Title: Section 69-4.12 - Monitoring of approved service providers (including evaluators, service providers and service coordinators)
69-4.12 Monitoring of approved service providers (including evaluators, service providers and service coordinators).
(a) Providers and municipalities shall be monitored on a periodic basis on a schedule determined by the department and shall comply with all department requirements for monitoring, including timely provision of all applicable records in a format requested by the department or the department’s agent or contractor.
(b) Monitoring procedures shall be used to identify any non-compliance, deficiencies, and need for improvement and shall include any procedures determined necessary by the department to fulfill its obligations to oversee and monitor the Early Intervention Program, and may include, but not be limited to, any of the following components:
(1) On-site visits and desk reviews.
(2) Interviews with personnel responsible for the administration and/or provision of early intervention services.
(3) Where applicable and practicable, interviews with parents of children who received early intervention services from the provider, or parents of eligible children who reside in the municipality responsible for ensuring that early intervention services contained in an IFSP are provided to the eligible child and the child’s family.
(4) A review of any of the following:
(i) Child records, including: child referral information; evaluation reports; individualized family service plans; where applicable, physician referrals for early intervention services; transition plans; session notes; progress notes; and any other documents related to a child’s and family’s participation in the EIP, as requested.
(ii) Data systems and other electronic record-keeping system reviews as determined necessary to assess compliance with the provisions of Title II-A of Article 25 of the Public Health Law and this Subpart, including confidentiality requirements.
(iii) Where applicable, personnel records, including the status of licensure, certification, or registration of qualified personnel, and required clearances, such as the Statewide Central Register on Child Abuse and Neglect.
(iv) Where applicable, the organizational structure of the provider agency and staffing requirements and patterns, including supervision of employees, in-service training, and oversight of contracted providers.
(v) Quality assurance procedures used to monitor the quality, consistency, and service delivery practices, including mechanisms for parent involvement in planning and participating in early intervention services.
(vi) Procedures used to evaluate parent experiences and satisfaction with early intervention services, such as parent surveys and exit interviews; and
(vii) Where applicable, the status of any corrective action plans for any previously identified non-compliance and deficiencies, including verification of correction of non-compliance and identified deficiencies.
(c) When non-compliance or deficiency is identified through one or more monitoring procedures, the department may ensure compliance is attained and maintained by implementing actions that include, but are not limited to, the following:
(1) require submission of a corrective action plan by the provider or municipality and timely correction to address non-compliance and deficiency;
(2) impose conditions on the provider’s participation in the Early Intervention Program;
(3) impose monetary fines or penalties, which may include the withholding or adjustment of state aid reimbursement owed to the provider or municipality; or
(4) initiate proceedings under section 69-4.24 of this Subpart to revoke, suspend, limit, or annul the approval of a provider.
(d) A municipality may monitor evaluators and providers of early intervention services to eligible children who reside in such municipality. Such monitoring may include site visits.
(1) The service coordinator shall report to the municipality, in a format and frequency determined by the municipality, on the delivery of services to an eligible child in accordance with the child’s individualized family service plan.
(i) The municipality may submit a written request to the parent, in accordance with section 69-4.17(b), requesting that the parent select a new service coordinator, if the municipality finds that the service coordinator has not been fulfilling his or her responsibilities to the child and family or that services have not been provided in accordance with the child’s individualized family service plan. If the parent consents to the request, the individualized family service plan shall be reviewed, in accordance with procedures set forth in section 69-4.11(b) of this Part, and amended to include the name of the new service coordinator responsible for implementation of the individualized family service plan.
(ii) The municipality may require the service coordinator to select a new provider of service if the municipality finds that services have not been delivered in accordance with the child’s individualized family service plan. In such cases, the Early Intervention Official shall provide written notice to the parent of the determination, in accordance with procedures set forth in section 69-4.17(b) of this Subpart.
(2) If the Early Intervention Official determines that the evaluator has not complied with the Public Health Law or requirements in section 69-4.8 of this Subpart in conducting an evaluation to determine eligibility, the Early Intervention Official may require that the evaluator immediately submit additional documentation to support the eligibility determination of a child for the Early Intervention Program. If the evaluator does not provide the requested documentation, or the documentation provided continues to be inconsistent with the requirements of the Public Health Law or this Subpart, the Early Intervention Official may require that the parent select another evaluator to conduct a multidisciplinary evaluation to determine whether the child meets eligibility criteria for the Early Intervention Program.
(3) The municipality may implement additional procedures to monitor providers that conduct evaluations and deliver services, including service coordination, to children residing in the municipality, to ensure adherence to the provisions of Title II-A of Article 25 of the Public Health Law and this Subpart.
(i) The municipality shall coordinate the scheduling and monitoring of providers with the department to minimize the administrative burden on providers.
(ii) The municipality shall inform the department of findings of provider monitoring, including any corrective actions imposed on the provider, required timelines for correction, and verification of corrective actions.
(e) Fiscal auditing. For purposes of this section, providers means evaluators and providers of early intervention services approved to deliver services to eligible children and their families.
(1) Each municipality may conduct an audit, in accordance with applicable state laws and regulations, of approved providers who conduct evaluations and provide early intervention services to children residing in the municipality. The municipality shall submit the results of any such audit to the Commissioner for review and, if warranted, adjustments in state aid reimbursement, as well as for recovery by the municipality of its share of any disallowances identified in such audit.
(i) All audits will be based upon these and other applicable regulations and generally accepted accounting principles.
(ii) Audits may include a comprehensive review of all financial records and related documentation.
(2) Prior to the initiation of such audit, the Early Intervention Official shall ascertain that neither the department nor the municipality where evaluations are conducted and services are provided has performed or intends to perform such an audit within 6 months.
(3) A full fiscal audit shall be performed by the municipality.
(4) Where appropriate, auditing shall be performed in conjunction with the department to avoid unnecessary duplication of audit procedures.
(5) Results of the audit shall be made available upon request of any other municipality making payments under the Early Intervention Program to the approved evaluator or provider.
(6) No other municipality may conduct an additional audit for the time period specified above.
VOLUME A-1a (Title 10)