Title of Regulation: 12VAC35-220. Certification Requirements for Early Intervention Professionals, Early Intervention Specialists, and Early Intervention Case Managers (amending 12VAC35-220-10, 12VAC35-220-30, 12VAC35-220-50, 12VAC35-220-80, 12VAC35-220-90; adding 12VAC35-220-35).

Statutory Authority: § 2.2-5304 of the Code of Virginia.

Effective Dates: February 14, 2012, through February 13, 2013.

Agency Contact: Catherine Hancock, Part C Administrator, Department of Behavioral Health and Developmental Services, 1220 Bank Street, Richmond, VA 23218-1797, telephone (804) 371-6592, FAX (804) 371-7959, or email catherine.hancock@dbhds.virginia.gov.

Preamble:

The proposed emergency regulations are mandated by Item 304 Q of Chapter 890 of the 2011 Acts of Assembly and provide requirements for the certification of early intervention case managers who may provide early intervention services and support to children and their families under the federal Part C program.

These regulations provide specific requirements for certification of practitioners as early intervention case managers under Virginia's early intervention services system. Section 2.2-5304 of the Code of Virginia designates the department as the state lead agency responsible for implementing Virginia's early intervention services system and ensuring compliance with the applicable federal requirements. The goal of these regulations is to ensure the competence of early intervention service providers under the authority granted to the lead agency. The regulations are also intended to provide the basis for the department to certify qualified practitioners of early intervention services so that they may be enrolled as service providers and receive reimbursement under the Medicaid State Plan. The department consulted with the Department of Medical Assistance Services in developing these regulations.

This regulatory action is required by legislation and will provide a means to ensure that providers have the appropriate credentials to provide and obtain reimbursement for services to children with developmental delays and their families. The proposed regulatory requirements have been developed to reflect professional practice standards in the field and provide a framework for the department to provide oversight as the lead agency for Virginia's early intervention services system. These regulations will help to ensure that providers have the expertise to effectively address the needs of Virginia's children with developmental delays and their families under the federal Part C program and are therefore essential to protect health, safety, and welfare of this vulnerable population.

The proposed regulations also will allow for expanded reimbursement for early intervention services under Medicaid, thereby maximizing the availability of federal and state funding under Part C of the Individuals with Disabilities Education Act.

CHAPTER 220
CERTIFICATION REQUIREMENTS FOR EARLY INTERVENTION PROFESSIONALS AND, EARLY INTERVENTION SPECIALISTS, AND EARLY INTERVENTION CASE MANAGERS

12VAC35-220-10. Authority and applicability.

A. Pursuant to § 2.2-5304 of the Code of Virginia, the Governor has designated the Department of Behavioral Health and Developmental Services as the state lead agency responsible for implementing the Virginia early intervention services system and ensuring compliance with federal requirements. These regulations are necessary to ensure the competence for early intervention services system practitioners under the authority granted to the lead agency.

B. Individual providers of early intervention services under the Medicaid State Plan must be certified by the Department of Behavioral Health and Developmental Services as qualified to provide certain early intervention professionals or early intervention specialists services. These regulations provide certification requirements for these early intervention professionals and early intervention specialists providers.

12VAC35-220-30. Certification required for the provision of early intervention services professionals and early intervention specialists.

A. Individual practitioners of early intervention services, with the exception of physicians, audiologists, and registered dietitians, shall be certified by the department as early intervention professionals or early intervention specialists.

B. Certified early intervention professionals shall have expertise in a discipline trained to enhance the development of children with a disability, as evidenced by state licensure, including application for state licensure if the discipline authorizes practice in Virginia while the application is pending and the individual practitioner meets all applicable requirements for such practice; state endorsement; or certification by a national professional organization. Qualified personnel in the following disciplines may seek certification from the department as early intervention professionals:

1. Counselors:

a. Licensed professional counselors licensed by the Virginia Board of Counseling; and

b. School counselors (Pre K - 12) endorsed by the Virginia Board of Education;

2. Educators:

a. Educators licensed by the Virginia Board of Education with endorsement in Special Education - Early Childhood (Birth - 5);

b. Educators licensed by the Virginia Board of Education with endorsement in Early/Primary Education (Pre K - 3);

c. Educators licensed by the Virginia Board of Education with endorsement in Career and Technical Education - Family and Consumer Services;

d. Educators licensed by the Virginia Board of Education with endorsement in Special Education - Hearing Impairments (Pre K - 12);

e. Educators licensed by the Virginia Board of Education with endorsement in Special Education - Visual Impairments (Pre K - 12); and

f. Educators with a technical professional license issued by the Virginia Board of Education in Career and Technical Education - Family and Consumer Sciences;

3. Family and consumer science professionals certified through the American Association of Family and Consumer Sciences (AAFCS). Individuals certified by the AAFCS after June 30, 2009, shall meet certification requirements in family and consumer sciences - human development and family studies;

4. Marriage and family therapists licensed by the Virginia Board of Counseling;

5. Music therapists certified by the Certification Board for Music Therapists (CBMT);

6. Nurses:

a. Nurse practitioners licensed by the Virginia Board of Nursing; and

b. Registered nurses licensed by the Virginia Board of Nursing;

7. Occupational therapists licensed by the Virginia Board of Medicine;

8. Orientation and mobility specialists certified by the National Blindness Professional Certification Board as a National Orientation and Mobility Certificant (NOMC) or certified by the Academy for Certification of Vision Rehabilitation and Education Professionals (ACVREP) as a Certified Orientation and Mobility Specialist (COMS);

9. Physical therapists licensed by the Virginia Board of Physical Therapy;

10. Psychologists:

a. Applied psychologists licensed by the Virginia Board of Psychology;

b. Clinical psychologists licensed by the Virginia Board of Psychology; and

c. School psychologists licensed by the Virginia State Board of Education with an endorsement in school psychology;

11. Social workers:

a. Licensed clinical social workers licensed by the Virginia Board of Social Work; and

b. School social workers licensed by the Virginia State Board of Education with an endorsement as a school social worker;

12. Speech-language pathologists licensed by the Virginia Board of Audiology and Speech-Language Pathology; and

13. Therapeutic recreation specialists certified by the National Council on Therapeutic Recreation.

C. Certified early intervention specialists shall hold a minimum of a high school diploma or general equivalency diploma. Qualified personnel in the following disciplines may seek certification from the department as early intervention specialists:

1. Early intervention assistants whose qualifications have been approved by the Department of Behavioral Health and Developmental Services;

2. Licensed social workers licensed by the Virginia Board of Social Work;

3. Nurses:

a. Certified nurse aides certified by the Virginia Board of Nursing; and

b. Licensed practical nurses licensed by the Virginia Board of Nursing;

4. Occupational therapy assistants licensed by the Virginia Board of Medicine; and

5. Physical therapy assistants licensed by the Virginia Board of Physical Therapy.

D. Certified early intervention professionals and certified early intervention specialists shall demonstrate knowledge of early intervention principles and practices, including infant and toddler development, family-centered practice and multidisciplinary team practice, by successful completion of the early intervention principles and practices online training modules administered by the department. A score of at least 80% accuracy on each module's competency test shall be required for successful completion.

12VAC35-220-35. Certification required for early intervention case managers.

A. Individual practitioners of case management services who provide service coordination to children enrolled in early intervention services shall be certified by the department as early intervention case managers.

B. Certified early intervention case managers shall hold:

1. A minimum of an undergraduate degree in any of the following fields:

a. Allied health, including rehabilitation counseling, recreation therapy, occupational therapy, physical therapy, or speech or language pathology;

b. Child and family studies;

c. Counseling;

d. Early childhood;

e. Early childhood growth and development;

f. Early childhood special education;

g. Human development;

h. Human services;

i. Nursing;

j. Psychology;

k. Public health;

l. Social work;

m. Special education - hearing impairments;

n. Special education - visual impairments; or

o. Other related field or interdisciplinary studies approved by the department;

2. An associate degree in a related field such as occupational therapy assistant, physical therapy assistant, or nursing; or

3. A high school diploma or general equivalency diploma, or an undergraduate degree in an unrelated field, plus three years' experience coordinating direct services to children and families and implementing individual service plans. Direct services address issues related to developmental and physical disabilities, behavioral health or educational needs, or medical conditions. Experience may include supervised internships, practicums, or other field placements.

C. Qualified persons shall demonstrate:

1. Expertise in the provision of case management services, as evidenced by successful completion of training approved by the department. A score of at least 80% accuracy on the training competency test or tests shall be required for successful completion.

2. Knowledge of early intervention principles and practices, including infant and toddler development, and family-centered practice and multidisciplinary team practice, as evidenced by successful completion of the early intervention principles and practices online training modules administered by the department. A score of at least 80% accuracy on each module's competency test shall be required for successful completion.

12VAC35-220-50. Initial certification and recertification processes.

A. Initial certification. To apply for initial certification as an early intervention professional, or early intervention specialist, or early intervention case manager, practitioners shall:

1. Obtain the designated early intervention certification application package from the department; and

2. Submit a completed and signed application package to the department with:

a. A signed assurance that the practitioner will comply with all federal and state early intervention requirements;

b. Documentation of the practitioner's educational credentials, professional certification, licensing, endorsement, or other qualification for the practice of his profession in the Commonwealth of Virginia; and

c. Documentation of the practitioner's successful completion of the early intervention principles and practices training administered required by the department.

Any initial certification granted to individuals who have made application for state licensure and are awaiting licensure shall be valid only as long as that individual meets the requirements of their discipline to practice in Virginia.

B. Three-year recertification. At least 30 days prior to the expiration of the practitioner's certification period, the certified early intervention professionals and certified early intervention specialists practitioner shall submit an application for recertification to the department. This application shall include:

1. Documentation of the practitioner's continuing professional certification, licensing, endorsement, or other qualification for the practice of his profession in the Commonwealth of Virginia, and

2. Documentation that the practitioner has successfully completed at least 30 hours of continuing learning activities during the three-year certification period. The continuing learning activities shall address one or more of the following: (i) evidenced-based practices in early intervention services; (ii) changes in federal or state law, regulations, or practice requirements; (iii) topics identified on a personal development plan; and (iv) training needed for new responsibilities relating to early intervention services; and (v) training required by the department. For each continuing learning activity, documentation shall include a description of the activity and sponsoring organization, if applicable; the date or dates of training; the number of hours; and a copy of a certificate or verification of attendance, if applicable.

12VAC35-220-80. Restoration of expired certifications.

A. The department shall notify practitioners in writing of the date their certification as an early intervention professional or early intervention specialist expired and that the practitioner has been placed on inactive status in the practitioner database maintained by the department.

B. Practitioners whose certification as early intervention professionals or early intervention specialists has expired may apply to the department for restoration of their certifications.

C. The department may restore certification for practitioners as early intervention professionals or early intervention specialists under the following conditions:

1. The individual's certification has been lapsed for a period of less than one year; and

2. The certification:

a. Has lapsed because the practitioner failed to complete the three-year recertification requirements and the individual provides documentation to the department demonstrating (i) he is currently qualified for the practice of his discipline or profession in the Commonwealth of Virginia, and (ii) he has completed at least 30 hours of training addressing one or more of the topics specified in 12VAC35-220-50 B 2; or

b. Has lapsed because the practitioner's discipline or profession-specific qualification expired and the practitioner documents that he now holds a current license, certification, endorsement, or other qualification for the practice of his discipline or profession in the Commonwealth of Virginia.

D. The department shall provide written notice of the decision on reinstatement of the practitioner's certification within 30 days of the receipt of a completed request and required documentation.

E. Upon restoration of the practitioner's certification as an early intervention professional or early intervention specialist, the department shall reinstate the individual's active status in the practitioner database maintained by the department.

12VAC35-220-90. Termination of early intervention professional or early intervention specialist certification.

A. The department shall terminate a practitioner's certification as an early intervention professional or early intervention specialist under the following circumstances:

1. The practitioner's discipline-specific license, certification, or endorsement has been suspended or terminated;

2. The practitioner, after a year, fails to comply with the recertification requirements set forth in these regulations; or

3. The practitioner fails to comply with his signed assurance that he will comply with all federal and state early intervention requirements.

B. The department shall notify the practitioner in writing of the date of and reason for termination and that the practitioner has been removed from the practitioner database maintained by the department.