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TITLE 26 - HEALTH AND HUMAN SERVICES
PART 1 - HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 350 - EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER A - GENERAL RULES
SECTION/RULE §350.103 - Definitions
Chapter Review Date 02/27/2024

The following words and terms, when used in this chapter, will have the following meanings, unless the context clearly indicates otherwise.(1) Assessment--As defined in 34 CFR §303.321(a)(2)(ii), the ongoing procedures used by appropriate qualified personnel to assess the child's individual strengths and needs and determine the appropriate services to meet those needs throughout the period of a child's eligibility for ECI services.(2) Child--An infant or toddler under the age of three.(3) Child find--As described in 34 CFR §§303.115, 303.302, and 303.303, activities and strategies designed to locate and identify, as early as possible, infants and toddlers with developmental delay.(4) CFR--Code of Federal Regulations. The codification of the general and permanent rules published in the Federal Register by the departments and agencies of the Federal Government.(5) Complaint--A formal written allegation submitted to HHSC stating that a requirement of IDEA Part C or an applicable federal or state regulation has been violated.(6) Comprehensive needs assessment--The process for identifying a child's unique strengths and needs, and the family's resources, concerns, and priorities in order to develop an IFSP. The comprehensive needs assessment:(A) is conducted by an interdisciplinary team as defined in paragraph (29) of this section; and(B) gathers information across developmental domains regarding the child's abilities to participate in the everyday routines and activities of the family.(7) Consent--As defined in 34 CFR §303.7 and meeting all requirements in 34 CFR §303.420.(8) Co-visits--When two or more ECI professionals deliver different services to the child during the same period of time. Co-visits are provided when a child will receive greater benefit from services being provided at the same time, rather than individually.(9) Days--Calendar days.(10) Developmental delay--As defined in Texas Human Resources Code §73.001(3) and determined to be significant in compliance with the criteria and procedures in Subchapter H of this chapter (relating to Eligibility, Evaluation, and Assessment).(11) Developmental screenings--General screenings provided by the ECI program to assess the child's need for further evaluation. (12) DFPS--Department of Family and Protective Services. The state agency that provides family reunification services for families. These services are provided to families and children to protect the children from abuse and neglect and help the family reduce the risk of abuse and neglect.(13) ECI--Early Childhood Intervention.(14) ECI professional--An individual employed by or under the direction of an ECI program who meets the requirements of qualified personnel as defined in 34 CFR §303.13(c) and §303.31, and who is knowledgeable in child development and developmentally appropriate behavior, possesses the requisite education and experience, and demonstrates competence to provide ECI services.(15) ECI program--In addition to the definition of early intervention service program as defined in 34 CFR §303.11, a program operated by a subrecipient of HHSC ECI with the express purpose of implementing a system to provide ECI services to children with developmental delays and their families.(16) ECI services--Individualized IDEA Part C services determined by the IFSP team to be necessary to support the family's ability to enhance their child's development. ECI services are further defined in 34 CFR §303.13 and §303.16 and §350.1105 of this chapter (relating to Capacity to Provide Early Childhood Intervention Services).(17) ECSE--Early Childhood Special Education. The state and federally mandated program for young children with disabilities ages three to five under IDEA Part B, Section 619.(18) EIS--Early intervention specialist. A credentialed professional who meets specific educational requirements established by HHSC ECI in §350.313(a) of this chapter (relating to Early Intervention Specialist) and has specialized knowledge in early childhood cognitive, physical, communication, social-emotional, and adaptive development.(19) Evaluation--The procedures used by qualified personnel to determine a child's initial and continuing eligibility for ECI services that comply with the requirements described in 34 CFR §303.21 and §303.321.(20) Face-to-face--The delivery of ECI services in-person or via telehealth.(21) FERPA--Family Educational Rights and Privacy Act of 1974, 20 USC §1232g, as amended, and implementing regulations at 34 CFR Part 99. Federal law that outlines privacy protection for parents and children enrolled in the ECI program. FERPA includes rights to confidentiality and restrictions on disclosure of personally identifiable information, and the right to inspect records.(22) Group services--ECI services provided at the same time to no more than four children and their parent or parents or routine caregivers per ECI professional to meet the developmental needs of the individual infant or toddler.(23) HHSC--Texas Health and Human Services Commission.(A) HHSC has the final authority and responsibility for the administration, supervision, and monitoring of programs and activities under this system.(B) HHSC has the final authority for the obligation and expenditure of funds and compliance with all applicable laws and rules.(24) HHSC ECI--Texas Health and Human Services Commission Early Childhood Intervention. The entity designated as the lead agency, as defined by 34 CFR §303.22. HHSC ECI is responsible for maintaining and implementing the statewide IDEA Part C system.(25) IDEA Part C--The Individuals with Disabilities Education Act, Part C, as amended in 2004.(26) IFSP--Individualized Family Service Plan as defined in 34 CFR §303.20. A written plan of care for providing ECI services and other medical, health, and social services to an eligible child and the child's family when necessary to enhance the child's development. The IFSP is considered complete when the parent has signed the IFSP and received a copy.(27) IFSP services--The individualized ECI services listed in the IFSP that have been determined by the IFSP team to be necessary to enhance an eligible child's development.(28) IFSP services pages--The standardized form designated by HHSC ECI that constitutes the required final pages of the IFSP used to record ECI services planned for the child.(29) IFSP team--An interdisciplinary team that meets the requirements in 34 CFR §303.24(b) and works collaboratively to develop, review, modify, and approve the IFSP. The IFSP team includes, at a minimum, the child's parent and at least two ECI professionals from different disciplines or professions.(A) At least one of the ECI professionals must be the family's assigned service coordinator.(B) At least one of the ECI professionals must be an LPHA.(C) At least one ECI professional must have been involved in conducting the evaluation. This may be the LPHA or another professional.(D) If the LPHA attending the IFSP meeting did not conduct the evaluation, the subrecipient must ensure that the most recent observations and conclusions of the LPHA who conducted the evaluation were communicated to the LPHA attending the initial IFSP meeting and incorporated into the IFSP.(E) Other team members may participate by other means acceptable to the team.(30) Interdisciplinary team--In addition to the definition of multidisciplinary team as defined in 34 CFR §303.24, a team that consists of at least two ECI professionals from different disciplines and the child's parent.(A) One of the ECI professionals must be an LPHA.(B) The team may include a teacher for the deaf and hard of hearing, a teacher for students with visual impairments, and a certified orientation and mobility specialist from the child's LEA, as appropriate.(C) Professionals on the team shall share a common perspective regarding infant and toddler development and developmental delay.(D) Professionals on the team must work collaboratively to:(i) conduct the evaluation and assessment;(ii) develop the IFSP; and(iii) provide ECI services.(31) LEA--Local educational agency as defined in 34 CFR §303.23.(32) LPHA--Licensed practitioner of the healing arts. A licensed physician, registered nurse, licensed physical therapist, licensed occupational therapist, licensed speech language pathologist, licensed professional counselor, licensed clinical social worker, licensed psychologist, licensed dietitian, licensed audiologist, licensed physician assistant, licensed marriage and family therapist, licensed intern in speech language pathology, licensed behavior analyst, or advanced practice registered nurse who is an employee or a subcontractor of an ECI subrecipient. LPHA responsibilities are further described in §350.312 of this chapter (relating to Licensed Practitioner of the Healing Arts).(33) Medicaid--The medical assistance entitlement program administered by HHSC.(34) MOU--Memorandum of understanding. A written document evidencing the understanding or agreement of two or more parties regarding the subject matter of the agreement.(35) Native language--As defined in 34 CFR §303.25.(A) When used with respect to an individual who is limited English proficient (as that term is defined in IDEA Part B, Section 602(18)), native language means:(i) the language normally used by that individual, or, in the case of a child, the language normally used by the parents of the child; and(ii) for evaluations and assessments conducted pursuant to 34 CFR §303.321(a)(5) and (a)(6), the language normally used by the child, if determined developmentally appropriate for the child by qualified personnel conducting the evaluation or assessment.(B) When used with respect to an individual who is deaf or hard of hearing, blind or visually impaired, or for an individual with no written language, "native language" means the mode of communication that is normally used by the individual (such as sign language, braille, or oral communication).(36) Natural environments--As defined in 34 CFR §303.26, settings that are natural or typical for a same-aged infant or toddler without a disability. A natural environment may include the home or community settings, include the daily activities of the child and family or caregiver, and must be consistent with the provisions of 34 CFR §303.126.(37) Parent--As defined in 20 USC §1401(23) and 34 CFR §303.27.(38) Personally identifiable information--As defined in 34 CFR §99.3 and 34 CFR §303.29.(39) Pre-enrollment--All family-related activities from the time the referral is received up until the time the parent signs the initial IFSP.(40) Primary referral sources--As defined in 34 CFR §303.303(c). (41) Public agency--HHSC and any other state agency or political subdivision of the state that is responsible for providing ECI services to eligible children under IDEA Part C.(42) Qualifying medical diagnosis--A diagnosed medical condition that has a high probability of developmental delay as determined by HHSC, as described in §350.811 of this chapter (relating to Qualifying Medical Diagnosis).(43) Referral date--The date the child's name and sufficient information to contact the family was obtained by the subrecipient.(44) Routine caregiver--An adult who:(A) has written authorization from the parent to participate in ECI services with the child, even in the absence of the parent;(B) participates in the child's daily routines;(C) knows the child's likes, dislikes, strengths, and needs; and(D) may be the child's relative, childcare provider, or other person who regularly cares for the child.(45) SEA--State educational agency as defined by 34 CFR §303.3(b).(46) Service coordinator--An employee or subcontractor of an ECI subrecipient who:(A) meets all applicable requirements in Subchapter C of this chapter (relating to Staff Qualifications);(B) is assigned to be the single contact point for the family;(C) is responsible for providing case management services as described in §350.405 of this chapter (relating to Case Management Services); and(D) is from the profession most relevant to the child's or family's needs or is otherwise qualified to carry out all applicable responsibilities.(47) SRS--Specialized rehabilitative services. Rehabilitative services outlined in §350.501 of this chapter (relating to Specialized Rehabilitative Services) that promote age-appropriate development by correcting deficits and teaching compensatory skills for deficits that directly result from medical, developmental, or other health-related conditions.(48) SST--Specialized skills training. As defined by 34 CFR 303.13(b)(14). SST seeks to reduce the child's functional limitations across developmental domains, including strengthening the child's cognitive skills, positive behaviors, and social interactions.(49) Subrecipient--A local private or public agency with proper legal status and governed by a board of directors or governing authority that accepts funds from HHSC to administer an ECI program.(50) Surrogate parent--A person assigned to act as a surrogate for the parent in compliance with IDEA Part C and this chapter.(51) TAC--Texas Administrative Code. A compilation of all state agency rules in Texas.(52) TCM--Targeted case management. Case management activities that meet criteria in §350.405(c) of this subchapter and are reimbursable by Medicaid when provided to Medicaid-enrolled children who are eligible for ECI.(53) TEA--Texas Education Agency. The state agency that oversees primary and secondary public education. It is headed by the commissioner of education.(54) Telehealth services--Health care services, other than telemedicine medical services, delivered by a health professional licensed, certified, or otherwise entitled to practice in Texas and acting within the scope of the health professional's license, certification, or entitlement to a patient who is located at a different physical location than the health professional using synchronous audio-visual telecommunications or information technology.(55) USC--United States Code. The official codification of the general and permanent federal statutes of the United States.

Source Note: The provisions of this §350.103 adopted to be effective September 1, 2011, 36 TexReg 5387; amended to be effective July 1, 2012, 37 TexReg 4621; amended to be effective September 1, 2013, 38 TexReg 5524; amended to be effective May 1, 2014, 39 TexReg 3445; amended to be effective March 7, 2015, 40 TexReg 939; amended to be effective June 30, 2019, 44 TexReg 3280; transferred effective March 1, 2021, as published in the Texas Register February 5, 2021, 46 TexReg 941; amended to be effective March 17, 2022, 47 TexReg 1277; amended to be effective February 13, 2025, 50 TexReg 772.

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