N.J. Admin. Code § 8:17-9.2

Current through Register Vol. 56, No. 11, June 3, 2024

Section 8:17-9.2 - Specific funding policies

(a) The Department shall carry out the following functions at public expense and without fees being charged to parents:

1. Implementation of the Child Find requirements, in accordance with N.J.A.C. 8:17-2;

2. Evaluation and assessment in accordance with N.J.A.C. 8:17-6;

3. Service coordination in accordance with N.J.A.C. 8:17-3; and

4. Administrative and coordination activities related to:

i. The development, review and evaluation of an IFSP in accordance with N.J.A.C. 8:17-8; and

ii. The implementation of procedural safeguards in accordance with N.J.A.C. 8:17-13 through 16 and all other components of the early intervention system in accordance with this chapter.

(b) Consistent with 8:17-8.5(f), an eligible child's IFSP shall be developed based upon the child's developmental needs.

1. Developmental services shall be subject to a family cost share for those families with incomes at or above 350 percent of the Federal poverty level.

2. Consistent with (b)4 below, fees shall be charged to families with incomes at or above 350 percent of the Federal poverty level, for services listed at 8:17-8.5(g) and identified as needed on the child's IFSP.

3. The NJEIS shall determine a family's ability to pay consistent with the State family cost participation regulations set forth at (b)4 below.

i. Consistent with the terms and conditions of a health services grant funded by the Department and implemented by each SPOE, the service coordinator shall inform the family about the NJEIS family cost participation policies and procedures during the intake process.

ii. Once eligibility for the child has been established, the service coordinator shall review the family cost participation policy and procedures with the family, and with family consent, collect information needed to complete the forms at Appendices A and B for submission to the NJEIS or its designee, and, as appropriate, assist the family to submit Appendix C to the NJEIS for processing.

iii. Written documentation, such as paid invoices or receipts for the goods or services claimed, shall accompany an application for consideration of extraordinary expenses submitted using the form at Appendix C.

iv. Families shall be informed of their rights to an administrative review by the Department if asking for special consideration of their financial status, mediation, an impartial due process hearing, or an administrative complaint to challenge their family cost share.

4. Families with an annual gross income at or above 350 percent of the Federal poverty level shall share in the cost of early intervention services provided, the amount of which shall be determined in accordance with the Family Cost Share formulas at Chapter Appendix E and the Family Cost Share Tables at Chapter Appendix E1, both of which are incorporated herein by reference, and consistent with the following:

i. The NJEIS family cost share is a progressive fee charged for each hour of early intervention services provided to the child and/or the child's family, based upon household size and gross income, as compared to the Federal poverty guidelines.

ii. The family's actual monthly cost will be either the family cost share payment determined in accordance with this subsection or the actual cost of services, whichever is less.

iii. The family cost share payment established for the family will be the same, regardless of the specific provider agencies from which services are received.

iv. In determining a household's gross income for purposes of calculating a family's cost share, the EIS shall consider written documentation that a family submits to show a change in or loss of household income, and shall deduct from a household's EIS-determined gross income the amount of the lost income if the EIS determines the documentation to be credible.

v. In determining a household's gross income for purposes of calculating a family's cost share, the EIS shall consider written documentation of expenses the household incurs associated with child care for the eligible child while the child's parents are at work and unavailable to care for the child, and shall deduct from the household's EIS-determined gross income the expenses the household incurs for child care for the eligible child to the extent by which they exceed usual and customary child care expenses for a child without special needs in a similar manner and setting, such as in a community-based child care facility or by a babysitter.

vi. For purposes of determining a family's cost share, and at a family's request, the EIS shall review information submitted using the form at Appendix C and shall deduct from a household's EIS-determined income extraordinary expenses to the extent by which they exceed five percent of the household's EIS-determined income.

5. The NJEIS shall adjust Appendices E and E1 upon the annual issuance by the US Department of Health and Human Services of revisions to the Federal Poverty Guidelines, and thereupon shall publish a notice in the New Jersey Register, usually prior to July 1 of each year, to announce the update to the Federal Poverty Guidelines at Appendix E and to update the Family Cost Share copays and monthly maximums in accordance with the updated Federal Poverty Guidelines at Appendix E1 and the effective date of the revisions, which usually will be July 1 of each year.

(c) The Department shall not charge fees for services that a child is otherwise required to receive at public expense, pursuant to (a) above.

(d) Early intervention services will not be provided in those instances in which a parent declines to pay the family cost share.

(e) A family's failure to timely satisfy family cost share obligations will result in a disruption of services and will disentitle the family to compensatory services.

N.J. Admin. Code § 8:17-9.2