SERVICE DELIVERY

• Part C services are those services that are necessary to achieve an outcome on a child’s IFSP. Early intervention services are not intended to treat a child’s primary diagnosis, but to focus as a team to help families conduct activities of daily living with their child and participate in the cultural and social experiences they hold valuable.

• Outcomes identified on the Individualized Family Support Plan are to be Functional Outcomes that address the concerns and priorities expressed by the family. They are not based on test scores but are to be developed by problem solving the issues that arise in conducting daily routines and activities such as feeding, dressing, moving, communicating, playing, etc.

• If the team determines that a skill cannot be taught in the natural environment and that direct therapy (treatment) in a clinic-based setting will be necessary, a Natural Environments Justification must be completed on the IFSP. The justification must be based on the needs of the child and there must be a plan for moving the service into the natural environment as soon as possible.
• According to the federal law (IDEA, Part C), early intervention services for infants and toddlers are to be provided in thenatural environment. This is defined as in locations with typically developing children and during normal daily routines and activities.
• If the team determines that direct therapy in a clinic setting has been justified on the IFSP, the service may be provided by a Therapy Assistant if this would be an appropriate provider for the service. The therapy assistant must be enrolled as an Early Steps provider and billed at the appropriate reimbursement rate.
• All services must address outcomes from the IFSP rather than child’s diagnosis. Services which are necessary to meet an IFSP outcome are authorized on the IFSP, Form G, under “Summary of Supports and Services.” The appropriate payer of the service is identified with Part C as the payer of Last Resort.
• Services that may be necessary to address a child’s diagnosis but do not relate to an IFSP outcome are recorded at the bottom of the IFSP, Form G, under “Other Services.” These services are not covered by Part C. Part C services may be referred to as “above the line” and other services may be referred to as “below the line.”
• The federal government has determined that Natural Environments takes precedence over Payer of Last Resort. This means that if a provider within the family’s health plan cannot provide services in the natural environment, Part C funds can be used to pay for the service to be provided by a provider outside the insurance plan that will provide the service in the natural environment.
• The Primary Service Provider (PSP) model used by Early Steps requires the team to select a primary member of the team to take the lead in providing instruction to the family in the natural environment. The PSP model requires a high degree of interaction and collaboration between team members for intervention planning, consultation and coaching. The role of primary service provider can change to other team members depending on the needs of the child/family or on the focus of the current functional outcomes being addressed. One factor to consider in selecting a PSP is to ensure that providers conduct services that are within their scope of practice and in accordance with the regulations of licensure boards.