ARTICLE 25 - EARLY INTERVENTION

43-2501. ACT, HOW CITED. Sections 43-2501 to 43-2513 shall be known and may be cited as the Early Intervention Act. (Laws 1991; 1993)

43-2502. LEGISLATIVE INTENT. It is the intent of the Legislature to assist in securing early intervention services to infants or toddlers with disabilities and their families in accordance with the federal early intervention program and whenever possible in concert with the family policy objectives prescribed in sections 43-532 to 43-534 and federal and state initiatives. Such services are necessary to:

1. Enhance the development of infants and toddlers with disabilities;
2. Reduce the costs to our society by minimizing the need for special services, including special education and related services, after such infants or toddlers reach school age;
3. Minimize the likelihood of institutionalization of persons with disabilities and maximize their potential for independent living in society;
4. Enhance the capacity of families to meet the needs of their infants or toddlers with disabilities;
5. Strengthen, promote, and empower families to determine the most appropriate use of resources to address the unique and changing needs of families and their infants or toddlers with disabilities; and
6. Enhance the capacity of state and local agencies and service providers to identify, evaluate, and meet the needs of historically under represented populations, particularly minority, low-income, and rural populations. (Laws 1991; 1993.)

43-2502.01. GENERAL FINDINGS AND DECLARATIONS. The Legislature hereby finds and declares that: (1) All families have strengths; (2) families strengthen communities; (3) families are the primary decision makers for their children; and (4) all families have needs that change over time and require the support of their communities. (Laws 1993.)

43-2502.02. LEGISLATIVE FINDINGS. The Legislature further finds that: (1) Many state initiatives for improving or reforming the current service delivery systems for children and their families have been identified and are currently underway within Nebraska; (2) there is a need to facilitate coordination and promote communication across these efforts to identify common visions and approaches and to establish linkages across health, social services, family support services, mental health, and education initiatives at the state and community levels; and (3) these initiatives need continued support and nurturing in order to empower communities and families and to provide and promote an integrated service delivery system. (Laws 1993.)

43-2502.03 LEGISLATIVE DECLARATIONS. The Legislature declares that it shall be the policy of the State of Nebraska to promote the development of a statewide system of comprehensive, coordinated, family-centered, community-based, and culturally competent services for children and their families to assure that services help build strong families and provide appropriate environments prenatally and for children from birth through their early years in programs and services which are;

1. Family-centered, recognizing that parents have the primary responsibility for their children's development and learning and that programs must recognize and support the role of parents through family-friendly criteria in planning their structure, services, staffing, and delivery;
2. Comprehensive, recognizing that services must include attention to all aspects of the child and family and address needed health and nutrition, education, family support, and social services. Such a service system should allow families to choose the services they need with minimal costs and requirements;
3. Coordinated, recognizing that collaboration among the state agencies and variety of private and community programs and services is required to assure that comprehensive child and family needs are met and that the most efficient use is made of public resources, community services, and informal support systems of families;
4. Quality, recognizing that outcomes for children in the early years are strengthened when programs and services display indicators of quality, including developmentally appropriate practices, extensive family involvement, trained staff, and culturally responsive approaches;
5. Inclusive, recognizing that all children benefit when they have optimum opportunities to interact with peer groups of children with diverse backgrounds and characteristics; and
6. Equitable, recognizing that program practices strive for potential achievement of all children including children from minority groups, with disabilities, from less advantaged backgrounds, and from less populated geographic areas. (Laws 1993.)

43-2502.04. DECLARATION OF POLICY. The Legislature further declares that it shall be the policy of the State of Nebraska, through the implementation of the Early Intervention Act, to promote, facilitate, and support;

1. Healthy families, enhancing the well-being of each family member as well as that of the family as a unit and encouraging family independence and decision making about the future of their children;
2. Service systems which are responsive, flexible, integrated, and accessible to children and their families;
3. Community ownership, recognizing that families live and children grow up in communities, that programs are implemented in communities, and that all families need supportive communities; and
4. Maximum impact of prevention and early intervention, encouraging and supporting active parent and family partnership in all programs and services. (Laws 1993.)

43-2503. PURPOSES OF ACT. The purposes of the Early Intervention Act shall be to:

1. Develop and implement a statewide system of comprehensive, coordinated, family-centered, community-based and culturally competent early intervention services for infants or toddlers with disabilities and their families through the collaboration of the Department of Health and Human Services, the Department of Health and Human Services Finance and Support, the State Department of Education, and all other relevant agencies or organizations at the state, regional and local levels;
2. Establish and implement a billing system for accessing federal Medicaid funds;
3. Establish and implement services coordination through a community team approach;
4. Facilitate the coordination of payment for early intervention services from federal, state, local, and private sources including public and private insurance coverage; and
5. Enhance Nebraska's capacity to provide quality early intervention services and expand and improve existing early intervention services being provided to eligible infants or toddlers with disabilities and their families. (Laws 1991; 1993; 1996.)

43-2505. TERMS, DEFINED. For purposes of the Early Intervention Act.

1. Collaborating agencies means the Department of Health and Human Services, and the State Department of Education;
2. Developmental delay has the definition found in section 79-1118.01;
3. Early intervention services may include services which:
   (a) Are designed to meet the developmental needs of each eligible infant or toddler with disabilities and the needs of the family related to enhancing the development of their infant or toddler;
   (b) Are selected in collaboration with the parent or guardian;
   (c) Are provided in accordance with an individualized family service plan;
   (d) Meet all applicable federal and state standards; and
   (e) Are provided, to the maximum extent appropriate, in natural environments including the home and community settings in which infants and toddlers without disabilities participate;
4. Eligible infant or toddler with disabilities means a child who needs early intervention services and is two years of age or younger, except that toddlers who reach age three during the school year shall remain eligible throughout that school year. The need for early intervention services is established when the infant or toddler experiences developmental delays or any of the other disabilities described in the Special Education Act;
5. Federal early intervention program means the federal early intervention program for infants and toddlers with disabilities, 20 U.S.C. 1471 to 1485;
6. Individualized family service plan means the process, periodically documented in writing, of determining appropriate early intervention services for an eligible infant or toddler with disabilities and his or her family;
7. Interagency planning team means an organized group of interdisciplinary, interagency representatives, community leaders, and family members in each local community or region;
8. Lead agency or agencies means the Department of Health and Human Services and State Department of Education and any other agencies designated by the Governor for general administration, supervision, and monitoring of programs and activities receiving federal funds under the federal early intervention program and state funds appropriated for early intervention services under the Early Intervention Act;
9. Nebraska Interagency Coordinating Council means the state council the function of which is to advise and assist the collaborating agencies in carrying out the provisions of the act. The members of the council shall be appointed by the Governor and shall include, but not be limited to, representatives of school districts, social services, health and medical services, parents, mental health services, developmental disabilities services, educational service units, Head Start, higher education, physicians, the Legislature, and the collaborating agencies; and
10. Services coordination means a flexible process of interaction facilitated by a services coordinator to assist the family of an eligible infant or toddler with disabilities within a community to identify and meet their needs pursuant to the act. Services coordination under the act shall not duplicate any case management services which an eligible infant or toddler with disabilities and his or her family are already receiving or eligible to receive from other sources. (Laws 1991; 1993; 1996; 1997; 1999.)

43-2506. NEBRASKA INTERAGENCY COORDINATING COUNCIL; COLLABORATING AGENCIES; DUTIES.

1. The Nebraska Interagency Coordinating Council and collaborating agencies shall make recommendations regarding the following to the lead agency or agencies which shall have the responsibility and authority for:
   (a) The general administration, supervision, and monitoring of programs and activities receiving federal funds under the federal early intervention program to ensure compliance with federal law;
   (b) The identification and coordination of all available resources within the state from federal, state, local and private sources;
   (c) The development of procedural safeguards, including procedures for complaints and appeals, to ensure that services coordination is provided to eligible infants or toddlers with disabilities or possible disabilities and their families in a timely manner pending the resolution of any disputes among public agencies or service providers;
   (d) The entry into formal interagency agreements that include components necessary to ensure meaningful cooperation and coordination; and
   (e) The coordination of interagency rules and regulations pursuant to the Early Intervention Act.
2. The Nebraska Interagency Coordinating Council and collaborating agencies shall make recommendations to the lead agency or agencies which shall prepare and submit all applications for funding under the federal early intervention program and shall distribute federal funds according to such applications. (Laws 1991; 1993.)

43-2507. COLLABORATING AGENCY; STATEWIDE SYSTEM; COMPONENTS; DUTIES; SHARING INFORMATION AND DATA.

1. Planning for early intervention services shall be the responsibility of each collaborating agency. The planning shall address a statewide system of comprehensive, coordinated, family-centered, community-based, and culturally competent early-intervention services to all eligible infants or toddlers with disabilities and their families in Nebraska. The statewide system shall include the following minimum components:
   (a) A public awareness program, including a central director;
   (b) A comprehensive early identification system, including a system for identifying children and making referrals for infants or toddlers who may be eligible for early intervention services;
   (c) Common intake, referral, and assessment processes, procedures, and forms to determine the eligibility of infants and toddlers and their families referred for early intervention services;
   (d) An individualized family service plan, including services coordination, for each eligible infant or toddler with disabilities and his or her family;
   (e) A comprehensive system of personnel development;
   (f) A uniform computer data base and reporting system which crosses agency lines; and
   (g) Services coordination to access the following early intervention services: Audiology; family training, counseling, and home visits; health services; medical services only for diagnostic or evaluation purposes; nursing services; nutrition services; occupational therapy; physical therapy; psychological services; social work services; special instruction speech-language pathology; transportation and related costs that are necessary to enable an eligible infant or toddler with disabilities and his or her family to receive early intervention services; assistive technology devices and assistive technology services; vision services; and hearing services.
2. Collaborating agencies shall review standards to ensure that personnel are appropriately and adequately prepared and trained to carry out the Early Intervention Act.
3. Collaborating agencies shall be responsible for designing, supporting, and implementing a statewide training and technical assistance plan which shall address preservice, inservice, and leadership development for service providers and parents of eligible infants and toddlers with disabilities.
4. Policies and procedures shall be jointly examined and analyzed by the collaborating agencies to satisfy data collection requirements under the federal early intervention program and to assure the confidentiality of the data contained in the statewide system. Not withstanding any other provision of state law, the collaborating agencies shall be permitted to share information and data necessary to carry out the provisions of the federal early intervention program, including the personal identification or other specific information concerning individual infants, toddlers, or their families, except that the vital and medical records and health information concerning individuals provided to the Department of Health and Human Services may be released only under the laws authorizing the provision of such records and information. Nothing in this section shall prohibit the use of such data to provide for the preparation of reports, fiscal information, or other documents required by the Early Intervention Act, but no information in such reports, fiscal information, or other documents shall be used in a manner which would allow for the personal identification of an individual infant, toddler, or family. (Laws 1991; 1993; 1996.)

43-2507.01. ELIGIBLE INFANTS AND TODDLERS WITH DISABILITIES; ENTITLEMENT.

1. Infants or toddlers who are referred because of possible disabilities shall be entitled, at no cost to their families, to early identification of eligible infants or toddlers, evaluation and assessment in order to determine eligibility under the Special Education Act, and procedural safeguards.
2. By June 1, 1995, eligible infants or toddlers with disabilities shall also be entitled, at no cost to their families, to services coordination and development of the individualized family service plan.
3. For other early intervention services not mandated under the Special Education Act and not paid through any other source, including, but not limited to, insurance, Medicaid, or other third-party payer, payment for such services shall be the responsibility of the parent, guardian, or other person responsible for the eligible infant or toddler.
4. Except for service coordination, the Early Intervention Act shall not be construed to create new early intervention or family services or establish an entitlement to such new services. (Laws 1993.)

43-2507.02. STATE DEPARTMENT OF EDUCATION; DUTIES. The State Department of Education shall maintain its responsibility under the Special Education Act regarding special education and related services. The department shall provide grants for the costs of such programs to the school district of residence as provided in section 79-1132. (Laws 1993; 1996.)

43-2508. DEPARTMENT OF HEALTH AND HUMAN SERVICES; DEPARTMENT OF HEALTH AND HUMAN SERVICES FINANCE AND SUPPORT; DUTIES.

1. The Department of Health and Human Services shall be responsible for providing or contracting for services.
2. Whenever possible, the medical assistance program prescribed in sections 68-1018 to 68-1025 shall be used for payment of services coordination.
3. It is the intent of this section that the Department of Health and Human Services Finance and Support shall apply for and implement a Title XIX Medicaid waiver as a way to assist in the provision of services coordination to eligible infants or toddlers with disabilities and their families. (Laws 1991; 1993; 1996.)

43-2509. DEPARTMENT OF HEALTH AND HUMAN SERVICES; DUTIES. The Department of Health and Human Services shall be responsible for incorporating components required under the federal early intervention program into the state plans developed for the Special Supplemental Food Program for Women, Infants, and Children, the Commodity Supplemental Food Program, planning, and coordination related to the incorporation of such components. (Laws 1991; 1993; 1995; 1996.)

43-2510. DEPARTMENT OF HEALTH AND HUMAN SERVICES; DUTIES. The Department of Health and human Services shall be responsible for incorporation components required under the federal early intervention program into the mental health and developmental disabilities planning responsibilities of the department. The department shall provide technical assistance, planning, and coordination related to the incorporation of such components. (Laws 1991; 1993; 1996.)

43-2511. STATEWIDE BILLING SYSTEM; ESTABLISHMENT; PARTICIPATION REQUIRED. There is hereby established a statewide billing system for accessing federal Medicaid funds for special education and related services provided by school districts. The system shall apply to all students verified with disabilities from date of diagnosis to twenty-one years of age as allowed under the federal Medicare Catastrophic Coverage Act of 1988. The system shall be developed jointly by the Department of Health and Human Services, the Department of Health and Human Services Finance and Support, and the State Department of Education. School districts, educational service units, or approved cooperatives providing special education and related services shall be required to participate in the statewide billing system. It is the intent of this section that costs to school districts associated with the implementation of such a system shall be eligible for payment through the Medicaid reimbursement rates to be established for each therapy. (Laws 1991; 1993; 1996.)

43-2511.01. STATEWIDE SERVICES COORDINATION SYSTEM; DEVELOPMENT; IMPLEMENTATION. The lead agencies shall develop and implement a statewide services coordination system for eligible infants or toddlers with disabilities and their families pursuant to the Early Intervention Act. The amount and duration of services coordination shall be based on need as specified on the individualized family service plan. Services coordination under the act shall not duplicate any case management services which an eligible infant or toddler with disabilities and his or her family are already receiving or eligible to receive from whatever source. (Laws 1993.)

43-2512. INTERAGENCY PLANNING TEAM; MEMBERS; DUTIES; DEPARTMENT OF HEALTH AND HUMAN SERVICES; PROVIDE SERVICES COORDINATION. Each region established pursuant to section 79-1135 shall establish an interagency planning team, which planning team shall include representatives from school districts, social services, health and medical services, parents, and mental health, developmental disabilities, Head Start, and other relevant agencies or persons serving children from birth to age five and their families and parents or guardians. Each interagency planning team shall be responsible for assisting in the planning and implementation of the Early Intervention Act in each local community or region. The Department of Health and Human Services, in collaboration with each regional interagency planning team, shall provide or contract for services coordination. (Laws 1991; 1993; 1996.)

43-2513. SPECIAL GRANT FUNDS; DESIGNATION. For purposes of the general fund budget of expenditures as defined in section 79-1003, funds received to carry out the services coordination functions and the administration of the billing system shall be considered special grant funds. (Laws 1991; 1993; 1994; 1995; 1996.)

43-2515. FEDERAL MEDICAID FUNDS; CERTIFICATION; APPROPRIATIONS. On or before October 1, 1993, and for each year thereafter, the Department of Health and Human Services Finance and Support and the State Department of Education shall jointly certify to the budget administrator of the budget division of the Department of Administrative Services the amount of federal Medicaid funds paid to school districts pursuant to the Early Intervention Act for special education services for children age five and older. The General Fund appropriation to the State Department of Education, for state special education aid shall be decreased by an amount equal to the amount that would have been reimbursed with state general funds to the school districts through the special education reimbursement process for special education services for children age five and older that was paid to school districts or approved cooperatives with federal Medicaid funds. It is the intent of the Legislature that an amount equal to the amount that would have been reimbursed with state general funds to the school districts, certified to the budget administrator, be appropriated from the General Fund to aid in carrying out the provisions of the Early Intervention Act and other related early intervention services. (Laws 1993; 1996; 1998.)

43-2516. RULES AND REGULATIONS. The lead agencies shall adopt and promulgate rules and regulations pursuant to the Early Intervention Act. (Laws 1993.)