911 KAR 2:120. Kentucky Early Intervention Program evaluation and eligibility.

911 KAR 2:120. Kentucky Early Intervention Program evaluation and eligibility.

RELATES TO: KRS 200.654, 34 C.F.R. 303.11, 303.300, 303.322, 20 U.S.C. 1471-1476

STATUTORY AUTHORITY: KRS 194A.030(7), 194A.050, 200.660(7), 200.650-676, 34 C.F.R. 303.322, 20 U.S.C. 1474, 1475(a)(10), EO 2004-726

NECESSITY, FUNCTION, AND CONFORMITY: EO 2004-726 reorganized the Cabinet for Health and Family Services and placed the Department for Public Health under the Cabinet for Health and Family Services. KRS 200.660 requires the cabinet to administer funds appropriated to implement the provisions of KRS 200.650 to 200.676, to enter into contracts with service providers, and to promulgate administrative regulations. This administrative regulation establishes the evaluation and eligibility requirements for First Steps, Kentucky's Early Intervention Program.

Section 1. Evaluation. (1)(a) A child referred to the First Steps Program shall be initially evaluated to determine eligibility if:

1.a. The screen indicates a developmental delay; or

b. The screen does not indicate a delay, but the family still has concerns; and

2. The child does not have an established risk condition.

(b) A child with established risk as listed in Section 2(3)(b) of this administrative regulation shall receive a five (5) area assessment done by a primary level evaluator in lieu of a primary level evaluation. If a child is eligible due to an established risk condition of hearing loss, the five (5) area assessment shall be performed by a speech therapist or a teacher of the deaf and hard of hearing who is approved as a primary level evaluator.

(2)(a) A determination of initial eligibility pursuant to Section 2 of this administrative regulation, assessments in the identified area of delay, in accordance with 911 KAR 2:130, and the initial IFSP team meeting shall occur within forty-five (45) calendar days after a point of entry receives an initial referral.

(b) If a determination of initial eligibility, assessments and initial IFSP team meeting does not occur within forty-five (45) calendar days due to illness of the child or a request by the parent, the delay circumstances shall be documented.

(c) If a family is referred for a determination of initial eligibility and the family is under court order or a social services directive to enroll their child in First Steps, the court or social service agency shall be informed within three (3) working days by the initial service coordinator, if the family refuses the determination of eligibility.

(3) Child records of evaluations transferred from an in-state or out-of-state developmental evaluator shall be reviewed by the initial service coordinator and shall be utilized for eligibility determination if:

(a) The records meet First Steps evaluation time lines established in subsection (4)(a) of this section; and

(b) The records contain the developmental evaluation information established in subsection (11)(a) and (b) of this section.

(4) The primary level evaluation shall be utilized to determine eligibility of children without established risk, developmental status and recommendations for further assessment to determine program planning.

(a) If there is a previous primary level evaluation available, it shall be used to determine eligibility if:

1.a. For children under twelve (12) months of age, the evaluation was performed within three (3) months prior to referral to First Steps; or

b. For children twelve (12) months to three (3) years of age, the evaluation was performed within six (6) months prior to referral to First Steps; and

2. There is no additional information or the family has not expressed new concerns that would render the previous evaluation no longer valid.

(b) If there is a previous primary level evaluation available that was performed within the timeframes established in paragraph (a)1 of this subsection but there are new concerns that render the evaluation no longer valid, the initial service coordinator shall request a new primary level evaluation.

(c) Primary level evaluations shall provide evaluation in the five (5) developmental areas identified in Section 2(1)(c)1 through 5 of this administrative regulation using norm-referenced standardized instruments that provide a standard deviation score in the total domain for the five (5) areas.

(d) The primary level evaluation shall be provided by:

1. A physician or nurse practitioner; and

2. A primary evaluator approved by the cabinet.

(e) A primary level evaluation shall include:

1. A medical component completed by a physician or a nurse practitioner that shall include:

a. A history and physical examination;

b. A hearing and vision screening; and

c. A child's medical evaluation that shall be current in accordance with the EPSDT Periodicity Schedule; and

2. A developmental component completed by a cabinet-approved primary level evaluator that utilizes norm-referenced standardized instruments, the results of which shall:

a. Include the recommendation of a determination of eligibility or possible referral for a record review; and

b. Be interpreted to the family prior to the discussion required by subsection (5) of this section.

(5)(a) Prior to the initial IFSP team meeting, the initial service coordinator shall contact the family and primary level evaluator to discuss the child's eligibility in accordance with subsection (4)(e)2b of this section. If the child is determined eligible, the service coordinator shall:

1. Make appropriate arrangements to select a primary service coordinator;

2. Arrange assessments in the areas identified in Section 2(1)(c) of this administrative regulation found to be delayed; and

3. Assist the family in selecting service providers in accordance with 911 KAR 2:110. If the child is receiving therapeutic services from a provider outside of the First Steps Program, the service coordinator shall:

a. Invite the current provider to be a part of the IFSP team;

b. Request that the provider supply the team with his assessment and progress reports; and

c. If the current provider does not want to participate, have the First Steps provider consult with the current provider if assessing the area being treated by the current provider.

(b) If the child does not have an established risk condition identified in Section 2(1)(c) of this administrative regulation, and is determined not eligible, the team shall discuss available community resources, such as Medicaid, EPSDT, the Department for Public Health's and the Commission for Children with Special Health Care Need's (CCSHCN’s) Title V programs, and other third-party payors.

(6) At the initial IFSP team meeting, the IFSP team shall:

(a) Include the following members at a minimum:

1. The parent of the child;

2. Other family members, as requested by the parent, if feasible to do so;

3. An advocate or person outside of the family, if the family requests that the person participate;

4. The initial service coordinator;

5. The primary service coordinator;

6. A provider who performed an assessment on the child; and

7. If appropriate, a First Steps provider who shall provide services to the child or family;

(b) Verify the child’s eligibility;

(d) Review the assessment reports in accordance with 911 KAR 2:130;

(e) Determine the family’s outcomes, strategies and activities to meet those outcomes as determined by the family's priorities and concerns; and

(f) Determine the services the child shall receive in order for the family to learn the strategies and activities identified on the IFSP. This shall include identifying:

1. The discipline;

2. The professional, paraprofessional, or both;

3. The method in which services shall be delivered, such as individual, group, or both;

4. The payor source for the service; and

5. The frequency of the service.

(7)(a) Reevaluations shall be provided if the IFSP team determines a child's eligibility warrants review and the child does not have an established risk condition.

(b) Primary level reevaluations shall not be used to:

1. Address concerns that are medical in nature; or

2. Provide periodic, ongoing follow-up services for post-testing or testing for transition.

1. Continue with the same level of services;

2. Continue with modified services; or

3. Transition the child from First Steps services.

(8) Beginning January 1, 2005, an annual IFSP meeting shall be held in accordance with KRS 200.664(7), to determine continuing program eligibility and the effectiveness of services provided to the child. A delay ranking by developmental domain shall be assigned in the progress review report by each therapeutic interventionist using the delay ranking scale. (9) A review of the child's First Steps record by the Record Review Team shall be the second level in the First Steps evaluation system that shall be utilized to determine eligibility, medical or mental diagnosis, program planning, or plan evaluation.

(a) Upon obtaining a written consent by the parent, a service coordinator shall submit a child's record to the Department for Public Health for a record review if:

1. A primary evaluator identifies a need for further developmental testing necessary to clarify a diagnosis to further define the child's developmental status in terms of a child's strengths and areas of need;

2. A child does not meet eligibility guidelines at the primary level, but an IFSP team member and the family still have concerns that the child is developing atypically and a determination of eligibility based on professional judgment is needed; or

3. The IFSP team requests an intensive level evaluation for the purposes of obtaining a medical diagnosis or to make specific program planning and evaluation recommendations for the individual child.

(b)1. If a service coordinator sends a child’s record for a record review, the following shall be submitted to the Record Review Team, Department for Public Health, at the address indicated by the Department for Public Health:

a. A cover letter from the service coordinator or primary evaluator justifying the referral for a record review;

b. Primary level evaluation information specified in subsection (11) of this section;

c. Available assessment reports required in 911 KAR 2:130;

d. Available IFSPs and amendments;

e. Most recent progress reports from the IFSP team members. Reports older than three (3) months shall include an addendum reflecting current progress;

f. Therapeutic staff notes from the previous two (2) months; and

g. If requesting a record review for a child who is receiving speech therapy, a hearing evaluation performed by an audiologist within six (6) months of the request.

2. The service coordinator requesting the record review shall attempt to procure and submit the following information, if available:

a. Birth records, if neonatal or perinatal complications occurred;

b. General pediatric records from the primary pediatrician;

c. Medical records from hospitalizations; and

d. Records from medical subspecialty consultations, such as neurology, orthopedic, gastroenterology or ophthalmology.

2. After conducting the record review, Record Review Team shall:

a. Determine whether there are at least sixty (60) calendar days from the date of the review before the child turns three (3) years of age;

b. Determine that the child meets or does not meet the eligibility criteria established in Section 2(1) of this administrative regulation; and

c. Provide the IFSP team with recommendations for service planning.

3. If there are at least sixty (60) calendar days from the date of the review before the child turns three (3) years of age, Record Review Team shall:

a. Determine if further developmental testing, diagnostics or additional professional judgment are required in order to adequately ascertain the child’s developmental needs; and

b. Refer:

(i) The child for an intensive level evaluation, the third level in the First Steps evaluation system; or

(ii) The family to local community resources.

4. If there are not at least sixty (60) calendar days from the date of the review before the child turns three (3) years of age, Record Review Team shall provide the IFSP team with a recommendation for transition planning.

5. Upon the record review team reviewing the child’s record, the team shall provide the family and service coordinator with a letter, within fourteen (14) calendar days of the review, informing them of the information described in this paragraph.

(d) Intensive level evaluations shall be conducted by one (1) or more of the following as determined by the Department for Public Health approved Record Review Team:

1. A board certified developmental pediatrician;

2. A pediatrician who has experience in the area of early childhood development;

3. A pediatric physiatrist;

4. A pediatric neurologist;

5. One (1) or more developmental professionals identified in 911 KAR 2:150, Section 1; or

6. If an IFSP is currently in place, a developmental professional representing at least one (1) discipline that is currently on the IFSP in addition to a professional whose scope of work addresses additional concerns expressed by the Record Review Team.

(10) Family rights shall be respected and procedural safeguards followed in providing evaluation services.

(a) Written parental consent shall be obtained before conducting an evaluation or assessment by the evaluator or assessor respectively.

(b) If a parent or guardian refuses to allow a child to undergo a physical or medical examination for eligibility because of religious beliefs:

1. Documentation shall be obtained in the form of a notarized statement. The notarized statement shall be signed by the parent or guardian to the effect that the physical examination or evaluation is in conflict with the practice of a recognized church or religious denomination to which they belong;

2. If a child is determined to be eligible, First Steps shall provide, at the parent’s request, services that do not require, by statute, proper physical or medical evaluations; and

3. The initial service coordinator shall explain to the family that refusal due to religious beliefs may result in a denial of services which require a medical assessment on which to base treatment protocols.

(11) A report shall be written in accordance with the time frames established in paragraph (c)1 of this subsection upon completion of each primary level and intensive level evaluation.

(a) A report resulting from a primary level evaluation or an intensive level evaluation shall include the following components:

1. Date of evaluation;

2. Names of evaluators and those present during the evaluation, professional degree, and discipline;

3. The setting of the evaluation;

4. Name and telephone number of the contact person;

5. Identifying information that includes the:

a. Child’s Central Billing and Information System (CBIS) identification number;

b. Child’s name and address;

c. Child’s chronological age (and gestational age, if prematurely born) at the time of the evaluation;

d. Health of the child during the evaluation;

e. Date of birth;

g. Reason for referral or presenting problems;

6. Tests administered or evaluation procedures utilized and the purpose of the instrument. One (1) method of evaluation shall not be used, but a combination of tests and methods shall be used;

7. Test results and interpretation of strengths and needs of the child;

8.a. Test results reported in standard deviation pursuant to subsection (4)(e)2 of this section; and

b. A rank on the delay ranking scale for each of the five (5) developmental areas identified in Section 2(1)(c)1 through 5 of this administrative regulation;

9. Factors that may have influenced the test conclusion;

10. Eligibility;

11. Developmental status or diagnosis;

12. Suggestions regarding how services may be provided in a natural environment that address the child's holistic needs based on the evaluation;

13. Parent's assessment of the child's performance in comparison to abilities demonstrated by the child in more familiar circumstances;

14. A narrative description of the five (5) areas of the child's developmental status;

15. Social history;

16. Progress reports, if any, on the submitted information; and

17. A statement that results of the evaluation were discussed with the child's parent.

(b) The report required by paragraph (a) of this subsection shall be written in clear, concise language that is easily understood by the family.

(c)1. The reports and notification of need for further evaluation shall be made available to the current IFSP team and family within fourteen (14) calendar days from the date the evaluator received the complete evaluation referral.

2. In addition to the requirements established in this section, an intensive level evaluation site shall:

a. Provide to the Record Review Team a copy of the evaluation report within fourteen (14) calendar days from the date the evaluator received the evaluation referral; and

b. If an IFSP is currently in place:

(i) Focus recommendations on areas that are specified on the IFSP as being of concern to the family;

(ii) Identify strategies and activities that would help achieve the outcomes identified on the IFSP; and

(iii) Provide suggestions for the discipline most appropriate to transfer the therapeutic skills to the parents.

3. If it is not possible to provide the report and notification required in this paragraph by the established time frame due to illness of the child or a request by the parent, the delay circumstances shall be documented and the report shall be provided within five (5) calendar days of completing the evaluation.

Section 2. Eligibility. (1) Except as provided in subsection (2) or (3) of this section, a child shall be eligible for First Steps services if he is:

(a) Aged birth through two (2) years;

(b) A resident of Kentucky at the time of referral and while receiving a service;

(c) Through the evaluation process determined to have fallen significantly behind developmental norms in the following skill areas:

1. Total cognitive development;

2. Total communication area through speech and language development, which shall include expressive and receptive;

3. Total physical development including growth, vision and hearing;

4. Total social and emotional development; or

5. Total adaptive skills development; and

(d) Significantly behind in developmental norms as evidenced by the child's score being:

1. Two (2) standard deviations below the mean in one (1) skill area; or

2. At least one and one-half (1 1/2) standard deviations below the mean in two (2) skill areas.

(2)(a) If a norm-referenced testing reveals a delay in one (1) of the five (5) skill areas but does not meet the eligibility criteria required by subsection (1)(d) of this section, a more in-depth standardized test in that area of development may be administered if the following is evident:

1. The primary level evaluator, service coordinator or the family has a concern or suspects that the child’s delay may be greater than the testing revealed;

2. A more sensitive norm-referenced test tool may reveal a standardized score which would meet eligibility criteria; and

3. There is one (1) area of development that is of concern.

(b) Upon completion of the testing required by paragraph (a) of this subsection, the results and information required by Section 1(9)(b) of this administrative regulation shall be submitted by the service coordinator to the record review team for a determination of eligibility.

(3) A child shall be eligible for First Steps services if the child:

(a) Is being cared for by a neonatal follow-up program and its staff determine that the child meets the eligibility requirements established in subsection (1) or (4) of this section; or

(b) In accordance with KRS 200.654(10)(b), has one (1) of the following conditions diagnosed by a physician or advanced registered nurse practitioner (ARNP):

Aase-Smith syndrome

Aase syndrome

Acrocallosal syndrome

Acrodysostosis

Acro-Fronto-Facio-Nasal Dysostosis

Adrenoleukodystrophy

Agenesis of the Corpus Callosum

Agyria

Aicardi syndrome

Alexander's Disease

Alper's syndrome

Amelia

Angelman syndrome

Aniridia

Anophthalmia/Microphthalmia

Antley-Bixler syndrome

Apert syndrome

Arachnoid cyst with neuro-developmental delay

Arhinencephaly

Arthrogryposis

Ataxia

Atelosteogenesis

Autism

Baller-Gerold syndrome

Bannayan-Riley-Ruvalcaba syndrome

Bardet-Biedl syndrome

Bartsocas-Papas syndrome

Beals syndrome (congenital contractural arachnodactyly)

Biotinidase Deficiency

Bixler syndrome

Blackfan-Diamond syndrome

Bobble Head Doll syndrome

Borjeson-Forssman-Lehmann syndrome

Brachial Plexopathy

Brancio-Oto-Renal (BOR) syndrome

Campomelic Dysplasia

Canavan Disease

Carbohydrate Deficient Glycoprotein syndrome

Cardio-Facio-Cutaneous syndrome

Carpenter syndrome

Cataracts - Congenital

Caudal Dysplasia

Cerebro-Costo-Mandibular syndrome

Cerebellar Aplasia/Hypoplasia/Degeneration

Cerebral Atrophy

Cerebral Palsy

Cerebro-oculo-facial-skeletal syndrome

Charge Association

Chediak Higashi syndrome

Chondrodysplasia Punctata

Christian syndrome

Chromosome Abnormality

a. unbalanced numerical (autosomal)

b. numerical trisomy (chromosomes 1-22)

c. sex chromosomes XXX; XXXX; XXXXX; XXXY; XXXXY

CNS Aneurysm with Neuro-Developmental Delay

CNS Tumor with Neuro Developmental Delay

Cockayne syndrome

Coffin Lowry syndrome

Coffin Siris syndrome

Cohen syndrome

Cone Dystrophy

Congenital Cytomegalovirus

Congenital Herpes

Congenital Rubella

Congenital Syphilis

Congenital Toxoplasmosis

Cortical Blindness

Costello syndrome

Cri du chat syndrome

Cryptophthalmos

Cutis Laxa

Cytochrome-c Oxidase Deficiency

Dandy Walker syndrome

DeBarsy syndrome

DeBuquois syndrome

Dejerine-Sottas syndrome

DeLange syndrome

DeSanctis-Cacchione syndrome

Diastrophic Dysplasia

DiGeorge syndrome (22q11.2 deletion)

Distal Arthrogryrosis

Donohue syndrome

Down syndrome

Dubowitz syndrome

Dyggve Melchor-Clausen syndrome

Dyssegmental Dysplasia

Dystonia

EEC (Ectrodactyly-ectodermal dysplasia-clefting) syndrome

Encephalocele

Encephalo-Cranio-Cutaneous syndrome

Encephalomalacia

Exencephaly

Facio-Auriculo-Radial dysplasia

Facio-Cardio-Renal (Eastman-Bixler) syndrome

Familial Dysautonomia (Riley-Day syndrome)

Fanconi Anemia

Farber syndrome

Fatty Acid Oxidation Disorder (SCAD, ICAD, LCHAD)

Femoral Hypoplasia

Fetal Alcohol syndrome/Effects

Fetal Dyskinesia

Fetal Hydantoin syndrome

Fetal Valproate syndrome

Fetal Varicella syndrome

FG syndrome

Fibrochondrogenesis

Floating Harbor syndrome

Fragile X syndrome

Fretman-Sheldon (Whistling Facies) syndrome

Fryns syndrome

Fucosidosis

Glaucoma - Congenital

Glutaric Aciduria Type I and II

Glycogen Storage Disease

Goldberg-Shprintzen syndrome

Grebe syndrome

Hallermann-Streiff syndrome

Hays-Wells syndrome

Head Trauma with Neurological Sequelae/Developmental Delay

Hearing Loss (30dB or greater in better ear as determined by ABR audiometry or audiometric behavioral measurements)

Hemimegalencephaly

Hemiplegia/Hemiparesis

Hemorrhage-Intraventricular Grade III, IV

Hereditary Sensory & Autonomic Neuropathy

Hereditary Sensory Motor Neuropathy (Charcot Marie Tooth Disease)

Herrmann syndrome

Heterotopias

Holoprosencephaly (Aprosencephaly

Holt-Oram syndrome

Homocystinuria

Hunter syndrome (MPSII)

Huntington Disease

Hurler syndrome (MPSI)

Hyalanosis

Hydranencephaly

Hydrocephalus

Hyperpipecolic Acidema

Hypomelanosis of ITO

Hypophosphotasia-Infantile

Hypoxic Ischemic encephalopathy

I-Cell (mucolpidosis II) Disease

Incontinentia Pigmenti

Infantile spasms

Ininencephaly

Isovaleric Acidemia

Jarcho-Levin syndrome

Jervell syndrome

Johanson-Blizzard syndrome

Joubert syndrome

Kabuki syndrome

KBG syndrome

Kenny-Caffey syndrome

Klee Blattschadel

Klippel-Feil Sequence

Landau-Kleffner syndrome

Lange-Nielsen syndrome

Lanqer Giedion syndrome

Larsen syndrome

Laurin-Sandrow syndrome

Leber's Amaurosis

Legal blindness (bilateral visual acuity of 20/200 or worse corrected vision in better eye)

Leigh Disease

Lennox-Gastaut syndrome

Lenz Majewski syndrome

Lenz Microophthalmia syndrome

Levy-Hollister (LADD) syndrome

Lesch-Nyhan syndrome

Leukodystrophy

Lissencephaly

Lowe syndrome

Lowry-Maclean syndrome

Maffucci syndrome

Mannosidosis

Maple Syrup Urine Disease

Marden Walker syndrome

Marshall syndrome

Marshall-Smith syndrome

Maroteaux-Lamy syndrome (MPS VI)

Maternal PKU Effects

Megalencephaly

MELAS

Meningocele (cervical)

MERRF

Metachromatic Leukodystrophy

Metatropic Dysplasia

Methylmalonic Acidemia

Microcephaly

Microtia-Bilateral

Midas syndrome

Miller (postaxial acrofacial-Dysostosis) syndrome

Miller-Dieker syndrome

Mitochondrial Disorder

Moebius syndrome

Morquio syndrome (MPS IV)

Moya-Moya Disease

Mucolipidosis II, III

Multiple congenital anomalies (major organ birth defects)

Multiple Pterygium syndrome

Muscular Dystrophy

Myasthenia Gravis - Congenital

Myelocystocele

Myopathy - Congenital

Myotonic Dystrophy

Nager (Acrofacial Dysostosis) syndrome

Nance Horan syndrome

NARP

Neonatal Meningitis/Encephalitis

Neuronal Ceroid Lipofuscinoses

Neuronal Migration Disorder

Nonketotic Hyperglycinemia

Noonan syndrome

Ocular Albinism

Oculocerebrocutaneous syndrome

Oculo-Cutaneous Albinism

Optic Atrophy

Optic Nerve Hypoplasia

Oral-Facial-Digital syndrome Type I-VII

Osteogenesis Imperfecta Type III-IV

Osteopetrosis (Autosomal Recessive)

Oto-Palato-Digital Syndrome Type I-II

Pachygyria

Pallister Mosaic syndrome

Pallister-Hall syndrome

Pelizaeus-Merzbacher Disease

Pendred's syndrome

Periventricular Leukomalacia

Pervasive Developmental Disorder

Peters Anomaly

Phocomelia

Pierre Robin Sequence

Poland Sequence

Polymicrogyria

Popliteal Pterygium syndrome

Porencephaly

Prader-Willi syndrome

Progeria

Propionic Acidema

Proteus syndrome

Pyruvate carboxylase Deficiency

Pyruvate Dehydrogenase Deficiency

Radial Aplasia/Hypoplasia

Refsum Disease

Retinoblastoma

Retinoic Acid Embryopathy

Retinopathy of Prematurity Stages III, IV

Rett syndrome

Rickets

Rieger syndrome

Roberts SC Phocomelia

Robinow syndrome

Rubinstein-Taybi syndrome

Sanfilippo syndrome (MPS III)

Schinzel-Giedion syndrome

Schimmelpenning syndrome (Epidermal Nevus syndrome)

Schizencephaly

Schwartz-Jampel syndrome

Seckel syndrome

Septo-Optic Dysplasia

Shaken Baby syndrome

Short syndrome

Sialidosis

Simpson-Golabi-Behmel syndrome

Sly syndrome (MPS VII)

Smith-Fineman-Myers syndrome

Smith-Limitz-Opitz syndrome

Smith-Magenis syndrome

Sotos syndrome

Spina Bifida (Meningomyelocele)

Spinal Muscular Atrophy

Spondyloepiphyseal Dysplasia Congenita

Spondylometaphyseal Dysplasia

Stroke

Sturge-Weber syndrome

TAR (Thrombocytopenia-Absent Radii syndrome)

Thanatophoric Dysplasia

Tibial Aplasia (Hypoplasia)

Toriello-Carey syndrome

Townes-Brocks syndrome

Treacher-Collins syndrome

Trisomy 13

Trisomy 18

Tuberous Sclerosis

Urea Cycle Defect

Velocardiofacial syndrome (22q11.2 deletion)

Wildervanck syndrome

Walker-Warburg syndrome

Weaver syndrome

Wiedemann-Rautenstrauch syndrome

Williams syndrome

Winchester syndrome

Wolf Hirschhorn syndrome

Yunis-Varon syndrome

Zellweger syndrome

(4) A child shall have continuing program eligibility for First Steps services if the child is under three (3) years old, is a resident of Kentucky, and the results of the semi annual progress review:

(a) Meet the initial eligibility requirements of subsections (1) to (3) of this section; or

(b) Indicate a continued delay on the semi annual progress review's delay ranking scale.

(5) If a child referred to the First Steps Program was born at less than thirty-seven (37) weeks gestational age, the following shall be considered:

(a) The chronological age of infants and toddlers who are less than twenty-four (24) months old shall be corrected to account for premature birth. The evaluator shall ensure that the instrument being used allows for the adjustment for prematurity. If it does not, another instrument shall be used.

(b) Correction for prematurity shall not be appropriate for children born prematurely whose chronological age is twenty-four (24) months or greater.

(c) Documentation of prematurity shall include a physician's or nurse practitioner's written report of gestational age and a brief medical history.

(d) Evaluation reports on premature infants and toddlers shall include test scores calculated with the use of both corrected and chronological ages.

Section 3. Incorporation by Reference. (1) The Early, Periodic, Screening, Diagnostic and Treatment (EPSDT) Periodicity Schedule, August 2003 edition, is incorporated by reference.

(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Department for Public Health, 275 East Main Street, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m. (23 Ky.R. 3133; Am. 3851; 4171; eff. 6-16-97; 25 Ky.R. 661; 1407; eff. 1-19-99; Recodified from 908 KAR 2:120, 10-25-2001; 30 Ky.R. 318; 619; 1287; eff. 9-16-03; 31 Ky.R. 485; 1270; eff. 1-19-05).