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Connecticut Birth to Three System A Family Handbook Guide 1 Referral and Eligibility Evaluation July 2014
Connecticut Birth to Three System  A Family Handbook Guide 1  Referral and Eligibility Evaluation July 2014
Connecticut Birth to Three System A Family Handbook This handbook and others are available at www birth23 org
Connecticut Birth to Three System  A Family Handbook  This handbook and others are available at www.birth23.org
Table of Contents Welcome to the Connecticut Birth to Three System 2 An introduction to the Birth to Three System 3 The evaluation visit 3 Parent participation in the evaluation 4 How is my child s eligibility decided 6 What if my child is not eligible for Birth to Three 7 What if my child is eligible for Birth to Three 8 How much will I have to pay 9 What can my Birth To Three program offer 10 Services in the Birth to Three System 11 What are my rights 12 Who can I call if I have a question 15 Glossary 15 Inserts Programs that serve your town State and national resources Birth to Three DVD Providing Hope Realizing Dreams if requested
Table of Contents Welcome to the Connecticut Birth to Three System . . . . . .  . 2 An introduction to the Birth to Three ...
Welcome to the Connecticut Birth to Three System For families worried that their child s development is lagging behind other children his age the infant toddler and preschool years can be spent anxiously waiting for developmental milestones to be met Early intervention and the Birth to Three System can help you put your concerns to rest You have taken a very important first step by talking with the Child Development Infoline and scheduling an eligibility evaluation visit for your child This handbook introduces you to the Connecticut Birth to Three System and lets you know what to expect during your child s evaluation and beyond A welcome video is available for viewing on our website www birth23 org under Videos for Families If you do not have access to a computer and would like a DVD copy of our welcome video please contact Child Development Infoline at 800 505 7000 This handbook lets you know what to expect during your child s evaluation 2 NOTE All bold underscored words are explained in the glossary
Welcome to the Connecticut Birth to Three System  For families worried that their child   s development is lagging behind ...
An introduction to the Birth to Three System The Birth to Three System was created under Part C of a federal law called the Individuals with Disabilities Education Act IDEA and by state law 17a 248 In Connecticut the Department of Developmental Services is the lead agency that administers the Birth to Three System The lead agency operates a central office for outreach training and fiscal operations In addition a family liaison is on staff to work directly with families who have questions or concerns about the Connecticut Birth to Three System or their individual Birth to Three program Staff members from each program work directly with families and eligible children Birth to Three professionals will coach you in ways to embed early intervention strategies into your daily routines with your child Each program serves a specific set of towns The programs serving your hometown appear on our website www birth23 org under Birth 23 by Town and are also included with this book Since Birth to Three visits usually take place in the homes of eligible children do not be concerned if your program s office address is not in your hometown Most towns have more than one program serving their town giving families the option of choosing a specific program This can be done before or after the eligibility evaluation and right up to the time you leave the Birth to Three System Information that can help you learn more about each program is available on our website at www birth23 org by clicking on About our Programs If you would like to know how a particular program compares to other state programs click on How are we doing then click on Public Reporting of APR Annual Performance Review data You can also click on State Performance Plans to learn how well the State of Connecticut is doing If you don t have access to the Internet you can contact the Birth to Three Accountability and Monitoring office at 860 496 3073 The evaluation visit The evaluation visit usually takes place in your home if that is where you and your child feel most comfortable When scheduling this visit think of the best time of day for you and your child When is your child awake and alert Can your spouse partner or other caregiver also be home to participate At least one parent must be present for the evaluation The evaluators will work with you to find a good time for the visit that also fits into their schedules 3
An introduction to the Birth to Three System The Birth to Three System was created under Part C of a federal law called th...
The team will ask you to sign several forms at the start of the visit including consent to Evaluate your child Bill your health insurance company for the evaluation with no co pay or deductible for you Get information from your doctor or others you identify The evaluators will explain each form to you before you sign Your consent is voluntary and may be cancelled at any time Information about your child and family is confidential and cannot be shared without your permission See page 12 for more details about your rights in the Birth to Three System Parent participation in the evaluation Please participate in the evaluation by Helping your child feel comfortable during the evaluation visit Helping with activities that explore your child s abilities Telling the team whether or not what they are seeing is typical for your child P roviding truthful and accurate responses to questions about your child s development no matter how painful those answers may be Helping the team see your child s unique strengths and needs Asking questions and offering your opinions about how your child s evaluation is going The Birth to Three team will ask you to share information from other developmental assessments or evaluations your child might have had outside of Birth to Three These outside evaluations may be very important for determining eligibility Team members are interested in hearing about things your child can already do and the things that are difficult for your child They will watch your child playing with you and with toys to see what he or she can do You know more about your child than anyone else Your input is extremely valuable 4 NOTE All bold underscored words are explained in the glossary
The team will ask you to sign several forms at the start of the visit including consent to        Evaluate your child     ...
You can best prepare for the evaluation by taking some time beforehand to think about the following your child s prenatal history your child s birth your child s health and developmental history any significant changes in your life or your child s life that may contribute to behavior changes in your child when you were first concerned that something might not be quite right what you may have done to learn more about the suspected problem your concerns now The team will review results from this testing the information you provide about your child s history and development and any reports received from medical providers to arrive at an eligibility decision If at all possible you will be given a written draft copy of the results and eligibility decision in your native language The evaluation report is not final until you have had a chance to read it and make sure that it is correct 5
You can best prepare for the evaluation by taking some time beforehand to think about the following        your child   s ...
How is my child s eligibility decided Your child may be found eligible for early intervention in one of two ways 1 your child has a confirmed medical condition that is expected to lead to a developmental delay and therefore is automatically eligible or 2 eligibility evaluation by staff from two different professions for example speech therapy and physical therapy confirming that there is a significant developmental delay If a Birth to Three professional holds two certificates or licenses from different disciplines for example social work and speech therapy then he or she can complete the eligibility evaluation without a second person from a different discipline The information you gave to the Child Development Infoline CDI about your child and family over the phone was recorded in our confidential electronic database and transferred to the Birth to Three program that will evaluate your child If you gave consent for CDI to follow up with you two months after the referral your information was also recorded in a separate confidential electronic database for that purpose The Birth to Three program will send two staff or one professional with two certificates or licenses to your home to complete an evaluation visit with you and your child If your child does not have a confirmed medical condition from our diagnosed condition list making the child automatically eligible or an outside evaluation that can be used document a significant delay an evaluation of your child s abilities and possible developmental delays will be used to determine eligibility You will be an important part of the Birth to Three evaluation team that will assess five areas of your child s development Five Areas of Development 6 physical development such as vision hearing movement and health communication skills such as pointing understanding your words expressing thoughts adaptive or self help skills such as feeding and dressing cognitive skills such as thinking learning and reasoning social emotional development such as getting along with others expressing feelings developing relationships NOTE All bold underscored words are explained in the glossary
How is my child   s eligibility decided  Your child may be found eligible for early intervention in one of two ways  1.   ...
If your child was referred to Birth to Three because of concerns about his or her speech or language abilities it is very important to have your child s hearing tested Hearing problems even minor ones often result in speech and language delays Your child may even exhibit tantrums and behavioral concerns that may result from the frustration of not being able to communicate It is very important for your Birth to Three team to know your child s level of hearing when it completes the initial assessment Talk to your pediatrician about the possibility of being referred to a pediatric audiologist for an in depth hearing evaluation Many health insurance plans cover this so check your health plan to see if yours does What if my child is not eligible for Birth to Three If you disagree with the results of the Birth to Three eligibility evaluation and this cannot be resolved by talking with the program or the family liaison there are other ways of resolving disputes You may file a written complaint request mediation or request a due process hearing For more information on your rights see page 12 Children who have mild delays are not eligible for Birth to Three services If your child is not eligible your evaluation team will link you to other programs that will help you understand your child s development Ages and Stages is a free program that helps you keep track of your child s development If you enroll the Child Development Infoline CDI will mail you a questionnaire about your child s development every four to six months Mail your answers back to CDI for scoring If your child s development continues on schedule CDI will send you a note telling you so along with some activities you can enjoy with your child If your child s development shows that he or she might need some help from Birth to Three CDI will phone you to discuss scheduling another evaluation All evaluations are free 7
If your child was referred to Birth to Three because of concerns about his or her speech or language abilities it is very ...
What if my child is eligible for Birth to Three In order to be considered eligible your child s development must fall two standard deviations below average in one developmental area or one and a half standard deviations below average in two or more developmental areas While this may seem complicated in simple terms it means that according to the evaluation tools used your child s development was considerably behind all other children of his age in one or more areas Early intervention through Birth to Three will work to close these gaps and assist you as you help your child reach age appropriate developmental milestones After eligibility is determined you will be assigned a service coordinator Your service coordinator will help bring together all the people information and resources that are an important part of your life Your service coordinator is your guide as you make connections to community resources including those outside of Birth to Three These may include a wide variety of developmental health economic and quality of life issues Your service coordinator will guide you in developing a plan called the Individualized Family Service Plan IFSP The IFSP will describe the real life outcomes you want for your child and family The IFSP lists how where and when your family will work with the program staff to reach those outcomes Your service coordinator will offer you more details about the IFSP and many other topics as you work together Birth to Three is a system of supports for families to help them meet the needs of their infants and toddlers who have disabilities or delays in their development All eligible families will receive service coordination In addition most families receive one or more direct services for their child Birth to Three programs include up to seventeen different services but typical services for most families include working with a developmental specialist teacher physical or occupational therapist speech pathologist social worker or other professional These professionals will demonstrate for your family how to teach your child new skills or behaviors They will coach you as you practice these skills with your child in your daily activities so they become a part of your routine Birth to Three is different from outpatient rehabilitation services where professionals work with your child for a fixed amount of time while you watch Research shows infants and toddlers learn best when skills are incorporated into their daily routines by their caregivers You and your child s other caregivers are an essential part of the Birth to Three team 8 NOTE All bold underscored words are explained in the glossary
What if my child is eligible for Birth to Three  In order to be considered eligible, your child   s development must fall ...
How much will I have to pay Your child s eligibility evaluation is completed at no cost to your family You will be asked for permission to bill your health insurance to help offset the cost but this is voluntary and will not affect your child s evaluation in any way If your child is found eligible you will be asked again for permission to bill your health insurance plan for reimbursement of some of the services This is also voluntary and will not affect any of your services but will result in an additional copayment based on your income If your child is found eligible and your income is under 45 000 you will NOT be asked to pay fees If your income is over 45 000 and you wish to receive direct services you will be asked to begin making monthly payments after your first full month of services Parent payments are determined on a sliding fee scale according to your income and family size There will also be an additional copayment based on income if you do not consent to have your insurance billed For example a family of four with and annual adjusted gross income of 122 000 with permission to bill insurance would pay 144 If this same family decided not to allow their insurance to be billed they would pay a fee of 144 PLUS a copayment of 75 for a total monthly cost of 219 If you feel last year s adjusted gross income does not reflect your family s current income you will have the opportunity to adjust your income For example there may be changes in your family s income due to job loss reduced hours or maternity leave Or you may now be paying childcare costs The Family Cost Participation Form you fill out prior to services beginning will guide you through the categories of extraordinary expenses You will be required to provide proper documentation and the approval of Birth to Three staff prior to an income reduction that may result in a decrease in your monthly family fee Be sure to ask your service coordinator for assistance in filling out your form Or check the Birth to Three website for an interactive presentation for families Birth to Three Family Cost Participation There are some services that will be offered to your family at no cost They are Child Find service coordination development and review of an IFSP assessment and assistance with transition out of Birth to Three If you and your family decide you would like to obtain direct services from a private provider in your community at your own cost or through your own health insurance these other services will still be available to you If your child is enrolled in the Medicaid program HUSKY A there is no fee 9
How much will I have to pay  Your child   s eligibility evaluation is completed at no cost to your family. You will be ask...
What can my Birth to Three program offer Your service coordinator is employed by an agency that earned approval to provide Birth to Three services and supports Each approved agency employs staff that are licensed or certified in different specialties These specialties include education physical therapy social work audiology behavior analysis occupational therapy speech therapy and other areas of expertise The staff will work with you and your family to help you and your child reach the outcomes you choose for your child and family All programs and their staff meet the standards for excellence set by the Birth to Three System Each Birth to Three program offers 10 free eligibility evaluation by trained professionals typically in your home a service coordinator who will also be providing direct services such as speech and who is responsible for identifying resources in your community to assist your family coordinating all the different people information and resources that support your family and assist your family as you plan for your child s transition out of Birth to Three Trained staff will help you to work on goals related to your child s and your family s needs Services that will help you practice new skills with your child during activities that are a part of your family s regular routine Practicing these skills with your child in your home and in the places where you both spend time in your community for example at childcare or grandma s house is the best way for your child to most successfully learn new skills Due process rights under IDEA Part C guarantee families certain rights called procedural safeguards Please refer to pages 12 through 14 of this handbook to learn more about your rights in the Birth to Three System NOTE All bold underscored words are explained in the glossary
What can my Birth to Three program offer  Your service coordinator is employed by an agency that earned approval to provid...
Services in the Birth to Three System Services are designed around your family s needs concerns and priorities Natural learning opportunities happen throughout your day and are used for practicing new skills with your child Here is a quick look at supports and services FOCUS Your whole family not just your eligible child will be supported in Birth to Three OUTCOMES You choose which skills you want to work on with your child so that he may become successful in family and community activities PROVIDERS Providers will work with you and your family in a close partnership using a transdisciplinary model demonstrating and coaching you on incorporating skills into your child s daily routine LENGTH OF SERVICE Services are voluntary You may leave whenever you choose when services are no longer needed or by the time of your child s third birthday The service coordinator assists the family in transitioning to community programs upon exiting from Birth to Three Examples of community programs may include child care early childhood special education or Head Start WHERE Services will be provided in your home and community wherever your child spends time during the day INTENSITY The frequency and length of visits is designed to match the outcomes for your child and family The frequency of visits you and your Birth to Three team decide on may look different from what your doctor or medical team is prescribing Many medical professionals are more familiar with an outpatient rehabilitation model where you sit and watch a professional work with your child During Birth to Three visits providers will be demonstrating and coaching you on how you can implement specific techniques and strategies into your daily routines Research shows that this is how very young children learn best Research also indicates more frequent visits do not guarantee faster development You are an essential part of your child s team EASURES OF SUCCESS Success is measured by your child learning new M skills your family gaining confidence in meeting your child s needs and connecting with community resources and activities 11
Services in the Birth to Three System Services are designed around your family   s needs, concerns, and priorities. Natura...
What are my rights The IDEA gives you certain rights under the Birth to Three System beginning immediately with your first contact with Birth to Three If at any time you are not sure of your rights please talk with your service coordinator program director the Birth to Three family liaison or the Child Development Infoline Your service coordinator will also give you a brochure called Parent Rights Under IDEA Part C that describes your rights in more detail Here is a brief summary 12 You have the right to give written permission before your child is evaluated before services begin or change and before any information about your child or family is shared with anyone You have the right to be notified before any action takes place You must be told in advance about any meetings evaluations services or actions affecting your child under the Birth to Three System This is called prior written notice You will be asked to sign forms given to you by your service coordinator to show your agreement You can change your mind at any time If your child is eligible you have the right to an Individualized Family Service Plan IFSP delivered by a team that includes you and anyone you want to invite Meetings to develop or review an IFSP should be at a convenient time and place for you and your family You have the right at any time to request an IFSP meeting to review change discontinue or add a different service that will help you and your family reach your outcomes You also have the right to postpone a meeting in progress if necessary I FSP meetings must be held in your native l anguage or other mode of communication you need such as sign language unless for some reason it is not possible to do so You may ask for an interpreter to help you understand and actively participate in the IFSP discussion You have the right to request an IFSP meeting at any time to review the supports and services your child and family receive However in order to change your IFSP a multidisciplinary team including you and at least two individuals from separate disciplines must participate One of the individuals must be the service coordinator Please keep in mind that it may take time to make arrangements for the team to assemble for an IFSP meeting You have the right to privacy Information about your child or family is confidential Only select Birth to Three staff Lead Agency auditors and accrediting agencies can review your child s record without your specific written consent NOTE All bold underscored words are explained in the glossary
What are my rights  The IDEA gives you certain rights under the Birth to Three System beginning immediately with your firs...
You have the right to examine your child s record An electronic record is begun at the time your child is referred and is updated until you exit the program Your service coordinator also maintains a folder of important documents You may schedule an appointment to examine these records or request a copy of them at any time Within 10 days of your request you must be provided with a copy of the records If you do not understand something in the record it will be explained to you If you do not agree with something in the record you can request that it be changed Your program must agree to change the record within ten days of you re your request If they disagree they must inform you of your right to a hearing You have the right to disagree with the Birth to Three System There are four ways to do this 1 Very often the quickest and most satisfying way to resolve a concern is to talk with your service coordinator You can also speak to the program director of your Birth to Three program If you are uncomfortable doing this or you feel the problem has not been resolved you may contact the family liaison at the Birth to Three central office She will try to understand the problem and work with you and your Birth to Three program to make adjustments to meet the needs of the situation In many instances an explanation of why something is done in a certain way is all that is needed usually to resolve the problem 2 I f this is not successful or if you choose you may also file a written complaint The letter should be addressed to Lynn Skene Johnson Acting Director CT Birth to Three System 460 Capitol Avenue Hartford CT 06106 1308 The complaint must be signed and include your name address and phone number the name and address of the program or person that you are complaining about plus a statement of what the complaint is about and a proposed solution You must also mail a copy of the complaint to the program about which you have a complaint It is helpful to also include the best days and times that you can be reached by telephone T he Director will then ask a Birth to Three manager or an independent person to investigate your charges That person will contact you to see if you have any additional information that you wish to submit The 13
      You have the right to examine your child   s record. An electronic record is begun at the time your child is referre...
Director will send you a written response within sixty calendar days It will include the facts and conclusions the reason for the decision the corrective actions if required that will be taken 3 Another way to resolve a disagreement is to write to the family liaison to request mediation Mediation allows you and your program s staff to talk about the details of your disagreement with an impartial trained mediator The mediator will work with you and your program to find a suitable solution and then write up the terms of your agreement Mediation works well in many situations and you are encouraged to consider this option However you are not required to use mediation 4 You may also write to the Family Liaison to request a due process hearing a more formal process conducted before an impartial hearing officer The incident about which you are requesting a due process hearing must have occurred in the previous 12 months unless there are extenuating circumstances Normally legal counsel or another person with professional knowledge of your child should represent your case An Assistant Attorney General will represent the Birth to Three System At the request of either party the hearing officer may extend the 30 day timeline for a due process hearing decision Witnesses are called to testify and are cross examined evidence is presented and shortly after the hearing ends and within 30 days of the request the hearing officer issues a written decision The hearing is provided at no cost but you must pay for any professionals that represent you You can request a brochure on mediation or due process hearings from the Family Liaison While a complaint is being resolved in any of the ways described you have the right to continue receiving services that are not in dispute until your child turns three or unless you and Birth to Three team agree that this is not in your child s best interest For more information about your rights in Birth to Three visit our website at www birth23 org and click on Videos for Families then click on Welcome videos for families 14 NOTE All bold underscored words are explained in the glossary
Director will send you a written response within sixty calendar days. It will include         the facts and conclusions   ...
Who can I call if I have a question If you have already scheduled your child s evaluation visit you may call the evaluation team with questions or ask questions once they arrive in your home Refer to the insert that comes with this booklet to find the agency name and phone number for your program You may contact the family liaison at any time before or after your child s evaluation for answers to your questions about all aspects of early intervention If you do not speak English over the phone interpretation services in your native language are available at no charge to you The Birth to Three website which is updated often is a great source of information Visit the website at www birth23 org Glossary accrediting agencies national organizations that give an approved status to those programs that meet their standards for excellence Birth to Three program an agency under contract with the Birth to Three System or run by the lead agency in order to provide supports and services that help you help your child and family to reach your chosen outcomes Birth to Three evaluation team people who have specialized knowledge about what works to reach developmental outcomes the team always includes your family and may include one or more therapists a teacher and other professionals who are trained to help with your outcomes and needs confidential private cannot be shared without your permission consent the approval that you give for someone to do something consent in the Birth to Three System is always voluntary and may be cancelled at any time 15
Who can I call if I have a question  If you have already scheduled your child   s evaluation visit, you may call the evalu...
Glossary continued delays a developmental milestone that failed to happen at the intended or expected time development the process of learning and mastering new skills over time including the ability to move communicate think see hear and play with toys or other people disabilities conditions that limit or slow down one or more kinds of development due process hearing the most formal way to resolve a disagreement between an enrolled family and the Birth to Three System usually used after verbal discussion written complaint and or mediation have not successfully resolved the complaint early intervention supports and services offered to an eligible child and family as soon as a developmental delay is identified in order to improve the child s ability to live learn and play in their home and community eligible meeting the requirements to participate eligibility evaluation By using developmental measurements to test a child s abilities and then comparing these with what is expected for children of the same age if it is found then that there is a significant difference the child will be eligible for early intervention Individualized Family Service Plan IFSP a written plan describing the outcome you want for your child and family the Birth to Three services and supports used to reach those outcomes where and when they will take place and who will work with you Individuals with Disabilities Education Act IDEA A federal law that supports the provision of early intervention to eligible infants and toddlers under Part C of the law and guarantees that all children ages 3 to 21 who need special education receive a free appropriate public education under Part B of the law lead agency the State agency responsible for IDEA Part C which assures quality and conducts audits in order to maintain compliance with all applicable laws the lead agency in Connecticut is the Department of Developmental Services mediation a way to settle a conflict so both sides win Parents and professionals discuss their differences and with the help of a trained mediator reach a settlement that both sides accept natural learning opportunities the everyday routines and activities of life that can be used to teach and practice new skills for example snack time diaper changing bath time etc outcomes the changes that a family would like to work toward achieving 16
Glossary continued delays  a developmental milestone that failed to happen at the intended or expected time development  t...
Part C part of the Individuals with Disabilities Education Act IDEA providing funds to State lead agencies to assist in the provision of early intervention services to infants and toddlers with disabilities from birth until the child s third birthday service coordination supports an active ongoing process provided at no cost that assists and enables families to access services and assures their rights and procedural safeguards service coordinator a person from your Birth to Three program who will help you to communicate with the people on your team understand the information given to you and will work with you to connect your family to community resources outside of Birth to Three covering a wide variety of developmental health economic and life quality issues transdisciplinary when parents and professionals from two or more different disciplines teach learn and work together across traditional disciplinary or professional boundaries For example a developmental specialist working with parents on their child s problem solving skills will include speech activities during the visit if language development is a concern The team may designate one member as the primary interventionist Team members may provide direct services consulting services or both A transdisciplinary approach to service delivery is recommended for all early intervention and support services Visit the website at www birth23 org 17
Part C  part of the Individuals with Disabilities Education Act  IDEA  providing funds to State lead agencies to assist in...
www birth23 org 1 866 888 4188 Funding provided under Part C of the Individuals with Disabilities Education Improvement Act IDEA through the United States Department of Education Office of Special Education Programs Designed by Gardner Group Graphic Design LLC West Hartford CT www gardnerggd com Printing by State of Connecticut Department of Administrative Services Print Shop
www.birth23.org 1-866-888-4188  Funding provided under Part C of the Individuals with Disabilities Education Improvement A...