CTR077022_Contract_Documents__FE__-_signed__1_.pdf

Yesenia Sandoval

Chief Procurement Officer

06/05/2025 https://azdesgov.na1.adobesign.com/verifier?tx=CBJCHBCAABAAlh0nqhhG-GwAFTf6k1zNU2OGeMP5BKcU

Table of Contents

Contract No.: CTR077022

Description: Team-Based Early Intervention Services

Rev. 05-2025, v12

CONTRACTOR IS STRONGLY ENCOURAGED TO READ THE ENTIRE CONTRACT.

Table of Contents

Scope of Work

Exhibit A - AzEIP GSR Historical Utilization Average

Exhibit B - AzEIP Geographic Service Regions

Exhibit C – AzEIP Service Providing Agency Staffing Roster

Exhibit D – AzEIP Home Visitor Safety Guidance

Exhibit E – AzEIP Contractor Code of Conduct

Exhibit F - AzEIP Otoacoustic Emission (OAE) Machine Loan Agreement

Exhibit G – AzEIP Performance Measures

ADES Special Terms and Conditions

Uniform Terms and Conditions

Attachment 1 - Certification Regarding Lobbying

Attachment 2 - Participation in Boycott of Israel

Attachment 3 - Certification Regarding: Debarment, Suspension, Ineligibility and Voluntary Exclusion

Attachment 4 – Forced Labor of Ethnic Uyghurs Ban

Attachment 5 – Affirmation of Central Registry Background Checks

Attachment 6 – Business Associate Agreement

Scope of Work

1. ADES Mission and Vision Statements

1.1 ADES Mission: To strengthen individuals, families, and communities for a better quality of life.

1.2 ADES Vision: A thriving Arizona.

2. Purpose

2.1 Purpose Statement: The purpose of this contract it to provide comprehensive Team-based Early

Intervention Services to children who are determined eligible under Part C of the Individuals with Disabilities Education Act (IDEA) and enrolled with the ADES, Arizona Early Intervention Program (AzEIP) to enhance the development of the child, maximize independent living and the capacity of the families to meet their child’s needs.

2.2 Legal Authority: A.R.S. § 41-1954 provides the Department the authority to contract and meet obligations within the general scope of its activities and operations.

2.2.1 The IDEA, Part C, as may be amended.

2.2.2 A.R.S. § 41-2021-2022 provides the ADES the authority to provide Early Intervention

Services to children and families.

2.3 Projected Utilization: Service provision is on an as needed basis in the Geographic Service Regions (GSR). ADES make no guarantee of the projected utilization of service, including, but not limited to referrals and ongoing services. Historical Data from May 2017 through April 2018 is provided. Refer to the AzEIP GSR Historical Utilization Average (Exhibit A).

2.4 Funding: The contents of this Contract were developed under a grant from the U.S. Department of Education, H181A210002. However, those contents do not necessarily represent the policy of the U.S. Department of Education, and you should not assume endorsement by the Federal Government.

3. Service Description

3.1 Taxonomy Definition: Early Intervention HP10-00.

3.2 Taxonomy Definition: Early Intervention Services provide activities to meet and enhance the developmental needs of children or families. Services may include, but are not limited to managed, and/or health care services, family support, and preservation.

3.3 Actual Service Description: AzEIP is established by Part C of the IDEA, which provides eligible children and their family’s access to services to enhance the capacity of families and caregivers to support the child’s development through a team-based approach. ADES AzEIP is seeking contractor(s) to provide team-based Early Intervention services and support to families and eligible children in accordance with the child’s IFSP developed by their Multidisciplinary Team.

This team-based approach is expected to enhance the child’s development and the family and/or caregiver’s capacity to facilitate the child’s development by teaching therapeutic activities to implement in their daily routines to support full participation in the child’s primary caregiving relationships and home environment. Services shall be provided in the contracted GSR as https://sites.ed.gov/idea/regs/c https://sites.ed.gov/idea/regs/c outlined in the AzEIP Geographic Service Region Effective 07-01-2019 (Exhibit B), in collaboration with the Arizona Department of Health Services (ADHS), the Arizona State Schools for the Deaf and the Blind (ASDB), the Arizona Department of Education (ADE), the Arizona Health Care Cost Containment System (AHCCCS) and other community resources as part of this team-based model and early intervention program.

3.4 Background: IDEA Part C was established as the federal grant program that assists states in operating a comprehensive statewide program of Early Intervention Services for infants and toddlers with disabilities, ages birth through three (3) years, and their families. ADES has been designated as Arizona’s lead agency to receive this grant and administer the early intervention program through its’ AzEIP. As the designated agency, the AzEIP oversees a statewide, comprehensive, coordinated, multidisciplinary, interagency system of services and supports to enhance the development of the child and the family and/or caregivers’ capacity to support the development of eligible children from birth through age three (3) years with significant developmental delays or disabilities. Additionally, the administration of this program includes identification and coordination of resources available to AzEIP families and children from federal, state, and local resources, to ensure eligible children and their families receive the Early Intervention Services needed to support learning and development.

4. Definitions

4.1 Arizona Early Intervention Program (AzEIP): Arizona’s statewide Interagency system of Early Intervention Services for infants and toddlers, birth through three (3) years of age, with disabilities or significant developmental delays, and their families. AzEIP is governed by IDEA Part C and administered through the Arizona Department of Economic Security (ADES) as the lead agency.

4.2 AzEIP Eligibility: Infants and toddlers, birth through three (3) years of age, who have not reached fifty percent (50%) of the developmental milestones expected at his/her chronological age, in one

(1) or more of the developmental domains or who have an established medical condition that has a high probability of resulting in a developmental delay.

4.3 AzEIP-Only Eligible: A child who is eligible for AzEIP but is not determined eligible for DDD or ASDB services.

4.4 Arizona State Schools for the Deaf and the Blind (ASDB): An AzEIP service providing agency that serves infants and toddlers birth through three (3) years of age who have a significant auditory or visual impairment. ASDB will provide the vision and/or hearing specialist on early intervention teams under this contract.

4.5 ASDB Eligibility: ASDB determines ASDB eligibility. ASDB serves infants and toddlers birth through three (3) years of age who have:

4.5.1 A hearing impairment, which is a permanent bilateral loss of hearing acuity, as determined by an audiologist; and/or

4.5.2 A visual impairment, which means a permanent bilateral loss in visual acuity or a loss of visual field, as determined by an ophthalmological evaluation, that interferes with the child’s development.

4.6 Assessment: The ongoing procedure used by qualified personnel to identify the child's unique strengths and needs and the early intervention services appropriate to meet those needs throughout the child’s eligibility for AzEIP.

4.7 Assistive Technology (AT): Any service or device that directly assists to increase, maintain, or improve the functional capabilities of an infant or toddler.

4.8 Business Day: Monday through Friday, excluding State holidays. Dates of observance of the following State holidays are maintained by the Arizona Department of Administration (ADOA).

4.8.1 New Year’s Day, Martin Luther King, Jr. Day, Presidents Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day, and Christmas Day.

4.9 Capacity Building: Activities that strengthen the ability of primary caregivers and/or team leads to support eligible infants and toddlers to achieve greater performance and impact on outcomes.

4.10 Conflict of Interest: When a Contractors or subcontractor(s) relationship with a client is compromised, or might be compromised, because of decisions or actions taken for personal benefit from actions or decisions made in their official capacity.

4.11 Contractor Personnel: Any of the Contractor’s personnel who provide services under this contract, including the Contractor’s subcontractor(s), and/or volunteers.

4.12 Coordination of Benefits: The activities involved in determining medical coverage benefits, including Medicaid, when a child has coverage through an individual, entity, insurance, or program that is liable to pay for health care services prior to seeking payment from the AzEIP.

4.13 Core Team: The team of Early Intervention Professionals who support and provide early interventions services to children and their families who are referred to and eligible for AzEIP.

4.14 Data System: Any ADES electronic data system that Contractors will be required to use to collect and report data to AzEIP.

4.15 Developmental Domains: The areas of development that must be continuously assessed throughout the early intervention process. The five (5) developmental domains include the following:

4.15.1 Physical (fine and gross motor), including vision and hearing;

4.15.2 Communication;

4.15.3 Self-Help/Adaptive;

4.15.4 Cognitive; and

4.15.5 Social Emotional.

4.16 Developmental Special Instructionist (DSI): An early intervention professional specializing in early childhood special education and development, meeting minimum qualifications as defined in AzEIP Policy and Procedure Manual.

4.17 Division of Developmental Disabilities (DDD): The Division provides individuals with developmental disabilities and their families, services and supports that are flexible, high quality, and member-driven. These services provide individuals with opportunities to exercise their rights and responsibilities of independent decision-making and engagement in the community.

4.18 DDD Eligibility: DDD determines DDD eligibility. DDD serves individuals who meet their eligibility criteria.

4.19 Early Intervention Professionals: Includes occupational therapists, physical therapists, speech-language pathologists, developmental special instructionists, service coordinators, vision specialists, hearing specialists, psychologists, and social workers who serve infants and toddlers birth through three (3) years of age by building family and team member capacity.

4.20 Early Intervention Program (EIP): An AzEIP contracted region for team-based early intervention services that includes: the early intervention professionals working with one (1) Contractor, as well as the DDD service coordinators and ASDB Vision and Hearing Specialists working as part of the team.

4.21 Early Intervention Services: Developmental services identified in 34 C.F.R. § 303.13(b).

4.22 Evaluation: Evaluation for children ages birth through three (3) years means the procedures, in accordance with 34 C.F.R. § 303.321, used by appropriate, qualified personnel to determine a child's initial and continuing eligibility for AzEIP, including determining the status of the child in each of the developmental areas. A child may also be determined eligible for AzEIP based on an established condition or when records confirm a developmental delay consistent with AzEIP eligibility criteria. For all eligible children, a multidisciplinary assessment is required covering all areas of development.

4.23 Evidence-Based Practices: Practices that are informed by research, in which the characteristics and consequences of environmental variables are functionally established, and the relationship directly informs what the team can do to support the family with their desired outcome.

4.24 Fraud: An intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person. It includes any act that constitutes fraud under applicable State or Federal law, as defined in 42 C.F.R. § 455.2.

4.25 IDEA Parent: The parent who will make early intervention decisions, including whether or not to participate in AzEIP, consent to screening, evaluation, assessment, consent to the provision of services, and consent to share early intervention records, for a child. The IDEA Parent can be defined as a:

4.25.1 biological or adoptive parent of a child;

4.25.2 foster parent, unless Arizona law, regulations, contractual obligations with an Arizona or local entity prohibit a foster parent from acting as a parent;

4.25.3 guardian generally authorized to act as the child’s parent, or authorized to make early intervention, educational, health or developmental decisions for the child (but not the State if the child is a ward of the State);

4.25.4 person acting in the place of a biological or adoptive parent (including a grandparent, stepparent, or other relative) with whom the child lives, or an individual who is legally responsible for the child's welfare; or

4.25.5 surrogate parent who has been appropriately appointed.

4.26 Individualized Family Service Plan (IFSP): A written plan for providing early intervention services to an AzEIP eligible infant or toddler and the child’s family that:

4.26.1 is based on the evaluation of the child and the assessment of the child and family;

4.26.2 is based on priorities, concerns and resources of the family and the interests of the child;

4.26.3 includes parental consent;

4.26.4 is implemented on or before the planned start date(s) for each service; and

4.26.5 is developed in accordance with 34 C.F.R. §§ 303.340, et seq.

4.27 IFSP Meeting: A meeting convened by a Service Coordinator to develop an initial, annual, or periodic review of the IFSP which meets the requirements specified in Chapter Three (3) of the AzEIP Policy Manual and AzEIP Procedure Manual (Scope of Work Sections 5.1.2 - 5.1.3).

4.28 IFSP Team: The following group of individuals who must participate in each initial, periodic, and annual IFSP meeting:

4.28.1 IDEA Parent(s);

4.28.2 other family members, if requested by the parent(s);

4.28.3 an advocate or any other person outside of the family, if requested by the parent(s);

4.28.4 the designated AzEIP or DDD service coordinator;

4.28.5 the person(s) directly involved in conducting the assessment/evaluations; and

4.28.6 person(s) who will be providing services, if appropriate.

4.29 Initial Planning Process (IPP): The events and activities that must be completed within forty-five

(45) days of receiving a referral, including eligibility determination and development of the IFSP.

4.30 Joint Visitor (JV): An early intervention professional who visits a family with the Team Lead and uses coaching practices to support achievement of the outcomes identified on the IFSP.

4.31 Service Coordination: An active ongoing process that assists and enables the family to access services and assures their rights and procedural safeguards through the process.

4.32 Service Coordinator (SC): The early intervention professional who supports the family to ensure services are provided as written on the IFSP. Every child is assigned either a dedicated (AzEIP or DDD) or dual role service coordinator.

4.33 Dedicated SC: The service coordinator solely provides service coordination to the family and does not have any other role on the team and cannot act as Team Lead.

4.34 Dual Role SC: The Early Intervention Professional (OT, PT, SLP, DSI) who is chosen as the Team Lead for the child also serves as the family’s service coordinator.

4.35 Team Meeting: A collaborative weekly meeting which includes all core team members, and other service providing agencies, as appropriate, to discuss the progress in the children who are assigned to the early intervention program.

4.36 Team-Based Early Intervention Services (TBEIS): Services provided by a multidisciplinary team where a Team Lead (TL) is selected as a primary support for a family. The TL receives support from other team members and focuses services on building parent/caregiver capacity for the child in their natural learning environment.

4.36.1 Teaming Practices: One (1) member of the Core Team who is selected as the TL will use coaching to support building the capacity of parents/caregivers to identify and build upon the child’s interests, child and family engagement and everyday learning opportunities. This will include receiving support from Core Team members during joint visits or team meetings.

4.36.2 Coaching Practices: An interaction style used to build capacity for team members and caregivers through joint planning, observation, action/practice, reflection, and feedback to support the family in achieving identified outcomes.

4.36.3 Natural Learning Environment Practices: Practices which include the same everyday routines and activities as typical of non-disabled peers that are family-identified, promote parent’s abilities to identify interests and activities and to increase the number, frequency, and depth of learning opportunities.

4.36.4 Family Centered Practices: Family-Centered practice is a way of working with families, both formally and informally, across service systems to enhance their capacity to care for and support their children.

4.37 Team Lead (TL): The primary core team member who acts as the liaison between the family and the IFSP team for the provision of TBEIS. The team lead selected must be the best possible long-term match to support in achieving the child and family’s outcomes.

4.38 Waste: Overutilization or inappropriate utilization of services. Misuse of resources, or practices that result in unnecessary cost to the ADES.

5. General Requirements

The Contractor shall:

5.1 Comply with and meet all applicable provisions of federal, state, and local laws, regulations, policies and procedures to provide Early Intervention Services, including without limitations the requirements and standards as follows:

5.1.1 IDEA, Part C, of 34 C.F.R. § 303.100 et. seq., as may be amended,

5.1.2 AzEIP Policy Manual Effective 04-01-2022, as may be amended,

5.1.3 AzEIP Procedure Manual Effective 04-01-2022, as may be amended,

5.1.4 DDD Policies and Procedures, as may be amended.

5.1.5 In the event a provision of Federal or State law, regulation, policy, or procedure is repealed or modified during the term of this Contract, effective on the date the repeal or modification by its own terms takes effect:

5.1.5.1 The provisions of this Contract shall be deemed to have been amended to incorporate the repeal or modification; and

5.1.5.2 The Contractor shall comply with the requirements of the Contract as amended, unless the AzEIP and the Contractor otherwise stipulate in writing.

5.2 Ensure services are provided in a culturally competent manner to all children and families, including those with limited English proficiency and diverse cultural and ethnic backgrounds, disabilities, and regardless of gender, sexual orientation or gender identity.

5.3 Coordinate interpretation and/or translation services through resources available to the family or provide appropriate interpretation and/or translation services as a component of service delivery as needed.

5.4 Be AHCCCS registered and ensure all Core Team Members are:

5.4.1 AHCCCS registered,

5.4.2 Have a National Provider Identifier (NPI), as appropriate,

5.4.3 Be appropriately licensed and/or certified per their discipline, and

5.4.4 Operating within their scope of practice.

https://sites.ed.gov/idea/regs/c https://des.az.gov/sites/default/files/dl/AzEIP-TBEIS-Policy-Manual.pdf?time=1710256268239 https://des.az.gov/sites/default/files/media/AzEIP-TBEIS-Procedure-Manual-effective-04-01-2022.pdf?time=1710256268239 https://des.az.gov/services/disabilities/developmental-disabilities/policies-and-rules/policies https://des.az.gov/services/disabilities/developmental-disabilities/policies-and-rules/policies

5.5 Develop and implement procedures to ensure timely coordination of services for eligible children including eligibility determination and transition activities with other service providing agencies.

5.6 Establish and implement internal controls to include, but not limited to, policies and procedures to ensure contract compliance to be made available to AzEIP upon request.

5.7 Comply with the statutory obligation to report child maltreatment, as prescribed in A.R.S. § 13- 3620. Complete and submit an AzEIP incident report when child maltreatment is reported as specified in Chapter Two (2) of the AzEIP Procedure Manual (Scope of Work Section 5.1.3).

5.8 Collaborate with the early childhood community for the coordinated and streamlined support and services for all children referred to AzEIP.

5.9 Ensure that all staff maintain confidential information in a secure filing system for all child records in accordance with all applicable state, and federal regulations.

5.10 Establish and implement a mechanism for tracking all forms of communication to families to ensure services are provided.

5.11 Ensure teams adhere to utilization of all AzEIP forms and documents required by the AzEIP Policy Manual and the AzEIP Procedure Manual (Scope of Work Sections 5.1.2 – 5.1.3).

5.12 Maintain a complete and accurate Records Release and Access Log in the child record, including the appropriate consent for releasing any records, and when requested, supply supporting documentation of child records to the requestor.

5.13 Participate in public relations activities with community partners that demonstrate awareness of the early intervention system in alignment with AzEIP’s Mission and Key Principals, and/or other activities as identified and requested by AzEIP.

5.14 Attend and participate in all AzEIP required trainings to assist in meeting the requirements in this contract.

5.15 Ensure all staff directly working with children or vulnerable adults comply with the Background Checks for Employment through Central Registry requirement outlined in Section 6 of the ADES Special Terms and Conditions.

5.15.1 Staff shall be required to resubmit their Background Checks for Employment through Central Registry on a yearly basis (one (1) year from their most recent check).

6. Staffing Requirements

6.1 Ensure that all Contractor’s personnel involved in the provision of Early Intervention Services are trained and adhere to all related federal and state law, rule, and policy.

6.2 Ensure sufficient staffing are in place who meet the appropriate qualifications and discipline specific licensures specified in Chapter Six (6) of the AzEIP Policy Manual (Scope of Work Section 5.1.2).

6.3 Retain the following Core Team key staff, who shall be located in Arizona:

6.3.1 Service Coordinator (SC);

6.3.2 Occupational Therapist (OT);

6.3.3 Physical Therapist (PT);

6.3.4 Speech-Language Pathologist (SLP); and

6.3.5 Developmental Special Instructionist (DSI).

6.3.6 When applicable, the contractor shall retain the following additional Core Team members:

6.3.6.1 Psychologist; and

6.3.6.2 Social Worker.

6.4 Retain the following administrative key staff:

6.4.1 Program Manager: Responsible for direct supervision and oversight of the Contractor’s early intervention program.

6.4.2 Data Manager: Responsible for ensuring the efficient and effective operation and usage of data to meet program service requirements.

6.5 Ensure the Core Team has balanced representation and capacity sufficient to serve 100-125 families within the contracted GSR.

6.5.1 A balanced representation should be equivalent to one (1) full-time Core Team member for the following positions, unless otherwise approved in writing by AzEIP:

6.5.1.1 DSI;

6.5.1.2 OT;

6.5.1.3 PT; and

6.5.1.4 SLP.

6.5.2 The Core Team shall be adjusted accordingly to meet GSR needs.

6.6 Ensure that each Core Team member has the availability and capacity to fulfill each of the following responsibilities:

6.6.1 Participate in all IPP activities;

6.6.2 All IFSP meetings and services;

6.6.3 All other Early Intervention Services identified on the IFSP; and

6.6.4 Serve as the Team Lead, joint visitor and/or provide coaching to other Core Team members as appropriate.

6.7 Ensure that all Core Team members are trained in early childhood development, parenting practices, early childhood special education standards, discipline specific personnel standards, and assistive technology.

6.8 Ensure that early intervention professionals adhere to the code of ethics within their professional practice.

6.9 Have staff to accommodate family schedules, including weekends and evenings, and work with children and their caregivers in the environments in which they regularly participate, such as childcare, local parks, libraries, the family and extended family home, etc.

6.9.1 Provide services to a child only in the presence of the parent, guardian, or an adult caregiver.

6.9.2 Staff shall not transport any child enrolled in AzEIP or their family.

6.10 Establish and implement procedures to recruit and retain qualified personnel to fulfill the Contract requirements.

6.11 Submit proof of recruitment efforts upon request when there is a capacity shortage for core team and key personnel.

6.11.1 Capacity shortage is identified when the Contractor has a vacancy for a specific discipline, as well as an underrepresentation of a discipline needed, based on the number of current children in the contracted region.

6.12 Submit transcripts and obtain approval from AzEIP prior to hiring a SC and/or DSI as specified in Chapter Six (6) of the AzEIP Procedure Manual (Scope of Work Section 5.1.3).

6.13 Enroll all Contractor Personnel in the ADES training system and complete all training within the ADES identified training schedule.

7. Administrative Requirements

7.1 Submit a Business Organizational Chart outlining any business affiliations and/or subsidiaries within ten (10) business days of the Contract Effective Date and upon request. The chart shall include an organizational diagram showing the overall business structure and lines of responsibility and authority of Contractor personnel.

7.2 Submit the AzEIP Service Providing Agency Staffing Roster (Exhibit C) to AzEIP as follows:

7.2.1 Within ten (10) business days of Contract Effective Date;

7.2.2 The first week of each business quarter;

7.2.3 Within five (5) business days of any Contractor Personnel changes; and

7.2.4 Upon request by AzEIP.

7.3 Establish a policy and procedure for a system to track and trend complaints regarding Early Intervention Services and take systematic action as necessary and appropriate – including coordination with other service providers.

7.4 The tracking system shall at a minimum identify:

7.4.1 The Contractor and all Contractor Personnel involved in the complaint;

7.4.2 The dates of all actions regarding the complaint; and

7.4.3 The basis and resolution of the complaint.

7.5 Provide a copy of each child and family assessment and IFSP no later than ten (10) business days after completion of the document at no cost to the family.

7.6 Ensure that all staff are knowledgeable in home visitor safety protocols in accordance with AzEIP Home Visitor Safety Guidance (Exhibit D).

7.7 Adhere to the AzEIP Contractor Code of Conduct (Exhibit E).

8. Services Requirements

8.1 Provide Early Intervention Services through a team-based approach that shall include, but not limited to, the following practices:

8.1.1 Teaming Practices;

8.1.2 Coaching Practices;

8.1.3 Natural Learning Environment Practices; and

8.1.4 Evidence-Based Practices.

8.2 Establish one (1) of the following service coordination models:

8.2.1 Dual Role: In this model, OT, PT, SLP, and DSI team members must be able to act as a service coordinator and will provide service coordination when selected as TL.

8.2.2 Dedicated Role: In this model, teams have identified service coordinator(s) acting only in the service coordination role, and no other disciplines shall serve in this role.

8.2.3 AzEIP may allow a combination of both models on a case-by-case basis upon request of the Contractor.

8.3 Complete the IPP within forty-five (45) days of the initial referral as specified in Chapter Three (3) of the AzEIP Policy Manual and AzEIP Procedure Manual (Scope of Work Sections 5.1.2 - 5.1.3).

The IPP shall include the following:

8.3.1 Initial visit (with developmental screens if applicable);

8.3.2 AzEIP Eligibility determination;

8.3.3 Child and Family Assessment; and

8.3.4 Development of the IFSP.

8.4 Not refuse to implement Early Intervention Services in the GSR specified in this Contract.

8.5 Conduct hearing screening during the initial visit, and annually when appropriate, in accordance with Arizona Administrative Code R9-13-207.

8.5.1 The Contractor shall enter all hearing screenings in the AzEIP data system within ten (10) calendar days.

8.5.2 The AzEIP may loan an Otoacoustic Emission (OAE) machine to the Contractor to conduct hearing screenings only when there are no reasonable alternative resources available to the Contractor.

8.5.3 The Contractor shall complete the AzEIP OAE Machine Loan Agreement (Exhibit F) before utilizing equipment loaned by AzEIP.

8.5.4 Report all OAE screenings performed for children under the age of two (2) years to the Arizona Department of Health Services (ADHS) by the sixth (6th) day of the subsequent week per Arizona Administrative Code R9-13-207.

8.6 Ensure simultaneous eligibility is determined in the IPP for all service providing agencies. (AzEIP, DDD, and ASDB).

8.7 Develop and evaluate the interim, initial, annual, and periodic IFSPs as specified in Chapter Three

(3) of the AzEIP Policy Manual and AzEIP Procedure Manual (Scope of Work Sections 5.1.2 - 5.1.3).

8.8 Implement the services identified in the IFSP within thirty (30) days of the IFSP date.

8.9 Conduct Team Meetings on a weekly basis as a core component of Early Intervention Services.

Conduct Team Meetings as specified in Chapter Three (3) of the AzEIP Policy Manual and AzEIP Procedure Manual (Scope of Work Sections 5.1.2 - 5.1.3)

8.10 Conduct Child Indicator Summary as specified in Chapter Three (3) of the AzEIP Policy Manual and AzEIP Procedure Manual (Scope of Work Sections 5.1.2 - 5.1.3).

8.11 Complete transition activities timely as specified in Chapter Four (4) of the AzEIP Policy Manual (Scope of Work Section 5.1.2).

8.12 Complete appropriate Child Find activities as specified in Chapter One (1) of the AzEIP Policy Manual and AzEIP Procedure Manual (Scope of Work Sections 5.1.2 - 5.1.3) to ensure that children who are referred and/or determined AzEIP eligible are an appropriate representation of the population in the assigned GSR.

8.13 Transfer service coordination responsibilities to DDD when the child is determined DDD eligible and DDD is the designated service coordinator.

8.14 Ensure an Arizona Long Term Care System (ALTCS) referral is submitted to AHCCCS for DDD eligible children for whom service coordination is provided by the Contractor.

8.15 Utilize the AzEIP Approved Tools in AzEIP Approved Screening, Evaluation, and Assessment Instruments to conduct screenings, evaluations, and assessments to determine eligibility as specified in Chapter Three (3) of the AzEIP Policy Manual and AzEIP Procedure Manual (Scope of Work Sections 5.1.2 - 5.1.3).

8.16 Have procedures in place to ensure communication and collaboration occurs between early childhood providers, and that care is coordinated with other agencies involved with the child and family in meeting the child’s outcomes.

8.17 Accept all referrals for children who reside in the Contractor’s assigned GSR.

8.17.1 Have staff available to accept referrals by telephone, fax, e-mail, ADES data system, or in-person during business days and process accordingly.

8.17.2 The Contractor shall forward all referral information and materials within one (1) business day of receipt to AzEIP or its Central Referral Contractor when a referral is received for a child who resides outside the Contractor’s GSR.

8.17.3 Comply with Chapter Three (3) of the AzEIP Procedure Manual (Scope of Work Section 5.1.3) when transitioning children between Contractors or GSRs.

https://des.az.gov/sites/default/files/dl/GCI-1145A_0.pdf?time=1710193865205 https://des.az.gov/sites/default/files/dl/GCI-1145A_0.pdf?time=1710193865205

8.17.4 The Contractor shall implement procedures to ensure the family is notified within three (3) business days of the completion of the transfer. Notification shall include information of the Contractor who will resume Early Intervention Services.

8.17.5 Ensure a request to transfer between Contractors or GSRs is accepted within twenty-four

(24) hours of the receipt.

8.18 Update and enter information in relation to the provision of this service, including family and child information, into the ADES designated data system(s) within ten (10) days of the activity.

8.19 Provide an assessment for AT when the need has been identified through the IFSP Team.

8.19.1 The Contractor shall provide ongoing AT services and coordinate the acquisition of an AT device as indicated in the IFSP.

9. Performance Measures

9.1 The Contractor shall meet the annual performance standards as established by IDEA Part C State

Performance Plan/Annual Performance Report (SPP/APR). Refer to the AzEIP Performance Measures (Exhibit G).

10. Billing

The Contractor shall:

10.1 Bill accurately for services that have been identified in the child’s record, in accordance with the AzEIP Billing Manual Effective 10-01-2023.

10.2 Comply with IDEA Part C regarding billing early intervention programs accurately to ensure appropriate funding sources have been billed.

10.3 Ensure Coordination of Benefits for all children with multiple payor sources, as described in the AzEIP Billing Manual.

10.3.1 Accurately bill AHCCCS for IDEA, Part C services prior to seeking payment from AzEIP.

10.4 Accept established rates identified in the AzEIP Billing Manual which encompass all costs associated with the provision of the service including but not limited to:

10.4.1 salaries;

10.4.2 operating and administrative costs;

10.4.3 materials;

10.4.4 supplies;

10.4.5 insurance;

10.4.6 transportation; and

10.4.7 preparation of billing and reports.

https://des.az.gov/sites/default/files/dl/AzEIP-TBEIS-Billing-Manual-October-2023.pdf?time=1710254456086

11. Reporting Requirements

The Contractor shall submit the following reports:

11.1 All reports related to the requirements under this contract including annual financial statements as referenced by the Department.

11.2 Disciplinary Action Reports: Notify AzEIP, within five (5) business days of receiving notification from an applicable Arizona licensing and regulatory board or agency, of any disciplinary action taken on the license of any of the Contractor’s personnel.

12. Notices and Correspondence

12.1 The Contractor shall submit the required certificate of insurance and policy endorsements within ten (10) days calendar days of a contract award and shall maintain valid insurance, including policy renewals, on file in the ADES certificate of insurance tracking portal, myCOI.

12.2 Notices, correspondence, and reports from the Contractor to AzEIP should be sent to:

Arizona Department of Economic Security Arizona Early Intervention Program (AzEIP) Contract Manager 1789 W. Jefferson Street- MD 2HP1 Phoenix, AZ 85007 Email: AzEIPContracts@azdes.gov mailto:AzEIPContracts@azdes.gov

Exhibit A – AzEIP GSR Historical Utilization Average

Exhibit A - AzEIP GSR Historical Utilization Average

Region Name Number of Children Referred per Year*

Average Number of Children

Referred per Month**

Number of Initial IFSPs per Year*

Average Number of Initial IFSPs per Month** Number of Annual Reviews per Year*

Average Number of

Annual Reviews per

Month**

Single Day Case

Count***

Single Day Case Count for Service

Coordination Provided by Contractor

Northwest Maricopa County 1143 95 464 39 207 17 613 418

Northeast Maricopa County 1032 86 458 38 458 38 587 457

West Central Maricopa County 1256 105 438 37 173 14 595 312

North Central Maricopa County 970 81 294 25 294 25 423 265

South Central Maricopa County 801 67 275 23 117 10 375 248

East Central Maricopa County 1051 88 397 33 190 16 541 346

Southwest Maricopa County 1464 122 492 41 179 15 587 331

Southeast Maricopa County 1313 109 406 34 214 18 614 430

West Pinal & Southeast Maricopa County

1119 93 404 34 211 18 575 411

East Pinal, Southern Gila, & Southeast Maricopa County

1266 106 472 39 256 21 724 497

Yavapai & Northern Gila County 535 45 176 15 77 6 210 144

Northwest Pima County 452 38 161 13 68 6 124 42

Northeast Pima County 501 42 168 14 104 9 267 170

Southwest Pima County 603 50 147 12 68 6 312 234

Southeast Pima & Santa Cruz County 588 49 173 14 96 8 199 93

Graham, Greenlee, & Cochise County 450 38 187 16 40 3 206 156

Yuma County 451 38 147 12 63 5 193 153 Southern Apache County 21 2 11 1 <10 1 9 7

Southern Navajo County 239 20 92 8 30 3 107 72

Coconino County & Hopi Nation 332 28 74 6 38 3 178 155

LaPaz & Mohave County 318 27 121 16 42 4 160 89

Colorado Strip 42 4 14 1 11 1 30 24

Navajo Nation 313 26 77 6 35 3 100 70

* Based on the cumulative Child Contract Report from 5/1/2017 - 4/30/2018.

** Based on the cumulative Child Contract Report from 5/1/2017 - 4/30/2018 and divided by 12 months.

*** Based on a single day case count on 4/30/2018.

Exhibit B – AzEIP Geographic Service Regions

Exhibit B - AzEIP Geographic Service Regions

Southern Apache R17

Exhibit C – AzEIP Service Providing Agency Staffing Roster

Exhibit C – AzEIP Service Providing Agency Staffing Roster

Attached as an Excel Spreadsheet

Exhibit D – AzEIP Home Visitor Safety Guidance

Exhibit D – AzEIP Home Visitor Safety Guidance

Attached as a PDF Document

Exhibit E – AzEIP Contractor Code of Conduct

Exhibit E – AzEIP Contractor Code of Conduct

1. Subcontract with or recommend only those individuals or organizations that are culturally sensitive, who meet accessibility standards for the persons with disabilities, and who do not discriminate based on ethnicity, gender, age, race, religion, marital status, sexual orientation, or socioeconomic status.

Subcontractors and their credentials need to be approved by AzEIP prior to providing services under this contract.

2. Represent himself/herself accurately to children and their families and shall not mislead the families regarding the Contractor’s relationship with ADES/AzEIP, or mislead the families regarding the Contractor’s skills, capabilities or credentials.

3. Collaborate with AzEIP and other service providers (if applicable) in the best interest of the family and child and, to the extent possible, avoid disagreements that might have adverse effects on the child’s outcomes. When collaborating with other community agencies that serve the same family and child, abide by the decisions that were agreed upon by all of the involved parties and assist in implementing such decisions which are consistent with applicable laws, regulations, rules and policies.

4. Ensure at all times that child and family information is used only for the purpose of fulfilling contractual responsibility and is not released to any other individual, agency, or organization. Confidential information and reports obtained, for under this contract shall never be shared without the expressed permission from the child’s parent or their legal guardian/representative.

5. Develop and maintain a confidentiality policy statement and establish procedures that restrict access to confidential child records and information. This provision shall not be construed to limit the right of AzEIP staff or other authorized representative(s) to access consumer case records and information pertinent to the provision of the contracted service.

6. Always act in a professional manner, honor commitments, treat consumers with respect, dignity, and courtesy, and project a positive attitude.

7. Contractor shall NEVER:

7.1. Engage in any form of intimate and sexual activity with the child’s family.

7.2. Enter into any business partnership with the child’s family.

7.3. Employ authority or influence with the child’s family for the benefit of third parties, including the consumer’s family or friends.

7.4. Exploit the child’s family’s trust in the Contractor or its personnel for any purpose.

7.5. Accept any commission, rebates, or any other form of remuneration when serving consumers, except payment for service provided from AzEIP.

7.6. Bill according to the AzEIP Billing Manual (Section 13.1) for services under this contract which are required as part of any other contract.

Exhibit F – AzEIP Otoacoustic Emission (OAE) Machine Loan Agreement

Exhibit F - AzEIP Otoacoustic Emission (OAE) Machine Loan Agreement

Exhibit F – AzEIP Otoacoustic Emission (OAE) Machine Loan Agreement

Exhibit G – AzEIP Performance Measures

Performance Measure Target Method Measurement

Percent of infants and toddlers with Individual Family Service Plans (IFSPs) who receive the early intervention services on their IFSPs within 45 days.

(20 U.S.C. 1416(a)(3)(A) and 1442)

Compliance:

100%

AzEIP data system, Contractor self-report, formal complaint investigations, and child file reviews.

Percent = [(# of infants and toddlers with IFSPs who receive the early intervention services on their IFSPs in a timely manner) divided by the (total # of infants and toddlers with IFSPs)] times 100.

The measurement will include data identified during the monitoring period (April 1-June 30) of a given federal fiscal year (July 1-June 30).

Percent of infants and toddlers with IFSPs who primarily receive early intervention services in the home or community-based settings.

(20 U.S.C. 1416(a)(3)(A) and 1442)

Results:

98.00%

The AzEIP data system, Contractor self-report, and child file reviews.

Percent = [(# of infants and toddlers with IFSPs who primarily receive early intervention services in the home or community-based settings) divided by the (total # of infants and toddlers with IFSPs)] times 100.

The measurement will include data identified during the federal fiscal year (July 1-June 30).

A.1 Percent of infants and toddlers with substantial increase in the rate of growth in positive social-emotional skills by age three (3) or at the time of exit.

(20 U.S.C. 1416(a)(3)(A) and 1442)

72.74%

The AzEIP data system and child file reviews.

Percent = [(# of infants and toddlers reported in progress category (c) plus # of infants and toddlers reported in category (d)) divided by (# of infants and toddlers reported in progress category (a) plus # of infants and toddlers reported in progress category (b) plus # of infants and toddlers reported in progress category (c) plus # of infants and toddlers reported in progress category (d))] times 100 for each identified global outcome.

The measurement includes the numerator and denominator of infants and toddlers with IFSPs who received early intervention services for at least six months before exiting the Part C program.

The measurement will include data identified during the federal fiscal year (July 1-June 30).

A.2 Percent of infants and toddlers within age expectations in positive social-emotional skills by age three (3) or at the time of exit.

53.98%

The AzEIP data system and child file reviews.

Percent = [(# of infants and toddlers reported in progress category (d) plus # of infants and toddlers reported in progress category (e)) divided by the (total # of infants and toddlers reported in progress categories (a) + (b) + (c) + (d) + (e))] times 100 for each identified global outcome.

The measurement includes the numerator and denominator of infants and toddlers with IFSPs who received early intervention services for at least six months before exiting the Part C program.

Performance Measure Target Method Measurement

B.1 Percent of infants and toddlers with substantial increase in the rate of growth in acquisition and use of knowledge and skills.

78.26%

The AzEIP data system and child file reviews.

Percent = [(# of infants and toddlers reported in progress category (c) plus # of infants and toddlers reported in category (d)) divided by (# of infants and toddlers reported in progress category (a) plus # of infants and toddlers reported in progress category (b) plus # of infants and toddlers reported in progress category (c) plus # of infants and toddlers reported in progress category (d))] times 100 for each identified global outcome.

The measurement includes the numerator and denominator of infants and toddlers with IFSPs who received early intervention services for at least six months before exiting the Part C program.

The measurement will include data identified during the federal fiscal year (July 1-June 30).

B.2 Percent of infants and toddlers within age expectation in acquisition and use of knowledge and skills.

54.48%

The AzEIP data system and child file reviews.

Percent = [(# of infants and toddlers reported in progress category (d) plus # of infants and toddlers reported in progress category (e)) divided by the (total # of infants and toddlers reported in progress categories (a) + (b) + (c) + (d) + (e))] times 100 for each identified global outcome.

The measurement includes the numerator and denominator of infants and toddlers with IFSPs who received early intervention services for at least six months before exiting the Part C program.

C.1 Percent of infants and toddlers with substantial increase in the rate of growth in use of appropriate behaviors to meet their needs.

77.45%

The AzEIP data system and child file reviews.

Percent = [(# of infants and toddlers reported in progress category (c) plus # of infants and toddlers reported in category (d)) divided by (# of infants and toddlers reported in progress category (a) plus # of infants and toddlers reported in progress category (b) plus # of infants and toddlers reported in progress category (c) plus # of infants and toddlers reported in progress category (d))] times 100 for each identified global outcome.

The measurement includes the numerator and denominator of infants and toddlers with IFSPs who received early intervention services for at least six months before exiting the Part C program.

C.2 Percent of infants and toddlers within age expectation in use of appropriate behaviors to meet their needs.

(20 U.S.C. 1416(a)(3)(A) and 1442)

Results:

47.94%

The AzEIP data system and child file reviews.

Percent = [(# of infants and toddlers reported in progress category (d) plus # of infants and toddlers reported in progress category (e)) divided by the (total # of infants and toddlers reported in progress categories (a) + (b) + (c) + (d) + (e))] times 100 for each identified global outcome.

The measurement includes the numerator and denominator of infants and toddlers with IFSPs who received early intervention services for at least six months before exiting the Part C program.

A. Percent of families who report that early intervention services have helped the family know their rights.

(20 U.S.C. 1416(a)(3)(A) and 1442)

Results:

94.50% Family Surveys

Percent = [(# of respondent families participating in Part C who report that early intervention services have helped the family know their rights) divided by the (# of respondent families participating in Part C)] times 100.

B. Percent of families who report that early intervention services have helped the family effectively communicate their children's needs.

(20 U.S.C. 1416(a)(3)(A) and 1442)

Results:

95.50% Family Surveys

Percent = [(# of respondent families participating in Part C who report that early intervention services have helped the family effectively communicate their children’s needs) divided by the (# of respondent families participating in Part C)] times 100.

C. Percent of families who report that early intervention services have helped the family help their children develop and learn.

(20 U.S.C. 1416(a)(3)(A) and 1442)

Results: FFY 2023 96.25% Family Surveys

Percent = [(# of respondent families participating in Part C who report that early intervention services have helped the family help their children develop and learn) divided by the (# of respondent families participating in Part C)] times 100.

Percent of infants and toddlers birth to one (1) with IFSPs compared to national data.

(20 U.S.C. 1416(a)(3)(B) and 1442)

Results: .73%

The data will be taken from multiple sources including, but not limited to, the AzEIP data system and file reviews.

Percent = [(# of infants and toddlers birth to 1 with IFSPs) divided by the (population of infants and toddlers birth to 1)] times 100.

The measurement will include data identified during the federal fiscal year (July 1-June 30).

Percent of infants and toddlers birth to three (3) with IFSPs compared to national data.

(20 U.S.C. 1416(a)(3)(B) and 1442)

Results:

1.95%

The data will be taken from multiple sources including, but not limited to, the AzEIP data system and file reviews.

Percent = [(# of infants and toddlers birth to 3 with IFSPs) divided by the (population of infants and toddlers birth to 3)] times 100.

The measurement will include data identified during the federal fiscal year (July 1-June 30).

Percent of eligible infants and toddlers with IFSPs for whom an initial evaluation and initial assessment and an initial IFSP meeting were conducted within Part C’s 45-day timeline.

Compliance:

100%

The AzEIP data system, Contractor self-report, formal complaint investigations, and child file reviews.

Percent = [(# of eligible infants and toddlers with IFSPs for whom an initial evaluation and initial assessment and an initial IFSP meeting were conducted within Part C’s 45-day timeline) divided by the (# of eligible infants and toddlers evaluated and assessed for whom an initial IFSP meeting was required to be conducted)] times 100.

Measurement must account for untimely evaluations, assessments, and initial IFSP meetings, including the

(20 U.S.C. 1416(a)(3)(B) and 1442) reasons for delays. Documented family delays are included in the numerator and denominator.

The measurement will include data identified during the monitoring period (April 1-June 30) of a given federal fiscal year (July 1-June 30).

A. The percentage of toddlers with disabilities exiting Part C with timely transition planning for whom the Contractor has developed an IFSP with transition steps and services at…