~ Part C Dispute Resolution ~ If It Ain

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Part C Dispute Resolution If It Aint Broke,
How Will We Know? (National DR Data and An
Examination of One State System)

• Dick Zeller Marshall Peter, CADRE
• Terry Harrison, NJ Department of Education
  
• OSEP National Early Childhood Conference
• Presented on December 3, 2006

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Session Overview

• CADRE and Dispute Resolution Context
• New Jersey Experience
• ADR Database Development
• Summary Active States
• National Summary of Activity
• Activity Level Part B and Part C
• Observations/Discussion

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About CADRE

• Mission
• Support to States
• Research-based practice RAISE
• National ADR Database
• CADRE Website
• http//www.directionservice.org/cadre/

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Influences on the Use of Dispute Resolution

• Quality of early intervention programs
• Culture with respect to contention
• Community or service system size
• Awareness of dispute resolution options
• Availability of legal representation
• Parental education/SES variables
• PTI/SEA PTI/Lead Agency relationships
• Investment in DR systems

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(No Transcript)
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New Jersey Early Intervention System (NJEIS)
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NJEIS Website

• www.nj.gov/health/fhs/eis
• www.state.nj.us/health/fhs/eis/procsafeguards.shtm
  l

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GENERAL SUPERVISION NJEIS COMPONENTS

• Central Management Office (Data Collection)
• Data Desk Audit Inquiry
• Self-Assessment
• Focused On-site Monitoring
• Targeted Technical Assistance
• Procedural Safeguards/Dispute Resolution
• Enforcement

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NJEIS INFRASTRUCTURE

• Lead Agency-Quality Assurance Team
• Contracts
• Procedural Safeguards
• Central Management Office
• Monitoring
• Personnel Development
• Regional Early Intervention Collaboratives (4)
• Service Coordination Units (21)
• EIP Provider Agencies (80)/Practitioners (4000)
• Targeted Evaluation Teams
• Comprehensive EIPs
• Service Vendors

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CMO FEATURES

• Child Specific Data Collection
• State access to timely statewide data
• Local Access to Data
• Data Verification (Accuracy)
• Provides Accountability
• Timely system of payment
• Maximization of funding resources
• Supports Monitoring
• Personnel Enrollment/Matrix
• Reports

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DISPUTE RESOLUTIONPROCEDURAL SAFEGUARDSOFFICE
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INFORMAL RESPONSE

• The Procedural Safeguards Office and designated
  consultant parent liaisons respond to parent
  issues/concerns and document contacts on state
  logs for review and analysis.
• Parents can contact the Procedural Safeguards
  Office through a toll-free hotline and the nature
  and scope of their concerns are gathered by a
  consultant parent liaison within two (2) business
  days.
• Most informal matters are resolved within 10 to
  15 business days and only on rare occasions,
  where the Procedural Safeguards Office is
  awaiting documentation to support/dispel the
  complainants allegations, does the matter go
  unresolved beyond ten (10) business days from the
  date of the complainants call to the hotline.

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SFY07 Informal Resolutions

• About 500 contacts are received each year in the
  Procedural Safeguards Office. Most of these are
  technical assistance calls from parents,
  practitioners and agencies.
• Of these, last year, 142 calls resulted in the
  need for informal resolution of issues
  identified.
• These are recorded in a database and can be
  disaggregated by issues, sub-issues, service
  coordinator, family information, time to reach
  resolution, entities involved, and resolution,
  etc.

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Summary of SFY07 Issues Resolved(Not an
Unduplicated Count)

• Make-up service before age three 58
• Delay of services 54
• No provider available 51
• Disruption of services 47
• Reimburse out-of-pocket 43
• Compensatory services 39
• Timely services/30 days 33
• Appropriate services 22
• Provider of choice-EIP/therapist/discipline 22

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Informal Issues (cont)

• Autism issues/conflicts 17
• Family cost share/non-payment 14
• Change of services 8
• Services beyond age 3 7
• Service coordinator issue 7
• Make up services after age three 6
• Other 45 day/IFSP/transition 13

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FORMAL RESPONSE

• The Procedural Safeguards Coordinator directly
  intervenes to resolve an informal dispute if the
  matter cannot be resolved within ten (10)
  business days, the family specifically requests
  that the Procedural Safeguards Coordinator
  directly investigate the matter, or the
  consultant parent liaison determines that the
  Procedural Safeguards Coordinator should resolve
  the matter due to the complexity of the dispute.
• Complainants who call are always advised of their
  right to file a request for formal dispute
  resolution at any time.

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FORMAL RESPONSE (cont.)

• If a complainant requests formal dispute
  resolution, the Procedural Safeguards Office
  explains to the complainant how to download the
  Formal Dispute Resolution Request form off the
  Procedural Safeguards Office website, and
  provides families with flowcharts describing the
  formal dispute resolution processes to help
  families to understand the processes and
  timelines for dispute resolution.
• In SFY07, there were 3 mediations and one
  complaint

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Procedural Safeguards Information Forms

• NJ Procedural Safeguards Handbook
• Family Rights Handbook
• State Informal Case History Form
• State Formal Case History Form
• NJ Dispute Resolution Request Form
• NJ Withdrawal of Complaint Form

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INCIDENT REPORTS

• Incident Reports may be used to follow-up on
  specific issues identified by parents, provider
  agencies, or practitioners to ensure that an
  individual incident is not indicative of a
  systemic problem.
• If a NJEIS provider agency responds with
  insufficient/non-conclusive documentation or
  identifies performance issues, the lead agency
  proceeds with an appropriate next step that may
  include desk audit performance review, on-site
  focused monitoring, improvement plan or
  corrective action plan.

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Procedural Safeguards Reports

• Quality Assurance Team
• Regional Early Intervention Collaboratives
• State Interagency Coordinating Council
• OSEP
• Public Reporting
• Ability to drill down reporting by
• County, Region, SCU, EIP, Service Coordinator,
  Family, Issue, Time Period

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New Jersey Part C Dispute Resolution System
Informal Concerns Parent Liaison (toll-free
hotline)
Early Complaint Resolution (by Procedural
Safeguards Coordinator)
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CADREs National ADR Database

• Longitudinal database development
• Three years of verifiable APR/SPP data
  collection (2003-04, 04-05, 05-06 changes each
  year new IDEA 04 data elements)
• Support to states to report clean data (TA, error
  checker)
• ADR data collection (Table 4) is now under
  Section 618, the new Data Accountability Center

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Five Years of DR Data Reporting

• What hasnt changed
• Complaints filed, reports issued, pending
• Mediations held and agreements reached
• Hearing requests, hearings held, pending
• What has changed
• Timeliness measures for complaints hearings
• Report period and pending dates now prescribed
• Mediations not held now include mediations
  pending
• Resolution sessions
• Reported calculated values
• Expedited hearings (B only)

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Example 2006-07 Error Checker
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Dispute Resolution Data Summary

• We are hesitant to display data identifiable by
  state at this point
• We believe we have all Part C data from all
  states for three years
• We doubt the comparability of some data elements
  across years without revision
• We intend to eventually publish summaries that
  are state identifiable
• What follows are partial summaries (B C) that
  suggest the data have value in examining DR
  activity and system performance

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States Reporting Part C Complaint Activity
03-04 04-05 05-06
At Least One Complaint Filed 23 33 29
At Least One Complaint Report with Findings 21 20 22
At Least One Complaint Report without Findings 15 7 7
At Least One Complaint Completed in 60 Days 15 22 23
At Least One Complaint Completed within Extended Timelines 10 9 5
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of States Reporting Part C Mediation Activity
03-04 04-05 05-06
At Least One Mediation Held Related to Due Process 3 8 3
At Least One Mediation Agreement Related to Due Process 1 7 3
At Least One Mediation Held Not Related to Due Process 12 6 7
At Least One Mediation Agreement Not Related to Due Process 8 5 7
At Least One Mediation Not Held 1 5 5
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States Reporting Part C Hearings Activity
03-04 04-05 05-06
At Least One Hearing Filed 9 13 10
At Least One Hearing Held 3 5 6
At Least One Hearing Completed within Standard Timelines 2 1 5
At Least One Hearing Completed within Extended Timelines 2 3 3
At Least One Hearing Pending 3 5 1
At Least One Resolved w/o a Hearing 6 9 6
At Least One Resolution Meeting 0 1 0
At Least One Settlement Agreement 0 1 0
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Part C Total Dispute Resolution Events (56
Entities)
03-04 04-05 05-06
Complaints Filed 180 173 176
Reports in 60 Days 87 101 103
Reports in Extended Timeline 26 27 19
Mediations, Not DP Related 27 16 10
Agreements, Not DP Related 13 13 9
Mediations, DP Related 24 41 60
Agreements, DP Related 19 24 60
Hearing Requests 186 200 135
Hearings Held 13 24 17
Decisions in Standard Timelines 5 16 9
Decisions in Extended Timelines 7 7 6
Resolved without a Hearing --- 139 117
Italicized cells with yellow shading may be less
dependable numbers.
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Dispute Resolution Event Rates

• Dispute Resolution Events (DR Events)
  Complaints Filed Mediations Held Hearings
  Requested
• We calculate a comparable measure across States
  and Programs (B C)
• DR Events per 10,000 served

)
(
of DR Events
X 10,000
Served
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National Means - Dispute Resolution Events Per
10,000 Part C Child Count

03-04 04-05 05-06
Complaints Filed 6.6 6.1 5.9
Reports with Findings 3.7 3.0 2.5
Completed within Timeline 1.3 1.0 1.4
Mediations Held 1.9 2.0 2.4
Mediation Agreements 1.2 1.3 2.3
Hearings Held 0.5 0.9 0.6
Decisions within Timelines 0.2 0.6 0.3
States Reporting Any Event 27 33 30
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State Reported Dispute Resolution Performance
Indicators
03-04 04-05 05-06
C10 - Complaints On Time 81 88 87
States with at least one complaint report completed 22 25 26
C11 - Hearings On Time 92 80 90
States with at least one hearing held 3 5 6
C13 - Med. Agreements 59 88 95
States with at least one mediation held 13 12 10
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National Rates of Part B and Part C
Part C Part C Part C Part B Part B Part B
03-04 04-05 05-06 03-04 04-05 05-06
Complaints Filed 6.6 6.1 5.9 8.9 9.1 8.7
Reports Issued 5.1 4.7 4.5 7.1 6.4 6.2
Mediations Held 1.9 2.0 2.3 9.1 10.4 6.1
Med. Agreements 1.2 1.3 2.3 6.7 8.0 4.4
Hearing Requests 6.8 7.1 4.5 26.6 31.0 27.9
Hearings Held 0.5 0.8 0.6 7.2 10.8 7.9
States w/ 1 Event 27 33 30 55 57 55
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National Part B Part C Rates
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Only 28 states had 05-06 Part C activity
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If every state added one event in 05-06
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Why So Little Part C DR Activity?

• Hypotheses
• Parents of infants are overwhelmed
• Parents dont know the EI system or their rights
• Fear of reprisal or
• Dont dump your one best friend
• Time is short transition is nigh
• Mean IFSP age 17 months (NEILS, 2001)

18 interviews with Part C Coordinators from
Gittler Hurth (1998) Conflict management in
early intervention Procedural safeguards and
mediation. Inf Yg Children.11(1)
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Why So Little Part C DR Activity?

• Hypotheses (continued)
• By law, early intervention is voluntary
• Parents are the primary decision-makers
• Accept or reject any recommended EI service
• Infant and toddler programs are family- centered,
  in home and intimate
• Prevention and informal complaint resolution
  mechanisms resolve concerns
• Population is smaller (between 17 months and 36
  months vs. between 36 months and 21 years)
• Not from Gittler Hurth (1998)

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Making the C Data Public

• Part B State Data Reports are posted on the CADRE
  Web site CADRE has received requests for
  comparable Part C reports.
• What can we do together to ensure the data are as
  good as they can be when they are posted?
• CADRE could
• Provide each state access to a summary of their
  data
• Identify any clear errors or possible concerns
  (common sense issues)
• Request state review and corrections within a
  reasonable period prior to public posting
• Append data notes from states where desired

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Discussion

• Questions/Comments?
• Whats happening in your state?
• How can CADRE be of assistance to you?