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HIPAA Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html
With the recent closing of many Local Education Agencies (LEAs) due to the COVID-19, remote learning is being implemented throughout the state/country. Below are several resources available to help you navigate this new normal with students who are D/HH:
The above resources plus additional information can be found in the following article from Dr. Karen Anderson: E-Learning & Coronavirus (Success for Kids with Hearing Loss)
Providing DHH Birth to 3 Services and COVID-19
There have been many questions surrounding how to handle services to families with infants and toddlers who are deaf/hard of hearing during the COVID-19 outbreak. There are a wide range of circumstances including closures of LEAs, use of telehealth, makeup services for families who want to suspend services, and more. The following information is here to give you what information we currently have regarding services to our vulnerable and at-risk population. As new information becomes available, it will be forwarded on.
Excerpts from Guidance from the Office of Special Education Programs (OSEP) – March, 2020
IDEA Part C: If the offices of the state lead agency or the EIS program or the provider are closed, then Part C services would not need to be provided to infants and toddlers with disabilities and their families during that period of time. If the lead agency’s offices are open but the offices of the EIS program or provider in a specific geographical area are closed due to public health and safety concerns as a result of a COVID-19 outbreak in that area, the EIS program or provider would not be required to provide services during the closure.
If the offices remain open, but Part C services cannot be provided in a particular location (such as in the child’s home), by a particular EIS provider, or to a particular child who is infected with COVID-19, then the lead agency must ensure the continuity of services, for example, by providing services in an alternate location, by using a different EIS provider, or through alternate means, such as consultative services to the parent.
If offices are closed for an extended period and services are not provided for an extended period, the IFSP team must meet under 34 CFR §303.342(b)(1) to determine if changes are needed to the IFSP and to determine whether compensatory services** are needed to address the infant’s or toddler’s developmental delay.
Additionally, if the lead agency or EIS provider determines that face-to-face Part C services should not be provided for a period of time, then the EIS provider or service coordinator may consult with the parent through a teleconference or other alternative means (such as email or video conference), consistent with privacy interests, to provide consultative services, guidance, and advice as needed. However, determining how to provide Part C services in a manner that is consistent with the most updated health and safety guidance is left to the discretion of the lead agency and the EIS program and provider serving a particular child and family.
**Compensatory services to infants and toddlers are not addressed in IDEA Part C, the Texas Administrative Code, nor the Texas Education Code. Typically, if a service is missed it must be made up within the same calendar month. If a child/family will be missing weeks of services due to agency/program closure or parent choice, the IFSP team will need to determine how to proceed once services resume. If too many weeks or months of services are missed, the burden on the family, child, and service providers could outweigh attempting to provide compensatory services.
So, what does all of that mean?
OSEP wants us to err on the side of health and safety while also trying to provide Part C services to infants and toddlers. If any of the key players are closed (HHSC/ECI = “lead agency;” local ECI = “EIS program;” or, LEA = “provider”), then services are not required to be provided to families during the period of closure. Best practice would be to continue offering services, if at all possible, via telehealth. If ECI is closed, services are not required but can still be provided by DHH. If the LEA is closed and not providing educational services to their students under IDEA Part B, then technically DHH Parent Advisors would not be required to provide services to families. However, due to the fact that our infants and toddlers are at-risk for language delays and they are still in the critical period for language development, we want to provide services to them, even if the LEA or ECI is closed.
If services are not being provided to a family, there is nothing that prevents you from checking in with them to see if they are OK and if they need anything. Some families may want resources, activities, or just to hear from someone they know and trust. Others may be overwhelmed and may not respond. But reaching out is something we can all do as long as we respect the responses, or lack thereof, we receive.
The decision to use telehealth is at the discretion of the local ECI offices. If your local ECI is offering telehealth services, please contact your ECI Service Coordinator to get more information about how to connect with families remotely including what kind of meeting platform you can use. Currently there is not a standard platform for telehealth services in Texas, so each individual ECI will be making this decision.
TAC §108.1104 states:
(a) Early childhood intervention services needed by the child must be initiated in a timely manner and delivered as planned in the IFSP . . .
(b) The contractor must ensure that early childhood intervention services are appropriate, as determined by the IFSP team . . . In addition to the requirements in 34 CFR §303.13, early childhood intervention services must be provided:
(1) according to a plan and with a frequency that is individualized to the parent and child to effectively address the goals established in the IFSP;
(2) in the presence of the parent or other routine caregiver, with an emphasis on enhancing the family's capacity to meet the developmental needs of the child;
(3) in the child’s natural environment, as defined in 34 CFR §303.26, unless the criteria listed in 34 CFR §303.126 are met and documented in the case record, and may be provided via telehealth with the written consent of the parent. If the parent declines to consent to telehealth for some or all services, those services must be provided in person.
Although (3) states that if a parent declines telehealth services will be provided in person, clearly that will not be the case right now. If a parent does not want telehealth services, ECI will need to determine what action to take in order to document this while also ensuring that the family will be able to resume services when they are ready. If this situation arises, please talk with your ECI Service Coordinator about how to proceed.
Transition to Age 3:
TEA put out a COVID-19 guidance document updated April 2, 2020. Most of it is focused on Part B services, but they did address transition from Part C to Part B:
Q: What if early childhood transition services and timelines have been affected due COVID 19 pandemic response related issues?
A: School closure dates are not applicable for Part C ECI to Part B IDEA evaluation timelines, and LEAs should make reasonable efforts to expedite timelines once school resumes, so as not to delay provision of services and FAPE if the student is determined eligible. If there are deviations from legally established timelines, LEAs should document in the student’s folder all reasonable efforts made to follow timelines.
First and foremost, be safe and stay healthy. These are scary and unpredictable times, and we are all very human. We are all trying to balance this crucial work we do with our personal mental and emotional needs as well as those of our own families. Please remember to breathe and be kind to yourself. Take breaks, do the things you can to rejuvenate yourself, and give as much as you can in service while ensuring you save enough of your mental and emotional energy so you can take care of you and your loved ones.
CONNECTING AND COLLABORATING:
The National Association of Interpreters in Education has provided information for administrators.
REMOTE LEARNING RESOURCES:
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Region 17 Education Service Center
1111 West Loop 289 | Lubbock, TX 79416
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