IDEA Part C: Referral Timelines and Requirements
What IDEA Says
Part C regulations address pre-referral, referral, and post-referral components of the IDEA Part C statewide system. A provision identifies the major components of the statewide comprehensive, coordinated, multidisciplinary interagency system by specifically distinguishing among pre-referral activities (public awareness and Child Find), referral, and post-referral individualized family service plan (IFSP) activities (including screening, evaluations, assessments, and IFSP development, review, and implementation).
Below is information on what the IDEA Part C final regulations say, the implications for ASHA members, and what members can do.
Pre-Referral Procedures
The Children's Health Insurance Program (CHIP) and the state Early Hearing Detection and Intervention (EHDI) system are included on the list of programs with which the lead agency must coordinate its Child Find efforts.
§303.301(c) requires each lead agency, as part of its public awareness obligation, to provide for informing parents of toddlers about preschool programs under Section 619 of the Act not fewer than 90 days prior to the toddler's third birthday.
Implications for ASHA Members
Members should be aware of the full list of programs in the state that have Child Find responsibilities and should coordinate efforts with these programs.
In addition to their work with other programs they have coordinated within the past, ASHA members need to coordinate with the CHIP programs and the state EHDI systems to assist the lead agency in its Child Find responsibilities to identify infants and toddlers with disabilities. Similarly, ASHA members who are part of a state's EHDI system should be aware of the need to coordinate with the state's Part C Child Find system.
The lead agency is responsible for ensuring that information about Part B preschool services (Section 619) is available to parents of all toddlers with disabilities exiting the Part C program and not just to parents whose toddlers who have been determined by the lead agency to be potentially eligible under Part B of the Act.
What ASHA Members Can Do
ASHA members should collect and share information with parents, as appropriate, about Part B preschool program resources no fewer than 90 days prior to the toddler's third birthday.
Referral Procedures
§303.303(a)(2)(i) requires primary referral sources to refer a child to the Part C program "as soon as possible but in no case more than seven days'' after identification.
Implications for ASHA Members
ASHA members who serve as primary referral sources to Part C programs need to know that their state's policy may allow up to seven days to refer an infant/toddler with a disability to Child Find.
What ASHA Members Can Do
The maximum timeline of seven days provides audiologists and speech-language pathologists (SLPs) with flexibility for making referrals to Part C. ASHA members who serve as primary referral sources to Part C programs need to stay current on the Child Find referral process and timelines for their state and maintain current Child Find referral packets.
Post-Referral Procedures
§303.310 requires that, within 45 days after the lead agency or early intervention service provider receives a referral of a child, the screening (if applicable), initial evaluation, initial assessments (of the child and family), and the initial IFSP meeting for that child must be completed (45-day timeline).
§303.310(b)(2) adds an exception to the 45-day timeline if the parent has not provided consent to the initial screening, evaluation, or assessment of the child, despite documented, repeated attempts to obtain parental consent. §303.310(c) requires the lead agency to ensure completion of the initial evaluation, assessments, and IFSP meeting as soon as possible after parental consent is provided.
§303.320 requires the lead agency to provide notice to parents of its intent to screen and clarifies that, at any time during the screening process, a parent may request an evaluation.
§303.321(a)(2)(i) clarifies that 1) the term initial evaluation refers to the evaluation of a child that is used to determine their initial eligibility under Part C of the Act and 2) the term initial assessments refers to the assessment of the child and the family assessment that are conducted prior to the child's first IFSP meeting.
§303.342(e) requires early intervention services to be provided as soon as possible after parental consent.
Implications for ASHA Members
ASHA members need to comply with the timelines and make sure that other IFSP team members are aware of them.
The 45-day timeline commences on the date of referral, rather than on the date the lead agency or early intervention service (EIS) providers obtain parental consent for the initial evaluation. The 45-day timeline from the date of the child's referral will result in fewer delays in infants and toddlers with disabilities receiving early intervention services as quickly as possible after being referred. The timeline applies to both lead agencies and EIS providers because EIS providers as well as lead agencies implement these requirements and conduct initial evaluations, initial assessments, and initial IFSP meetings.
The exception cannot result in absolute waivers of the 45-day timeline, as lead agencies or EIS providers are required to complete activities as soon as possible after the basis for the exceptions cease to exist and develop and implement an interim IFSP to the extent appropriate and consistent with the regulations.
The regulations clarify that parents have an ongoing right to request an evaluation before, during, or after their child is screened. Parents are considered a valuable source of information in determining whether a child is suspected of having a disability.
Understand the differences in the definitions of initial evaluation and initial assessment as explained in the new regulations at both federal and state levels.
Parental consent means "written" informed consent. The term as soon as possible may vary from state to state. It is important for the timeline for early intervention services to run from the date of parental consent and not from the initiation date identified at the IFSP meeting because this results in fewer delays in providing early intervention services.
What ASHA Members Can Do
ASHA members can ensure the other team members are aware of and comply with the timeline requirements, including the requirement that once parent consent is obtained, the child and family need to be scheduled as soon as possible for screening (if indicated), initial evaluation, and initial assessment.
ASHA members need to ensure that the team is aware that any team member may be responsible to document in the child's early intervention records each time an exception to the 45-day timeline occurs and describe the nature of the exception.
Once parental consent has been gained, ASHA members and team members need to inform families of timelines and need to support efforts to schedule screening (if indicated), initial evaluation, initial assessment, and initial IFSP meetings as soon as possible.
