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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 REENGROSSED
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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 REENGROSSED
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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
or more 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 REENGROSSED
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(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) Costs associated with transportation that are necessary to enable an19
infant or toddler and the infant's or toddler's family to receive early intervention20
services.21
(f) Are provided by qualified personnel, including:22
(i) Special educators.23
(ii) Speech-language pathologists and audiologists.24
(iii) Occupational therapists.25
(iv) Physical therapists.26
(v) Psychologists.27
(vi) Social workers.28
(vii) Nurses.29 HLS 13RS-406 REENGROSSED
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(viii) Registered dieticians.1
(ix) Family therapists.2
(x) Vision specialists, including ophthalmologists and optometrists.3
(xi) Orientation and mobility specialists.4
(xii) Pediatricians and other physicians.5
(g) To the maximum extent appropriate, are provided in natural6
environments, including the home and community settings in which children without7
disabilities participate.8
(h) Are provided in conformity with an individualized family service plan9
adopted in accordance with the provisions of this Chapter.10
(5) "IDEA" means the federal Individuals with Disabilities Education Act.11
(6)(a) "Infant or toddler with a disability " means an individual under three12
years of age who needs early intervention services because of either of the following:13
(i) The individual is experiencing developmental delays, as measured by14
appropriate diagnostic instruments and procedures in the areas of cognitive15
development, physical development, communication development, social or16
emotional development, or adaptive development.17
(ii) The individual has a diagnosed physical or mental condition which has18
a high probability of resulting in developmental delay.19
(b) This definition may also include, at the department's discretion, at-risk20
infants and toddlers as defined in Subparagraph (c) of this Paragraph.21
(c) "At-risk infant or toddler" means an individual under three years of age22
who would be at risk of experiencing a substantial developmental delay if early23
intervention services were not provided to the individual.24
(7) "Parent" means a person who meets the definition of such term in federal25
regulations relative to early intervention programs for infants and toddlers with26
disabilities and their families (34 CFR 303.27).27 HLS 13RS-406 REENGROSSED
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§463. Goals1
A. Louisiana shall adopt a policy which incorporates all of the components2
of a statewide system as provided in this Chapter.3
B. The department shall include in its annual application for federal funds4
assurances that the statewide system provided for in this Chapter meets federal5
requirements for such a system and a description of services to be provided in6
accordance with the provisions of this Chapter.7
§464. Requirements for statewide system8
A statewide comprehensive, coordinated, multidisciplinary, interagency9
system to provide early intervention services for infants and toddlers with disabilities10
and their families shall include, at a minimum, the following components:11
(1) A definition of the term "developmental delay" that will be used by the12
department in carrying out the provisions of this Chapter in order to appropriately13
identify infants and toddlers with disabilities who are in need of services provided14
for in this Chapter.15
(2) A state policy that is in effect and which ensures that appropriate early16
intervention services based on scientific research, to the extent practicable, are17
available to all infants and toddlers with disabilities and their families, including18
Indian infants and toddlers with disabilities and their families residing on a19
reservation geographically located in Louisiana, infants and toddlers with disabilities20
who are homeless and their families, and infants and toddlers with disabilities who21
are wards of the state.22
(3) A timely, comprehensive, multidisciplinary evaluation of the functioning23
of each infant and toddler with a disability in Louisiana and a family-directed24
identification of the needs of each family of such an infant or toddler to assist25
appropriately in the development of the infant or toddler.26
(4) For each infant and toddler with a disability in Louisiana, an27
individualized family service plan developed in accordance with applicable federal28 HLS 13RS-406 REENGROSSED
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regulations, including family service coordination in accordance with such service1
plan.2
(5) A comprehensive child-find system, consistent with the federal3
requirements of IDEA-Part B, including a system for making referrals to service4
providers that includes timelines and provides for participation by primary referral5
sources and that ensures rigorous standards for appropriately identifying infants and6
toddlers with disabilities for services pursuant to this Chapter that will reduce the7
need for future services.8
(6) A public awareness program focusing on early identification of infants9
and toddlers with disabilities, including the preparation and dissemination by the10
department to all primary referral sources, especially hospitals and physicians, of11
information for parents, especially for parents with premature infants, or infants with12
other physical risk factors associated with learning or developmental complications,13
on the availability of early intervention services, and procedures for assisting such14
sources in disseminating such information to parents of infants and toddlers with15
disabilities.16
(7) A central directory that includes information on early intervention17
services, resources, and experts available in Louisiana and research and18
demonstration projects being conducted in Louisiana.19
(8)(a) A comprehensive system of personnel development, including the20
training of paraprofessionals and the training of primary referral sources with respect21
to the basic components of early intervention services available in Louisiana, that22
shall include:23
(i) Implementing innovative strategies and activities for the recruitment and24
retention of early education service providers.25
(ii) Promoting the preparation of early intervention providers who are fully26
and appropriately qualified to provide early intervention services.27 HLS 13RS-406 REENGROSSED
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(iii) Training personnel to coordinate transition services for infants and1
toddlers with disabilities from an early intervention program provided for in this2
Chapter to preschool or other appropriate services.3
(b) The comprehensive system of personnel development may include:4
(i) Training personnel to work in rural and inner-city areas.5
(ii) Training personnel in the emotional and social development of young6
children.7
(9) Policies and procedures relating to the establishment and maintenance8
of qualifications to ensure that personnel necessary to carry out the provisions of this9
Chapter are appropriately and adequately prepared and trained, including the10
establishment and maintenance of qualifications that are consistent with any11
state-approved or recognized certification, licensing, registration, or other12
comparable requirements that apply to the area in which such personnel are13
providing early intervention services. Nothing in this Chapter shall be construed to14
prohibit the use of paraprofessionals and assistants who are appropriately trained and15
supervised in accordance with Louisiana law, regulations, or written policy to assist16
in the provision of early intervention services to infants and toddlers with disabilities17
pursuant to the provisions of this Chapter.18
(10) A single line of responsibility in the department for carrying out the19
following functions:20
(a) General administration and supervision of programs and activities21
receiving assistance pursuant to this Chapter, and the monitoring of programs and22
activities used by Louisiana to carry out the provisions of this Chapter, whether or23
not such programs or activities are receiving assistance made available by this24
Chapter, to ensure compliance with this Chapter.25
(b) Identification, coordination, and collection of all available resources26
within Louisiana from federal, state, local, and private sources, including those of27
the system of payments established pursuant to the provisions of R.S. 28:469.28
(c) Assignment of financial responsibility to the appropriate agencies.29 HLS 13RS-406 REENGROSSED
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(d) Development of procedures to ensure that services are provided to infants1
and toddlers with disabilities and their families in a timely manner pending the2
resolution of any disputes among public agencies or service providers.3
(e) Resolution of intra-agency and interagency disputes.4
(f) Entry into formal interagency agreements which conform with all5
applicable provisions of Louisiana law that provide the following:6
(i) Definitions of the financial responsibility of each agency for paying for7
early intervention services.8
(ii) Procedures for resolving disputes.9
(iii) Any additional component necessary to ensure meaningful cooperation10
and coordination.11
(11) A policy pertaining to the contracting or making of other arrangements12
with service providers to provide early intervention services in Louisiana, consistent13
with the provisions of this Chapter, including the contents of the application used and14
the conditions of the contract or other arrangements.15
(12) A procedure for securing timely reimbursement of funds.16
(13) Procedural safeguards with respect to programs.17
(14) A system for compiling data in accordance with information and18
reporting requirements of the United States Secretary of Education.19
(15) A state interagency coordinating council that meets the requirements of20
R.S. 28:470.21
(16) Policies and procedures to ensure all of the following:22
(a) To the maximum extent appropriate, early intervention services are23
provided in natural environments.24
(b) The provision of early intervention services for any infant or toddler with25
a disability occurs in a setting other than a natural environment that is most26
appropriate, as determined by the parent and the individualized family service plan27
team, only when early intervention cannot be achieved satisfactorily for the infant28
or toddler in a natural environment.29 HLS 13RS-406 REENGROSSED
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§465. Individualized family service plan1
A. Assessment and program development shall provide, at a minimum, for2
each infant and toddler with disabilities and the infant's or toddler's family to receive:3
(1) A multidisciplinary assessment of the unique strengths and needs of the4
infant or toddler and the identification of services appropriate to meet such needs.5
(2) A family-directed assessment of the resources, priorities, and concerns6
of the family and the identification of the supports and services necessary to enhance7
the family's capacity to meet the developmental needs of the infant or toddler.8
(3) A written individualized family service plan developed by a9
multidisciplinary team, including the parents, as required by Subsection D of this10
Section, including a description of the appropriate transition services for the infant11
or toddler.12
B. The individualized family service plan shall be evaluated annually, and13
the family shall be provided a review of the plan at six-month intervals or more often14
as appropriate based on the infant or toddler and family needs.15
C. The individualized family service plan shall be developed within a16
reasonable time after the assessment required by Paragraph (A)(1) of this Section is17
completed. With the parent's consent, early intervention services may commence18
prior to the completion of the assessment.19
D. The individualized family service plan shall be in writing and contain all20
of the following:21
(1) A statement of the infant's or toddler's present level of physical22
development, cognitive development, communication development, social or23
emotional development, and adaptive development, based on objective criteria.24
(2) A statement of the family's resources, priorities, and concerns relating to25
enhancing the development of the family's infant or toddler with a disability.26
(3) A statement of the measurable results or outcomes expected to be27
achieved for the infant and toddler and the family, including preliteracy and language28
skills, as developmentally appropriate for the child, and the criteria, procedures, and29 HLS 13RS-406 REENGROSSED
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timelines used to determine the degree to which progress toward achieving the1
results or outcomes is being made and whether modifications or revisions of the2
results or outcomes or services are necessary.3
(4) A statement of specific early intervention services based on4
peer-reviewed research, to the extent practicable, necessary to meet the unique needs5
of the infant or toddler and the family, including the frequency, intensity, and the6
method of delivering services.7
(5) A statement of the natural environments in which early intervention8
services shall appropriately be provided, including a justification of the extent, if9
any, to which the services will not be provided in a natural environment.10
(6) The projected dates for initiation of services and the anticipated length,11
duration, and frequency of the services.12
(7) The identification of the family service coordinator from the profession13
most immediately relevant to the infant's or toddler's or family's needs or who is14
otherwise qualified to carry out all applicable responsibilities pursuant to the15
provisions of this Chapter who will be responsible for the implementation of the plan16
and coordination with other agencies and persons, including transition services.17
(8) The steps to be taken to support the transition of the toddler with a18
disability to preschool or other appropriate services, including the following steps:19
(a) Notify the local educational agency for the area in which such a child20
resides that the child will shortly reach the age of eligibility for preschool services21
pursuant to IDEA-Part B federal regulations as determined in accordance with22
Louisiana law.23
(b) In the case of a child who may be eligible for such preschool services,24
with the approval of the family of the child, convene a conference among the family25
service coordinator, the family, and the local educational agency at least ninety days26
but no more than six months before the child is eligible for the preschool services,27
to discuss any such services that the child may receive.28 HLS 13RS-406 REENGROSSED
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(c) In the case of a child who may not be eligible for such preschool services,1
with the approval of the family, make reasonable efforts to convene a conference2
among the family service coordinator, the family, and providers of other appropriate3
services for children who are not eligible for preschool service pursuant to4
IDEA-Part B federal regulations to discuss the appropriate services that the child5
may receive.6
E. The contents of the individualized family service plan shall be fully7
explained to the parents and informed written consent from the parents shall be8
obtained prior to the provision of early intervention services described in such plan.9
If the parents do not provide consent with respect to a particular early intervention10
service, then only the early intervention services to which consent is obtained shall11
be provided.12
§466. Uses of funds13
In addition to utilizing funds provided pursuant to the provisions of this14
Chapter to implement and maintain the statewide system, the department shall use15
such funds for the following purposes:16
(1) For direct early intervention services for infants and toddlers with17
disabilities and their families as provided in this Chapter that are not otherwise18
funded through public or private sources.19
(2) To expand and improve upon services for infants and toddlers and their20
families as provided in this Chapter that are otherwise available.21
(3) To strengthen the statewide system by initiating, expanding, or22
improving collaborative efforts related to at-risk infants and toddlers, including23
establishing linkages with appropriate public or private community-based24
organizations, services, and personnel for the purposes of:25
(a) Identifying and evaluating at-risk infants and toddlers.26
(b) Making referrals of the infants and toddlers identified and evaluated27
pursuant to the provisions of Subparagraph (a) of this Paragraph.28 HLS 13RS-406 REENGROSSED
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(c) Conducting periodic follow-up on each such referral to determine if the1
status of the infant or toddler involved has changed with respect to the eligibility of2
the infant or toddler for services pursuant to this Chapter.3
§467. Procedural safeguards4
The procedural safeguards which shall be included in a statewide system5
shall provide, at a minimum, the following:6
(1) The timely administrative resolution of complaints by parents. Any party7
aggrieved by the findings and decision regarding an administrative complaint shall8
have the right to bring a civil action with respect to the complaint in any state court9
of competent jurisdiction or in a district court of the United States without regard to10
the amount in controversy. In any action brought pursuant to the provisions of this11
Paragraph, the court shall receive the records of the administrative proceedings, shall12
hear additional evidence at the request of a party, and, basing its decision on the13
preponderance of the evidence, shall grant such relief as the court determines is14
appropriate.15
(2) The right to confidentiality of personally identifiable information,16
including the right of parents to written notice of and written consent to the exchange17
of such information among agencies consistent with applicable provisions of federal18
and state law.19
(3) The right of the parents to determine whether they, their infant or toddler,20
or other family members will accept or decline any early intervention service21
provided for in this Chapter in accordance with state law without jeopardizing other22
early intervention services provided for in this Chapter.23
(4) The opportunity for parents to examine records relating to assessment,24
screening, eligibility determinations, and the development and implementation of the25
individualized family service plan.26
(5) Procedures to protect the rights of the infant or toddler whenever the27
parents of the infant or toddler are not known or cannot be found or the infant or28
toddler is a ward of the state, including the assignment of an individual, who shall29 HLS 13RS-406 REENGROSSED
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not be an employee of the department or any other state agency; and who shall not1
be any person, or any employee of a person, providing early intervention services to2
the infant or toddler or any family member of the infant or toddler to act as a3
surrogate for the parents.4
(6) Written prior notice to the parents of the infant or toddler with a5
disability whenever the state agency or service provider proposes to initiate or6
change or refuses to initiate or change the identification, evaluation, or placement of7
the infant or toddler with a disability, or the provision of appropriate early8
intervention services to the infant or toddler.9
(7) Procedures designed to ensure that the notice required by Paragraph (6)10
of this Section fully informs the parents, in the parents' native language, unless it is11
not feasible to do so, of all procedures available pursuant to this Section.12
(8) The right of parents to use mediation in accordance with Section 615 of13
IDEA.14
(9) During the pendency of any proceeding or action involving a complaint15
by the parents of an infant or toddler with a disability, unless the department and the16
parents otherwise agree, the infant or toddler shall continue to receive the appropriate17
early intervention services currently being provided, or if applying for initial18
services, shall receive the services not in dispute.19
§468. Payor of last resort; nonsubstitution; reduction of other benefits20
A. Funds provided pursuant to this Chapter may not be used to satisfy a21
financial commitment for services that would have been paid for from another public22
or private source, including any medical program administered by the Secretary of23
Defense, but for the enactment of this Chapter; except that whenever considered24
necessary to prevent a delay in the receipt of appropriate early intervention services25
by the infant or toddler or family according to the department's established timeline26
for timely delivery of services, funds provided pursuant to this Chapter may be used27
to pay the provider of services pending reimbursement from the agency that has28
ultimate responsibility for the payment.29 HLS 13RS-406 REENGROSSED
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B. Nothing in this Chapter shall be construed to permit the department to1
reduce medical or other assistance available or to alter eligibility pursuant to Title2
V of the Social Security Act, relating to maternal and child health, or Title XIX of3
the Social Security Act, relating to Medicaid for infants or toddlers with disabilities,4
within the state of Louisiana.5
§469. System of payments; authority of the Department of Health and Hospitals;6
cost participation schedule7
A. The department is hereby authorized to establish a statewide system of8
payments in accordance with the provisions of 34 CFR Part 303.9
B.(1) In implementing the system of payments, the department shall10
promulgate rules for the reimbursement of services from all third-party payers, both11
private and public.12
(2) The department or its designee shall seek payment from all third-party13
payers prior to claiming payment from the IDEA-Part C early intervention system14
of this state for services rendered to eligible children.15
(3) The department or its designee may pay directly to a provider any16
required deductible, copayment, coinsurance, or other out-of-pocket expense for a17
child who is eligible for services from the IDEA-Part C early intervention system of18
this state.19
C.(1)(a) The department shall promulgate rules in accordance with the20
Administrative Procedure Act that establish a schedule of monthly cost participation21
for early intervention services per qualifying family. Cost participation shall be22
based on a sliding scale and shall consider elements, including but not limited to23
adjusted gross income, family size, financial hardship, extraordinary expenses24
associated with the child, and Medicaid eligibility. The department shall be subject25
to all of the following limitations and requirements relative to the cost participation26
schedule:27
(i) The department shall utilize the most recent federal poverty guidelines28
issued in the Federal Register by the United States Department of Health and Human29 HLS 13RS-406 REENGROSSED
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Services as the basis for determining the income threshold based on family size for1
eligibility for cost participation.2
(ii) The department shall not assess any fee or other charge through the cost3
participation schedule upon a family which has annual income of less than three4
hundred percent of the federal poverty level.5
(iii) In any month, the department shall not assess fees or other charges6
through the cost participation schedule which total more than three percent of the7
monthly income level for a family of four, according to the federal poverty guideline8
schedule.9
(iv) The department shall not assess a fee or other charge through the cost10
participation schedule for any service provided for in Item (c)(ii) of this Paragraph.11
(b) Parents who have public or private insurance and elect not to assign such12
right of recovery or indemnification to the department or choose not to release13
financial information shall be assessed the cost for each early intervention service14
listed on the individualized family service plan according to the most current service15
rate schedule and cost participation schedule promulgated by the department.16
(c) The cost participation schedule promulgated by the department shall17
provide all of the following:18
(i) Procedures by which a service provider may notify the department that19
a family is not complying with the cost participation requirements and procedures20
for suspending services.21
(ii) A statement of assurance that fees are not charged for services which a22
child is otherwise entitled to receive at no cost to parents, including child-find23
activities, evaluation and assessment for eligibility and individualized family service24
planning, service coordination, administrative and coordinative activities related to25
development review, evaluation of individualized family service plans, and26
implementation of procedural safeguards and other components of the statewide27
system provided for in R.S. 28:464.28 HLS 13RS-406 REENGROSSED
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(2)(a) The department shall provide prior notification in writing to families1
for use of public or private insurance according to the requirements of 34 CFR2
303.414. Such notification shall include a statement of the general categories of3
costs that the parent would incur and a statement of the process for resolution of a4
dispute regarding decisions related to use of public or private insurance, failure to5
pay for services or the state's determination of a family's ability to pay.6
(b) The department shall ensure that the procedures utilized to resolve such7
disputes will not delay or deny the parents' rights or the child's ability to access8
timely services.9
(3) The aggregate contributions made by the parent shall not exceed the10
aggregate cost of the early intervention services received by the child and family,11
inclusive of any amount received from other sources of payment for a service.12
(4)(a) At least annually, or at any time the department determines is13
warranted, the department shall conduct a reassessment of the parents' financial14
status. A parent may request such reassessment at any time when significant changes15
in financial circumstances may affect the calculation of the cost participation16
amount.17
(b) The department shall not make any administrative decision regarding18
suspension or termination of services for a family prior to the family having been in19
arrears, with respect to fees or other charges assessed pursuant to cost participation,20
for a duration of three months.21
(c) On at least a monthly basis, the department shall send to any family in22
arrears, with respect to fees or other charges assessed pursuant to cost participation,23
notice of the family's right for reconsideration of their financial status and the24
family's right to apply for exemption from cost participation due to financial25
hardship. A copy of the notice shall be sent to the representative and senator in26
whose district the family resides.27 HLS 13RS-406 REENGROSSED
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are additions.
(5) The department shall not limit early intervention services for a child in1
any month if the cost of such services in that month exceeds the maximum monthly2
contribution from the child's family as provided in Item (1)(a)(iii) of this Subsection.3
§470. Louisiana State Interagency Coordinating Council for EarlySteps: Louisiana's4
Early Intervention Program for Infants and Toddlers with Disabilities and5
Their Families6
A. The Louisiana State Interagency Coordinating Council for EarlySteps:7
Louisiana's Early Intervention Program for Infants and Toddlers with Disabilities8
and Their Families is hereby created. All council members shall be appointed by the9
governor who shall also appoint the chairperson. No member of the council who is10
a representative of the department may serve as the chairperson of the council. At11
least twenty percent of the members shall be parents of infants or toddlers with12
disabilities or children with disabilities age twelve or younger, with knowledge of13
or experience with programs for infants and toddlers with disabilities; and at least14
twenty percent of the members shall be public or private providers of early15
intervention services.16
B. The council shall be comprised of the following members:17
(1) At least one member shall be a parent of either of the following:18
(a) An infant or toddler with disabilities.19
(b) A child with disabilities age six or younger.20
(2) At least one member shall be an elected member of the Louisiana21
Legislature.22
(3) At least one member shall be involved in the preparation and training of23
early intervention providers to become qualified to provide services.24
(4) Members in the number of one each from each state agency involved in25
the provision of or payment for early intervention services to infants and toddlers26
with disabilities and their families, including Medicaid, and such members shall have27
sufficient authority to engage in policy planning and implementation on behalf of28
their respective agencies.29 HLS 13RS-406 REENGROSSED
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are additions.
(5) At least one member shall be from the office of the Louisiana1
Department of Education which is responsible for preschool services to children with2
disabilities and who shall have sufficient authority to engage in policy planning and3
implementation on behalf of such agency.4
(6) At least one member shall be from the Louisiana Department of5
Insurance.6
(7) At least one member shall be from a Head Start agency or program.7
(8) At least one member shall be from the Louisiana Department of Children8
and Family Services.9
(9) At least one member designated by the Louisiana Department of10
Education who is responsible for coordination of the education of homeless children11
and youth.12
(10) One member from the Department of Children and Family Services who13
is responsible for foster care.14
(11) One member from the Department of Health and Hospitals, office of15
behavioral health.16
(12) Any other members duly appointed by the governor.17
C. The council shall meet at least quarterly and in such places as it deems18
necessary. The meetings shall be publicly announced and to the extent appropriate,19
open, and accessible to the general public.20
D.(1) Subject to the approval of the governor, the council may prepare and21
approve a budget using funds provided pursuant to the provisions of this Chapter to22
conduct hearings and forums; to reimburse members of the council for reasonable23
and necessary expenses, including child care for parent representatives, for attending24
council meetings, and performing council duties; and to pay compensation to a25
member of the council if the member is not employed or must forfeit wages from26
other employment when performing official council business.27
(2) The council shall use funds provided pursuant to this Chapter to hire an28
executive director who shall be responsible to and report directly to the council and29 HLS 13RS-406 REENGROSSED
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are additions.
the governor or his designee to carry out its functions pursuant to this Chapter. The1
executive director shall be hired as an unclassified employee of the office of the2
governor. The cost of maintaining the functions of the executive director and council3
shall be specified by an interagency agreement between the department and the4
office of the governor. The council may also use funds provided pursuant to this5
Chapter to obtain the services of other such professional, technical, and clerical6
personnel as may be necessary to carry out its functions as provided in this Chapter.7
E. The council shall have the following duties:8
(1) To advise and assist the department in the performance of responsibilities9
established pursuant to this Chapter, particularly the identification of sources of10
fiscal and other support for services for early intervention programs, assignment of11
financial responsibility to the appropriate agency, and the promotion of interagency12
agreements.13
(2) To advise and assist the department in the preparation of applications and14
amendments thereto.15
(3) To advise and assist the department relative to the transition of toddlers16
with disabilities to preschool and other appropriate services.17
(4) To prepare and submit an annual report to the governor and to the United18
States Secretary of Education on the status of early intervention programs for infants19
and toddlers with disabilities and their families operated within the state.20
(5) The council may advise appropriate agencies in the state with respect to21
the integration of services for infants and toddlers with disabilities and at-risk infants22
and toddlers and their families, regardless of whether at-risk infants and toddlers are23
eligible for early intervention services in the state.24
(6) To prepare and submit an annual report to the Legislature of Louisiana25
on the status of the early intervention program of this state for infants and toddlers26
with disabilities and their families.27 HLS 13RS-406 REENGROSSED
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are additions.
F. No member of the council shall cast a vote on any matter which would1
provide direct financial benefit to that member or otherwise give the appearance of2
a conflict of interest.3
Section 2. R.S. 36:4(R) is hereby amended and reenacted to read as follows:4
§4. Structure of executive branch of state government5
* * *6
R. The Louisiana State Interagency Coordinating Council for Child Net:7
EarlySteps: Louisiana's Early Intervention Program for Infants and Toddlers with8
Special Needs Disabilities and Their Families (R.S. 17:1979 R.S. 28:470) is placed9
within the office of the governor and shall exercise and perform its powers, duties,10
functions, and responsibilities in the manner provided for agencies transferred under11
the provisions of R.S. 36:802, except that it shall have any other powers, duties,12
functions, and responsibilities specifically provided in R.S. 17:1979 R.S. 28:470.13
* * *14
Section 3. Part III of Chapter 8 of Title 17 of the Louisiana Revised Statutes of 1950,15
comprised of R.S. 17:1971 through 1979, is hereby repealed in its entirety.16
Section 4. All administrative rules relative to ChildNet: Louisiana's Early17
Intervention Program for Infants and Toddlers with Special Needs and Their Families duly18
promulgated by the Department of Education shall remain effective and shall be deemed to19
have been promulgated by the Department of Health and Hospitals until such time as those20
rules may be revised and repromulgated to provide for the EarlySteps program in accordance21
with the provisions of this Act.22
Section 5. This Act shall become effective upon signature by the governor or, if not23
signed by the governor, upon expiration of the time for bills to become law without signature24
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If25
vetoed by the governor and subsequently approved by the legislature, this Act shall become26
effective on the day following such approval.27 HLS 13RS-406 REENGROSSED
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are additions.
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.
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 requires that DHH utilize funds received pursuant to fees and other charges
authorized by proposed law 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 HLS 13RS-406 REENGROSSED
HB NO. 375
Page 23 of 26
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are additions.
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 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.
(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 subjects DHH to all of the following limitations and requirements relative to
cost participation:
(1)DHH shall utilize the most recent federal poverty guidelines issued in the Federal
Register by the U.S. Dept. of Health and Human Services as the basis for
determining the income threshold based on family size for eligibility for cost
participation.
(2)DHH shall not assess any fee or other charge through the cost participation schedule
upon a family which has annual income of less than 300% of the federal poverty
level.
(3)In any month, DHH shall not assess fees or other charges through the cost
participation schedule which total more than 3% of the monthly income level for a
family of four, according to the federal poverty guideline schedule.
(4)DHH shall not assess a fee or other charge through the cost participation schedule
for any service identified elsewhere in proposed law as a free service.
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. HLS 13RS-406 REENGROSSED
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Page 24 of 26
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are additions.
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 prohibits DHH from making any administrative decision regarding suspension
or termination of services for a family prior to the family having been in arrears, with respect
to fees or other charges assessed pursuant to cost participation, for a duration of three
months.
Proposed law requires DHH, on at least a monthly basis, to send to any family in arrears,
with respect to fees or other charges assessed pursuant to cost participation, notice of the
family's right for reconsideration of their financial status and the family's right to apply for
exemption from cost participation due to financial hardship. Further, requires DHH to send
such notice to the representative and senator in whose district the family resides.
Proposed law prohibits DHH from limiting early intervention services for a child in any
month if the cost of such services in that month exceeds the maximum monthly contribution
from the child's family as provided in proposed law
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.
(2)To advise and assist DHH in the preparation of applications and amendments thereto. HLS 13RS-406 REENGROSSED
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are additions.
(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.
(5)To prepare and submit an annual report to the legislature on the status of the early
intervention program for infants and toddlers with disabilities and their families.
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)
Summary of Amendments Adopted by House
House Floor Amendments to the engrossed bill.
1. Added requirement that the La. State Interagency Coordinating Council for
EarlySteps prepare and submit an annual report to the legislature concerning the
program.
2. Added provisions subjecting DHH to all of the following limitations and
requirements relative to the cost participation schedule provided for in proposed
law:
(a)DHH shall utilize the most recent federal poverty guidelines issued in the
Federal Register by the U.S. Dept. of Health and Human Services as the
basis for determining the income threshold based on family size for
eligibility for cost participation.
(b)DHH shall not assess any fee or other charge through the cost
participation schedule upon a family which has annual income of less
than 300% of the federal poverty level.
(c)In any month, DHH shall not assess fees or other charges through the
cost participation schedule which total more than 3% of the monthly
income level for a family of four, according to the federal poverty
guideline schedule.
(d)DHH shall not assess a fee or other charge through the cost participation
schedule for any service identified elsewhere in proposed law as a free
service. HLS 13RS-406 REENGROSSED
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are additions.
3. Added provision prohibiting DHH from limiting early intervention services for
a child in any month if the cost of such services in that month exceeds the
maximum monthly contribution from the child's family as provided in proposed
law.
4. Added provision prohibiting DHH from making any administrative decision
regarding suspension or termination of services for a family prior to the family
having been in arrears, with respect to fees or other charges assessed pursuant to
cost participation, for a duration of three months.
5. Added provision requiring DHH, on at least a monthly basis, to send to any
family in arrears, with respect to fees or other charges assessed pursuant to cost
participation, notice of the family's right for reconsideration of their financial
status and the family's right to apply for exemption from cost participation due
to financial hardship. Added further requirement that DHH also send such notice
to the representative and senator in whose district the family resides.
6. Changed permissive provision authorizing DHH to utilize funds received
pursuant to fees and other charges authorized by proposed law for support of the
EarlySteps program to a provision requiring that DHH utilize the funds in such
manner.
7. Made technical changes.