Report of Children Receiving Early Intervention Services in Accordance with Part C

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TABLE 3

REPORT ON INFANTS AND TODDLERS EXITING PART C¹

2019 - 2020

Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1820-0557. Public reporting burden for this collection of information is estimated to average 39 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is required to obtain or retain a benefit (P.L. 108.446 Section 618). If you have any comments concerning the accuracy of the time estimate, suggestions for improving this individual collection, or if you have comments or concerns regarding the status of your individual form, application or survey, please contact the Office of Special Education, 400 Maryland Ave., SW, Washington, DC 20202-4536 or email [email protected] directly.

All States must submit these data via the IDEA Part C Exiting survey in the EDFacts online survey tool, EMAPS.

Instructions

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

Due Date: November 1, 2020

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.

2. 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.

3. 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.

4. 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).

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

   • the child had turned age three at the start of the reporting period;² 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.

6. 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.

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

8. 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.

9. STATES SHOULD NOT PROVIDE PERCENTAGES IN SECTIONS A AND B. THESE WILL BE CALCULATED BY EDFACTS ONLINE SURVEY TOOL, EMAPS.

10. 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.

2. 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 U.S.C. 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 U.S.C. 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.

3. 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 unduplicated count of all children served under IDEA, Part C by race/ethnicity of the child, not the family based on the October 2007 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). The following definitions of the seven categories for aggregate report of race/ethnicity have been adapted from definitions appearing in this 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 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, according to the child’s gender and reason for no longer receiving services.

2. 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	2019-2020	FORM EXPIRES: xx/xx/xxxx
		STATE:____________________________

SECTION A

12-Month Reporting Period (From MM/YY to MM/YY)

to

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	2019-2020	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.

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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	2019-2020	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	2019-2020	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”.