Tracking# 2013-01207
FA/P 1/10/14, eff. 3/2/14 

I:/13091601.rtf
(I:/13091601.doc)

(12 CCR 2509-1) 

[Instructions: insert before line 2463954.] 
Revisions to Sections 7.900, 7.913, 7.920, and 7.980 were final adoption following publication at the 1/10/2014 State Board meeting (Rule-making# 13-9-16-1), with an effective date of 3/2/2014. Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration.

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(12 CCR 2509-10) 

[Instructions: replace lines 2408719 through 2408725.] 
7.900  EARLY INTERVENTION PROGRAM [Rev. eff. 3/2/14]
The Early Intervention Program shall provide services for an infant or toddler, birth through two (2) years of age, with a developmental delay or disability and his or her family through a statewide, comprehensive, coordinated, multidisciplinary, interagency system of Early Intervention Services.
A.  The Early Intervention Program shall provide services consistent with the following requirements:
1.  The Colorado Revised Statutes (C.R.S.) Title 27, Article 10.5, Sections 701, et seq., which are incorporated by reference; no later amendments or editions are included. The documents may be examined at any state publications depository library and at the Colorado Department of Human Services, Office of Early Childhood, Division of Community and Family Support, 1575 Sherman Street, Denver, Colorado 80203.
2.  The Colorado Revised Statutes (C.R.S.) Title 10, Article 16, Sections 102(46) and 104(1.3), which are incorporated by reference; no later amendments or editions are included. The documents may be examined at any state publications depository library and at the Colorado Department of Human Services, Office of Early Childhood, Division of Community and Family Support, 1575 Sherman Street, Denver, Colorado 80203.
3.  The Colorado Revised Statutes (C.R.S.) Title 22, Article 20, Sections 103 and 118, which are incorporated by reference; no later amendments or editions are included. The documents may be examined at any state publications depository library and at the Colorado Department of Human Services, Office of Early Childhood, Division of Community and Family Support, 1575 Sherman Street, Denver, Colorado 80203.
4.  The United States Code (U.S.C.), Title 20, Parts 1232, as amended January 2, 2013, 1401, 1419, 1431-1441 (the federal Individuals with Disabilities Education Act of 2004), U.S.C. Title 42, Part 1320, as amended (the Public Health Service Act), and Title 42, Part 9801 (the Head Start Act) published by Office of the Law Revision Counsel of the U.S. House of Representatives, which are incorporated by reference; no later amendments or editions are included. These documents are for sale by the Superintendent of Documents, U.S Government Printing Office, Washington, D.C., 20402 and can be found at www.gpoaccess.gov/uscode. The documents may also be examined at any state publications depository library and at the Colorado Department of Human Services, Office of Early Childhood, Division of Community and Family Support, 1575 Sherman Street, Denver, Colorado 80203. 

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[Instructions: replace lines 2408733 through 2408736.] 
D.  All available resources that pay for early intervention services shall be identified and coordinated, including, but not limited to, federal, state, local, and private sources.
E.  A system for the resolution of intra- and inter-agency disputes shall be used.
F.  Formal interagency operating agreements, as needed, shall be developed to facilitate the development and implementation of a statewide, comprehensive, coordinated, multidisciplinary, interagency system of early intervention services.
G.  A statewide system for compiling data on the early intervention services shall be used to comply with state and federal reporting requirements.

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[Instructions: replace lines 2408913 through 2408948.] 
7.913  CERTIFIED EARLY INTERVENTION SERVICE BROKERS [Rev. eff. 3/2/14]
A.  Designation of Roles and Responsibilities
1.  One entity per Community Centered Board service area shall be designated in writing by the Department as the Certified Early Intervention Service Broker for that region.
2.  A Community Centered Board or other interested agency shall submit a Department approved application for designation as a Certified Early Intervention Service Broker.
3.  Designation as a Certified Early Intervention Service Broker shall be based on the following criteria:
a.  Agency background and expertise in early intervention services; and,
b.  Agency policies and procedures that ensure accurate data entry as required by the Department; and,
c.  Demonstrated ability to conform with generally accepted accounting and contracting practices; and,
d.  Assurance to comply with state and federal laws and regulations regarding early intervention services as defined in Section 7.900, et seq.
4.  Failure to maintain ongoing compliance with the above criteria may result in revocation of designation as a Certified Early Intervention Service Broker.
5.  If the Department determines that a Community Centered Board or other entity does not meet the criteria to be designated as a Certified Early Intervention Service Broker or is de-designated as the certified early intervention service broker, the Community Centered Board or other entity may dispute the decision in accordance with Section 16.210, G (2 CCR 503-1).
6.  If a Community Centered Board is unwilling to be the Certified Early Intervention Service Broker for its service area, or the Community Centered Board does not meet the criteria established in Section 7.913, A, 3, then applications from other entities shall be solicited and accepted and another entity shall be designated as the Certified Early Intervention Service Broker.
7.  If no Certified Early Intervention Service Broker can be found, the Department may act as the Early Intervention Service Broker until such time as a Certified Early Intervention Service Broker can be found.
8.  Upon designation, a Certified Early Intervention Service Broker shall:
a.  Ensure payment for early intervention services are rendered pursuant to an Individualized Family Service Plan; and,
b.  Ensure that federal funds for early intervention services are utilized as payor of last resort; and,
c.  Use procedures and forms as defined by the Department to document the provision or purchase of early intervention services; and,
d.  Negotiate, within state and federally-defined parameters and Section 7.913, B, for payment of early intervention services; and,
e.  With written parental consent, notify the appropriate public or private health insurance plan within ten (10) working days that a covered infant or toddler has been determined eligible for early intervention services. At a minimum, the notification shall include:
1)  The child's name; and,
2)  The child's date of birth; and,
3)  The name of the public or private health insurance carrier; and,
4)  The policy/group number and subscriber number or Social Security Number; and,
5)  The name of the primary policy holder; and,
6)  The customer service telephone number for the insurance carrier; and,
7)  The initial Individualized Family Service Plan date; and,
8)  The contact person and telephone number for the Early Intervention Service Broker.
f.  Establish a registry of qualified early intervention service providers who have active records in the Early Intervention Provider Database from which early intervention services for eligible infants and toddlers in the designated service area shall be purchased; and,
g.  Accept and process insurance claims in accordance with state and federal law for those families with health insurance coverage for early intervention services; and,
h.  Ensure that all required demographic and billing information is entered into the statewide data system as defined by the Department, for each child who is eligible for early intervention services, as defined in Section 7.920, F; and,
i.  Participate in ongoing reviews of the use of the funding hierarchy; and,
j.  Provide the Department with accurate data for reporting purposes for the legislature or other funding sources.
9.  Certified Early Intervention Service Brokers may provide early intervention services directly or may subcontract the provision of services to other qualified providers. 
10.  Invoices or insurance claims for early intervention services shall be submitted based on the available funding source for each eligible child and the reimbursement rate for the appropriate federal, state, local, or private funding sources, including public health insurance and benefits, and private health insurance.
11.  Reimbursement rates for Early Intervention Service Broker functions shall be established with input from Certified Early Intervention Service Brokers.
12.  Use of a Certified Early Intervention Service Broker for billing non-qualifying plans on behalf of a contractor shall be voluntary. Qualified early intervention service providers may directly bill the appropriate program of a public health insurance plan or benefits, or a participating private health insurance carrier, for services rendered, in accordance with Section 10-16-104(1.3), C.R.S., as defined in Section 7.900, A, 2. 

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[Instructions: replace line 2409026.] 
7.920  CHILD IDENTIFICATION [Rev. eff. 3/2/14]

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[Instructions: replace lines 2409116 through 2409122.] 
H.  Eligibility Determination Based on an Established Condition
1.  There shall be supporting documentation from a qualified health professional maintained in the child’s record for a diagnosed physical or mental condition.
2.  The diagnosis or condition shall be included in the Established Conditions Database.
3.  There shall be documentation in the Individualized Family Service Plan regarding the name of the diagnosed condition on which eligibility is based.
4.  A child with an established condition does not have to be exhibiting delays in development at the time of diagnosis to be eligible for early intervention services. 
5.  A multidisciplinary assessment for a child with an established condition shall be conducted to identify a child’s current levels of development in all developmental domains, including hearing and vision, in order to develop an initial Individualized Family Service Plan.
I.  An infant or toddler who lives with a parent who has been determined by a Community Centered Board to have a developmental disability is eligible to receive early intervention services using any funding source other than the federal Part C funds. Such services may include, but are not limited to, developmental intervention for parent education and monitoring child development.

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[Instructions: replace line 2409367.] 
7.980  PROCEDURAL SAFEGUARDS [Rev. eff. 3/2/14]

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[Instructions: replace lines 2409374 through 2409378.] 
D.  Parental rights include: 
1.  Confidentiality
a.  Personally identifiable data, information, or records pertaining to a referred child shall not be disclosed by a Community Centered Board, any early intervention service provider, or any personnel involved in dispute resolution to any person other than his or her parent, except as provided in the federal Health Insurance Portability and Accountability Act (HIPAA) of 1996, 42 U.S.C. Section 1320, as amended, and the federal Family Educational Rights and Privacy Act (FERPA) of 1974, 20 U.S.C. Section 1232g, as amended, which is incorporated by reference as defined in Section 7.900, A, 4.
b.  A parent may voluntarily give written parental consent for the exchange of confidential information to other parties.
c.  A Community Centered Board shall ensure that all persons collecting, maintaining, and using personally identifiable information receive training to comply with state and federal confidentiality policies and procedures.

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