CABINET FOR HEALTH AND FAMILY SERVICES
Department for Public Health
Division of Maternal and Child Health
RELATES TO: KRS 200.650-200.676, 20 U.S.C. Chapter 33, 34 C.F.R. Part 303
STATUTORY AUTHORITY: KRS 194A.050, 200.660
NECESSITY, FUNCTION, AND CONFORMITY: KRS 200.660 requires the Cabinet for Health and Family Services to administer all funds appropriated to implement provisions, to enter into contracts with service providers, and to promulgate administrative regulations necessary to implement KRS 200.650 to 200.676. This administrative regulation establishes the definitions for 902 KAR Chapter 30 pertaining to First Steps, Kentucky's Early Intervention Program.
Section 1. Definitions. (1) "Ability to pay" means a family has an income at 200 percent of the poverty level or above.
(2) "Assessment" means the ongoing procedures used by appropriate qualified service providers throughout the child’s period of eligibility in First Steps to identify:
(a) The child’s unique strengths and needs, and the services appropriate to meet those needs;
(b) The resources, priorities, and concerns of the family; and
(c) The supports and services necessary to enhance the family’s capacity to meet the developmental needs of the family’s infant or toddler with a disability.
(3) "Assistive technology device" means any item, piece of equipment, or product system:
(a) Whether acquired commercially off the shelf, modified, or customized;
(b) That is used to:
1. Increase, maintain, or improve the functional capabilities of a child with a disability; and
2. Implement the individualized family service plan; and
(c) Except for a medical device that is surgically implanted, including a cochlear implant, or the optimization (e.g. mapping), maintenance, or replacement of that device.
(4) "Assistive Technology Service" means a service that directly assists the child with a disability in the selection, acquisition, or use of an assistive technology device in accordance with 20 U.S.C. 1401(2).
(5) "Cabinet-approved criterion referenced instrument" means any of the three (3) assessments, incorporated by reference in 902 KAR 30:120, used to assess children from birth to three (3) years of age.
(6) "Cabinet-approved screening protocol" means a screening protocol that is:
(a) Designed to evaluate the developmental status of children; and
(b) Used by the cabinet.
(7) "Child find" is defined by KRS 200.654(3).
(8) "Consent" is defined by 34 C.F.R. 303.7.
(9) "Destruction" means the physical destruction of the record or ensuring that personal identifiers are removed so that the record is no longer personally identifiable under 34 C.F.R. 303.29.
(10) "Direct supervision" means the continuous, on-site observation and guidance as activities are implemented with children and families.
(11) "District Early Intervention Committee" or "DEIC" is defined by KRS 200.654(6).
(12) "Early intervention record" means all records, electronic and hard copy, regarding a child that are required to be collected, maintained, or used under part C of the Individuals with Disabilities Education Act, 20 U.S.C. 1400-1482, and 902 KAR Chapter 30.
(13) "Early intervention service provider" is defined by 34 C.F.R. 303.12.
(14) "Early intervention services" is defined by 34 C.F.R. 303.13(a)-(d) and 34 C.F.R. 303.16.
(15) "Established risk" means a diagnosed physical or mental condition that has a high probability of resulting in a developmental delay.
(16) "Evaluation" means the use of procedures to determine eligibility for First Steps services in accordance with 902 KAR 30:120.
(17) "Extraordinary family expenses" means those out of pocket expenses, including purchases, medical care cost, and home or automobile modifications to accommodate the needs related to the eligible child’s disability, and these expenses related to other family members with a disability. These considerations do not extend to medical services for other family members without a disability.
(18) "Family-centered" means practices that:
(a) Are driven by the family’s priorities and concerns;
(b) Support the family's role as the constant in a child's life;
(c) Complement a family's natural activity settings and daily routines; and
(d) Support, respect, encourage, and enhance the strengths, competence, and confidence of the family.
"First Steps" means Kentucky's early intervention system, which is
defined by KRS 200.654(8).
"First Steps data management system" means the online data system
that consists of each child’s early intervention record and financial
"Homeless child" means a child who meets the federal definition of
homeless children and youths established in 42 U.S.C. 11434a(2).
"Inability to pay" means a family’s income is below 200 percent of
the poverty level.
"Indirect supervision" means the regular, periodic, on-site
observation and guidance as activities are implemented with children and
"Individualized family service plan" or "IFSP" means an
individual family service plan as defined by 34 C.F.R. 303.340.
"Initial assessment" means the assessment of the child and family
assessment conducted prior to the child’s first IFSP meeting.
"Kentucky Early Childhood Data System" or "KEDS" means the
internet based data collection system to provide data for analysis to determine
the degree to which Kentucky’s children are meeting the major child outcomes
and learning standards required by the Office of Special Education Programs
(OSEP) in the United States Department of Education and the state early
"Multidisciplinary team" is defined by 34 C.F.R. 303.24
"Natural environments" is defined by 34 C.F.R. 303.26.
(a) A natural, adoptive, or foster parent of a child;
(b) A guardian, except for the state if the child is a ward of the state;
(c) An individual acting in the place of a natural or adoptive parent including a grandparent, stepparent, or other relative with whom the child lives, or an individual who is legally responsible for the child’s welfare; or
(d) An individual assigned as a surrogate parent pursuant to 20 U.S.C. 1439(a)(5).
"Part C Coordinator" means the individual designated by the cabinet
to be Kentucky’s liaison with the federal Department of Education, Office of
Special Education Programs (OSEP) to oversee the state’s implementation of the
early intervention system.
"Participating provider or agency" is defined by 34 C.F.R.
"Period of eligibility" means the time from referral to First Steps
to termination of services due to:
(a) Failure to meet initial program eligibility requirements;
(b) Attainment of age three (3);
(c) Documented refusal of service by the child’s parent or legal guardian, inclusive of disappearance; or
(d) Change of residence to another state.
(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 social security number or TOTS number; or
(d) A list of personal characteristics or other information that would make it possible to identify the child with reasonable certainty.
"Point of entry" or "POE" is defined by KRS 200.654(12).
"Prematurity" means a gestational age, at birth, of less than
thirty-seven (37) weeks.
"Primary referral source" is defined by 34 C.F.R. 303.302(c) and 34
"Primary service provider" means a professional who is a member of
the IFSP team and is selected by the parent as the team lead to provide regular
support to the family.
"Qualified service provider" means a provider who meets the
qualifications listed in 902 KAR 30:150.
"Record review team" means a group of early intervention experts
representing each discipline of early intervention providers as listed in 902
KAR 30:150, Section 2(1)(a)-(r), who are utilized by the state lead agency to
review complex cases for eligibility and service provision, and make
recommendations to IFSP teams.
"Referral" means a child identified between birth and three (3) years
of age who is:
(a) A Kentucky resident or a homeless child within the boundaries of the Commonwealth; and
(b) Suspected of having an established risk diagnosis or a developmental delay.
"State Lead Agency" means the designated staff in the Department for Public
Health who are responsible for implementing the First Steps Program in
accordance with 34 C.F.R. 303.22, 20 U.S.C. Chapter 33, and KRS 200.650 to
"Ward of the state" means a child declared by a circuit court judge
to be a ward of the state pursuant to KRS 625.043(2) or 625.100(2).
STEPHANIE MAYFIELD GIBSON, MD, FCAP, Commissioner
AUDREY TAYSE HAYNES, Secretary
APPROVED BY AGENCY: May 7, 2014
FILED WITH LRC: May 9, 2014 at 2 p.m.
PUBLIC HEARING AND PUBLIC COMMENT PERIOD: A public hearing on this administrative regulation shall, if requested, be held on June 23, 2014, at 9:00 a.m. in the Auditorium, Health Services Building, First Floor, 275 East Main Street, Frankfort, Kentucky. Individuals interested in attending this hearing shall notify this agency in writing by June 16, 2014, five (5) workdays prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing is receive by that date, the hearing may be canceled. The hearing is open to the public. Any person who attends will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to attend the public hearing, you may submit written comments regarding this proposed administrative regulation. You may submit written comments on the proposed administrative regulation until June 30, 2014. Send written notification of intent to attend the public hearing or written comments on the proposed administrative regulation to:
CONTACT PERSON: Tricia Orme, Office of Legal Services, 275 East Main Street 5 W-B, Frankfort, Kentucky 40621, phone 502-564-7905, fax 502-564-7573, email firstname.lastname@example.org.
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person: Paula Goff
(1) Provide a brief summary of 902 KAR 30:001:
(a) What this administrative regulation does: This administrative regulation provides definitions unique to the early intervention system as defined by Pub.L. 108-446, the Individuals with Disabilities Education Improvement Act.
(b) The necessity of this administrative regulation: 902 KAR 30:001 is necessary to define specific terminology used in the early intervention system.
(c) How this administrative regulation conforms to the content of the authorizing statute: KRS 200.650 requires that the Cabinet for Health and Family Services be in compliance with federal law.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes: The regulation is needed to provide guidance and clarity for the implementation of the early intervention system in compliance with federal statute and regulation.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation: The amendment adds the following definitions: extraordinary family expenses and personally identifiable information. The amendment expands the definition of early intervention service.
(b) The necessity of the amendment to this administrative regulation: KRS 200.650 (6) requires compliance with federal law. KEIS needs to update the state regulations to stay in compliance with the updated federal regulations, 34 C.F.R. Part 303 released in September 2011.
(c) How the amendment conforms to the content of the authorizing statutes: This amendment adds or expands the definitions related to early intervention services to conform to the updated definitions in federal regulation.
(d) How the amendment will assist in the effective administration of the statutes: These amendments will help to assure compliance with federal statute and regulation.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by the administrative regulation: Approximately 1,500 early intervention providers, including Point of Entry staff, will be affected by these regulations. No state or local governments are affected by the administrative regulation.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
Regulated entities will continue to provide early intervention services as they currently practice.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3): There are no additional costs to entities to comply with the amended regulations.
(c) As a result of the compliance, what benefits will accrue to the entities identified in question (3): Early intervention providers will be eligible for continued funding and participation in First Steps.
(5) Provide an estimate of how much it will cost to implement this regulation:
(a) Initially: There are no costs to implement this regulation.
(b) On a continuing basis: There are no costs to implement this regulation.
(6) What is the source of the funding that will be used for the implementation and enforcement of the administrative regulation? Federal Part C funds, state general funds, and Medicaid funds are used to support the early intervention system.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if this is an amendment: No increase in fees or funding is necessary to implement this amended administrative regulation.
(8) State whether or not this administrative regulation established any fees or directly or indirectly increase any fees? No, this administrative regulation does not directly or indirectly increase any fees.
(9) TIERING: Is tiering applied? Tiering is not applied because First Steps regulations apply consistently across all children and families participating in the First Steps program as well as all providers participating in the First Steps program.
FISCAL NOTE ON STATE OR LOCAL GOVERNMENT
1. What units, parts or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation? This administrative regulation impacts the 15 local Point of Entry offices, 1500 direct service providers as well as the state administrative office that governs the First Steps program.
2. Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation. 20 U.S.C. Chapter 33, 34 C.F.R. Part 303, KRS 194A.050, KRS 200.650-676
3. Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect. This administrative regulation provides clarification of program terms.
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year? There will be no new revenue generated by this administrative regulation during the first year.
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years? There will be no revenues generated by this administrative regulation during subsequent years.
(c) How much will it cost to administer this program for the first year? There will be no new expenditures to implement this administrative regulation during the first year.
(d) How much will it cost to administer this program for subsequent years? There will be no expenditures to implement this administrative regulation during the subsequent years.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Other Explanation: There is no fiscal impact on local or state government for this administrative regulation.
FEDERAL MANDATE ANALYSIS COMPARISON
1. Federal Statute or regulation constituting the federal mandate. 34 C.F.R. 303 Subpart A - General list the definitions commonly used in early intervention services. As a recipient of federal Part C monies, Kentucky Early Intervention Services is mandated to fully comply with all federal statutes. The changes in the definitions bring KEIS into full compliance with this federal statute and are required for continued receipt of those funds.
2. State compliance standards KRS 200.650 charges the Cabinet for Health and Family Services and the Department for Public Health to comply with federal law as it pertains to services for infants and toddlers with disabilities and their families.
3. Minimum or uniform standards contained in the federal mandate. By revising this administrative regulation to mirror the federal language regarding definitions the state will be in full compliance under this part of the federal statute.
4. Will this administrative regulation impose stricter requirements, or additional or different responsibilities or requirements, than those required by the federal mandate? This amendment does not impose stricter than federal requirements.
5. Justification for the imposition of stricter standard, or additional or different responsibilities or requirement. This amendment does not impose stricter than federal requirements