34 C.F.R. Subpart F—State Administration
Title 34 - Education
Each system must include a single line of responsibility in a lead agency that— (a) Is established or designated by the Governor; and (b) Is responsible for the administration of the system, in accordance with the requirements of this part. (Authority: 20 U.S.C. 1435(a)(10)) (a) General. Each lead agency is responsible for— (1) The general administration and supervision of programs and activities receiving assistance under this part; and (2) The monitoring of programs and activities used by the State to carry out this part, whether or not these programs or activities are receiving assistance under this part, to ensure that the State complies with this part. (b) Methods of administering programs. In meeting the requirement in paragraph (a) of this section, the lead agency shall adopt and use proper methods of administering each program, including— (1) Monitoring agencies, institutions, and organizations used by the State to carry out this part; (2) Enforcing any obligations imposed on those agencies under part C of the Act and these regulations; (3) Providing technical assistance, if necessary, to those agencies, institutions, and organizations; and (4) Correcting deficiencies that are identified through monitoring. (Authority: 20 U.S.C. 1435(a)(10)(A))
Title 34: Education
PART 303—EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES
Subpart F—State Administration
General
§ 303.500 Lead agency establishment or designation.
§ 303.501 Supervision and monitoring of programs.
Lead Agency Procedures for Resolving Complaints
§ 303.510 Adopting complaint procedures.
(a) General. Each lead agency shall adopt written procedures for—
(1) Resolving any complaint, including a complaint filed by an organization or individual from another State, that any public agency or private service provider is violating a requirement of Part C of the Act or this Part by—
(i) Providing for the filing of a complaint with the lead agency; and
(ii) At the lead agency's discretion, providing for the filing of a complaint with a public agency and the right to have the lead agency review the public agency's decision on the complaint; and
(2) Widely disseminating to parents and other interested individuals, including parent training centers, protection and advocacy agencies, independent living centers, and other appropriate entities, the State's procedures under §§303.510–303.512.
(b) Remedies for denial of appropriate services. In resolving a complaint in which it finds a failure to provide appropriate services, a lead agency, pursuant to its general supervisory authority under Part C of the Act, must address:
(1) How to remediate the denial of those services, including, as appropriate, the awarding of monetary reimbursement or other corrective action appropriate to the needs of the child and the child's family; and
(2) Appropriate future provision of services for all infants and toddlers with disabilities and their families.
(Authority: 20 U.S.C. 1435(a)(10))
[64 FR 12536, Mar. 12, 1999]
§ 303.511 An organization or individual may file a complaint.
(a) General. An individual or organization may file a written signed complaint under §303.510. The complaint must include—
(1) A statement that the State has violated a requirement of part C of the Act or the regulations in this part; and
(2) The facts on which the complaint is based.
(b) Limitations. The alleged violation must have occurred not more than one year before the date that the complaint is received by the public agency unless a longer period is reasonable because—
(1) The alleged violation continues for that child or other children; or
(2) The complainant is requesting reimbursement or corrective action for a violation that occurred not more than three years before the date on which the complaint is received by the public agency.
(Authority: 20 U.S.C. 1435(a)(10))
[64 FR 12536, Mar. 12, 1999]
§ 303.512 Minimum State complaint procedures.
(a) Time limit, minimum procedures. Each lead agency shall include in its complaint procedures a time limit of 60 calendar days after a complaint is filed under §303.510(a) to—
(1) Carry out an independent on-site investigation, if the lead agency determines that such an investigation is necessary;
(2) Give the complainant the opportunity to submit additional information, either orally or in writing, about the allegations in the complaint;
(3) Review all relevant information and make an independent determination as to whether the public agency is violating a requirement of Part C of the Act or of this Part; and
(4) Issue a written decision to the complainant that addresses each allegation in the complaint and contains—
(i) Findings of fact and conclusions; and
(ii) The reasons for the lead agency's final decision.
(b) Time extension; final decisions; implementation. The lead agency's procedures described in paragraph (a) of this section also must—
(1) Permit an extension of the time limit under paragraph (a) of this section only if exceptional circumstances exist with respect to a particular complaint; and
(2) Include procedures for effective implementation of the lead agency's final decision, if needed, including—
(i) Technical assistance activities;
(ii) Negotiations; and
(iii) Corrective actions to achieve compliance.
(c) Complaints filed under this section, and due process hearings under §303.420. (1) If a written complaint is received that is also the subject of a due process hearing under §303.420, or contains multiple issues, of which one or more are part of that hearing, the State must set aside any part of the complaint that is being addressed in the due process hearing until the conclusion of the hearing. However, any issue in the complaint that is not a part of the due process action must be resolved within the 60-calendar-day timeline using the complaint procedures described in paragraphs (a) and (b) of this section.
(2) If an issue is raised in a complaint filed under this section that has previously been decided in a due process hearing involving the same parties—
(i) The hearing decision is binding; and
(ii) The lead agency must inform the complainant to that effect.
(3) A complaint alleging a public agency's or private service provider's failure to implement a due process decision must be resolved by the lead agency.
(Authority: 20 U.S.C. 1435(a)(10))
[64 FR 12536, Mar. 12, 1999]
Policies and Procedures Related to Financial Matters
§ 303.520 Policies related to payment for services.
(a) General. Each lead agency is responsible for establishing State policies related to how services to children eligible under this part and their families will be paid for under the State's early intervention program. The policies must—
(1) Meet the requirements in paragraph (b) of this section; and
(2) Be reflected in the interagency agreements required in §303.523.
(b) Specific funding policies. A State's policies must—
(1) Specify which functions and services will be provided at no cost to all parents;
(2) Specify which functions or services, if any, will be subject to a system of payments, and include—
(i) Information about the payment system and schedule of sliding fees that will be used; and
(ii) The basis and amount of payments; and
(3) Include an assurance that—
(i) Fees will not be charged for the services that a child is otherwise entitled to receive at no cost to parents; and
(ii) The inability of the parents of an eligible child to pay for services will not result in the denial of services to the child or the child's family; and
(4) Set out any fees that will be charged for early intervention services and the basis for those fees.
(c) Procedures to ensure the timely provision of services. No later than the beginning of the fifth year of a State's participation under this part, the State shall implement a mechanism to ensure that no services that a child is entitled to receive are delayed or denied because of disputes between agencies regarding financial or other responsibilities.
(d) Proceeds from public or private insurance. (1) Proceeds from public or private insurance are not treated as program income for purposes of 34 CFR 80.25.
(2) If a public agency spends reimbursements from Federal funds (e.g., Medicaid) for services under this part, those funds are not considered State or local funds for purposes of the provisions contained in §303.124.
(Authority: 20 U.S.C. 1432(4)(B), 1435(a)(10))
[58 FR 40959, July 30, 1993, as amended at 64 FR 12536, Mar. 12, 1999]
§ 303.521 Fees.
(a) General. A State may establish, consistent with §303.12(a)(3)(iv), a system of payments for early intervention services, including a schedule of sliding fees.
(b) Functions not subject to fees. The following are required functions that must be carried out at public expense by a State, and for which no fees may be charged to parents:
(1) Implementing the child find requirements in §303.321.
(2) Evaluation and assessment, as included in §303.322, and including the functions related to evaluation and assessment in §303.12.
(3) Service coordination, as included in §§303.22 and 303.344(g).
(4) Administrative and coordinative activities related to—
(i) The development, review, and evaluation of IFSPs in §§303.340 through 303.346; and
(ii) Implementation of the procedural safeguards in subpart E of this part and the other components of the statewide system of early intervention services in subparts D and F of this part.
(c) States with mandates to serve children from birth. If a State has in effect a State law requiring the provision of a free appropriate public education to children with disabilities from birth, the State may not charge parents for any services (e.g., physical or occupational therapy) required under that law that are provided to children eligible under this part and their families.
(Approved by the Office of Management and Budget under control number 1820–0550)(Authority: 20 U.S.C. 1432(4))
§ 303.522 Identification and coordination of resources.
(a) Each lead agency is responsible for—
(1) The identification and coordination of all available resources for early intervention services within the State, including those from Federal, State, local, and private sources; and
(2) Updating the information on the funding sources in paragraph (a)(1) of this section, if a legislative or policy change is made under any of those sources.
(b) The Federal funding sources in paragraph (a)(1) of this section include—
(1) Title V of the Social Security Act (relating to Maternal and Child Health);
(2) Title XIX of the Social Security Act (relating to the general Medicaid Program, and EPSDT);
(3) The Head Start Act;
(4) Parts B and H of the Act;
(5) The Developmental Disabilities Assistance and Bill of Rights Act (Pub. L. 94–103); and
(6) Other Federal programs.
(Approved by the Office of Management and Budget under control number 1820–0550)(Authority: 20 U.S.C. 1435(a)(10)(B))
[58 FR 40959, July 30, 1993, as amended at 63 FR 18296, Apr. 14, 1998]
§ 303.523 Interagency agreements.
(a) General. Each lead agency is responsible for entering into formal interagency agreements with other State-level agencies involved in the State's early intervention program. Each agreement must meet the requirements in paragraphs (b) through (d) of this section.
(b) Financial responsibility. Each agreement must define the financial responsibility, in accordance with §303.143, of the agency for paying for early intervention services (consistent with State law and the requirements of this part).
(c) Procedures for resolving disputes. (1) Each agreement must include procedures for achieving a timely resolution of intra-agency and interagency disputes about payments for a given service, or disputes about other matters related to the State's early intervention program. Those procedures must include a mechanism for making a final determination that is binding upon the agencies involved.
(2) The agreement with each agency must—
(i) Permit the agency to resolve its own internal disputes (based on the agency's procedures that are included in the agreement), so long as the agency acts in a timely manner; and
(ii) Include the process that the lead agency will follow in achieving resolution of intra-agency disputes, if a given agency is unable to resolve its own internal disputes in a timely manner.
(d) Additional components. Each agreement must include any additional components necessary to ensure effective cooperation and coordination among all agencies involved in the State's early intervention program.
(Approved by the Office of Management and Budget under control number 1820–0550)(Authority: 20 U.S.C. 1435(a)(10)(C) and (a)(10)(F))
Note: A State may meet the requirement in paragraph (c)(1) of this section in any way permitted under State law, including (1) providing for a third party (e.g., an administrative law judge) to review a dispute and render a decision, (2) assignment of the responsibility by the Governor to the lead agency or Council, or (3) having the final decision made directly by the Governor.
§ 303.524 Resolution of disputes.
(a) Each lead agency is responsible for resolving individual disputes, in accordance with the procedures in §303.523(c)(2)(ii).
(b)(1) During a dispute, the individual or entity responsible for assigning financial responsibility among appropriate agencies under §303.143 (“financial designee”) shall assign financial responsibility to—
(i) An agency, subject to the provisions in paragraph (b)(2) of this section; or
(ii) The lead agency, in accordance with the “payor of last resort” provisions in §303.527.
(2) If, during the lead agency's resolution of the dispute, the financial designee determines that the assignment of financial responsibility under paragraph (b)(1)(i) of this section was inappropriately made—
(i) The financial designee shall reassign the responsibility to the appropriate agency; and
(ii) The lead agency shall make arrangements for reimbursement of any expenditures incurred by the agency originally assigned responsibility.
(c) To the extent necessary to ensure compliance with its action in paragraph (b)(2) of this section, the lead agency shall—
(1) Refer the dispute to the Council or the Governor; and
(2) Implement the procedures to ensure the delivery of services in a timely manner in accordance with §303.525.
(Approved by the Office of Management and Budget under control number 1820–0550)(Authority: 20 U.S.C. 1435(a)(10)(C) and (a)(10)(E))
§ 303.525 Delivery of services in a timely manner.
Each lead agency is responsible for the development of procedures to ensure that services are provided to eligible children and their families in a timely manner, pending the resolution of disputes among public agencies or service providers.
(Approved by the Office of Management and Budget under control number 1820–0550)(Authority: 20 U.S.C. 1435(a)(10)(D))
§ 303.526 Policy for contracting or otherwise arranging for services.
Each system must include a policy pertaining to contracting or making other arrangements with public or private service providers to provide early intervention services. The policy must include—
(a) A requirement that all early intervention services must meet State standards and be consistent with the provisions of this part;
(b) The mechanisms that the lead agency will use in arranging for these services, including the process by which awards or other arrangements are made; and
(c) The basic requirements that must be met by any individual or organization seeking to provide these services for the lead agency.
(Approved by the Office of Management and Budget under control number 1820–0550)(Authority: 20 U.S.C. 1435(a)(11))
Note: In implementing the statewide system, States may elect to continue using agencies and individuals in both the public and private sectors that have previously been involved in providing early intervention services, so long as those agencies and individuals meet the requirements of this part.
§ 303.527 Payor of last resort.
(a) Nonsubstitution of funds. Except as provided in paragraph (b)(1) of this section, funds under this part may not be used to satisfy a financial commitment for services that would otherwise have been paid for from another public or private source, including any medical program administered by the Secretary of Defense, but for the enactment of part C of the Act. Therefore, funds under this part may be used only for early intervention services that an eligible child needs but is not currently entitled to under any other Federal, State, local, or private source.
(b) Interim payments—reimbursement. (1) If necessary to prevent a delay in the timely provision of services to an eligible child or the child's family, funds under this part may be used to pay the provider of services, pending reimbursement from the agency or entity that has ultimate responsibility for the payment.
(2) Payments under paragraph (b)(1) of this section may be made for—
(i) Early intervention services, as described in §303.12;
(ii) Eligible health services (see §303.13); and
(iii) Other functions and services authorized under this part, including child find and evaluation and assessment.
(3) The provisions of paragraph (b)(1) of this section do not apply to medical services or “well-baby” health care (see §303.13(c)(1)).
(c) Non-reduction of benefits. Nothing in this part may be construed to permit a State to reduce medical or other assistance available or to alter eligibility under title V of the Social Security Act (SSA) (relating to maternal and child health) or title XIX of the SSA (relating to Medicaid for children eligible under this part) within the State.
(Approved by the Office of Management and Budget under control number 1820–0550)(Authority: 20 U.S.C. 1440)
Note: The Congress intended that the enactment of part C not be construed as a license to any agency (including the lead agency and other agencies in the State) to withdraw funding for services that currently are or would be made available to eligible children but for the existence of the program under this part. Thus, the Congress intended that other funding sources would continue, and that there would be greater coordination among agencies regarding the payment of costs.
The Congress further clarified its intent concerning payments under Medicaid by including in section 411(k)(13) of the Medicare Catastrophic Coverage Act of 1988 (Pub. L. 100–360) an amendment to title XIX of the Social Security Act. That amendment states, in effect, that nothing in this title shall be construed as prohibiting or restricting, or authorizing the Secretary of Health and Human Services to prohibit or restrict, payment under subsection (a) of section 1903 of the Social Security Act for medical assistance for covered services furnished to an infant or toddler with a disability because those services are included in the child's IFSP adopted pursuant to part C of the Act.
[58 FR 40959, July 30, 1993, as amended at 63 FR 18296, Apr. 14, 1998]
§ 303.528 Reimbursement procedure.
Each system must include a procedure for securing the timely reimbursement of funds used under this part, in accordance with §303.527(b).
(Approved by the Office of Management and Budget under control number 1820–0550)(Authority: 20 U.S.C. 1435(a)(12))
Reporting Requirements
§ 303.540 Data collection.
(a) Each system must include the procedures that the State uses to compile data on the statewide system. The procedures must—
(1) Include a process for—
(i) Collecting data from various agencies and service providers in the State;
(ii) Making use of appropriate sampling methods, if sampling is permitted; and
(iii) Describing the sampling methods used, if reporting to the Secretary; and
(2) Provide for reporting data required under section 618 of the Act that relates to this part.
(b) The information required in paragraph (a)(2) of this section must be provided at the time and in the manner specified by the Secretary.
(Approved by the Office of Management and Budget under control number 1820–0550)(Authority: 20 U.S.C. 1435(a)(14))
[58 FR 40959, July 30, 1993, as amended at 63 FR 18296, Apr. 14, 1998]
Use of Funds for State Administration
§ 303.560 Use of funds by the lead agency.
A lead agency may use funds under this part that are reasonable and necessary for administering the State's early intervention program for infants and toddlers with disabilities.
(Authority: 20 U.S.C. 1433, 1435(a)(10))
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