9 CAR § 40-343. Early intervention referrals and services

(a)(1) For children who have or are at risk of a developmental delay, appropriate early intervention services are essential. (2) Early intervention services are designed to lessen the effects of any potential or existing developmental delay. (3) Ultimately, early intervention services help the child learn and reach their individual potential with the support and involvement of the child’s family, as appropriate. (4) It is important for such services to begin as early as possible and for caregivers to be involved in decisions related to early intervention services. (b) Referrals to the Division of Developmental Disabilities Services for early intervention services. (1)(A) When a child maltreatment investigation involving any children in the home under three (3) years of age is initiated, the Division of Children and Family Services will consider referring as appropriate all children in the home under three (3) years of age to the Division of Developmental Disabilities Services’ Children’s Services for an early intervention (such as, First Connections; this program is not the same as the waiver program) screening in an effort to enhance the well-being of these children. (B) Any children under three (3) years of age involved in a substantiated case of child maltreatment (regardless of whether all of the children are named as alleged victims) must be referred to the Division of Developmental Disabilities Services’ Children’s Services for an early intervention screening if not already referred while the investigation was pending. (C) This will not only ensure the Division of Children and Family Services compliance with the Child Abuse Prevention and Treatment Act (CAPTA), Pub. L. No. 93-247 regarding substantiated cases of child abuse and neglect involving children under three (3) years of age but will further promote the well-being of this population. (2)(A) The Division of Developmental Disabilities Services’ Children’s Services will screen all the children under three (3) years of age who have been referred to First Connections to determine their need and eligibility for early intervention services. (B) If the results of the screening determine that a child will benefit from Division of Developmental Disabilities Services early intervention services, the person serving as the caregiver (that is, biological parent in an in-home services case or other individual legally caring for the child involved in an in-home services or permanency case including resource parents) must consent to allow their child to participate before services are initiated. (3) For children under three (3) years of age, eligibility for the Division of Developmental Disabilities Services’ Children’s Services will be determined by a screening assessment to determine the need for additional evaluations (if a child referred to the Division of Developmental Disabilities Services’ Children’s Services is within forty-five (45) days or less of their third birthday, then the Division of Developmental Disabilities Services’ Children’s Services may forward the referral to the Department of Education, Special Education Unit (Part B)). (4)(A) If warranted, a developmental evaluation for children under three (3) years of age will be completed in the areas of cognition, communication, social and emotional, physical, and adaptive as available and appropriate. (B) Based upon the developmental evaluation results, a speech, occupational, or physical therapy evaluation may be conducted as available and appropriate. (C) All evaluation results, as well as medical information, a professional informed clinical opinion or opinions, and information gathered from caregivers and the Division of Children and Family Services will be utilized to determine early intervention eligibility. (5) While a referral for early intervention services is encouraged for all children under three (3) years of age when an investigation is initiated and is required for children under three (3) years of age in substantiated cases of child maltreatment, a referral for early intervention services on behalf of any child suspected of having a developmental delay or disability may be sent at any time. (c) The Division of Developmental Disability Services early intervention individualized family service planning. (1)(A) If a child is determined to be eligible for services and the person acting as a caregiver of the child (that is, biological parent involved in an in-home services case; other individual legally caring for the child in an in-home services or permanency case including resource parents) consents to services, individualized family service plan (IFSP) meetings will be held to develop an appropriate service plan for the child. (B) IFSP activities and services must be added to the child’s family case plan. (2)(A) Adult participation in the IFSP meetings and related decision-making on the child’s behalf is required. (B) If the child is involved in an in-home services case or if a child experiencing foster care has a goal of reunification, the child’s biological parents should be invited and encouraged to attend the IFSP meetings to make decisions related to individualized family service planning and early intervention services for their child. (3) However, another adult who is legally caring for the child on a daily basis may serve in place of the biological parent if: (A) The court orders that the child’s caregiver shall have no involvement in the child’s educational planning; (B) The child’s parents cannot be located; or (C) The goal is not reunification for those children experiencing foster care cases. (4) If for one (1) of the reasons listed above or if for any other reason the biological parents are unable or unwilling to attend IFSP meetings and make the decisions related to early intervention services for their child, one (1) of the following may serve as the parent to make decisions regarding early intervention planning and services for the child, provided the court has not issued a no contact order for the person selected to act in place of the parent: (A) Resource parent; (B) Guardian, generally authorized to act as the child’s parent (but not the state; if the child is a ward of the state, the Division of Children and Family Services may act as the liaison between the Division of Developmental Disabilities Services and the parent or surrogate parent, but the Division of Children and Family Services may not be the sole contact or decision-maker for a child); (C) An individual otherwise acting in place of a biological parent (such as a grandparent, stepparent, or any other relative with whom the child lives); or (D) An individual who is legally responsible for the child’s welfare. (5)(A) For any individual serving in place of the parent in the child’s early intervention process, support in the form of Division of Developmental Disability Services surrogate parent training is available but not required. (B) The local Division of Developmental Disabilities Services Service Coordinator or designee can assist in coordinating the Division of Developmental Disabilities Services surrogate parent training. (C) After an individual has completed the Division of Developmental Disabilities Services surrogate parent training, they may serve as a surrogate parent for any child. (6)(A) However, an appointed Division of Developmental Disabilities Services-certified surrogate may be assigned by the lead Part C agency (such as, Division of Developmental Disabilities Services) to represent the child during the IFSP if there is no adult (as listed in subdivision (c)(4) of this section, above) available to represent the interests of the child. (B) An appointed Division of Developmental Disabilities Services surrogate parent is generally the least preferred option since this person does not have daily interaction with the child. (C) Furthermore, a Division of Developmental Disability Services-certified surrogate parent will usually only be appointed in the event that the child’s parent, resource parent, is unable or unwilling to participate in the child’s early intervention process and IFSP meetings. (7) In any situation in which an individual other than the biological parent, resource parent, or relative is acting on behalf of the child, that individual will be discharged when the child’s biological parent is ready and able to resume involvement. (d) Referrals for fetal alcohol syndrome disorders screening. (1)(A) Fetal alcohol syndrome disorders is an umbrella term used to describe the range of effects or disorders that can occur in an individual whose mother consumed alcohol during pregnancy. (B) All healthcare providers involved in the delivery or care of infants must contact DCFS regarding an infant born with and affected by a fetal alcohol spectrum disorder (FASD) as well as infants born with and affected by maternal substance abuse resulting in prenatal drug exposure to an illegal or a legal substance or withdrawal symptoms resulting from prenatal drug exposure to an illegal or a legal substance. (C) A plan of safe care must be developed for any infant born with and affected by an FASD, maternal substance abuse resulting in prenatal drug exposure to an illegal or a legal substance, or withdrawal symptoms resulting from prenatal drug exposure to an illegal or a legal substance who is referred to the Division of Children and Family Services by a healthcare provider via the Child Abuse Hotline. (D) Please see 9 CAR § 40-329, substance exposed infant referral and assessments, and related procedures for more information. (2)(A) In addition, the Division of Children and Family Services Social Service Specialists and health service assistants will refer children who have known prenatal alcohol exposure, or exhibit FASD symptoms or behaviors, to the local resource unit. (B) The resource unit will collaborate with the child’s Social Service Specialist and health service assistants (to help determine if early intervention programs or other services specific to FASD are needed) and connect the child and placement provider to such programs and services in an effort to better support the child and the placement provider. (3)(A) As part of this process, the Social Service Specialist or health service assistant will gather information regarding the child’s in utero and birth history. (B) Depending on the information collected, a referral for an FASD screening or diagnosis may be provided. (C) Regardless of an FASD diagnosis, the following services may be offered to the family as available and appropriate: (i) Referral to the Division of Developmental Disabilities Services (for early intervention or Division of Developmental Disabilities Services waiver), if applicable and available; (ii) Referral to specialized day care, if applicable; (iii) Referral to FASD family support group (available to biological, resource, and adoptive families), if available; and (iv) FASD parenting classes (available to biological, resource, and adoptive families).