Administrative Letter: 13
Policy Code: BGB
To: Public School Administrators and Special Education Directors
From: Robert G. Hasson, Jr., Ed. D. Commissioner
Date: April 14, 2018
Subject: Important changes in documenting medical services in Individualized Education Plans (IEPs)
The Maine Department of Education has instituted new requirements for Individualized Education Programs (IEPs) beginning May 1, 2018. This guidance is offered in collaboration with the Department of Health and Human Services. The purpose of this change is to clarify the documentation of educationally and medically necessary services on the IEP aligning to Section 65 and Section 28 of the MaineCare Benefits Manual. These changes will ensure compliance with documentation required for access to MaineCare benefits.
When an IEP Team determines that the nature and severity of a child’s educational needs are significant enough that education in regular classes with the use of supplementary aids and services cannot be achieved satisfactorily (MUSER X.2.B. page 120), the least restrictive environment (LRE) statement must reflect the fact that certain services will be necessary in order for the child to access the curriculum.
Beginning May 1, 2018, the Department requires that newly developed or amended IEPs contain justification for medically and educationally necessary services such as day treatment services, rehabilitation services, nursing services, or other medical services that a child needs in order to receive a free appropriate public education (FAPE). Other educationally and medically necessary services such as speech and language, occupational therapy, physical therapy, social work services, and transportation are already listed in the service grid. The justification will be stated in the least restrictive environment section (LRE) of the IEP (Section 9).
The LRE statement must include information that would justify MaineCare paid educationally necessary medical services. An example of such a statement is the following: “Due to the child’s complex medical needs, the child requires a highly-structured setting with a predictable routine, clear and consistent consequences and integrated therapy for social and emotional needs in a significantly more restrictive day treatment setting”. Please note that an LRE statement might include additional explanation and that the above example is not intended to necessarily model a complete LRE statement.
Beginning May 1, 2018, schools are requested to write an LRE statement similar to the above example depending on the specific needs of the child. When the revised IEP form goes into effect on August 1, 2018, it will still be important to develop an appropriate LRE statement but the documentation for MaineCare purposes will be in section 8, “Additional Medical Services for FAPE”.
A draft copy of the revised IEP form can be accessed at the following site: http://maine.gov/doe/specialed/forms/index.html. Please note: this form is only a draft and the revised IEP form will change before implementation on August 1, 2018.
Further guidance will be included in a revision of the procedural manual available on the Special Services webpage sometime before the August 1 date. For more information, contact the Department of Education – Office of Special Services at (207) 624 -6713.