HLS 13RS-406 ENGROSSED Page 1 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. Regular Session, 2013 HOUSE BILL NO. 375 BY REPRESENTATIVE HOFFMANN Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana. EXCEP PERSON/DISABLED: Provides for the EarlySteps childhood disability intervention program and authorizes a fee schedule known as cost participation for services of the program AN ACT1 To amend and reenact R.S. 36:4(R), to enact Chapter 4-B of Title 28 of the Louisiana2 Revised Statutes of 1950, to be comprised of R.S. 28:461 through 470, and to repeal3 Part III of Chapter 8 of Title 17 of the Louisiana Revised Statutes of 1950, comprised4 of R.S. 17:1971 through 1979, relative to the early intervention program of this state5 for infants and toddlers with disabilities and their families; to establish the official6 name of such program; to provide for definitions; to provide for duties of the7 Department of Health and Hospitals relative to program administration; to provide8 requirements for a statewide system of services; to provide relative to payment for9 services; to allow for uses of funds for provision of certain services to eligible10 persons; to provide for authority to establish a statewide system of payments; to11 provide for authority to establish a schedule of fees for services provided to certain12 recipients; to create and provide for duties of the Louisiana State Interagency13 Coordinating Council for EarlyS teps: Louisiana's Early Intervention Program for14 Infants and Toddlers with Disabilities and their Families; to authorize promulgation15 of rules by the Department of Health and Hospitals; to provide for continuation of16 effectiveness of certain administrative rules; and to provide for related matters.17 Be it enacted by the Legislature of Louisiana:18 Section 1. Chapter 4-B of Title 28 of the Louisiana Revised Statutes of 1950,19 comprised of R.S. 28:461 through 470, is hereby enacted to read as follows:20 HLS 13RS-406 ENGROSSED HB NO. 375 Page 2 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. CHAPTER 4-B. EARLYSTEPS: LOUISIANA'S EARLY INTERVENTION1 PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES2 AND THEIR FAMILIES3 §461. Findings; policy4 A. The Louisiana Legislature hereby finds that there is an urgent and5 substantial need in this state for all of the following:6 (1) Enhancements in the development of infants and toddlers with7 disabilities in order to minimize their potential for developmental delay.8 (2) Greater recognition of the significant brain development that occurs9 during a child's first three years of life.10 (3) A reduction to the educational costs to our society, including costs borne11 by Louisiana's schools, through minimizing the need for special education and12 related services after infants and toddlers with disabilities reach school age.13 (4) Maximization of the potential for individuals with disabilities to live14 independently in the community.15 (5) Enhancement of families' capacity to meet the special needs of their16 infants and toddlers with disabilities.17 (6) Enhancement of the capacity of state and local agencies and service18 providers to identify, evaluate, and meet the needs of all children; particularly19 minority, low-income, inner-city, and rural children, and infants and toddlers in20 foster care.21 B. In consideration of the needs described in this Section, it is therefore the22 policy of Louisiana:23 (1) To develop and implement a statewide, comprehensive, coordinated,24 multidisciplinary interagency system that provides early intervention services for25 infants and toddlers with disabilities and their families.26 (2) To establish a state system of payments that provides for the collection,27 facilitation, and coordination of payment for early intervention services from federal,28 HLS 13RS-406 ENGROSSED HB NO. 375 Page 3 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. state, local, and private sources, including public and private insurance coverage and1 cost sharing with those families who qualify.2 (3) To enhance Louisiana's capacity to provide quality early intervention3 services and to expand and improve existing early intervention services currently4 being provided to infants and toddlers with disabilities and their families.5 (4) To encourage Louisiana to expand opportunities for children under three6 years of age who would be at risk of having substantial developmental delay if they7 did not receive early intervention services.8 §462. Definitions9 As used in this Chapter, the following terms shall have the meaning ascribed10 to them in this Section, unless the context clearly indicates otherwise:11 (1) "Cost participation" means fees or other charges through which families12 share in the cost for early intervention services provided pursuant to the provisions13 of this Chapter.14 (2) "Council" means the Louisiana State Interagency Coordinating Council15 for EarlySteps established pursuant to R.S. 28:470.16 (3) "Department" means the Department of Health and Hospitals.17 (4) "Early intervention services" means developmental services that:18 (a) Are provided under public supervision.19 (b) Are provided at no cost except where federal or state law provides for a20 system of payments by families, including but not limited to a schedule providing21 a sliding scale of fees as provided in R.S. 28:469.22 (c) Are designed to meet developmental needs of an infant or toddler with23 a disability, as identified by the individualized family service plan team, in any one24 of the following areas:25 (i) Physical development.26 (ii) Cognitive development.27 (iii) Communication development.28 (iv) Social or emotional development.29 HLS 13RS-406 ENGROSSED HB NO. 375 Page 4 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (v) Adaptive development.1 (d) Meet the standards of the state of Louisiana.2 (e) Include but are not limited to:3 (i) Family training, counseling, and home visits.4 (ii) Special instruction.5 (iii) Speech-language pathology and audiology services and sign language6 and cued language services.7 (iv) Occupational therapy.8 (v) Physical therapy.9 (vi) Psychological services.10 (vii) Family service coordination services.11 (viii) Medical services only for diagnostic or evaluation purposes.12 (ix) Early identification, screening, and assessment services.13 (x) Health services necessary to enable the infant or toddler to benefit from14 other early intervention services.15 (xi) Social work services.16 (xii) Vision services.17 (xiii) Assistive technology devices and assistive technology services.18 (xiv) Transportation and related costs that are necessary to enable an infant19 or toddler and the infant's or toddler's family to receive early intervention services.20 (f) Are provided by qualified personnel, including:21 (i) Special educators.22 (ii) Speech-language pathologists and audiologists.23 (iii) Occupational therapists.24 (iv) Physical therapists.25 (v) Psychologists.26 (vi) Social workers.27 (vii) Nurses.28 (viii) Registered dieticians.29 HLS 13RS-406 ENGROSSED HB NO. 375 Page 5 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (ix) Family therapists.1 (x) Vision specialists, including ophthalmologists and optometrists.2 (xi) Orientation and mobility specialists.3 (xii) Pediatricians and other physicians.4 (g) To the maximum extent appropriate, are provided in natural5 environments, including the home and community settings in which children without6 disabilities participate.7 (h) Are provided in conformity with an individualized family service plan8 adopted in accordance with the provisions of this Chapter.9 (5) "IDEA" means the federal Individuals with Disabilities Education Act.10 (6)(a) "Infant or toddler with a disability " means an individual under three11 years of age who needs early intervention services because of either of the following:12 (i) The individual is experiencing developmental delays, as measured by13 appropriate diagnostic instruments and procedures in the areas of cognitive14 development, physical development, communication development, social or15 emotional development, or adaptive development.16 (ii) The individual has a diagnosed physical or mental condition which has17 a high probability of resulting in developmental delay.18 (b) This definition may also include, at Louisiana's discretion, at-risk infants19 and toddlers as defined in Subparagraph (c) of this Paragraph.20 (c) "At-risk infant or toddler" means an individual under three years of age21 who would be at risk of experiencing a substantial developmental delay if early22 intervention services were not provided to the individual.23 (7) "Parent" means a person who meets the definition of such term in federal24 regulations relative to early intervention programs for infants and toddlers with25 disabilities and their families (34 CFR 303.27).26 §463. Goals27 A. Louisiana shall adopt a policy which incorporates all of the components28 of a statewide system as provided in this Chapter.29 HLS 13RS-406 ENGROSSED HB NO. 375 Page 6 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. B. The department shall include in its annual application for federal funds1 assurances that the statewide system provided for in this Chapter meets federal2 requirements for such a system and a description of services to be provided in3 accordance with the provisions of this Chapter.4 §464. Requirements for statewide system5 A statewide comprehensive, coordinated, multidisciplinary, interagency6 system to provide early intervention services for infants and toddlers with disabilities7 and their families shall include, at a minimum, the following components:8 (1) A definition of the term "developmental delay" that will be used by9 Louisiana in carrying out the provisions of this Chapter in order to appropriately10 identify infants and toddlers with disabilities who are in need of services provided11 for in this Chapter.12 (2) A state policy that is in effect and which ensures that appropriate early13 intervention services based on scientific research, to the extent practicable, are14 available to all infants and toddlers with disabilities and their families, including15 Indian infants and toddlers with disabilities and their families residing on a16 reservation geographically located in Louisiana, infants and toddlers with disabilities17 who are homeless and their families, and infants and toddlers with disabilities who18 are wards of the state.19 (3) A timely, comprehensive, multidisciplinary evaluation of the functioning20 of each infant and toddler with a disability in Louisiana and a family-directed21 identification of the needs of each family of such an infant or toddler to assist22 appropriately in the development of the infant or toddler.23 (4) For each infant and toddler with a disability in Louisiana, an24 individualized family service plan developed in accordance with applicable federal25 regulations, including family service coordination in accordance with such service26 plan.27 (5) A comprehensive child-find system, consistent with the federal28 requirements of IDEA-Part B, including a system for making referrals to service29 HLS 13RS-406 ENGROSSED HB NO. 375 Page 7 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. providers that includes timelines and provides for participation by primary referral1 sources and that ensures rigorous standards for appropriately identifying infants and2 toddlers with disabilities for services pursuant to this Chapter that will reduce the3 need for future services.4 (6) A public awareness program focusing on early identification of infants5 and toddlers with disabilities, including the preparation and dissemination by the6 department to all primary referral sources, especially hospitals and physicians, of7 information for parents, especially for parents with premature infants, or infants with8 other physical risk factors associated with learning or developmental complications,9 on the availability of early intervention services, and procedures for assisting such10 sources in disseminating such information to parents of infants and toddlers with11 disabilities.12 (7) A central directory that includes information on early intervention13 services, resources, and experts available in Louisiana and research and14 demonstration projects being conducted in Louisiana.15 (8)(a) A comprehensive system of personnel development, including the16 training of paraprofessionals and the training of primary referral sources with respect17 to the basic components of early intervention services available in Louisiana, that18 shall include:19 (i) Implementing innovative strategies and activities for the recruitment and20 retention of early education service providers.21 (ii) Promoting the preparation of early intervention providers who are fully22 and appropriately qualified to provide early intervention services.23 (iii) Training personnel to coordinate transition services for infants and24 toddlers served pursuant to this Chapter from an early intervention program provided25 for in this Chapter to preschool or other appropriate services.26 (b) The comprehensive system of personnel development may include:27 (i) Training personnel to work in rural and inner-city areas.28 HLS 13RS-406 ENGROSSED HB NO. 375 Page 8 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (ii) Training personnel in the emotional and social development of young1 children.2 (9) Policies and procedures relating to the establishment and maintenance3 of qualifications to ensure that personnel necessary to carry out the provisions of this4 Chapter are appropriately and adequately prepared and trained, including the5 establishment and maintenance of qualifications that are consistent with any6 state-approved or recognized certification, licensing, registration, or other7 comparable requirements that apply to the area in which such personnel are8 providing early intervention services. Nothing in this Chapter, including this9 Paragraph, shall be construed to prohibit the use of paraprofessionals and assistants10 who are appropriately trained and supervised in accordance with Louisiana law,11 regulations, or written policy to assist in the provision of early intervention services12 to infants and toddlers with disabilities pursuant to the provisions of this Chapter.13 (10) A single line of responsibility in the department for carrying out the14 following functions:15 (a) General administration and supervision of programs and activities16 receiving assistance pursuant to this Chapter, and the monitoring of programs and17 activities used by Louisiana to carry out the provisions of this Chapter, whether or18 not such programs or activities are receiving assistance made available by this19 Chapter, to ensure compliance with this Chapter.20 (b) Identification, coordination, and collection of all available resources21 within Louisiana from federal, state, local, and private sources, including those of22 the system of payments established pursuant to the provisions of R.S. 28:969.23 (c) Assignment of financial responsibility to the appropriate agencies.24 (d) Development of procedures to ensure that services are provided to infants25 and toddlers with disabilities and their families in a timely manner pending the26 resolution of any disputes among public agencies or service providers.27 (e) Resolution of intra-agency and interagency disputes.28 HLS 13RS-406 ENGROSSED HB NO. 375 Page 9 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (f) Entry into formal interagency agreements which conform with all1 applicable provisions of Louisiana law that provide the following:2 (i) Definitions of the financial responsibility of each agency for paying for3 early intervention services.4 (ii) Procedures for resolving disputes.5 (iii) Any additional component necessary to ensure meaningful cooperation6 and coordination.7 (11) A policy pertaining to the contracting or making of other arrangements8 with service providers to provide early intervention services in Louisiana, consistent9 with the provisions of this Chapter, including the contents of the application used and10 the conditions of the contract or other arrangements.11 (12) A procedure for securing timely reimbursement of funds.12 (13) Procedural safeguards with respect to programs.13 (14) A system for compiling data in accordance with information and14 reporting requirements of the United States Secretary of Education.15 (15) A state interagency coordinating council that meets the requirements of16 R.S. 28:470.17 (16) Policies and procedures to ensure all of the following:18 (a) To the maximum extent appropriate, early intervention services are19 provided in natural environments.20 (b) The provision of early intervention services for any infant or toddler with21 a disability occurs in a setting other than a natural environment that is most22 appropriate, as determined by the parent and the individualized family service plan23 team, only when early intervention cannot be achieved satisfactorily for the infant24 or toddler in a natural environment.25 §465. Individualized family service plan26 A. Assessment and program development shall provide, at a minimum, for27 each infant and toddler with disabilities and the infant's or toddler's family to receive:28 HLS 13RS-406 ENGROSSED HB NO. 375 Page 10 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (1) A multidisciplinary assessment of the unique strengths and needs of the1 infant or toddler and the identification of services appropriate to meet such needs.2 (2) A family-directed assessment of the resources, priorities, and concerns3 of the family and the identification of the supports and services necessary to enhance4 the family's capacity to meet the developmental needs of the infant or toddler.5 (3) A written individualized family service plan developed by a6 multidisciplinary team, including the parents, as required by Subsection D of this7 Section, including a description of the appropriate transition services for the infant8 or toddler.9 B. The individualized family service plan shall be evaluated annually, and10 the family shall be provided a review of the plan at six-month intervals or more often11 as appropriate based on the infant or toddler and family needs.12 C. The individualized family service plan shall be developed within a13 reasonable time after the assessment required by Paragraph (A)(1) of this Section is14 completed. With the parent's consent, early intervention services may commence15 prior to the completion of the assessment.16 D. The individualized family service plan shall be in writing and contain all17 of the following:18 (1) A statement of the infant's or toddler's present level of physical19 development, cognitive development, communication development, social or20 emotional development, and adaptive development, based on objective criteria.21 (2) A statement of the family's resources, priorities, and concerns relating to22 enhancing the development of the family's infant or toddler with a disability.23 (3) A statement of the measurable results or outcomes expected to be24 achieved for the infant and toddler and the family, including preliteracy and language25 skills, as developmentally appropriate for the child, and the criteria, procedures, and26 timelines used to determine the degree to which progress toward achieving the27 results or outcomes is being made and whether modifications or revisions of the28 results or outcomes or services are necessary.29 HLS 13RS-406 ENGROSSED HB NO. 375 Page 11 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (4) A statement of specific early intervention services based on1 peer-reviewed research, to the extent practicable, necessary to meet the unique needs2 of the infant or toddler and the family, including the frequency, intensity, and the3 method of delivering services.4 (5) A statement of the natural environments in which early intervention5 services shall appropriately be provided, including a justification of the extent, if6 any, to which the services will not be provided in a natural environment.7 (6) The projected dates for initiation of services and the anticipated length,8 duration, and frequency of the services.9 (7) The identification of the family service coordinator from the profession10 most immediately relevant to the infant's or toddler's or family's needs or who is11 otherwise qualified to carry out all applicable responsibilities pursuant to the12 provisions of this Chapter who will be responsible for the implementation of the plan13 and coordination with other agencies and persons, including transition services.14 (8) The steps to be taken to support the transition of the toddler with a15 disability to preschool or other appropriate services, including the following steps:16 (a) Notify the local educational agency for the area in which such a child17 resides that the child will shortly reach the age of eligibility for preschool services18 pursuant to IDEA-Part B federal regulations as determined in accordance with19 Louisiana law.20 (b) In the case of a child who may be eligible for such preschool services,21 with the approval of the family of the child, convene a conference among the family22 service coordinator, the family, and the local educational agency at least ninety days23 but no more than six months before the child is eligible for the preschool services,24 to discuss any such services that the child may receive.25 (c) In the case of a child who may not be eligible for such preschool services,26 with the approval of the family, make reasonable efforts to convene a conference27 among the family service coordinator, the family, and providers of other appropriate28 services for children who are not eligible for preschool service pursuant to29 HLS 13RS-406 ENGROSSED HB NO. 375 Page 12 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. IDEA-Part B federal regulations to discuss the appropriate services that the child1 may receive.2 E. The contents of the individualized family service plan shall be fully3 explained to the parents and informed written consent from the parents shall be4 obtained prior to the provision of early intervention services described in such plan.5 If the parents do not provide consent with respect to a particular early intervention6 service, then only the early intervention services to which consent is obtained shall7 be provided.8 §466. Uses of funds9 In addition to utilizing funds provided pursuant to the provisions of this10 Chapter to implement and maintain the statewide system, Louisiana may use such11 funds for the following purposes:12 (1) For direct early intervention services for infants and toddlers with13 disabilities and their families as provided in this Chapter that are not otherwise14 funded through public or private sources.15 (2) To expand and improve upon services for infants and toddlers and their16 families as provided in this Chapter that are otherwise available.17 (3) To strengthen the statewide system by initiating, expanding, or18 improving collaborative efforts related to at-risk infants and toddlers, including19 establishing linkages with appropriate public or private community-based20 organizations, services, and personnel for the purposes of:21 (a) Identifying and evaluating at-risk infants and toddlers.22 (b) Making referrals of the infants and toddlers identified and evaluated23 pursuant to the provisions of Subparagraph (a) of this Paragraph.24 (c) Conducting periodic follow-up on each such referral to determine if the25 status of the infant or toddler involved has changed with respect to the eligibility of26 the infant or toddler for services pursuant to this Chapter.27 HLS 13RS-406 ENGROSSED HB NO. 375 Page 13 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. §467. Procedural safeguards1 The procedural safeguards which shall be included in a statewide system2 shall provide, at a minimum, the following:3 (1) The timely administrative resolution of complaints by parents. Any party4 aggrieved by the findings and decision regarding an administrative complaint shall5 have the right to bring a civil action with respect to the complaint in any state court6 of competent jurisdiction or in a district court of the United States without regard to7 the amount in controversy. In any action brought pursuant to the provisions of this8 Paragraph, the court shall receive the records of the administrative proceedings, shall9 hear additional evidence at the request of a party, and, basing its decision on the10 preponderance of the evidence, shall grant such relief as the court determines is11 appropriate.12 (2) The right to confidentiality of personally identifiable information,13 including the right of parents to written notice of and written consent to the exchange14 of such information among agencies consistent with applicable provisions of federal15 and state law.16 (3) The right of the parents to determine whether they, their infant or toddler,17 or other family members will accept or decline any early intervention service18 provided for in this Chapter in accordance with state law without jeopardizing other19 early intervention services provided for in this Chapter.20 (4) The opportunity for parents to examine records relating to assessment,21 screening, eligibility determinations, and the development and implementation of the22 individualized family service plan.23 (5) Procedures to protect the rights of the infant or toddler whenever the24 parents of the infant or toddler are not known or cannot be found or the infant or25 toddler is a ward of the state, including the assignment of an individual, who shall26 not be an employee of the department or any other state agency; and who shall not27 be any person, or any employee of a person, providing early intervention services to28 HLS 13RS-406 ENGROSSED HB NO. 375 Page 14 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. the infant or toddler or any family member of the infant or toddler to act as a1 surrogate for the parents.2 (6) Written prior notice to the parents of the infant or toddler with a3 disability whenever the state agency or service provider proposes to initiate or4 change or refuses to initiate or change the identification, evaluation, or placement of5 the infant or toddler with a disability, or the provision of appropriate early6 intervention services to the infant or toddler.7 (7) Procedures designed to ensure that the notice required by Paragraph (6)8 of this Section fully informs the parents, in the parents' native language, unless it is9 not feasible to do so, of all procedures available pursuant to this Section.10 (8) The right of parents to use mediation in accordance with Section 615 of11 IDEA.12 (9) During the pendency of any proceeding or action involving a complaint13 by the parents of an infant or toddler with a disability, unless the department and the14 parents otherwise agree, the infant or toddler shall continue to receive the appropriate15 early intervention services currently being provided, or if applying for initial16 services, shall receive the services not in dispute.17 §468. Payor of last resort; nonsubstitution; reduction of other benefits18 A. Funds provided pursuant to this Chapter may not be used to satisfy a19 financial commitment for services that would have been paid for from another public20 or private source, including any medical program administered by the Secretary of21 Defense, but for the enactment of this Chapter; except that whenever considered22 necessary to prevent a delay in the receipt of appropriate early intervention services23 by the infant or toddler or family in a timely fashion, funds provided pursuant to this24 Chapter may be used to pay the provider of services pending reimbursement from25 the agency that has ultimate responsibility for the payment.26 B. Nothing in this Chapter shall be construed to permit Louisiana to reduce27 medical or other assistance available or to alter eligibility pursuant to Title V of the28 Social Security Act, relating to maternal and child health, or Title XIX of the Social29 HLS 13RS-406 ENGROSSED HB NO. 375 Page 15 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. Security Act, relating to Medicaid for infants or toddlers with disabilities, within the1 state of Louisiana.2 §469. System of payments; authority of the Department of Health and Hospitals;3 cost participation schedule4 A. The department is hereby authorized to establish a statewide system of5 payments in accordance with the provisions of 34 CFR Part 303.6 B.(1) In implementing the system of payments, the department shall7 promulgate rules for the reimbursement of services from all third-party payers, both8 private and public.9 (2) In the first instance and where applicable, the department or its designee10 shall seek payment from all third-party payers prior to claiming payment from the11 IDEA-Part C early intervention system of this state for services rendered to eligible12 children.13 (3) The department or its designee may pay directly to a provider any14 required deductible, copayment, coinsurance, or other out-of-pocket expense for a15 child who is eligible for services from the IDEA-Part C early intervention system of16 this state.17 C.(1)(a) The department shall promulgate rules in accordance with the18 Administrative Procedure Act that establish a schedule of monthly cost participation19 for early intervention services per qualifying family. Cost participation shall be20 based on a sliding scale and shall consider elements, including but not limited to21 adjusted gross income, family size, financial hardship, extraordinary expenses22 associated with the child, and Medicaid eligibility.23 (b) Parents who have public or private insurance and elect not to assign such24 right of recovery or indemnification to the department or choose not to release25 financial information shall be assessed the cost for each early intervention service26 listed on the individualized family service plan according to the most current service27 rate schedule and cost participation schedule promulgated by the department.28 HLS 13RS-406 ENGROSSED HB NO. 375 Page 16 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (c) The cost participation schedule promulgated by the department shall1 provide all of the following:2 (i) Procedures by which a service provider may notify the department that3 a family is not complying with the cost participation requirements and procedures4 for suspending services.5 (ii) A statement of assurance that fees are not charged for services which a6 child is otherwise entitled to receive at no cost to parents, including child find7 activities, evaluation and assessment for eligibility and individualized family service8 planning, service coordination, administrative and coordinative activities related to9 development review, evaluation of individualized family service plans, and10 implementation of procedural safeguards and other components of the statewide11 system provided for in R.S. 28:464.12 (2)(a) The department shall provide prior notification in writing to families13 for use of public or private insurance according to the requirements of 42 CFR14 303.414. Such notification shall include a statement of the general categories of15 costs that the parent would incur and a statement of the process for resolution of a16 dispute regarding decisions related to use of public or private insurance, failure to17 pay for services or the state's determination of a family's ability to pay.18 (b) The department shall ensure that the procedures utilized to resolve such19 disputes will not delay or deny the parents' rights or the child's ability to access20 timely services.21 (3) The aggregate contributions made by the parent shall not exceed the22 aggregate cost of the early intervention services received by the child and family,23 inclusive of any amount received from other sources of payment for a service.24 (4) At least annually, or at any time the department determines is warranted,25 the lead agency shall conduct a reassessment of the parents' financial status. A26 parent may request such reassessment at any time when significant changes in27 financial circumstances may affect the calculation of the cost participation amount.28 HLS 13RS-406 ENGROSSED HB NO. 375 Page 17 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. §470. Louisiana State Interagency Coordinating Council for EarlySteps: Louisiana's1 Early Intervention Program for Infants and Toddlers with Disabilities and2 Their Families3 A. The Louisiana State Interagency Coordinating Council for EarlySteps:4 Louisiana's Early Intervention Program for Infants and Toddlers with Disabilities5 and Their Families is hereby created. All council members shall be appointed by the6 governor who shall also appoint the chairperson. No member of the council who is7 a representative of the department may serve as the chairperson of the council. At8 least twenty percent of the members shall be parents of infants or toddlers with9 disabilities or children with disabilities age twelve or younger, with knowledge of10 or experience with programs for infants and toddlers with disabilities; and at least11 twenty percent of the members shall be public or private providers of early12 intervention services.13 B. The council shall be comprised of the following members:14 (1) At least one member shall be a parent of either of the following:15 (a) An infant or toddler with disabilities.16 (b) A child with disabilities age six or younger.17 (2) At least one member shall be an elected member of the Louisiana18 Legislature.19 (3) At least one member shall be involved in personnel preparation.20 (4) Members in the number of one each from each state agency involved in21 the provision of or payment for early intervention services to infants and toddlers22 with disabilities and their families, including Medicaid, and such members shall have23 sufficient authority to engage in policy planning and implementation on behalf of24 their respective agencies.25 (5) At least one member shall be from the office of the Louisiana26 Department of Education which is responsible for preschool services to children with27 disabilities and who shall have sufficient authority to engage in policy planning and28 implementation on behalf of such agency.29 HLS 13RS-406 ENGROSSED HB NO. 375 Page 18 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (6) At least one member shall be from the Louisiana Department of1 Insurance.2 (7) At least one member shall be from a Head Start agency or program.3 (8) At least one member shall be from the Louisiana Department of Children4 and Family Services.5 (9) At least one member designated by the Louisiana Department of6 Education who is responsible for coordination of the education of homeless children7 and youth.8 (10) One member from the Department of Children and Family Services who9 is responsible for foster care.10 (11) One member from the Department of Health and Hospitals, office of11 behavioral health.12 (12) Any other members duly appointed by the governor.13 C. The council shall meet at least quarterly and in such places as it deems14 necessary. The meetings shall be publicly announced and to the extent appropriate,15 open, and accessible to the general public.16 D.(1) Subject to the approval of the governor, the council may prepare and17 approve a budget using funds provided pursuant to the provisions of this Chapter to18 conduct hearings and forums; to reimburse members of the council for reasonable19 and necessary expenses, including child care for parent representatives, for attending20 council meetings, and performing council duties; and to pay compensation to a21 member of the council if the member is not employed or must forfeit wages from22 other employment when performing official council business.23 (2) The council shall use funds provided pursuant to this Chapter to hire an24 executive director who shall be responsible to and report directly to the council and25 the governor or his designee to carry out its functions pursuant to this Chapter. The26 executive director shall be hired as an unclassified employee of the office of the27 governor. The cost of maintaining the functions of the executive director and council28 shall be specified by an interagency agreement between the department and the29 HLS 13RS-406 ENGROSSED HB NO. 375 Page 19 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. office of the governor. The council may also use funds provided pursuant to this1 Chapter to obtain the services of other such professional, technical, and clerical2 personnel as may be necessary to carry out its functions as provided in this Chapter.3 E. The council shall have the following duties:4 (1) To advise and assist the department in the performance of responsibilities5 established pursuant to this Chapter, particularly the identification of sources of6 fiscal and other support for services for early intervention programs, assignment of7 financial responsibility to the appropriate agency, and the promotion of interagency8 agreements.9 (2) To advise and assist the department in the preparation of applications and10 amendments thereto.11 (3) To advise and assist the department relative to the transition of toddlers12 with disabilities to preschool and other appropriate services.13 (4) To prepare and submit an annual report to the governor and to the United14 States Secretary of Education on the status of early intervention programs for infants15 and toddlers with disabilities and their families operated within the state.16 (5) The council may advise appropriate agencies in the state with respect to17 the integration of services for infants and toddlers with disabilities and at-risk infants18 and toddlers and their families, regardless of whether at-risk infants and toddlers are19 eligible for early intervention services in the state.20 F. No member of the council shall cast a vote on any matter which would21 provide direct financial benefit to that member or otherwise give the appearance of22 a conflict of interest.23 Section 2. R.S. 36:4(R) is hereby amended and reenacted to read as follows:24 §4. Structure of executive branch of state government25 * * *26 R. The Louisiana State Interagency Coordinating Council for Child Net:27 EarlySteps: Louisiana's Early Intervention Program for Infants and Toddlers with28 Special Needs Disabilities and Their Families (R.S. 17:1979 R.S. 28:470) is placed29 HLS 13RS-406 ENGROSSED HB NO. 375 Page 20 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. within the office of the governor and shall exercise and perform its powers, duties,1 functions, and responsibilities in the manner provided for agencies transferred under2 the provisions of R.S. 36:802, except that it shall have any other powers, duties,3 functions, and responsibilities specifically provided in R.S. 17:1979 R.S. 28:470.4 * * *5 Section 3. Part III of Chapter 8 of Title 17 of the Louisiana Revised Statutes of 1950,6 comprised of R.S. 17:1971 through 1979, is hereby repealed in its entirety.7 Section 4. All administrative rules relative to ChildNet: Louisiana's Early8 Intervention Program for Infants and Toddlers with Special Needs and Their Families duly9 promulgated by the Department of Education shall remain effective and shall be deemed to10 have been promulgated by the Department of Health and Hospitals until such time as those11 rules may be revised and repromulgated to provide for the EarlySteps program in accordance12 with the provisions of this Act.13 Section 5. This Act shall become effective upon signature by the governor or, if not14 signed by the governor, upon expiration of the time for bills to become law without signature15 by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If16 vetoed by the governor and subsequently approved by the legislature, this Act shall become17 effective on the day following such approval.18 DIGEST The digest printed below was prepared by House Legislative Services. It constitutes no part of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)] Hoffmann HB No. 375 Abstract: Provides for the EarlySteps childhood disability intervention program and the La. State Interagency Coordinating Council for EarlySteps. Authorizes a fee schedule known as cost participation for services of the program. Proposed law deletes present law in Title 17 of the La. Revised Statutes of 1950 (R.S. 17:1971-1979), relative to ChildNet: La.'s Early Intervention Program for Infants and Toddlers with Special Needs and their Families. Proposed law recreates and revises certain provisions of present law relative to the ChildNet Program; changes the program name to "EarlySteps: La.'s Early Intervention Program for Infants and Toddlers with Disabilities and their Families"; and locates provisions relative to the EarlySteps Program in Title 28 of the La. Revised Statutes of 1950. HLS 13RS-406 ENGROSSED HB NO. 375 Page 21 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. Proposed law provides legislative findings relative to infants and toddlers with disabilities and their families, and defines terms used in proposed law. Proposed law provides for policies, goals, and requirements of a statewide comprehensive, coordinated, multidisciplinary, interagency system to provide early intervention services for infants and toddlers with disabilities and their families. Further provides for procedural safeguards which shall be included in such statewide system. Proposed law provides for requirements of individualized family service plans for infants, toddlers, and families who receive services through the EarlySteps program. Proposed law authorizes the use of funds for the following purposes: (1)Implementing and maintaining the statewide system providing early intervention services. (2)Providing direct early intervention services for infants and toddlers with disabilities and their families as provided in proposed law that are not otherwise funded through public or private sources. (3)Expanding and improving services for infants and toddlers and their families as provided in proposed law that are otherwise available. (4)Strengthening the statewide system by initiating, expanding, or improving collaborative efforts related to at-risk infants and toddlers, including establishing linkages with appropriate public or private community-based organizations, services, and personnel. Proposed law stipulates that funds provided to implement provisions of proposed law may not be used to satisfy a financial commitment for services that would have been paid for from another public or private source, including any medical program administered by the U.S. Secretary of Defense, but for the enactment of proposed law; except that whenever considered necessary to prevent a delay in the receipt of appropriate early intervention services by the infant or toddler or family in a timely fashion, funds provided pursuant to the provisions of proposed law may be used to pay the provider of services pending reimbursement from the agency that has ultimate responsibility for the payment. Proposed law provides that nothing in proposed law shall be construed to permit La. to reduce medical or other assistance available or to alter eligibility pursuant to Title V of the Social Security Act relating to maternal and child health, or Title XIX of the Social Security Act relating to Medicaid for infants or toddlers with disabilities, within the state of La. Proposed law authorizes DHH to establish a statewide system of payments for services provided pursuant to proposed law which comports with federal regulations relative to early intervention programs for infants and toddlers with disabilities and their families (34 CFR Part 303). Further provides that in implementing such system of payments, DHH: (1)Shall promulgate rules for the reimbursement of services from all third-party payers, both private and public. (2)Shall, in the first instance and where applicable, seek payment from all third-party payers prior to claiming payment from the early intervention system for services rendered to eligible children. (3)May pay directly to a provider any required deductible, copayment, coinsurance, or other out-of-pocket expense for a child who is eligible for services from the early intervention system. HLS 13RS-406 ENGROSSED HB NO. 375 Page 22 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (4)Shall promulgate rules that establish a schedule of monthly cost participation for early intervention services per qualifying family. Proposed law defines "cost participation" as fees or other charges through which families share in the cost for services provided pursuant to proposed law. Proposed law authorizes DHH to establish procedures by which a service provider may notify the department that a family is not complying with the cost participation requirements and procedures for suspending services. Proposed law requires DHH to include in the cost participation schedule a statement of assurance that fees are not charged for services which a child is otherwise entitled to receive at no cost to parents, including child find activities, evaluation and assessment for eligibility and individualized family service planning, service coordination, administrative and coordinative activities related to development review, evaluation of individualized family service plans, and implementation of procedural safeguards and other components of the statewide system provided for in proposed law. Proposed law requires DHH to provide prior notification in writing to families relative to use of public or private insurance according to requirements provided in federal regulations. Also requires DHH to ensure that procedures utilized to resolve disputes related to use of insurance to cover services will not delay or deny the parents' rights or the child's ability to access timely services. Proposed law provides that the aggregate contributions made by the parent for services provided pursuant to proposed law shall not exceed the aggregate cost of the services, inclusive of any amount received from other sources of payment for a service. Proposed law provides that at least annually, or at any time the department determines is warranted, the lead agency shall conduct a reassessment of the parents' financial status. Provides that a parent may request such reassessment at any time when significant changes in financial circumstances may affect the calculation of the cost participation amount. Proposed law creates and provides for the membership of the La. State Interagency Coordinating Council for EarlySteps: La.'s Early Intervention Program for Infants and Toddlers with Disabilities and Their Families, referred to hereafter as "the council". Proposed law provides that subject to the approval of the governor, the council may use funds provided pursuant to the provisions of proposed law for the following purposes: (1)To conduct hearings and forums. (2)To reimburse members of the council for reasonable and necessary expenses for attending council meetings and performing council duties. (3)To pay compensation to a member of the council if the member is not employed or must forfeit wages from other employment when performing official council business. (4)To obtain the services of professional, technical, and clerical personnel as may be necessary to carry out its functions as provided in proposed law. Proposed law requires that the council hire an executive director who shall be an unclassified employee of the office of the governor. Proposed law provides that the council shall have the following duties: (1)To advise and assist DHH in the performance of the responsibilities established pursuant to the provisions of proposed law. HLS 13RS-406 ENGROSSED HB NO. 375 Page 23 of 23 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (2)To advise and assist DHH in the preparation of applications and amendments thereto. (3)To advise and assist the department regarding the transition of toddlers with disabilities to preschool and other appropriate services. (4)To prepare and submit an annual report to the governor and to the U.S. Secretary of Education on the status of early intervention programs for infants and toddlers with disabilities and their families operating in La. Proposed law provides that the council may advise appropriate agencies in the state with respect to the integration of services for infants and toddlers with disabilities and at-risk infants and toddlers and their families, regardless of whether at-risk infants and toddlers are eligible for early intervention services in the state. Proposed law stipulates that no member of the council shall cast a vote on any matter which would provide direct financial benefit to that member or otherwise give the appearance of a conflict of interest. Proposed law provides that all administrative rules relative to the ChildNet program promulgated by the Dept. of Education shall remain effective and shall be deemed to have been promulgated by DHH until such time as those rules may be revised and repromulgated to provide for the EarlySteps program in accordance with the provisions of proposed law. Effective upon signature of governor or lapse of time for gubernatorial action. (Amends R.S. 36:4(R); Adds R.S. 28:461-470; Repeals R.S. 17:1971-1979)