~ Part C Dispute Resolution ~ If It Ain’t Broke, How Will We Know? (National DR Data and An...
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Transcript of ~ Part C Dispute Resolution ~ If It Ain’t Broke, How Will We Know? (National DR Data and An...
~ Part C Dispute Resolution ~~ Part C Dispute Resolution ~If It Ain’t Broke, How Will We Know? If It Ain’t Broke, How Will We Know? (National DR Data and An Examination (National DR Data and An Examination
of One State System)of One State System)
Dick Zeller & Marshall Peter, CADRETerry Harrison, NJ Department of Education
~ ~ ~ ~ ~ ~ ~ ~ ~OSEP National Early Childhood Conference
Presented on December 3, 2006
Session OverviewSession 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
About CADREAbout CADRE
•Mission
•Support to States
•Research-based practice: RAISE
•National ADR Database
•CADRE Website:http://www.directionservice.org
/cadre/
Influences on the Use of Dispute Influences on the Use of Dispute ResolutionResolution
•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
New Jersey Early Intervention New Jersey Early Intervention System (NJEIS)System (NJEIS)
NJEIS WebsiteNJEIS Website
www.nj.gov/health/fhs/eis
www.state.nj.us/health/fhs/eis/procsafeguards.shtml
•Central Management Office (Data Collection)
•Data Desk Audit & Inquiry
•Self-Assessment
•Focused On-site Monitoring
•Targeted Technical Assistance
•Procedural Safeguards/Dispute Resolution
•Enforcement
GENERAL SUPERVISION GENERAL SUPERVISION NJEIS COMPONENTSNJEIS COMPONENTS
NJEISNJEIS INFRASTRUCTUREINFRASTRUCTURE• 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
CMO FEATURESCMO 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
DISPUTE RESOLUTIONDISPUTE RESOLUTION
PROCEDURAL PROCEDURAL SAFEGUARDSSAFEGUARDS
OFFICEOFFICE
INFORMAL RESPONSE 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 complainant’s allegations, does the matter go unresolved beyond ten (10) business days from the date of the complainant’s call to the hotline.
SFY’07 Informal SFY’07 Informal ResolutionsResolutions
• 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.
Summary of SFY’07 Issues Summary of SFY’07 Issues ResolvedResolved
(Not an Unduplicated Count)(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
Informal Issues (cont)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
FORMAL RESPONSEFORMAL 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.
FORMAL RESPONSE (cont.)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 SFY’07, there were 3 mediations and one complaint
Procedural Safeguards Procedural Safeguards Information & FormsInformation & 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
INCIDENT REPORTSINCIDENT 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.
Procedural Safeguards Procedural Safeguards ReportsReports
• 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
Informal Concerns: Parent Liaison (toll-free hotline)
New Jersey Part C Dispute New Jersey Part C Dispute Resolution SystemResolution System
Early “Complaint” Resolution (by Procedural Safeguards
Coordinator)
Stage I Stage II Stage III Stage IV Stage V Stages of conflict
Prevention Disagreement Conflict Procedural Safeguards
Legal Review Levels of Intervention
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Assistance/ Intervention Options
CADRE’s National ADR CADRE’s National ADR DatabaseDatabase
• 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
Five Years of DR Data Five Years of DR Data ReportingReporting
What hasn’t changed:• Complaints filed, reports issued, pending• Mediations held and agreements reached• Hearing requests, hearings held, pendingWhat 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)]
Example: 2006-07 Error Example: 2006-07 Error CheckerChecker
Dispute Resolution Data Dispute Resolution Data SummarySummary
• 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
# States Reporting Part C Complaint # States Reporting Part C Complaint ActivityActivity
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
# of States Reporting Part C Mediation# of States Reporting Part C Mediation ActivityActivity
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
# States Reporting Part C Hearings # States Reporting Part C Hearings ActivityActivity
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
Part C Total Dispute Resolution Events (56 Part C Total Dispute Resolution Events (56 Entities)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 117Italicized cells with yellow shading may be less dependable
numbers.
Dispute Resolution Event Dispute Resolution Event RatesRates
•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
# Served )( X 10,000
National Means - Dispute National Means - Dispute Resolution Events Per 10,000 Part Resolution Events Per 10,000 Part
C Child CountC 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
State Reported Dispute State Reported Dispute Resolution Resolution
Performance IndicatorsPerformance Indicators03-04
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
““National” Rates of Part B and National” Rates of Part B and Part CPart C
Part C Part B03-04
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
““National” Part B & Part C RatesNational” Part B & Part C Rates
CC
C C
C
C
BB
B
B
B
B
Only 28 states had 05-06 Part C Only 28 states had 05-06 Part C activityactivity
NJ
If every state added one event in 05-If every state added one event in 05-06…06…
Why So Little Part C DR Why So Little Part C DR Activity?Activity?
Hypotheses*: Parents of infants are overwhelmed Parents don’t know the EI system or
their rights Fear of reprisal or…
Don’t 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)
Why So Little Part C DR Why So Little Part C DR Activity?Activity?
Hypotheses** (continued):By law, early intervention is voluntaryParents 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)
Making the “C” Data PublicMaking 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
DiscussionDiscussion
•Questions/Comments?
•What’s happening in your state?
•How can CADRE be of assistance to you?