N.Y. Comp. Codes R. & Regs. Tit. 10 §§ 69-4.23

Current through Register Vol. 46, No. 51, December 18, 2024

Section 69-4.23 - Initial and continuing eligibility criteria

(a) Initial eligibility for the Early Intervention Program shall be established by medical or other records or a multidisciplinary evaluation conducted in accordance with section 69-4.8 of this Subpart and shall be based on the following criteria:

(1) a diagnosed physical or mental condition with a high probability of resulting in developmental delay; or

(2) the presence of a developmental delay which affects functioning in one or more of the following domains of development: cognition, physical (including vision, hearing and oral motor feeding and swallowing disorders), communication, social-emotional, or adaptive development; and, as measured by qualified personnel using informed clinical opinion, appropriate diagnostic procedures, and/or instruments and documented as:

(i) a 12-month delay in one domain; or

(ii) a 33 percent delay in one domain or a 25 percent delay in each of two domains; or

(iii) if appropriate standardized instruments are individually administered in the evaluation process, a score of at least 2.0 standard deviations below the mean in one domain or a score of at least 1.5 standard deviation below the mean in each of two domains; or

(iv) notwithstanding subdivisions (i)-(iii) of this paragraph for children who have been found to have a delay only in the communication domain, delay shall be defined as a score of 2.0 standard deviations below the mean in the area of communication; or, if no standardized test is available or appropriate for the child, or the tests are inadequate to accurately represent the child's developmental level in the informed clinical opinion of the evaluator, a delay in the area of communication shall be a severe delay or marked regression in communication development as determined by specific qualitative evidence-based criteria articulated in clinical practice guidelines issued by the department, including the following:

(a) for children 18 months of age or older;

(1) a severe language delay as indicated by no single words by 18 months of age, a vocabulary of fewer than 30 words by 24 months of age, or no two-word combinations by 36 months of age; or

(2) the documented presence of a clinically significant number of known predictors of continued language delay at 18-36 months of age, in each of the following areas of speech language and non-speech development:

(i) language production;

(ii) language comprehension;

(iii) phonology;

(iv) imitation;

(v) play;

(vi) gestures;

(vii) social skills; and

(viii) health and family history of language problems; or

(b) for children younger than 18 months of age, documentation that the child has attained none of the normal language milestones expected for children in the next younger age range, and none for the upper limit of the child's current chronological age range, and the presence of a preponderance of established prognostic indicators of communication delay that will not resolve without intervention, as specified in clinical practice guidelines issued by the department.

(b) If there is an observable change in the child's developmental status that indicates a potential change in eligibility, the early intervention official may require a determination to be made of whether the child continues to be eligible for Early Intervention Program services. The early intervention official shall not, however, require that such a determination be made sooner than six months after a child and family's initial IFSP in the program.

(1) Continuing eligibility for the Early Intervention Program shall be established by a multidisciplinary evaluation conducted in accordance with section 69-4.8 of this Subpart which includes the right for the parent to select an approved evaluator, and shall be based on the following criteria:

(i) a delay consistent with the criteria established for initial eligibility as set forth above; or

(ii) a delay in one or more domains, such that the child's development is not within the normal range expected for his or her chronological age, as documented using clinical procedures, observations, assessments, and informed clinical opinion; or

(iii) a score of 1.0 standard deviation or greater below the mean in one or more developmental domains; or

(iv) the continuing presence of a diagnosed physical or mental condition with a high probability of resulting in a developmental delay.

(2) If pursuant to this subdivision, the early intervention official requests a determination of the child's continuing eligibility for the Early Intervention Program, and the parent refuses to consent to a multidisciplinary evaluation to establish the child's continuing eligibility, continuing eligibility has not been established and the child shall no longer be eligible for Early Intervention Program services. The early intervention official shall provide the parent with written notice ten working days before the early intervention official proposes to discharge the child from the Early Intervention Program. The notice must be in sufficient detail to inform the parent about the action that is being proposed, the reasons for taking such action; and, all procedural safeguards available under the Early Intervention Program, including the right of the parent to request mediation or an impartial hearing on the child's ongoing eligibility for the Early Intervention Program.

N.Y. Comp. Codes R. & Regs. Tit. 10 §§ 69-4.23

Amended New York State Register November 30, 2016/Volume XXXVIII, Issue 48, eff. 11/30/2016

Amended New York State Register December 5, 2018/Volume XL, Issue 49, eff. 12/5/2018

Amended New York State Register November 13, 2019/Volume XLI, Issue 46, eff. 11/13/2019