~ 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

Par

ticip

ant &

Sta

keho

lder

Tra

inin

g

Sta

keho

lder

Cou

ncil

Col

labo

rativ

e R

ule

Mak

ing

Par

ent-

to-P

aren

t A

ssi

stan

ce

Cas

e M

anag

er

Tel

epho

ne In

term

edia

ry

Fac

ilita

tion

Med

iatio

n M

odel

s

Om

bu

dsp

erso

n

Thi

rd-P

arty

Opi

nion

/Con

sulta

tion

Res

olut

ion

Ses

sion

Med

iati

on

Un

der

IDE

A

Co

mp

lain

ts

Du

e P

roce

ss H

eari

ng

Hea

ring

Pro

cess

(T

ier

II)

Lit

igat

ion

Leg

isla

tio

n

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?