Table 3 RE7 (for reporting race/ethnicity according to n

Report of Infants and Toddlers Receiving Early Intervention Services and of Program Settings Where Services are Provided in Accordance with Part C, and Report on Infants and Toddlers...

Att_1820-0557 (Pt C T3) form_RE7

Table 3 RE5 Report on Infants and Toddlers Exiting Part C

OMB: 1820-0557

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TABLE 3 - RE7 (for reporting race/ethnicity according to New 10/2007 Guidance)


REPORT ON INFANTS AND TODDLERS EXITING PART C1

2009 - 2010


Paperwork Burden Statement


According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 1820-0557. The time required to complete this information collection is estimated to average 50.3 hours per State response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: Office of Special Education Programs, U.S. Department of Education, 400 Maryland Avenue, SW, Washington, D.C. 20202.

All States must submit electronic versions of the completed data forms to OSEP’s data contractor at [email protected]. OSEP will provide electronic Data Transmission Spreadsheets (DTS) in Microsoft Excel format to facilitate this process.


Authorization: 20 U.S.C. 1418(a)(1)(C) and (a)(3)


Due Date: November 1, 2010


Sampling Allowed: No


General Instructions


  1. Report the number of infants and toddlers with disabilities who, during the 12-month reporting period, either no longer received services under Part C prior to age three or reached age three, and for each child, report by race/ethnicity, gender, and reason that services are no longer received.


  1. States should report counts for a 12-month reporting period. The State can determine the 12-month reporting period of data collection. This 12-month window (reporting period) should be the same for each annual report of these data. States must indicate on the form the specific 12-month period the State used for reporting. If the State needs to revise the dates for its 12-month reporting period, it should notify OSEP in advance of any change in the State-identified reporting period.


  1. Include on the form any child who was under age three and had an active individualized family service plan (IFSP) in place at some point during the reporting period and at the end of the reporting period either was no longer receiving services under Part C or had reached his or her third birthday.


  1. The infants and toddlers with disabilities represented on this form must be an unduplicated count; no child should be counted more than once during the 12-month reporting period. If a child is identified as no longer receiving services under Part C more than once during the reporting period, report the reason that services are no longer being received based on the last time the child exited (i.e., report the child in the category that corresponds to the most recent reason for no longer receiving services under Part C).


  1. Do NOT report a child as exiting Part C if:

    • the child had turned age three at the start of the reporting period2; or

    • services were temporarily interrupted and subsequently resumed before the end of the reporting period; or

    • the child was under age three at the end of the reporting period and had an active IFSP, even if services were intermittently stopped during the reporting period.


  1. If your State serves infants and toddlers who are at risk of having substantial delays if early intervention services are not provided as specified under 20 U.S.C. 1432(5)(B)(i), include these children in the table counts if they were no longer receiving service under Part C or reached age three during the reporting period.


  1. All reported totals must equal the sum of the subsequent rows or columns.


  1. For each reason that a child is no longer receiving services under Part C, the total number of children reported by race/ethnicity in Section A must equal the total number of children reported for that exit reason by gender in Section B.


  1. STATES SHOULD NOT PROVIDE PERCENTAGES IN SECTIONS A AND B. THESE WILL BE CALCULATED BY OSEP’S DATA TRANSMISSION SYSTEM.


  1. In providing data for this collection, the State is to submit complete and unsuppressed data.


Specific Row (Reason for No Longer Receiving Services) Instructions


Using the categories below, report each infant or toddler with a disability, as defined in 20 U.S.C. 1432(5), who reached age three or were no longer receiving services under Part C within this 12-month reporting period according to the most recent reason for no longer receiving services.


There are three major groupings of reasons: Program Completion (category 1), Exit at Age Three (categories 2 through 6), and Not Receiving Services (categories 7 through 10). The categories within each of these groupings are defined below.


  1. Program Completion


1. No longer eligible for Part C prior to reaching age three. Include all children who within this 12-month reporting period, have exited Part C before age three because they are no longer eligible under IDEA, Part C.


  1. Exit at Age Three


2. Part B eligible, exiting Part C. Include all children determined to be eligible for Part B during the reporting period and who exited (or will soon exit) Part C. This includes children who receive Part B services in conjunction with Head Start.


3. Part B eligible, continuing in Part C. Include all children determined to be eligible for Part B, and whose parents were offered and consented to have their child remain in Part C under 20 USC 1432(5)(B)(ii) and 1435(c). The Part B eligible, continuing in Part C category may ONLY be used by a state whose application for IDEA Part C funds includes a policy under which parents of children with disabilities who were eligible for services under IDEA Section 619 and previously received services under Part C may continue to receive early intervention services under Part C beyond age three. States that do not offer this option under 20 USC 1432(5)(B)(ii) and 1435(c) may NOT report children in this category.


4. Not eligible for Part B, exit with referrals to other programs. Include all children who reached age three, were evaluated and determined not eligible for Part B, and were referred to other programs, which may include preschool learning centers, Head Start (but not receiving Part B services), and child care centers, and/or were referred for other services, which may include health and nutrition services, such as WIC.


5. Not eligible for Part B, exit with no referrals. Include all children who reached age three, were evaluated and determined not eligible for Part B, but were not referred to other programs.


6. Part B eligibility not determined. Include all children who reached their third birthday and their Part B eligibility was not determined during this reporting period. This category includes children who were referred for Part B evaluation, but for whom the eligibility determination has not yet been made or reported or children for whom parents did not consent to transition planning. Include in this category any child who reached age three, and who has not been reported in categories 2-5 above.


  1. Not Receiving Services


7. Deceased. Include all children who died before their third birthday, even if their death occurred at the age of exit. Include only children who died during the reporting period.


8. Moved out of State. Include all children who moved out of state before their third birthday. Include only children who moved during the reporting period. Do not report a child who moved within State (i.e., from one program to another) if services are known to be continuing.


9. Withdrawal by parent (or guardian). Include all children under the age of three whose parents declined all services (including service coordination services) after an IFSP was in place, or declined to consent to Part C services on the IFSP and provided written or verbal indication of withdrawal from Part C services.


10. Attempts to contact the parent and/or child were unsuccessful. Include all children, under the age of three, who had an active IFSP, and for whom Part C personnel have been unable to provide early intervention services either due to lack of response from the parent or family, or inability to contact or locate the family or child after repeated, documented attempts. Include in this category any child who was no longer receiving services under Part C before reaching age three, and who has not been reported in categories 7-9 above.


Specific Column Instructions for Section A: Race/Ethnicity


STATES MUST REPORT THE RACE/ETHNICITY OF THE CHILD, NOT THE FAMILY. FOR EACH OF THE RACE/ETHNICITY CATEGORIES, REPORT AN UNDUPLICATED COUNT OF CHILDREN EXITING.


In October 2007, the Department of Education published its Final Guidance on Maintaining, Collecting and Reporting Racial and Ethnic Data to the U.S. Department of Education in the Federal Register (Vol. 72, No. 202, available at http://www.gpoaccess.gov/nara/index.html ), referred to in these instructions as the new guidance. The procedures for collecting, aggregating, and reporting race and ethnicity, as described in the new guidance, must be implemented by no later than the report of the 2010-11 Exiting data. When implementing the new guidance, States must do so at the beginning of the relevant reporting period and must apply the guidance consistently to ALL data reported within that period.


DO NOT USE THIS form to report race/ethnicity within the five categories as applied in previous years.3 For states that are still reporting Exiting data under the five race/ethnicity categories, you must use Table 3 – RE5 (5 race/ethnicity reporting categories as used prior to 2007 guidance).


States that have fully implemented the Department of Education’s new guidance should report all children with disabilities according to the seven categories listed below. The following definitions of the seven categories for aggregate report of race/ethnicity have been adapted from definitions appearing in the new guidance.


Hispanic/Latino

A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. Refers to Hispanic and/or Latino.

American Indian or Alaska Native

A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment. (Does not include persons of Hispanic/Latino ethnicity.)

Asian

A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent. This includes, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. (Does not include persons of Hispanic/Latino ethnicity.)

Black or African American

A person having origins in any of the Black racial groups of Africa. (Does not include persons of Hispanic/Latino ethnicity.)

Native Hawaiian or Other Pacific Islander

A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. (Does not include persons of Hispanic/Latino ethnicity.)

White

A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. (Does not include persons of Hispanic/Latino ethnicity.)

Two or more races

A person having origins in two or more of the five race categories listed immediately above. (Does not include persons of Hispanic/Latino ethnicity.)


Total

The unduplicated total across the seven (7) race/ethnicity designations.



Note that each child should be reported in only one of the race/ethnicity categories, above.


Specific Column Instructions for Section B: Gender


  1. Report the (unduplicated) number of children with an active IFSP who were no longer receiving services under Part C, according to the child’s gender and reason for no longer receiving services.


  1. The total numbers of children reported in Section B should equal the total numbers of children reported in Section A by reason for no longer receiving services.

U.S. DEPARTMENT OF EDUCATION

TABLE 3

PAGE 1 OF 4

OFFICE OF SPECIAL EDUCATION



AND REHABILITATIVE SERVICES

REPORT ON INFANTS AND TODDLERS EXITING PART C PROGRAMS

OMB NO.: 1820-0557

OFFICE OF SPECIAL EDUCATION



PROGRAMS

2009-2010

FORM EXPIRES: XX/XX/XXXX






STATE:____________________________




SECTION A


REASON FOR EXIT

TOTAL

HISPANIC/ LATINO

AMERICAN INDIAN OR ALASKA NATIVE

ASIAN


BLACK OR AFRICAN AMERICAN

NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER



WHITE

TWO OR MORE RACES

TOTAL NUMBER OF INFANTS AND TODDLERS EXITING BY RACE/ETHNICITY (ROWS 1-10)










PROGRAM COMPLETION


1. NO LONGER ELIGIBLE FOR PART C PRIOR TO REACHING AGE THREE














EXIT AT AGE THREE


2. PART B ELIGIBLE, EXITING PART C










3. PART B ELIGIBLE, CONTINUING IN PART C










4. NOT ELIGIBLE FOR PART B, EXIT WITH REFERRALS TO OTHER PROGRAMS










5. NOT ELIGIBLE FOR PART B, EXIT WITH NO REFERRALS










6. PART B ELIGIBILITY NOT DETERMINED










NOT RECEIVING SERVICES


7. DECEASED











8. MOVED OUT OF STATE










9. WITHDRAWAL BY PARENT (OR GUARDIAN)










10. ATTEMPTS TO CONTACT UNSUCCESSFUL











U.S. DEPARTMENT OF EDUCATION

TABLE 3 (CONTINUED)

PAGE 2 OF 4

OFFICE OF SPECIAL EDUCATION



AND REHABILITATIVE SERVICES

REPORT ON INFANTS AND TODDLERS EXITING PART C PROGRAMS

OMB NO.: 1820-0557

OFFICE OF SPECIAL EDUCATION



PROGRAMS

2009-2010

FORM EXPIRES: XX/XX/XXXX







SECTION A : PERCENT*


REASON FOR EXIT

TOTAL

HISPANIC/ LATINO

AMERICAN INDIAN OR ALASKA NATIVE

ASIAN


BLACK OR AFRICAN AMERICAN

NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER



WHITE

TWO OR MORE RACES

PERCENT* EXITING BY RACE/ETHNICITY (ROWS 1-10)


100%









PROGRAM COMPLETION


1. NO LONGER ELIGIBLE FOR PART C PRIOR TO REACHING AGE THREE


100%













EXIT AT AGE THREE


2. PART B ELIGIBLE, EXITING PART C


100%









3. PART B ELIGIBLE, CONTINUING IN PART C


100%









4. NOT ELIGIBLE FOR PART B, EXIT WITH REFERRALS TO OTHER PROGRAMS


100%









5. NOT ELIGIBLE FOR PART B, EXIT WITH NO REFERRALS


100%









6. PART B ELIGIBILITY NOT DETERMINED


100%









NOT RECEIVING SERVICES


7. DECEASED


100%










8. MOVED OUT OF STATE


100%









9. WITHDRAWAL BY PARENT (OR GUARDIAN)


100%









10. ATTEMPTS TO CONTACT UNSUCCESSFUL


100%










* STATES SHOULD NOT PROVIDE PERCENTAGES IN THIS SECTION, AS THEY WILL BE CALCULATED AFTER THE COUNTS ARE SUBMITTED.

.

.


U.S. DEPARTMENT OF EDUCATION

TABLE 3 (CONTINUED)

PAGE 3 OF 4

OFFICE OF SPECIAL EDUCATION



AND REHABILITATIVE SERVICES

REPORT ON INFANTS AND TODDLERS EXITING PART C PROGRAMS

OMB NO.: 1820-0557

OFFICE OF SPECIAL EDUCATION



PROGRAMS

2009-2010

FORM EXPIRES: XX/XX/XXXX






STATE:____________________________


SECTION B


REASON FOR EXIT

TOTAL

MALE

FEMALE


TOTAL NUMBER OF INFANTS AND TODDLERS EXITING BY GENDER (ROWS 1-10)





PROGRAM COMPLETION


1. NO LONGER ELIGIBLE FOR PART C PRIOR TO REACHING AGE THREE





EXIT AT AGE THREE


2. PART B ELIGIBLE, EXITING PART C





3. PART B ELIGIBLE, CONTINUING IN PART C





4. NOT ELIGIBLE FOR PART B, EXIT WITH REFERRALS TO OTHER PROGRAMS





5. NOT ELIGIBLE FOR PART B, EXIT WITH NO REFERRALS





6. PART B ELIGIBILITY NOT DETERMINED





NOT RECEIVING SERVICES


7. DECEASED





8. MOVED OUT OF STATE





9. WITHDRAWAL BY PARENT (OR GUARDIAN)





10. ATTEMPTS TO CONTACT UNSUCCESSFUL






U.S. DEPARTMENT OF EDUCATION

TABLE 3 (CONTINUED)

PAGE 4 OF 4

OFFICE OF SPECIAL EDUCATION



AND REHABILITATIVE SERVICES

REPORT ON INFANTS AND TODDLERS EXITING PART C PROGRAMS

OMB NO.: 1820-0557

OFFICE OF SPECIAL EDUCATION



PROGRAMS

2009-2010

FORM EXPIRES: XX/XX/XXXX






SECTION B: PERCENT*



REASON FOR EXIT


TOTAL


MALE


FEMALE


PERCENT* EXITING BY GENDER (ROWS 1-10)


100%




PROGRAM COMPLETION


1. NO LONGER ELIGIBLE FOR PART C PRIOR TO REACHING AGE THREE

100%




EXIT AT AGE THREE


2. PART B ELIGIBLE, EXITING PART C

100%




3. PART B ELIGIBLE, CONTINUING IN PART C

100%




4. NOT ELIGIBLE FOR PART B, EXIT WITH REFERRALS TO OTHER PROGRAMS

100%




5. NOT ELIGIBLE FOR PART B, EXIT WITH NO REFERRALS

100%




6. PART B ELIGIBILITY NOT DETERMINED

100%




NOT RECEIVING SERVICES


7. DECEASED

100%




8. MOVED OUT OF STATE

100%




9. WITHDRAWAL BY PARENT (OR GUARDIAN)

100%




10. ATTEMPTS TO CONTACT UNSUCCESSFUL

100%




* STATES SHOULD NOT PROVIDE PERCENTAGES IN THIS SECTION, AS THEY WILL BE CALCULATED AFTER THE COUNTS ARE SUBMITTED.



1 Note that in addition to capturing infants and toddlers exiting the Part C program, this form also requires reporting on those children with disabilities who may continue to receive services under Part C under 20 U.S.C. 1435(c).


2 These children should have been counted in the previous reporting period under “Exit at Age Three”.

3 If your State is collecting race/ethnicity information in a manner that is NOT in full accordance with the new guidance (including the two-part question format for ascertaining and reporting Hispanic ethnicity), you should report aggregate data through the 5-category format ( the ‘…-RE5’ version of the form for this collection) for the 2009-10 submission. States must fully implement the new guidance for all of the IDEA Part C collections associated with the 2010-11 reporting reference year. If you have not made or partially made the transition, you should use the –RE5 version of the form for 2009-10, and apply either of two options to account for children who are identified as multiracial or two or more races, as described in the document entitled, “Handling Missing Data When Reporting Race/Ethnicity” (https://www.ideadata.org/docs/PartCRaceEthnicity.doc).


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