Current through Register Vol. 35, No. 6, March 26, 2024
A.
Early intervention provider agencies shall collaborate with the New Mexico
early childhood education and care department and other state, federal and
tribal government agencies in a coordinated child find effort to locate,
identify and evaluate all children residing in the state who may be eligible
for early intervention services. Child find efforts shall include families and
children in rural and in Native American communities, children whose family is
homeless, children in foster care and wards of the state, and children born
prematurely.
B. Early intervention
provider agencies shall collaborate with the New Mexico early childhood
education and care department and shall inform primary referral sources
regarding how to make a referral when there are concerns about a child's
development. Primary referral sources include: hospitals; prenatal and
postnatal care facilities; physicians; public health facilities; child care and
early learning programs, school districts; home visiting programs; homeless
family shelters; domestic violence shelters and agencies; child protective
services, including foster care; other social service agencies; and other
health care providers.
C. Early
intervention provider agencies in collaboration with the New Mexico early
childhood education and care department shall inform parents, medical
personnel, local education agencies and the general public of the availability
and benefits of early intervention services. This collaboration shall include
an ongoing public awareness campaign that is sensitive to issues related to
accessibility, culture, language, and modes of communication.
D.
Referral and intake:
(1) Primary referral sources shall inform
parent(s) of their intent to refer and the purpose for the referral. Primary
referral sources should refer the child as soon as possible, but in no case
more than seven days after the child has been identified.
(2) Parents must give permission for a
referral of their child to the FIT program.
(3) The child must be under three years of
age at the time of the referral.
(4) If there are less than 45 days before the
child turns three at the time of referral, the early intervention provider
agency will not complete an evaluation to determine eligibility and will assist
the family with a referral to Part B preschool special education and other
preschool programs, as appropriate and with consent of the parent(s).
(5) The early intervention provider agency
receiving a referral shall promptly assign a family service coordinator to
conduct an intake with the parent(s).
(6) The family service coordinator shall
contact the parent(s) to arrange a meeting at the earliest possible time that
is convenient for the parent(s) in order to:
(a) inform the parent(s) about early
intervention services and the IFSP process;
(b) review the FIT family handbook;
(c) explain the family's rights and
procedural safeguards;
(d) if in a
county that is also served by other FIT provider, inform the parent(s) of their
choice of provider agencies and have them sign a "freedom of choice"
form.
(e) provide information about
evaluation options; and with the parent's consent, arrange the comprehensive
multidisciplinary evaluation.
(7) If the child is found eligible for FIT
services, the family service coordinator with parental consent shall schedule
and facilitate the initial IFSP meeting to be completed within 45 days of
referral to the FIT program for early intervention services.
(8) Exceptions to the 45-day timeline for
completion of the initial IFSP due to exceptional family circumstances must be
documented in the child's early intervention record. Exceptional family
circumstances include:
(a) The child or parent
is unavailable to complete the screening (if applicable), the initial
evaluation the initial assessments of the child and family, or the initial IFSP
meeting.
(b) The parent has not
provided consent for the screening (if applicable) the initial evaluation, or
the initial assessment of the child despite documented repeated attempts by the
early intervention provider.
E.
Screening.
(1) A developmental screening for a child who
has been referred may be conducted using a standardized instrument to determine
if there is an indication that the child may have developmental delay and
whether an evaluation to determine eligibility is recommended.
(2) A developmental screening should not be
used if the child has a diagnosis that would qualify them under established
condition or biological medical risk or where the referral indicates a strong
likelihood that the child has delay in their development, including when a
screening has already been conducted.
(3) If a developmental screening is
conducted:
(a) the written consent of the
parent(s) must be obtained for the screening; and
(b) the parent must be provided written
notice that they can request an evaluation at any point during the screening
process.
(4) If the
results of the screening:
(a) Do not indicate
that the child is suspected of having a developmental delay, the parent must be
provided written notice of this result and be informed that they can request an
evaluation at the present time or any future date.
(b) Do indicate that the child is suspected
of having a developmental delay, an evaluation must be conducted, with the
consent of the parent(s). The 45-day timeline from referral to the completion
of the initial IFSP and all of the referral and intake requirements of this
rule must still be met.
F.
Evaluation.
(1) A child who is referred for early
intervention services, and whose parent(s) has given prior informed consent,
shall receive a comprehensive multidisciplinary evaluation to determine
eligibility, unless the child receives a screening in accordance with the
screening requirements of this rule and the results do not indicate that the
child is suspected of having a developmental delay. Exception: If the parent of
the child requests and consents to an evaluation at any time during the
screening process, evaluation of the child must be conducted even if the
results do not indicate that the child is suspected of having a developmental
delay.
(2) The evaluation shall be:
(a) timely, multidisciplinary,
evaluation;
(b) conducted by
qualified personnel, in a nondiscriminatory manner so as not to be racially or
culturally discriminatory; and
(c)
shall include information provided by the parent(s).
(3) If parental consent is not given, the
family service coordinator shall make reasonable efforts to ensure that the
parent(s) is fully aware of the nature of the evaluation or the services that
would be available; and that the parent(s) understand that the child will not
be able to receive the evaluation or services unless consent is
given.
(4) A comprehensive
multidisciplinary evaluation shall be conducted by a multidisciplinary team
consisting of at least two qualified professionals from different
disciplines.
(5) The family service
coordinator shall coordinate the evaluation and shall obtain pertinent records
related to the child's health and medical history.
(6) The evaluation shall include information
provided by the child's parents, a review of the child's records related to
current health status and medical history and observations of the child. The
evaluation shall also include an assessment of the child's strengths and needs
and a determination of the developmental status of the child in the following
developmental areas:
(a) physical/motor
development (including vision and hearing);
(b) cognitive development;
(c) communication development;
(d) social or emotional development;
and
(e) adaptive
development.
(7) The
evaluation team shall use the tool(s) approved by the FIT program. Other domain
specific tools may be used in addition to the approved tool(s).
(8) The tool(s) used in the evaluation shall
be administered by certified or licensed personnel who have received training
in the use of the tool(s).
(9) The
evaluation shall be conducted in the child and family's native language, in
accordance with the definition of native language, unless it is clearly not
feasible to do so.
(10) The
evaluation team will collect and discuss all of the information obtained during
the evaluation process in order to make a determination of the child's
eligibility for the FIT program.
(11) An evaluation report shall be generated
that summarizes the findings of the multidisciplinary evaluation team. The
report shall summarize the child's level of functioning in each developmental
area based on assessments conducted and shall describe the child's overall
functioning and ability to participate in family and community life. The report
shall include recommendations regarding approaches and strategies to be
considered when developing IFSP outcomes. The report shall also include a
statement regarding the determination of the child's eligibility for the FIT
program.
(12) Parents shall receive
a copy of the evaluation report and shall have the results and recommendations
of the evaluation report explained to them by a member of the evaluation team
or a member of the IFSP team, with prior consultation with the evaluation
team.
(13) Information from the
evaluation process and the report shall be used to assist in determining a
rating for the initial early childhood outcome (ECO).
(14) If the child has a recent and complete
evaluation current within the past six months from another Early Intervention
Agency, the results may be used, in lieu of conducting an additional
evaluation, to determine eligibility.
(15) If, based on the evaluation conducted
the evaluation team determines that a child is not eligible, the evaluation
team must provide the parent with prior written notice, and include in the
notice information about the parent's right to dispute the eligibility
determination through dispute resolution mechanisms such as requesting a due
process hearing or mediation or filing a State complaint.
G.
Eligibility.
(1) The child's eligibility for early
intervention services shall be determined through the evaluation process as
identified in Section F. A statement of the child's eligibility for the FIT
Program shall be documented in the evaluation report.
(2) The child's age shall be adjusted
(corrected) for prematurity for children born less than 37 weeks gestation. The
adjusted age shall be used until a child is 24 months of age for the purpose of
eligibility determination.
(3)
Informed clinical opinion may be used by the evaluation team to establish
eligibility when the approved evaluation tool(s) or other approved assessment
tools are not able to establish developmental delay.
(a) If informed clinical opinion is used to
determine the child's eligibility, documentation must be provided to justify
the child's eligibility.
(b) A
second level review and sign off shall occur within the early intervention
provider agency by someone of equal or higher certification or licensure that
was not part of the evaluation team.
(c) Informed clinical opinion may only be
used to qualify a child for more than one year with review and approval of the
FIT program.
(4) The
child must be determined eligible under one of the following categories.
(a)
Developmental delay: a delay
of twenty-five percent or more, after correction for prematurity, in one or
more of the following areas of development: cognitive; communication;
physical/motor; social or emotional; adaptive.
(i) Twenty-five percent delay shall be
documented utilizing the tool(s) approved by the FIT program.
(ii) If the FIT program approved tool does
not indicate a twenty-five percent delay, a domain-specific tool may be used to
establish eligibility if the score is one and one-half standard deviations
below the mean or greater.
(iii)
Developmental delay includes "significant atypical development" documented on
the basis of informed clinical opinion.
(b)
Established condition: a
diagnosed physical, mental, or neurobiological condition that has a high
probability of resulting in developmental delay. The established condition
shall be diagnosed by a health care provider and documentation shall be kept on
file. Established conditions include the following:
(i) genetic disorders with a high probability
of developmental delay, including chromosomal anomalies including Down syndrome
and Fragile X syndrome (in boys); inborn errors of metabolism including Hurler
syndrome; and other syndromes, including Prader-Willi and Williams;
(ii) perinatal factors, including preterm
newborn, 28 completed weeks or less
(iii) perinatal factors, including
toxoplasmosis, rubella, CMV, and herpes (TORCH);
(iv) prenatal toxic exposures including fetal
alcohol syndrome (FAS); and birth trauma, including neurologic sequelae from
asphyxia;
(v) neurologic
conditions, including congenital anomalies of the brain including
holoprosencephaly lissencephaly, microcephaly, hydrocephalus; anomalies of
spinal cord including meningomyelocele; degenerative or progressive disorders
including muscular dystrophies, leukodystrophies, spinocerebellar disorders;
cerebral palsy (all types), including generalized, hypotonic patterns; abnormal
movement patterns including generalized hypotonia, ataxias, myoclonus, and
dystonia; peripheral neuropathies; traumatic brain injury; and CNS trauma
including shaken baby syndrome;
(vi) sensory abnormalities, including visual
impairment or blindness; congenital impairments including cataracts; acquired
impairments including retinopathy of prematurity; cortical visual impairment;
and chronic hearing loss;
(vii)
physical impairment, including congenital impairments including arthrogryposis,
osteogenesis imperfecta, and severe hand anomalies; and acquired impairments
including amputations and severe burns;
(viii) mental/psychosocial disorders,
including autism spectrum disorders; and
(ix) conditions recognized by the FIT program
as established conditions for purposes of this rule; a genetic disorder,
perinatal factor, neurologic condition, sensory abnormality, physical
impairment or mental/psychosocial disorder that is not specified above must be
recognized by the FIT program in order to qualify as an established condition
for purposes of this rule; physician, designated by the New Mexico early
childhood education and care department, shall make a determination of whether
a proposed condition will be recognized within seven days of the FIT program
receipt of the request for review.
(c)
Biological or medical risk for
developmental delay: a diagnosed physical, mental, or neurobiological
condition. The biological or medical risk conditionshall be diagnosed by a
health care provider and documentation shall be kept on file. Biological and
medical risk conditions include the following:
(i) genetic disorders with increased risk for
developmental delay, including chromosomal anomalies including Turner syndrome,
Fragile X syndrome (in girls), inborn errors of metabolism including
Phenylketonuria (PKU), and other syndromes including Goldenhar
neurofibromatosis, and multiple congenital anomalies (no specific
diagnosis);
(ii) perinatal factors,
including prematurity (less than 35 weeks and more than 28 completed weeks
gestation) or small for gestational age (less than 1750 grams); prenatal toxic
exposures including alcohol, polydrug exposure, and fetal hydantoin syndrome;
and birth trauma including seizures, and intraventricular or periventricular
hemorrhage;
(iii) neurologic
conditions, including anomalies of the brain including the absence of the
corpus callosum, and macrocephaly; anomalies of the spinal cord including spina
bifida and tethered cord; abnormal movement patterns including severe tremor
and gait problems; and other central nervous system (CNS) influences, including
CNS or spinal cord tumors, CNS infections (e.g., meningitis), abscesses,
acquired immunodeficiency syndrome (AIDS), and CNS toxins (e.g., lead
poisoning);
(iv) sensory
abnormalities, including neurological visual processing concerns that affect
visual functioning in daily activities as a result of neurological conditions,
including seizures, infections (e.g., meningitis), and injuries including
traumatic brain injury (TBI); and mild or intermittent hearing loss;
(v) physical impairment, including congenital
impairments including cleft lip or palate, torticollis, limb deformity, club
feet; acquired impairments including severe arthritis, scoliosis, and brachial
plexus injury;
(vi)
mental/psychosocial disorders, including severe attachment disorder, severe
behavior disorders, and severe socio-cultural deprivation;
(vii) other medical factors and symptoms,
including growth problems, severe growth delay, failure to thrive, certain
feeding disorders, and gastrostomy for feeding; and chronic illness/medically
fragile conditions including severe cyanotic heart disease, cystic fibrosis,
complex chronic conditions, and technology-dependency; and
(viii) conditions recognized by the FIT
program as biological or medical risk conditions for purposes of this rule; a
genetic disorder, perinatal factor, neurologic condition, sensory abnormality,
physical impairment, mental/psychosocial disorder, or other medical factor or
symptom that is not specified above must be recognized by the FIT program in
order to qualify as an medical or biological risk condition for purposes of
this rule; department of health physician, designated by the FIT program
manager, shall make a determination of whether a proposed condition will be
recognized within seven days of the FIT program manager's receipt of the
request for review.
(d)
Environmental risk for developmental delay: a presence of adverse
family factors in the child's environment that increases the risk for
developmental delay in children. Eligibility determination shall be made using
the tool approved by the FIT program.
(5) The families of children who are
determined to be not eligible for the FIT program shall be provided with prior
written notice and informed of their rights to dispute the eligibility
determination. Families shall receive information regarding other community
resources, such as home visiting and how to access specific resources in their
area. Families shall also be informed about how to request re-evaluation at a
later time should they suspect that their child's delay or risk for delay
increases.
H.
Redetermination of eligibility.
(1) The child's eligibility for the FIT
program shall be re-determined annually in accordance with the eligibility
determination requirements of this rule.
(2) The child's continued eligibility shall
be documented on the IFSP.
(3) If
the child no longer meets the requirements under the original eligibility
category, the team will determine if the child meets the criteria for one of
the other eligibility categories before exiting the child.
(4) If the child is determined to no longer
be eligible for the FIT program the family shall be provided with prior written
notice and informed of their rights to dispute the eligibility determination.
The family service coordinator will assist the family, with their consent, with
referrals to other agencies.
I.
Ongoing assessment.
(1) Each eligible child shall receive an
initial and ongoing assessment to determine the child's unique strengths and
needs and developmental functioning. The ongoing assessment will utilize
multiple procedures including the use of a tool that helps the team determine
if the child is making progress in their development, to determine
developmental levels for the IFSP and to modify outcomes and strategies, and to
determine the resources, priorities, and concerns of the family.
(2) Assessment information shall be used by
the team as part of the process of determining early childhood outcome (ECO)
scores at the time of the initial IFSP and prior to the child exiting the FIT
program.
(3) An annual assessment
of the resources, priorities, and concerns of the family shall be voluntary on
the part of the family. The IFSP shall reflect those resources, priorities and
concerns the family has identified related to supporting their child's
development.