Chapter 3701-8 Help Me Grow Program

As used in this chapter:

(A) “Assistive technology service” means a service that directly assists a child with a disability in the selection, acquisition or use of an assistive technology device.

(1) Assistive technology services include:

(a) The evaluation of the needs of a child with a disability, including a functional evaluation of the child in the child’s customary environment;

(b) Purchasing, leasing or otherwise providing for the acquisition of assistive technology devices by children with disabilities;

(c) Selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing or replacing assistive technology devices;

(d) Coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs;

(e) Training or technical assistance for a child with disabilities, or, if appropriate, that child’s family; and

(f) Training or technical assistance for professionals (including individuals providing early intervention services) or other individuals who provide services to or are otherwise substantially involved in the major life functions of individuals with disabilities.

(2) Assistive technology device means any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain or improve functional capabilities of children with disabilities. This term does not include a medical device that is surgically implanted or the replacement of such device.

(B) “County department of job and family services” or “CDJFS” means the county agency responsible for administering the PRC program.

(C) “Department” means the Ohio department of health.

(D) “Developmental delay” or “delay” means a delay as measured by an appropriate evaluation tool and as determined through informed clinical opinion in one or more of the following developmental domains:

(1) Cognitive development;

(2) Communication development;

(3) Social or emotional development;

(4) Adaptive development; or

(5) Physical development including vision, hearing and nutrition.

(E) “Developmental disability” or “disability” means a disability that is characterized by all of the following:

(1) It is attributable to a mental or physical impairment or a combination of mental and physical impairments;

(2) It is manifested before twenty-two years of age;

(3) It is likely to continue indefinitely; and

(4) It results in at least one delay or a condition known to result in a delay.

(F) “Developmental evaluation” means an evaluation using an age-appropriate research based tool that measures the level of functioning in the following developmental domains:

(1) Cognitive development;

(2) Communication development;

(3) Social or emotional development;

(4) Adaptive development; and

(5) Physical development, including screening of vision, hearing and nutrition.

(G) “Direct Services” means all of the following:

(1) Family support and community-based services that promote the well being of children and families and increase the strength, stability, confidence and learning environment of families through social services, health and education services, in home visits and parent support groups. Also included are programs designed to improve parenting skills, including skills in child development, family budgeting, coping with stress, health, and nutrition;

(2) Structured activities to strengthen parent-child interaction;

(3) Resource information and referral services;

(4) Developmental screening and evaluation of children;

(5) Developmental services for children to foster growth and development;

(6) Health related services such as public health nursing services and health education;

(7) Service coordination;

(8) Individualized family service plan development and delivery of services;

(9) Specialized services;

(10) Transition; and

(11) Any other similar service approved by the director.

(H) “Director” means the director of health or his or her authorized designee.

(I) “Expectant family” means a pregnant woman and her family or a family that is in the process of adopting a newborn, infant or toddler.

(J) “Family and children first council” or “FCFC” means the council established pursuant to section 121.37 of the Revised Code at state and county levels with a stated purpose of helping families seeking government services by streamlining and coordinating existing services and supports for children.

(K) “Help me grow” or “HMG” means Ohio’s birth to age three system designed to provide and maintain a coordinated, community-based infrastructure that promotes trans-disciplinary, family-centered services for expectant families, newborns, infants, toddlers and their families.

(L) “Help me grow system review” means the monitoring system used by the department to determine if a county is in compliance with Chapter 3701-8 of the Administrative Code and Part C.

(M) “Individualized family service plan” or “IFSP” means a written plan that identifies outcomes for expectant families, individual families and their infants or toddlers and describes resources, services and the coordination that will support those outcomes.

(N) “Individuals with Disabilities Education Act” or “IDEA” means the federal law addressing the education of children with disabilities codified at 20 U.S.C. section 1400 and federal regulations codified at 34 C.F.R. Parts 300 and 303.

(O) “Infant” means a child from birth to age eighteen months.

(P) “Informed clinical opinion” means a determination arrived at by one or more individuals who are licensed or certified early intervention professionals through the synthesization of information from the evaluation and assessment process, diagnostic data, and other observations in order to make a recommendation as to eligibility for services under Part C of IDEA. The professional uses both qualitative and quantitative information to shape an informed clinical opinion. In order to reach an informed clinical opinion about a child’s development, the professional may use any or all of the following:

(1) Clinical interviews with parents;

(2) Evaluation of the child at play;

(3) Observation of parent-child interaction;

(4) Information from teachers or childcare providers; and

(5) Neurodevelopmental or other physical examinations.

(Q) “Newborn” means an infant who is less than six weeks of age or less than six weeks from hospital discharge after birth.

(R) “Ohio help me grow advisory council” means the designated advisory group for formal interagency planning, policy development and implementation of the HMG system as required by 34 C.F.R. 303.600.

(S) “Parent” means a natural or adoptive parent of a child, the parent with legal custody of the child if the parents are separated or divorced, the guardian or custodian, a person acting in the place of a parent such as a grandparent or stepparent with whom the child lives, or a person who is legally responsible for the child’s welfare, or a surrogate parent who has been appointed in accordance with policies of the department of health.

(T) “Paraprofessional” means a person who is trained to provide a HMG service and assists or is supervised by a professional.

(U) “Part C” means that part of IDEA addressing infants and toddlers with disabilities, codified at 20 U.S.C. sections 1431 to 1445 and federal regulations codified at 34 C.F.R. Part 303.

(V) “Prevention, retention and contingency” or “PRC” means the county program established by Chapter 5108. of the Revised Code, and funded in part with federal funds provided under Title IV-A of the “Social Security Act,” 49 Stat. 620 (1935), as amended. HMG services provided under the PRC program are not considered “assistance” as defined in 45 C.F.R. 260.31(a).

(W) “Procedural safeguards” means the procedures set forth in rule 3701-8-08 of this chapter.

(X) “Professional” means a person who has a degree in a HMG related discipline or state certification or license in the discipline or profession which he or she is providing services.

(Y) “Risk factor” means an activity, illness, situation or event that places a child in serious danger of future developmental delays.

(Z) “Service coordinator” means a person assigned to assist in determining eligibility and coordinating services for expectant families, infants, toddlers and their families through the HMG process.

(AA) “Temporary assistance for needy families” or “TANF” means the program as defined in rule 5101:1-1-01 of the Administrative Code. TANF is funded in part with funds provided under the temporary assistance for need families block grant established by Title IV-A of the “Social Security Act,” 110 Stat. 2113 (1996), 42 U.S.C. 601, as amended.

(BB) “Toddler” means a child who is at least nineteen months old but less than thirty-six months old.

(CC) “Transition” means the change or exit from HMG services of an expectant family, infant, toddler and their family including:

(1) Transfer or discharge from a hospital or other healthcare facility;

(2) Exit from HMG due to ineligibility at age three years; or

(3) Exit from HMG service due to other reasons.

Effective: 08/08/2005

R.C. 119.032 review dates: 07/28/2010

Promulgated Under: 119.03

Statutory Authority: 3701.61

Rule Amplifies: 3701.61

(A) The purpose of HMG is to provide and maintain a comprehensive, coordinated system to meet the needs of eligible expectant families, newborns, infants and toddlers and their families who reside in Ohio, and includes the following eight components:

(1) Outreach, child find, intake, and procedural safeguards;

(2) Prenatal visits;

(3) Newborn home visits;

(4) Home visiting services;

(5) Service coordination, IFSP development, implementation and review;

(6) Paraprofessional home visiting/ family support services;

(7) Multi-disciplinary evaluation; and

(8) Specialized services in everyday routines, activities and places.

(B) Help me grow funds shall be allocated to each county as follows:

(1) The director allocates Part C and GRF funds to county FCFC’s administrative agents; and

(2) The Ohio department of job and family services allocates TANF funds to the county departments of job and family services to provide HMG services in accordance with the county PRC plan.

(C) Counties receiving HMG funds shall enroll and serve at least the number of eligible participants in the county as determined by the director. Annually, the director shall determine and notify the respective FCFC of the number of eligible participants in their county.

(D) Help me grow funds shall be used to:

(1) Provide direct services for eligible participants in accordance with the provisions of this chapter, terms of contracts, grants and subsidy agreements authorizing the allocation of funds, the county PRC plan, and other state and federal laws as applicable.

(2) To expand and improve on existing services already provided by other public and private sources, including but not limited to education, mental retardation and developmental delays, mental health, job and family services, hospitals and other related providers.

(E) Subject to the availability of funds, the county PRC plan, TANF regulations at 45 C.F.R. part 260, and terms of any contract or grant authorizing the award of HMG funds, the following HMG services shall be provided to all eligible families:

(1) Child find;

(2) Developmental screening;

(3) Family assessment;

(4) Development, review and evaluation of IFSPs;

(5) Service coordination;

(6) Transition services;

(7) Family support; and

(8) County FCFC dispute resolution process.

(F) Subject to Part C regulations, the following HMG services are provided at no cost to Part C eligible infants, toddlers and their families:

(1) Child find;

(2) Developmental screening;

(3) Developmental evaluation and family assessment;

(4) Development, review and evaluation of IFSPs;

(5) Service coordination;

(6) Transition services;

(7) Procedural safeguards and due process procedures; and

(8) Family support.

(G) Specialized services may be subject to a system of payment or use of private insurance. Specialized services include, but are not limited to the following:

(1) Assistive technology;

(2) Audiology;

(3) Family training and counseling;

(4) Health services necessary to enable newborns, infants and toddlers with delays or disabilities to benefit from other services during the time the child is receiving specialized services;

(5) Medical services only for diagnostic or evaluation purposes;

(6) Nursing;

(7) Nutrition;

(8) Occupational therapy;

(9) Physical therapy;

(10) Psychological and social work;

(11) Special developmental instruction;

(12) Speech-language pathology;

(13) Transportation and related costs;

(14) Vision (including orientation and mobility); and

(15) Other services the IFSP team deems necessary.

(H) Specialized services shall only be paid for through Part C funds if all of the following parameters have been met and documented:

(1) The child is eligible for Part C;

(2) The IFSP team is in full agreement regarding the services;

(3) The service best supports the family and its needs;

(4) As payor of last resort, when there is no other alternative source for payment Documentation must include evidence of the parent’s inability to pay, as well as alternative funding sources that were sought; and

(5) Unless inappropriate, the service will be provided in the child’s everyday routines, activities and places.

(I) Help me grow funds cannot be used for the following:

(1) Medical health services that are routinely recommended for all children such as immunizations and “well-baby” health care; or

(2) Medical services that is surgical or purely medical in nature.

Effective: 08/08/2005

R.C. 119.032 review dates: 07/28/2010

Promulgated Under: 119.03

Statutory Authority: 3701.61

Rule Amplifies: 3701.61

(A) Participation in HMG is voluntary. Each county HMG program shall obtain written consent from eligible individuals prior to any service being provided.

(B) Subject to the availability of funds, and in accordance with the county PRC plan, the following individuals are eligible for HMG:

(1) Newborns for newborn home visiting;

(2) Newborns, infants, toddlers and expectant families who have the number of risk factors designated by the county FCFC to place a newborn, infant or toddler at risk for a delay. The county FCFC shall:

(a) Designate the minimum number of risk factors for eligibility to be no less than four and no greater than six; and

(b) Notify the Department of the number of risk factors designated for eligibility and any changes to the designated minimum number of risk factors.

(3) Families of individuals listed in paragraphs (B)(1) to (B)(2) of this rule.

(C) Each CDJFS has financial eligibility criteria for use of TANF funds as set forth in their county PRC plan for eligible individuals listed in paragraphs (B)(1) to (B)(3) of this rule.

(D) The following individuals shall be eligible for Part C of HMG:

(1) Newborns, infants and toddlers who are experiencing a delay;

(2) Newborns, infants and toddlers who have a diagnosed physical or mental condition that has a high probability of resulting in a delay; and

(3) Families of individuals listed in paragraphs (D)(1) to (D)(2) of this rule. Financial eligibility is not a requirement for Part C eligibility.

(E) Each county HMG program shall provide eligible individuals a copy of the parent’s rights brochure published by the department.

(F) Except as provided in paragraph (G) of this rule, each county HMG program shall complete the following within forty-five days from referral of an infant or toddler:

(1) A screening by using the ages and stages questionnaire (“ASQ”), or the Denver developmental screening test II (“DDSTII”); or

(2) A developmental evaluation to determine Part C eligibility after the initial referral or the date of suspected delay for a child.

(G) For a newborn, infant or toddler with a diagnosed physical or mental condition that has a high probability of resulting in a delay, with parent consent, each county shall:

(1) Develop an IFSP and immediately begin identified needed services; and

(2) Conduct a developmental assessment for program planning within forty-five days of initial referral.

(H) Each county HMG program shall document and verify eligibility of HMG participants.

Effective: 08/08/2005

R.C. 119.032 review dates: 07/28/2010

Promulgated Under: 119.03

Statutory Authority: 3701.61

Rule Amplifies: 3701.61

(A) Each county FCFC shall assure that an IFSP is developed in conjunction with the family and implemented for each eligible participant within forty-five days of initial referral to HMG. The IFSP shall:

(1) Focus on intervention and prevention services and strategies;

(2) Include but not be limited to child and family outcomes, resources, priorities and concerns;

(3) Reflect coordination across agencies and services;

(4) Be completed on the form approved by the department;

(5) Contain the name of assigned service coordinator;

(6) Incorporate referral and transition strategies to assure continuity of services from one environment to another; and

(7) Include the use of formal and informal community support services.

(B) A review of the IFSP for the child and family must be conducted at least every one hundred twenty days, or sooner, upon the request of the family or an IFSP team member. A meeting must be conducted at least annually to evaluate the IFSP for the child and family, and to revise its provisions as needed.

(C) Each FCFC shall assure and document that eligible individuals are informed of their rights at least annually and upon a change in IFSP services throughout the time the individual is receiving HMG services.

(D) Families and providers will receive written notice of all IFSP meetings (initial, annual, and review meetings).

(E) Upon referral to HMG a service coordinator shall be assigned. There shall be only one service coordinator assigned for the family at any given time.

(F) A qualified service coordinator shall have a minimum of a two year degree from an accredited college or university in nursing, social work, early childhood education or a related discipline, or be a registered nurse; and meet the following requirements by October 31, 2005, or within one year after employment, whichever is first:

(1) Demonstrate certain skills as determined by the department and assessed by the clinical supervisor;

(2) Attend required in-service trainings; and

(3) Receive clinical supervision as required by paragraph (J) of this rule.

(G) Those persons who do not meet the degree qualification as stated in paragraph (F) of this rule may qualify as a provisional service coordinator if employed as a service coordinator in a HMG program by the effective date of this rule, and meets the following requirements:

(1) At least three years of employment in a full-time paid position under supervision in the HMG system or other early childhood program;

(2) Demonstrate certain skills as determined by the department and assessed by the clinical supervisor;

(3) Attend required in-service trainings;

(4) Receive clinical supervision as required by paragraph (J) of this rule; and

(5) Provide a documented action plan that meets one of the following requirements.

(a) Those with an unrelated associate or bachelor degree will obtain twelve semester hours from an accredited college or university in one of the related fields of study within two years after receipt of the provisional qualification status.

(b) Those without at least an associate degree will obtain an associate degree from an accredited college or university in one of the related fields of study within two years after the provisional qualification is granted.

(6) Qualification as a provisional service coordinator is non-renewable.

(H) To remain qualified, a service coordinator must complete twenty hours of continuing education as determined appropriate by the department every two year period following employment.

(I) Service coordinators shall attend mandatory trainings within the specified timelines as prescribed by the department.

(J) All full time equivalent personnel such as family support specialists, newborn home visiting nurses, paraprofessionals and service coordinators providing service to families must receive clinical supervision at a minimum of eight hours per month. Personnel who are less than full time equivalent must receive a proportional amount of clinical supervision.

Effective: 08/08/2005

R.C. 119.032 review dates: 07/28/2010

Promulgated Under: 119.03

Statutory Authority: 3701.61

Rule Amplifies: 3701.61

(A) Prior to providing any HMG services in the home, the HMG provider shall obtain a written request from the parent for home visiting services.

(B) Home visits to provide HMG services, supports, and education and community referrals shall:

(1) Be offered to all individuals who have been referred to or are eligible for HMG;

(2) Be confidential, culturally sensitive, and respectful of the family; and

(3) Be conducted by one or more professionals or a paraprofessional who assists or is supervised by a professional.

Effective: 08/08/2005

R.C. 119.032 review dates: 07/28/2010

Promulgated Under: 119.03

Statutory Authority: 119.

Rule Amplifies: 3701.61

(A) Each county FCFC shall assure that providers of county HMG services:

(1) Participate in the department’s electronic data collection system;

(2) Establish and maintain data collection procedures that assure the efficient and effective operation of the HMG program; and

(3) Comply with all related federal and state laws, regulations and policies.

(B) Each county HMG program shall submit program and fiscal reports within required timelines as prescribed by the department and other funding sources.

Effective: 08/08/2005

R.C. 119.032 review dates: 07/28/2010

Promulgated Under: 119.03

Statutory Authority: 3701.61

Rule Amplifies: 3701.61

(A) The department shall monitor each county HMG program for compliance with this chapter, Part C regulations and the terms of any contract or grant authorizing the award of HMG funds to the county.

(B) The director shall ensure a help me grow system review is conducted for every county HMG program receiving HMG funding. The department review may include an on-site visit, a desk review, or both.

(1) An onsite visit or desk review may be conducted by one or more of the following team members as designated by the department:

(a) The director of health or the director’s designee, who shall serve as team coordinator;

(b) The director of the Ohio department of job and family services or the director’s designee;

(c) The director of the Ohio department of mental retardation and developmental disabilities or the director’s designee;

(d) A representative of the Ohio office of family and children first; and

(e) Additional members as appointed to the team by the director of health which include a parent of a child that is or has received services offered under the HMG program.

(2) An on-site visit may include but is not limited to observation of the administration of HMG and provision of direct services, examination of records relevant to HMG, and focus group or individual interviews.

(3) A desk review may include review of electronic data, county records and consumer satisfaction surveys and other documentation as requested.

(C) Following the HMG system review, the team shall submit a written report to the director. The report shall include the team’s findings of fact and conclusions related to the county’s compliance with this chapter, Part C regulations and terms of any contract or grant authorizing the award of HMG funds.

(D) If the director determines that the county is not in compliance with this chapter, Part C regulations or the terms of a contract or grant authorizing the award of HMG funds, the director shall, within fifteen days of receiving the team’s report, notify the county of non-compliance. The director’s notice shall also require the county FCFC to submit a continuous improvement plan addressing the areas of non-compliance in the report and timelines for achieving compliance.

(E) The county FCFC shall cooperate with the director and review team during any review process and shall provide access to any and all documents and information requested by the director or review team.

(F) The director may withhold funds to a county if:

(1) The county FCFC receives the director’s finding of noncompliance and fails to submit a plan of continuous improvement or fails to come into compliance in accordance with the plan of continuous improvement; or

(2) The county FCFC does not cooperate with the director or review team during a review. The director’s finding of non-compliance and decision to withhold funds is final and is not subject to appeal.

(G) Delivery of all notices or correspondence regarding HMG funds shall be made to the county’s named project director, FCFC administrative agent and FCFC coordinator.

Effective: 08/08/2005

R.C. 119.032 review dates: 07/28/2010

Promulgated Under: 119.03

Statutory Authority: 3701.61

Rule Amplifies: 3701.61

(A) Children and their families eligible for HMG but not eligible for Part C, may file a complaint through the county family and children first council’s dispute resolution process as required by section 121.37 of the Revised Code.

(B) The department, as the lead agency shall establish procedural safeguards that are consistent with Part C regulations. The department in partnership with the state and county family and children first councils is responsible for assuring effective implementation of these procedural safeguards by each state or local agency or a private agency in the state that is involved in the provision of Part C services. The department assures implementation through the following activities:

(1) Disseminating written guidance regarding procedural safeguards to:

(a) County family and children first councils;

(b) Help me grow project directors;

(c) Centralized intake and referral sites;

(d) County boards of mental retardation and developmental disabilities;

(e) County departments of job and family services; and

(f) The family support consultant network;

(2) Entering into interagency agreements with the department of mental retardation and developmental disabilities and the department of job and family services, which includes the agreement to work together to consistently implement the Part C procedural safeguards, regulations and other applicable policies; and

(3) Monitoring county compliance with this rule.

(C) The department shall develop and assure the implementation of a process for the resolution of complaints regarding the provision of Part C services. The process shall specify the procedure for:

(1) Filing a complaint with the county FCFC;

(2) Filing a complaint with the department;

(3) Resolving the dispute through mediation or an administrative hearing within thirty days from receipt of the request for mediation or an administrative hearing; and

(4) Resolving the dispute through investigation by the lead agency within sixty calendar days from receipt of the complaint.

(D) Each county FCFC shall develop and maintain a resolution process for complaints, which shall be consistent with Part C.

(1) The FCFC shall notify the department of the complaint in writing (via electronic or U.S. mail or facsimile) within seven calendar days of receipt of the complaint; and

(2) The FCFC shall issue a written decision to the complainant and the department within thirty calendar days from receipt of the complaint.

(E) Each provider of Part C services may develop and maintain a resolution process for complaints which shall be consistent with Part C. If the provider has a resolution process for complaints:

(1) The provider of Part C services shall notify the department and the FCFC of the complaint in writing (via electronic or U.S. mail or facsimile) within seven calendar days of receipt of the complaint; and

(2) The provider of Part C services shall issue a written decision to the complainant, FCFC and the department within thirty calendar days from receipt of the complaint.

(F) Upon receiving a complaint, the department, FCFC or provider shall:

(1) Assure the individual registering the complaint has a copy of the procedural safeguards; and

(2) Explain the options available for dispute resolution.

(G) If the department receives notice that a complaint regarding Part C services was filed with the county FCFC or a provider, the department shall monitor the resolution process to assure that the complaint is resolved by the county FCFC or provider within thirty calendar days. If the complaint is not resolved within thirty calendar days, the department shall notify the complainant, the county FCFC and the provider, if applicable, that complainant may select one of the following:

(1) To have the department investigate the complaint in accordance with paragraph (C) (4) of this rule. If this option is selected, the department shall assure that the complaint is investigated and resolved within sixty calendar days from the date the county FCFC or provider received the complaint; and

(2) To mediate and/or to go to an administrative hearing in accordance with paragraph (C) (3) of this rule. The department shall assure that if the complainant selects mediation and/or administrative hearing, the hearing is completed within thirty days from receipt of the request for mediation and/or administrative hearing.

(H) Unless the state or other agencies and parents of a child otherwise agree, the child and family must continue to receive appropriate Part C services currently being provided, during the resolution of disputes arising under Part C. If the complaint involves the initiation of one or more services under this part, the child and family must receive those services that are not in dispute.

(I) The procedural safeguards policy and process is posted on the Ohiohelpmegrow.org website.

Effective: 08/08/2005

R.C. 119.032 review dates: 07/28/2010

Promulgated Under: 119.03

Statutory Authority: 3701.61

Rule Amplifies: 3701.61

(A) As used in this rule:

(1) “Language” means the mode of communication normally used by the parent of child eligible under this procedure, such as sign language, Braille, oral communication, or native language;

(2) “Personally identifiable” means information that includes:

(a) The name of the child, the child’s parent or other family member;

(b) The address of the child;

(c) A personal identifier such as the child’s or parent’s social security number; and

(d) Personal information that would make it possible to identify the child with reasonable certainty.

(B) Children and their families eligible for HMG have the following rights:

(1) To accept or decline some or all HMG services; except that a child, who has a suspected developmental delay or disability, may not receive other HMG services until the child has been evaluated in all five developmental domains in accordance with rule 3701-8-03 of this chapter;

(2) To be informed of their rights in a language the parents understand, unless it is not feasible to do so;

(3) The right to receive written notice before HMG services are initiated, refused, or changed. The written notice shall be provided in a language the parent understands, unless it is not feasible to do so, and shall include what and why the change is being proposed or denied;

(4) To keep personally identifiable information confidential and to provide written consent before any personally identifiable information about their family is shared between HMG providers or otherwise disclosed, unless such disclosure is authorized under state and federal law;

(5) The right to review HMG records about their family at no cost and without unnecessary delay;

(6) The right to request, be present at and take part in HMG meetings about their family, including the IFSP meetings held in accordance with rule 3701-8-04 of this chapter;

(7) The right to receive service coordination at no cost;

(8) The right to take part in HMG transition planning before the child turns three years of age or upon exit from the program; and

(9) The right to make a formal complaint about HMG services in accordance with rule 3701-8-08 (A) of this chapter.

(C) In addition to the rights listed in paragraph (A) of this rule, children and their families eligible for Part C services, have the right to the following services at no cost to the family:

(1) The right to a developmental evaluation of the child to determine eligibility;

(2) The right to have an advocate or friend present at any or all contacts with service providers at the parent’s expense;

(3) The right to receive written notice before HMG services are initiated, refused, or changed.

(a) The written notice shall be in a language the parent understands, unless it is not feasible to do so, and shall include the HMG service the provider is proposing to initiate, deny or change and the reason for the service initiation, denial or change.

(b) If a HMG provider proposes, or refuses, to initiate or change HMG eligibility, evaluation, or placement of a child, or the provision of Part C services to a Part C eligible child or his family, the parent has the right to timely written notice of the following:

(i) The action that is being proposed or refused, including but not limited to, an explanation of the scope, purpose and benefits of any Part C services that are being proposed or refused;

(ii) The reasons for proposing or refusing the action, including but not limited to, a description of other options considered and the reasons for rejecting the options;

(iii) The information upon which the proposal or refusal to act is founded, including, but not limited to, a description of each record or report used as a basis for the proposal or refusal to act; and

(iv) All procedural safeguards that are available under rule 3701-8-08 of this chapter.

(4) To review and make changes to HMG records about their family at no cost. The family has the right to inspect and review their HMG records without unnecessary delay and before any meeting regarding an IFSP or hearing relating to the identification, evaluation or placement of the child and in no case more than forty-five days after the request has been made. The right to inspect and review records includes:

(a) The right to a response from the HMG provider or agency to reasonable requests for explanation and interpretation of records;

(b) The right to receive copies of their HMG records within fifteen days after receipt of a request for copies for a fee not to exceed the actual amount of the copying cost.

(i) The fee may not include any cost for search or retrieval of the records.

(ii) The family has a right to receive the copies at no cost if charging a fee would prevent the parent from obtaining the copies.

(c) The right to have a representative of the parent to inspect and review their HMG records; and

(d) The right to seek corrections, additions and amendments to a HMG record that is inaccurate or misleading. If a HMG provider or agency refuses to correct a record alleged to be inaccurate or misleading by the family, the family may request the county FCFC to provide a hearing to resolve the dispute. The hearing shall be held before an individual who does not have a direct interest in the outcome of the hearing and shall be held within thirty days from the receipt of a request for the hearing, with a written decision issued within ten days from the date of the hearing. The county FCFC shall inform the parent of the date, time, and place of the hearing in advance and in a language the parent understands. If it is decided that the information is inaccurate or misleading, the record shall be amended to reflect the correct information. If it is decided that the information is accurate and not misleading, the parent place in the records a statement commenting on the information or the parent’s disagreement with the written decision. Any statement provided by the parent must be maintained with the record and be disclosed if the contested part of the record is disclosed.

(5) The right to make a formal complaint about HMG services in accordance with rule 3701-8-08 (B) of this chapter.

Effective: 08/08/2005

R.C. 119.032 review dates: 07/28/2010

Promulgated Under: 119.03

Statutory Authority: 3701.61

Rule Amplifies: 3701.61

(A) As used in this rule:

(1) “Ability to pay” means that the family unit’s maximum ability to pay for part C specialized services as defined in paragraph (A)(5) of this rule is greater than or equal to two thousand dollars.

(2) “Family income” means the current year’s projected adjusted gross earnings based on current gross earnings as reported on pay stubs and/or the sum of the annual adjusted gross incomes, as reported to the United States internal revenue service for federal income tax purposes for the previous year, of each member of the family unit.

For purposes of this rule, family income does not include educational scholarships, loans, and grants; amounts spent by the family unit for childcare expenses; amounts spent by the family unit for respite care (with appropriate verification from a qualified respite care provider); and lump-sum death benefits.

(3) “Family unit” means the group consisting of the following persons:

(a) Infant and toddler as defined in rule 3701-8-01 of the Administrative Code;

(b) Parents of the infant or toddler, specifically, the natural or adoptive parent of an infant or toddler or the parent with legal custody if the parents are separated or divorced, or a person acting in the place of a parent such as a grandparent or stepparent with whom the infant or toddler lives.

(c) Other persons, who, for federal income tax purposes, are considered dependents of the parents.

(4) “Income guidelines” means the guidelines, as established by the director on April first of each year, for use in determining financial eligibility for payment for part C specialized services. The income guidelines shall be equal to one hundred eighty-five per cent of the poverty income for each size family, as reported in the “Federal Register” by the United States department of health and human services, rounded up to the nearest five hundred dollars.

(5) “Maximum ability to pay for part C specialized services” means the difference between the amount the family unit spends, including payroll deductions, for health-related insurance coverage and the sum of the following amounts:

(a) Ten per cent of the first fifteen thousand dollars by which the family income exceeds the applicable income guideline, as defined in paragraph (A)(4) of this rule;

(b) Twenty-five per cent of the next twenty-five thousand dollars by which the family income exceeds the applicable income guideline, as defined in paragraph (A)(4) of this rule; and

(c) Thirty-seven and one half per cent of the remaining amount by which the family income exceeds the applicable income guideline, as defined in paragraph (A)(4) of this rule.

(6) “Service level credit” means a credit of two thousand dollars against the maximum ability to pay for part C specialized services.

(B) The director shall accept from families eligible for part C services applications for payment of part C specialized services. The director shall process an application within thirty days of receipt of a complete application. A determination that the family is unable to pay for part C specialized services shall be specified in writing to the family and shall include an effective period of time for the determination, which shall be no more than twelve months.

(1) The family unit shall be determined to be able to pay for part C specialized services if the family unit’s maximum ability to pay for part C specialized services as defined in paragraph (A)(5) of this rule is greater than or equal to two thousand dollars.

(2) If the director determines that the family is able to pay for part C specialized services as defined in paragraph (A)(1) of this rule, the director will provide the family with notice of the amount the director determines to be the family’s maximum ability to pay. Once the family spends an amount equal to their maximum ability to pay, minus the two thousand dollar service level credit, for unreimbursed medical, vision, dental, and part C specialized services, the department will pay for part C specialized services within the remaining effective period of time in accordance with paragraph (B)(3) of this rule.

(3) The family unit shall be determined to be unable to pay for part C specialized services and eligible for payment of part C specialized services by the department if:

(a) The family is not able to obtain part C specialized services at no charge to the family through a governmental program, such as medicaid, children with medical handicaps program, or the county board of mental retardation and developmental disabilities;

(b) The family does not have available insurance coverage, as specified in paragraph (H) of this rule, for part C specialized services; and

(c) The family unit’s income is less than or equal to the applicable income guideline defined in paragraph (A)(4) of this rule, or the family’s maximum ability to pay for part C specialized services as defined in paragraph (A)(5) of this rule is less than the two thousand dollar service level credit.

(C) Notwithstanding paragraph (B)(3)(c) of this rule, in order to assure that specialized services to a part C eligible child and family will not be interrupted, the family will be determined to be unable to pay for part C specialized services if the family unit provides satisfactory evidence of both of the following:

(1) During the twelve-month period before the date of written allegation of inability to pay the family unit paid for unreimbursed medical, vision, dental, or part C specialized services that were provided to any member of the family unit or the family unit has contracted in writing to pay for any such services during the twelve months after the written allegation of inability to pay; and

(2) The total dollar amount that the family unit spent or is contracted to pay equals or exceeds the difference between the maximum ability to pay for part C specialized services, as defined in paragraph (A)(5) of this rule, and the service level credit, as defined in paragraph (A)(6) of this rule.

(D) Applicants or recipients who are receiving services from the special supplemental food program for women, infants, and children (WIC), supplemental security income (SSI) benefits, or medicaid benefits, except for delayed medicaid spend-down cases as defined in rule 5101:1-39-10 of the Administrative Code, shall be determined unable to pay for part C specialized services.

(E) The director may contract with and pay as providers for part C specialized services provided to part C eligible families:

(1) Providers for the bureau for children with medical handicaps;

(2) Providers for the Ohio medicaid program; or

(3) Other provider types as determined necessary by the director.

(F) The department may pay part C providers authorized under paragraph (E) of this rule for part C specialized services provided to part C eligible families if the family unit has been determined unable to pay for part C specialized services in accordance with this rule and the specialized services are listed on the IFSP for the family.

(G) The provider shall bill medicaid or the bureau for children with medical handicaps if such services are covered by medicaid or the bureau for children with medical handicaps. The provider shall accept the payment from medicaid or the bureau for children with medical handicaps as payment in full. If medicaid or the bureau for children with medical handicaps does not cover the services, the provider may bill the department, bureau of early intervention services, for services authorized pursuant to this rule and the provider shall accept the payment from the bureau of early intervention as payment in full.

(H) The director may determine that the family does not have available insurance coverage for part C specialized services if the family documents to the director’s satisfaction that the family will be subject to a material risk of losing medical insurance coverage because:

(1) The insurance plan or policy covering the child is an individually purchased plan or policy purchased by the head of household who is not eligible for group medical insurance; or

(2) The insurance plan or policy has a lifetime cap that applies to one or more specific types of early intervention services specified in the IFSP and coverage for that service could be exhausted during the period covered by the service plan.

Replaces: 3701-8-10

Effective: 01/27/2006

R.C. 119.032 review dates: 01/27/2011

Promulgated Under: 119.03

Statutory Authority: 3701.61

Rule Amplifies: 3701.61

Prior Effective Dates: 9/30/2005 (Emer.)