RD372 - A Report on Virginia's Part C Early Intervention System - July 1, 2007 - June 30, 2008


Executive Summary:
Background

Congress enacted early intervention legislation in 1986 as an amendment to the Education of Handicapped Children's Act (1975) to ensure that all children with disabilities from birth through the age of three would receive appropriate early intervention services. This amendment formed Part H of the Act, which was re-authorized in 1991 and renamed the Individuals with Disabilities Education Act (IDEA). When the IDEA was re-authorized in 1998, Part H became Part C of the Act. IDEA was reauthorized most recently in December 2004. Virginia has participated in the federal early intervention program (under IDEA) since its inception.

General Assembly Guidance and Support

In 1992, the Virginia General Assembly passed state legislation that codified an infrastructure for the early intervention system that supports shared responsibility for the development and implementation of the system among various agencies at the state and local levels. The Department of Mental Health, Mental Retardation and Substance Abuse Services (the Department) was designated as the State Lead Agency. The broad parameters for the Part C system are established at the state level to ensure implementation of federal Part C regulations. Within the context of these broad parameters, 39 local lead agencies manage services across the Commonwealth. Some local lead agencies are the sole providers of early intervention services in their area while others support multiple providers.

Subsequent to 1992, the General Assembly passed legislation establishing mandates for state employees' health plan and private insurance coverage for early intervention services, maximizing Medicaid coverage for Part C eligible children. In 2001, the General Assembly adopted legislation requiring a statewide family fee system.

In 2004, the Social Science Research Center commissioned a private consulting firm, through a contract with the Department, to conduct a cost study of Virginia's Part C Early Intervention System. Based on the projected number of eligible children and the average annual per child cost for early intervention services ($4,148 for the fiscal year 2002-2003) identified in the cost study, the General Assembly adopted Budget Item 334K and significantly increased the allocation of state general funds for use in the provision of early intervention services from $125,000 per year in 1992 - 2003 to $975,000 in 2004 and $3,125,000 in 2005. For fiscal year 2007, the General Assembly appropriated a total of $7,203,366. The 2007 Appropriation Act continues Budget Item 334K as Budget Item 316 K.1 and K.2 and states:

"By October 15 of each year, the Department shall report to the Chairmen of the House Appropriations and Senate Finance Committees on the (a) total revenues used to support Part C services, (b) total expenses for all Part C services, (c) total number of infants and toddlers and families served using all Part C revenues, and (d) services provided to those infants and toddlers and families."

DMHMRSAS Activities

In order to report the data required by the budget language delineated in 316 K.2, the Department amended its fiscal year 2008 contract with local lead agencies to require additional reporting on revenues and expenses. However, the Department and the local lead agencies faced a number of challenges in reporting the required data including:

• No systemic collection of data regarding planned service levels,
• No systemic cost information captured,
• No systemic delivered service information, and
• No central listing of service providers.

In order to address these challenges, the Department completed an analysis in the spring of 2006 of the existing early intervention data system (ITOTS) and all federal and state reporting requirements; and, as a result, the Department developed a plan for enhancements to ITOTS that will facilitate data collection and reporting to meet requirements. The plan will be phased in. Implementation of the plan began by moving ITOTS into the Department on February 28, 2007 to ensure better control and a more cost-effective and efficient process for designing and implementing modifications to the system. Once the data plan is fully implemented, the Department will be better positioned to provide data to accurately and completely meet the legislative reporting requirements of Budget Item 316 K.2. In the meantime, the Department has taken steps to provide the most accurate data possible to address the reporting requirements of Budget Item 316 K.2. These steps included revisions to the expenditure report form and training for local systems toward the goal of more accurate reporting of revenue.