Title: Section 69-4.6 - Standards for initial and ongoing service coordinators
69-4.6 Standards for initial and ongoing service coordinators.
(a) All agencies and individuals approved to provide early intervention service coordination shall fulfill those functions and activities necessary to assist and enable an eligible infant and toddler and parent to receive the rights, procedural safeguards and services that are authorized to be provided under State and federal law, including other services not required under the Early Intervention Program, but for which the family may be eligible.
(1) Each eligible infant and toddler and their family shall be provided with one service coordinator who shall be responsible for:
(i) coordinating all services across agency lines; and,
(ii) serving as the single point of contact in helping parents to obtain the services and/or assistance they need.
(b) Service coordination shall be an active ongoing process that involves:
(1) assisting parents of eligible infants and toddlers in gaining access to the early intervention services and other services identified in the individualized family service plan, including making referrals to providers for needed early intervention services and other services identified in the IFSP, and scheduling appointments for infants and toddlers with disabilities and their families;
(2) ensuring the individualized family service plan outcomes and strategies reflect the family's priorities, concerns and resources, and that changes are made as the family's priorities concerns and resources change;
(3) coordinating the provision of early intervention services and other services (such as educational, social, and medical services for other than diagnostic and evaluation purposes) that the infant or toddler and the family needs or is receiving;
(4) facilitating the timely delivery of early intervention services; as soon as possible after written parental consent for the services in the IFSP is obtained and,
(5) continuously seeking the appropriate services and situations necessary to benefit the development of the child for the duration of the child's eligibility.
(c) Specific service coordination activities shall include:
(1) coordinating the performance of evaluations and assessments;
(2) facilitating and participating in the development, review and evaluation of individualized family service plans;
(3) conducting referral and other activities to assist families in identifying available early intervention program service providers;
(4) coordinating, facilitating, and monitoring the delivery of early intervention services to ensure that the services are provided and in a timely manner;
(5) conducting follow-up activities to determine that appropriate early intervention services are being provided and in a timely manner;
(6) informing families of their rights and procedural safeguards;
(7) informing families of the availability of advocacy services;
(8) coordinating with medical and health care providers, including a referral to appropriate primary health care providers as needed;
(9) coordinating the funding sources for services required under this Subpart; and
(10) facilitating the development of a transition plan to preschool services if appropriate or to other available supports and services.
(d) In a format prescribed by the department, initial and ongoing service coordinators shall obtain and update at least quarterly, and parents shall provide, any information and documentation necessary to establish an eligible child's third party payor coverage and the nature and extent of such coverage, including coverage through the medical assistance program, other state governmental insurance or benefit program, and/or other policy, plan, or contract under which the child has coverage. Such service coordinators shall transmit such information and documentation to the early intervention service provider and Early Intervention Official within 14 calendar days of receipt.
(1) Service coordinators shall obtain written parental consent for the exchange of information with the insurer regarding available benefits and to facilitate claiming and payment.
(2) Service coordinators shall submit a written request to, and shall obtain from, the insurer information on the extent of benefits available to the covered child under the child’s third party payor coverage, in accordance with applicable state laws and regulations. The service coordinator shall transmit such information, in a format prescribed by the department, to the early intervention service provider and Early Intervention Official within 14 calendar days of receipt.
(3) Service coordinators shall obtain, and parents shall provide, a written referral from a primary health care provider as documentation of the medical necessity of each early intervention service and shall, within 14 calendar days of receipt, forward this documentation to the early intervention service provider(s) delivering the service(s) to which the written referral applies and to the Early Intervention Official.
VOLUME A-1a (Title 10)