Current Status Introducing Body:House Bill Number:3504 Primary Sponsor:Waites Type of Legislation:GB Subject:Infants and toddlers with handicapping conditions Residing Body:House Companion Bill Number:615 Date Tabled:Apr 16, 1991 Computer Document Number:BR1/1168.AC Introduced Date:Feb 13, 1991 Last History Body:House Last History Date:Apr 16, 1991 Last History Type:Tabled Scope of Legislation:Statewide All Sponsors:Waites Rogers Haskins Quinn Wilder Meacham Corning Wright Rama Glover Whipper Tucker Vaughn Type of Legislation:General Bill
Bill Body Date Action Description CMN
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3504 House Apr 16, 1991 Tabled
3504 House Apr 11, 1991 Debate adjourned until
Tuesday, April 16
3504 House Apr 10, 1991 Debate adjourned until
Thursday, April 11
3504 House Apr 04, 1991 Debate adjourned until
Wednesday, April 10
3504 House Mar 28, 1991 Committee Report: Favorable 27
with amendment
3504 House Feb 13, 1991 Introduced, read first time, 27
referred to Committee
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COMMITTEE REPORT
March 28, 1991
H. 3504
Introduced by REPS. Waites, Rogers, Haskins, Quinn, Wilder, Meacham, Corning, Wright, Rama, Glover, Whipper, Tucker and Vaughn
S. Printed 3/28/91--H.
Read the first time February 13, 1991.
To whom was referred a Bill (H. 3504), to amend Act 114 of 1989 and Article 21, Chapter 7, Title 44, Code of Laws of South Carolina, 1976, relating to infants and toddlers with handicapping conditions, etc., respectfully
That they have duly and carefully considered the same, and recommend that the same do pass with amendment:
Amend the bill, as and if amended, Section 44-7-2530, by striking subsection (B) and inserting:
/(B) To ensure that all eligible infants and toddlers receive services, pending resolution of any dispute the department shall assign financial responsibility among agencies providing early intervention services./
Renumber sections to conform.
Amend title to conform.
DAVE C. WALDROP, JR., for Committee.
1. Estimated Cost to State-First Year $2,315,932
2. Estimated Cost to State-Annually
Thereafter $3,891,234
H. 3504 is a proposed Bill to amend Act 114 of 1989 and Article 21, Chapter 7, Title 44, Code of Laws of S.C., 1976, relating to infants and toddlers with handicapping conditions, so as to revise the legislative findings to conform to the amendments in this act and to revise the definitional section, provide the purpose of the Article, provide duties for the Department of Health and Environmental Control, require the comprehensive interagency system to implement components of the system, provide for early intervention services, individualized family service plans, clarify confidentiality of information, annual reporting by DHEC, establishment of local interagency coordinating councils and interfacing of such with the State Council.
This proposed legislation is a rewrite of a previously proposed Bill (S. 521/H. 3689-3/89) that clarifies and redefines some points of the Bill. Due to the clarifying language and improved population targeting, this proposed legislation has a higher estimate of cost for the first and subsequent years. (For purposes of this Bill's fiscal impact, the first and subsequent year will be fourth phase and fifth phase of the Babynet Program; additionally the costs estimates will take into consideration funding presently in place.)
The recent costing and population targeting estimates that, on an annual basis, 2,400 infants and toddlers will be provided services at a cost of $4,735/child. Based upon the scenario of services for phase four of PL99-457, (our first year for fiscal impact), the cost is estimated at $2,315,932. (Enclosure 1). In phase five, (subsequent year) the estimated cost for the state is $3,891,234. (Enclosure 2). These estimates are based upon a delivery of service for one (1) year as shown at enclosure 3 which was constructed by qualified professionals within the disciplines indicated. Within enclosure 2 is the existing funding available in the participating agencies involved in Part H of PL99-457. Estimates within the targeted population indicate that 50 % of the children will be eligible for Medicaid sponsorship for the services to be provided.
Some reduction of cost may occur in the service orientation delivery (case management) because of the better than expected result of parental involvement in the process. Less units of service coordination per child may result as parents become acquainted with the intra-interagency systems development.
This is a companion Bill to S. 615.
Prepared By: Approved By:
Edward P. Brophy George N. Dorn, Jr.
State Budget Analyst State Budget Division
TO AMEND ACT 114 OF 1989 AND ARTICLE 21, CHAPTER 7, TITLE 44, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO INFANTS AND TODDLERS WITH HANDICAPPING CONDITIONS, SO AS TO REVISE THE LEGISLATIVE FINDINGS TO CONFORM TO THE AMENDMENTS IN THIS ACT AND TO REVISE THE DEFINITIONAL SECTION, PROVIDE THE PURPOSE OF THE ARTICLE, PROVIDE DUTIES OF THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL, REQUIRE THE COMPREHENSIVE INTERAGENCY SYSTEM TO IMPLEMENT COMPONENTS OF THE SYSTEM, TO PROVIDE CERTAIN REQUIREMENTS FOR THE DELIVERY OF EARLY INTERVENTION SERVICES, TO INCLUDE PROVISIONS AND REQUIREMENTS FOR INDIVIDUALIZED FAMILY SERVICE PLANS, TO CLARIFY CONFIDENTIALITY OF INFORMATION, TO REQUIRE THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL TO SUBMIT AN ANNUAL REPORT TO THE JOINT LEGISLATIVE COMMITTEE ON CHILDREN AND TO PROVIDE FOR CONTENTS OF THE REPORT, TO REQUIRE THE ESTABLISHMENT OF LOCAL INTERAGENCY COORDINATING COUNCILS, AND TO PROVIDE FOR THEIR MEMBERSHIP, FUNCTIONS, AND INTERFACING WITH THE STATE INTERAGENCY COORDINATING COUNCIL.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Section 1 of Act 114 of 1989 is amended to read:
"Section 1. (A) The General Assembly finds that there is an urgent and substantial need to:
(1) enhance the development of infants and toddlers with handicapping conditions disabilities and to minimize their potential for developmental delay;
(2) reduce the educational costs to our society, including our schools, by minimizing the need for special education and related services after infants and toddlers with handicapping conditions disabilities reach school age;
(3) minimize the likelihood of institutionalization of individuals with handicapping conditions disabilities and maximize the potential for their independent living in society;
(4) enhance the capacity of families to meet the special needs of their infants and toddlers who have handicapping conditions disabilities.
(B) It is the policy of South Carolina to:
(1) develop and implement a statewide, comprehensive, coordinated program of early intervention services for infants and toddlers with handicapping conditions disabilities and their families;
(2) facilitate the coordination of payment for early intervention services from federal, state, local, and private sources, including public and private insurance coverage;
(3) enhance the capacity to provide quality early intervention services and expand and improve existing early intervention services being provided to infants and toddlers with handicapping conditions disabilities and their families."
SECTION 2. Article 21, Chapter 7, Title 44 of the 1976 Code, as added by Act 114 of 1989, is amended to read:
Section 44-7-2510. This article may be cited as the `Infants and Toddlers with Handicapping Conditions Disabilities Act'.
Section 44-7-2515. The purpose of this article is to provide early intervention services to infants and toddlers with disabilities in accordance with Subchapter VIII, Chapter 33, Title 20, U.S. Code Annotated, contingent upon appropriation of federal funds for Subchapter VIII.
Section 44-7-2520. As used in this article unless the context otherwise requires:
(1) `Department' means the agency designated as lead agency by the Governor by Executive Order pursuant to Title 20 of the United States Code, Section 1476(b)(9) Subchapter VIII, Chapter 33, Title 20, U. S. Code Annotated.
(2) `Infants and toddlers with handicapping conditions disabilities' means children from birth through two years of age in need of early intervention services due to measurable delays in cognitive development, physical development, language and speech development communication, psychosocial development, or self-help skills, or due to a diagnosed physical or mental condition which probably will result that has a high probability of resulting in developmental delay.
(3) `Early intervention services' are services designed to ameliorate the developmental delays of infants or toddlers with handicapping conditions meet the developmental needs of infants and toddlers with disabilities, provided in conformity with an individualized family service plan under public supervision by qualified personnel. They include but are not limited to family training, counseling and home visits, special instruction, speech pathology and audiology, occupational therapy, physical therapy, psychological services, case management services service coordination, medical services only for diagnostic or evaluation purposes, early identification, screening and assessment services, and health services necessary to enable the infant or toddler to benefit from the other early intervention services, and transportation services.
(4) `Council' means the State Interagency Coordinating Council which must be established in conformance with federal regulations.
Section 44-7-2530. (A) There is created a State Interagency Coordinating Council composed of fifteen members appointed by the Governor for terms of three years. In making appointments to the council the Governor shall ensure reasonable representation of the population of the State.
(B) The council must be composed of:
(1) at least three parents of infants or toddlers or children three through six years of age with disabilities;
(2) at least three public or private providers of early intervention services;
(3) at least one person involved in training personnel to provide early intervention services;
(4) one representative of the General Assembly, the State Mental Retardation Department, the State Health and Human Services Finance Commission, the State Department of Education, and the Department of Health and Environmental Control;
(5) other persons as determined by the Governor such as:
(a) adults other than parents responsible for infants, toddlers, or children with disabilities;
(b) representatives of other agencies involved in providing or paying for early intervention services to infants or toddlers with disabilities.
(C) The Governor shall designate a member as chairman for a term of two years. The chairman may not serve for more than two consecutive terms. The council shall meet at least quarterly and advise the department in carrying out its responsibilities under this article. No member may vote on a matter which would provide him a direct financial benefit or otherwise appears to be a conflict of interest under state law. The council shall prepare and submit an annual report to the Governor and General Assembly on the status of early intervention programs for infants and toddlers with disabilities and their families in the State. A copy of the report must be sent to the appropriate federal and state officials. The department must:
(1) monitor programs and activities to ensure compliance with federal law and regulations;
(2) identify, facilitate, and coordinate all available resources within the State from federal, state, local, and private sources;
(3) develop procedures to ensure that services are provided to infants and toddlers with disabilities and their families in a timely manner pending the resolution of disputes among public agencies or service providers;
(4) develop procedures to ensure resolution of intraagency and interagency disputes;
(5) develop formal interagency agreements that, consistent with state law, define the financial responsibility of each agency for paying for early intervention services and procedures for resolving disputes.
(B) To ensure that all eligible infants and toddlers receive services, the Budget and Control Board shall assign financial responsibility among the state agencies providing early intervention services.
(C) All publicly funded agencies shall continue to provide all services within their respective statutory responsibility to eligible infants and toddlers with disabilities.
Section 44-7-2540. (A) With the advice of the council the department shall develop and administer either directly or through an interagency agreement a comprehensive interagency system to provide early intervention services for infants and toddlers with disabilities and their families. The services must be provided by qualified personnel including but not limited to special educators, speech and language pathologists, audiologists, occupational therapists, physical therapists, psychologists, social workers, nurses, and nutritionists. The State Interagency Coordinating Council shall advise and assist the department in developing a comprehensive interagency system to provide early intervention services for all eligible infants and toddlers with disabilities and their families.
(B) The system must include: The comprehensive interagency system must implement:
(1) a timely, comprehensive, multidisciplinary assessment of the functioning of each infant and toddler with handicapping conditions disabilities in the State, including the needs of their families relating to enhancing the child's development;
(2) a written individualized family service plan for each eligible infant or toddler with a handicapping condition disability;
(3) a comprehensive method of identifying infants and toddlers with handicapping conditions disabilities;
(4) a public awareness program focusing on early identification of infants and toddlers with handicapping conditions disabilities;
(5) access to a central directory which includes early intervention services, resources, and experts available in the State;
(6) a comprehensive system of training personnel development for those who serve eligible infants and toddlers with handicapping conditions disabilities;
(7) formal interagency agreements which:
(a) define the responsibility of each agency for providing and paying for early intervention services;
(b) coordinate programs so as to permit children and their families to move easily among systems agencies in the system;
(c) adopt uniform program, health, and safety standards;
(d) establish contain procedures for resolving disputes;
(8) procedural safeguards as required by federal and state laws law;
(9) a method for compiling data on the number of infants and toddlers with handicapping conditions disabilities in the State in need of early intervention services, the number served, the types of handicapping conditions disabilities, the types of services provided, and other information required by the federal government or needed to deliver services effectively.
(C) Early intervention services must be available through the comprehensive interagency system and provided by appropriate state agencies in accordance with time requirements of Subchapter VIII, Chapter 33, Title 20, U. S. Code Annotated, to effectuate the individual family service plan for each eligible infant or toddler.
Section 44-7-2550. The department shall promulgate regulations necessary to carry out the purposes of this article. Through regulation or interagency agreement when appropriate the department may develop standards which address addressing the coordination and provision of early intervention services, including personnel qualifications and health, safety, and program standards for the facilities where the services are offered.
Section 44-7-2560. (A) Based on the assessment provided for in Section 44-7-2540 an individualized family service plan must be developed by a multidisciplinary team of appropriate qualified personnel which includes also must include the parent, guardian, or other adult responsible for the child. The family also may choose an advocate to be present during the development of the plan. The plan must be written and explained in easily understandable language and must contain:
(1) a statement of the present levels of physical, cognitive, psychosocial, language, speech communication, and self-help skill development for the infant or toddler with handicapping conditions disabilities;
(2) a statement of the health status and medical needs of the child and family to support the highest possible development of the child, including the names of the health care providers;
(3) with concurrence of the family, a statement of the family's strengths and needs resources relating to enhancing the child's development;
(4) a statement of the major outcomes expected to be achieved for the child and the family and the methods used to measure progress toward the outcomes;
(5) a statement of specific early intervention services necessary to meet the needs of the child and family, including the frequency, intensity, and method of delivering services and payment arrangement, if any;
(6) the projected dates for initiation of services and the anticipated duration of services;
(7) the name of the case manager from the profession most immediately relevant to the needs of the child or family service coordinator. The case manager service coordinator is responsible for the implementation of the plan and coordination with other agencies and persons;
(8) the steps necessary to support transition of the child to special education and related services for children three years of age and older other programs, if appropriate.
(B) The individualized family service plan must be developed within the time established by the department after the child initially is referred and after the assessment is completed. With the parent's consent early intervention services may begin before completion of the assessment or plan, provided an interim plan is developed. The plan serves as the comprehensive plan for all agencies involved in providing early intervention services to the child and family. Services must be provided in a timely manner, as established by the department, pending resolution of disputes among public agencies or service providers. The plan must be evaluated at least once a year and reviewed with the family at six-month three-month intervals or more frequently if appropriate.
Section 44-7-2570. (A) Families with incomes below the federal poverty guidelines must not be charged for early intervention services provided pursuant to this article. The department shall develop a schedule of sliding fees for families with incomes above the federal poverty level.
(B) Nothing in this section relieves public or private insurance programs, or other persons or agencies required by law to provide or pay for early intervention services, from their financial or legal responsibilities. As a condition of receiving services under this article, infants and toddlers with handicapping conditions disabilities and their families may be required to apply for a financial or medical assistance program for which they are eligible.
(C) Pursuant to Subchapter VIII, Chapter 33, Title 20, U. S. Code Annotated, all financial resources from federal, state, local, and private sources must be coordinated to fund early intervention services. A joint funding plan must be submitted by the department to the Joint Legislative Committee on Children on or before August first of each year. The individual components of the plan as they relate to individual agencies must be incorporated annually into each affected agency's budget request.
Section 44-7-2580. (A) During fiscal year 1988-89 the department shall identify:
(1) all early intervention services currently provided within the State through federal, state, local, and private programs;
(2) all other financial resources available within the State from federal, state, local, and private sources for funding the comprehensive service system provided for in this section.
The department may use these resources to support programs to demonstrate and evaluate different components of the service system.
(B) By August 1, 1989, the department shall recommend a comprehensive service system to the State Budget and Control Board and the General Assembly. The department shall identify components of the system which can be supported through existing resources and components for which additional funds are needed.
(C) Using all funds appropriated for this purpose, during fiscal year 1990-91 the department shall implement as much of the comprehensive service system as possible. The department shall contract with an independent consultant to evaluate the service system and submit a written report to the General Assembly by January 1, 1991.
(Reserved)
Section 44-7-2590. All information and reports related to children and families obtained pursuant to this article are confidential as provided in Subchapter VIII, Chapter 33, Title 20, U.S. Code Annotated except that they may be disclosed or made available to appropriate staff within the comprehensive interagency system for the purpose of assessment, coordination, and provision of services to infants, toddlers, and their families or pursuant to a court order for good cause shown. A person who disseminates or permits the unauthorized dissemination of the information or reports is guilty of a misdemeanor and, upon conviction, must be fined not more than one hundred dollars or imprisoned for not more than thirty days, or both.
Section 44-7-2600. The Joint Legislative Committee on Children shall receive timely reports from all agencies involved in the implementation of programs for handicapped infants, toddlers, and preschool children developed pursuant to Public Law 99-457 and shall provide consultation and guidance if necessary. By August first of each year the department shall submit an annual report to the Joint Legislative Committee on Children regarding the status of the comprehensive interagency system, including new and existing resources and gaps in services.
Section 44-7-2610. (A) County or multicounty local interagency coordinating councils (ICC) representing each county in the State must be established. Membership on each council must consist of parents, providers, local agencies, and government agencies.
(B) The function of the local ICC will be to advise and assist the State Council and the department in planning and implementing a system of early intervention services at the local community level.
(C) Each local ICC shall report to the State Council on the status of early intervention services in its county.
(D) With prior approval by the department and the State Council, local ICC's may enter into local interagency agreements. Local ICC's may give advice and assistance to local early intervention projects. No member of a local ICC may vote on a matter which directly would benefit the member financially or otherwise appear to be a conflict of interest under state law."
SECTION 3. This act takes effect upon approval by the Governor.