suspend a Service Provider's certification if the Service
Provider fails to comply with these standards.
(2) If a Service Provider's certification is
suspended, the Service Provider must immediately stop providing Early
Intervention Services until DDS reinstates its certification.
(b)
(1) DDS may permanently revoke a Service
Provider's certification if the Service Provider fails to comply with these
standards.
(2) If a Service
Provider's certification is revoked, the Service Provider must immediately stop
providing Early Intervention Services.
808.
Recoupment.
(a) DDS may recoup any Part C Fund payments
made to a Service Provider as reimbursement for Early Intervention Services if
it is determined that the Service Provider failed to comply with these
standards.
(b) The Arkansas
Department of Human Services, Division of Medical Services may recoup any
Medicaid payments made to a Service Provider for Early Intervention Services if
it is determined that the Service Provider failed to comply with these
standards or Medicaid requirements.
Subchapter 9.
Closure.
901.
Closure.
(a)
(1) A
Service Provider certification ends if a Service Provider permanently closes
(whether voluntarily or involuntarily) and is effective the date of the
permanent closure as determined by DDS.
(2) A Service Provider that intends to or
does permanently close (whether voluntarily or involuntarily) must:
(i) Provide Written Notice of the closure to
First Connections at least thirty (30) Calendar Days prior to effective date of
the proposed closure; and
(ii)
Arrange for the storage of child service records to satisfy the requirements of
Section 304.
(b)
(1) A
Service Provider that intends to voluntarily close temporarily may request to
maintain its Service Provider certification for up to one (1) year from the
date of the request.
(2) A Service
Provider must still comply with subdivision (a)(2)'s requirements for notice
and storage of child service records.
(3)
(i) DDS
may grant a temporary closure if the Service Provider demonstrates that it is
reasonably likely to reopen after the temporary closure.
(ii) DDS shall direct that the Service
Provider permanently close if the Service Provider fails to demonstrate that it
is reasonably likely to reopen after the temporary closure.
(4)
(i) DDS may end a Service Provider's
temporary closure if the Service Provider demonstrates that it is in full
compliance with these standards.
(ii) DDS shall end a Service Provider's
temporary closure and direct that the Service Provider permanently close if the
Service Provider fails to become fully compliant with these standards within
one (1) year from the date of the request.
Subchapter 10.
Appeals.
1001.
Reconsideration of
Adverse Regulatory Actions.
(a)
(1) A
Service Provider may ask for reconsideration of any adverse regulatory action
taken by DDS by submitting a written request for reconsideration to: Division
of Disabilities Services, Attn: DDS Director, P.O. Box 1437, Slot N501, Little
Rock, Arkansas 72203-1437.
(2) The
written request for reconsideration of an adverse regulatory action taken by
DDS must be submitted by the Service Provider and received by DDS within thirty
(30) Calendar Days of the date the Service Provider received Written Notice of
the adverse regulatory action.
(3)
The written request for reconsideration of an adverse regulatory action taken
by DDS must include without limitation the specific adverse regulatory action
taken, the date of the adverse regulatory action, the name of the Service
Provider against whom the adverse regulatory action was taken, the address and
contact information for the Service Provider against whom the adverse
regulatory action was taken, and the legal and factual basis for
reconsideration of the adverse regulatory action.
(b)
(1) DDS
shall review each timely received written request for reconsideration and
determine whether to affirm or reverse the adverse regulatory action taken
based on these standards.
(2) DDS
may request, at its discretion, additional information as needed to review the
adverse regulatory action and determine whether the adverse regulatory action
taken should be affirmed or reversed based on these standards.
(c)
(1) DDS shall issue in writing its
determination on reconsideration within thirty (30) days of receiving the
written request for reconsideration or within thirty (30) days of receiving all
information requested by DDS under subdivision (b)(2), whichever is
later.
(2) DDS shall issue its
determination to the Service Provider using the address and contact information
provided in the request for reconsideration.
(d) DDS may also unilaterally decide to
reconsider any adverse regulatory action any time it determines, in its sole
discretion, that an adverse regulatory action was inappropriate.
1002.
Appeal of
Regulatory Actions.
(a) A
Service Provider may administratively appeal any adverse regulatory action to
the DHS Office of Appeals and Hearings (OAH) except for appeals related to the
payment for Medicaid claims and services governed by the Medicaid Fairness Act,
Ark. Code Ann. §
20-77-1701
to -1718, which shall be governed by that Act.
(b) OAH shall conduct administrative appeals
of adverse regulatory actions pursuant to DHS Policy 1098 and other applicable
laws and rules.
(c) A Service
Provider may appeal any adverse regulatory action or other adverse agency
action to circuit court as allowed by the Administrative Procedures Act, Ark.
Code Ann. §
25-15-201 to
-220.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.