Current through Reg. 49, No. 38; September 20, 2024
(a)
Specialized rehabilitative services are rehabilitative services that promote
age-appropriate development by correcting deficits and teaching compensatory
skills for deficits that directly result from medical, developmental, or other
health-related conditions. Specialized rehabilitative services include physical
therapy, speech language pathology services, occupational therapy, and
specialized skills training.
(1) Physical
therapy.
(A) Physical therapy services are
defined in
34 CFR §
303.13(b)(9).
(B) Physical therapy services must meet the
requirements of subsection (b) of this section.
(C) Physical therapy services must be
provided by a licensed physical therapist who meets the requirements of
42
CFR §
440.110(a) and
all other applicable state and federal laws or a licensed physical therapy
assistant (LPTA) when the assistant is acting under the direction of a licensed
physical therapist in accordance with
42
CFR §
440.110 and all other applicable
state and federal laws.
(2) Speech language pathology services.
(A) Speech language pathology services are
defined in
34 CFR
303.13(b)(15).
(B) Speech therapy services must meet the
requirements of subsection (b) of this section.
(C) Speech therapy services must be provided
by:
(i) a licensed speech language pathologist
(SLP) who meets the requirements of
42
CFR §
440.110(c) and
all other applicable state and federal laws;
(ii) a licensed assistant in SLP when the
assistant is acting under the direction of a licensed SLP in accordance with
42
CFR §
440.110 and all other applicable
state and federal laws; or
(iii) a
licensed intern when the intern is acting under the direction of a qualified
SLP in accordance with
42
CFR §
440.110 and all other applicable
state and federal laws.
(3) Occupational therapy.
(A) Occupational therapy services are defined
in
34 CFR §
303.13(b)(8).
(B) Occupational therapy services must meet
the requirements of subsection (b) of this section.
(C) Occupational therapy services must be
provided by a licensed occupational therapist who meets the requirements of
42
CFR §
440.110(b) and
all other applicable state and federal laws or a certified occupational therapy
assistant (COTA) when the assistant is acting under the direction of a licensed
occupational therapist in accordance with
42
CFR §
440.110 and all other applicable
state and federal laws.
(4) Specialized skills training.
(A) Specialized skills training seeks to
reduce the child's functional limitations across developmental domains
including, strengthening the child's cognitive skills, positive behaviors, and
social interactions.
(B)
Specialized skills training includes skills training and anticipatory guidance
for family members or other routine caregivers to ensure effective treatment
and to enhance the child's development.
(C) Specialized skills training services must
meet the requirements of subsection (b) of this section.
(D) Specialized skills training must be
provided by an Early Intervention Specialist.
(b) Specialized rehabilitative services must:
(1) be designed to create learning
environments and activities that promote the child's acquisition of skills in
one or more of the following developmental areas: physical/motor,
communication, adaptive, cognitive, and social/emotional;
(2) be provided in the child's natural
environment, as defined in
34 CFR §
303.26, unless the criteria listed at
34 CFR §
303.126 are met and documented in the case
record and may be provided via telehealth with the prior written consent of the
parent, and if the parent does not consent to telehealth services, will be
provided in person;
(3) meet the
requirements of § 350.1104 of this chapter (relating to Early Childhood
Intervention Services Delivery); and
(4) be provided on an individual or group
basis.
(c) In addition to
the criteria in subsection (b) of this section, group services must meet the
requirements as described in § 350.1107 of this chapter (relating to Group
Services for Children).
(d) Service
Authorization.
(1) Specialized rehabilitative
services must be recommended by an interdisciplinary team that includes a
licensed practitioner of the healing arts and be documented in an
Individualized Family Service Plan (IFSP) in accordance with Subchapter J of
this chapter (relating to Individualized Family Service Plan (IFSP)).
(2) Services must be monitored by the
interdisciplinary team as described in § 350.1104 of this
chapter.
(e)
Documentation. Documentation of each specialized rehabilitative services
contact must meet the requirements in § 350.1111 of this chapter (relating
to Service Delivery Documentation Requirements).