Victory!

Finally, the waiting is over! The judge ruled in favor of the AAPPD, in favor of the families and providers, and in favor of federal law! It was ordered that services to kids ages 0-3 be reinstated as quickly as possible! At the moment, this is the best news that we could have hoped for! Families will continue to receive services until further notice. I don't know if this will save some of the providers who are closing their doors, but it should restore services for all of our kiddos!
I double-checked with my supervisor, and we get to start calling families and "breaking" the good news to them!
Thanks to all who wrote letters, e-mailed, rallied, blogged, prayed, and otherwise stood in the gap on behalf of our families. I don't think we're out of the woods yet, but its definitely looking brighter than it has in quite a while.

Here are some of the news stories about the court's decision.

"PHOENIX (AP) - A judge on Wednesday barred the state from implementing budget cuts for services for the developmentally disabled. Judge Joseph Heilman of Maricopa County Superior Court issued a preliminary injunction after a court hearing on a lawsuit filed by program beneficiaries and care providers."

And

"A judge on Wednesday temporarily barred the state from implementing budget cuts for services for the developmentally disabled.
Judge Joseph Heilman of Maricopa County Superior Court issued a preliminary injunction after a court hearing on a lawsuit filed by program beneficiaries and care providers.
"This case raises serious, indeed grave questions of public policy and law," Heilman's order stated. "The procedural violations have serious substantive impact. Sorting out the multiple legal issues can await disposition on the merits. Preventing immediate and irreparable harm is required.""

DDD Update

Yesterday the judge made a preliminary ruling on the injunction. He ruled in favor of the AAPPD (Arizona Association of Programs for People with Disabilities), and against the Arizona DDD/DES.
Here is the legalese:
"A declaratory judgment that SB1001, First Special Session, of the 2009 Arizona Legislature is invalid and unenforceable and that said Act may not be enforced or implemented, at the very least with respect to the DES-DDD program reductions.
B. Temporary, preliminary and permanent injunctive relief, restraining these defendants, their officers, agents and employees from implementing SB1001 in any respect with regard to the DES-DDD program.
C. Temporary, preliminary and permanent injunctive relief restraining defendant's, their officers, agents and employees from implementing the DES FY2009 budget reductions directed by these defendants as their method of administering SB1001."

The Attorney General's office has asked for time for "special considerations" and they have been given until Wednesday (tomorrow) to submit them. Keep in mind that this injunction is PRELIMINARY and TEMPORARY. The judge is to decide tomorrow how long it will be, or he could retract the injunction altogether. There is hope for some sort of agreement with the DES, since the judge cannot order legislation to give the DES money.
Overall, we are cautiously optimistic. Its a step in the right direction, but nothing official has changed yet. We're still holding our breath(s), and it looks like whatever decision is made will come down to the wire.

For those in the Tucson area, there is a rally this week at Reid Park in Ramada 7. It will be on Friday the 13th from 10am-12pm. This is to show support for families who have been affected by the cuts to AZ Early Intervention.

For those looking for news stories to pass along, here is one that appeared today and summarizes the issue very well.

And now, we wait

At least until Monday or Tuesday. That's when the judge should rule on the AAPPD case. A ruling in our favor would prevent 0-3 programs from being cut, at least for the time being. I honestly don't know that it would be a long-term solution- the likely best case scenario that I see at the moment is allowing kids to continue services until their FOCUS dates (authorizations) end, then not renewing. Still illegal though since services can't be reduced without parental consent. I've heard mumblings about pushing the DDD through the same redesign that AzEIP went through last year. In short, each child has a team of therapists, only ONE of which he or she sees on a weekly basis; the rest are consult only. Not a good solution, and still only barely legal, as all of the IFSP's would have to be changed to reflect the change in therapies. I want to make it clear that I'm just speculating here. Right now all I know is that we may have more info on Monday, depending on the outcome of the AAPPD case.
Action steps right now are to write and file those appeal letters. Be sure to emphasize the illegality of what they are doing- an emotional appeal is great, but sadly it won't hold water with the complaint department. And spread the word. Tell everyone you can think of...use any media contacts that you may have. The more attention we draw, and the more people realize the importance of 0-3 services, the better our chances.
Sigh. That being said, we (meaning the company I work for) received a list yesterday of children who will no longer be receiving services after next Friday. There are about 90 names on it...out of around 120 kids that we serve. I haven't seen the list yet, but I'm pretty sure I know most of them since I've had parents contacting me when they received their letters. We're being told to assume that next week will be our last with most of our kids. We will likely try to keep providing services for our kids who are ALTCS eligible, but that will only be enough kids for a few of us to work part time. I'd probably be one of them, and I'm working on some other options to fill in the gaps. I've been doing respite/habilitation on the side for quite a while, so I'm looking to connect with 1-2 other families who could use 5-10 hours/week and are authorized for hab or respite. I have a few families who have asked me if I could work independently and they could pay me out of pocket. I see it as a possibility since I've done similar things before. Unfortunately I well know that most families right now don't have the means to pay out of pocket, and I hate that services will end up being limited either based on an ability to pay, or based on having good insurance. That isn't the intent of IDEA or any of the other laws that govern 0-3 services- the state is supposed to provide the services that the child needs. They're what is known as the payer of last resort, which means that they try to get insurance and everyone else to pay first, but services shouldn't be only for the wealthy. It should be for everyone who needs it. Really, EI saves money in the long run- many kids who go through EI wind up NOT needing more services once they reach school age. Anyways, there I go on that soapbox again.
Really, I'm just trying to relax this weekend and pray that some sort of miracle happens on Monday to at least buy us a bit of time. If it does then we go from there. If not, well I really don't want to think about what that means for so many families.

How to file a complaint

Use the sample letter below as a format. Letters MUST be in writing and must include the legalities of IDEA Part C

Here is the page that describes the process of filing a complaint/appeal regarding your child's services: https://egov.azdes.gov/cmsinternet/main.aspx?menu=98&id=2366

Below the addresses to which you should send your complaint/appeals letters is the portion of the above-linked page that lays out the steps for filing a complaint with DES/AzEIP:

Send complaint/appeal letters to:
Arizona Center for Disability Law
5025 E Washington St, ste 202
Phoenix, AZ

AzEIP - Dispute
3839 N 3rd St
Suite 304
Phoenix, Az
KTaylor@azdes. gov

DDD - Disputes
1789 W Jefferson St., 4th floor
Phoenix, Az 85007

System Complaint

If you believe there has been any violation of the requirements and regulations of IDEA, Part C, including a violation of your child's or family's rights, you may file a complaint with DES/AzEIP.

Steps in initiating a complaint:

1. You must send a written, signed complaint to:
   Executive Director, DES/AzEIP
   3839 N. 3rd Street, Suite 304
   Phoenix, Arizona 85012
   
2. The written, signed complaint must include a statement that there has been a violation of a requirement or regulation of IDEA, Part C, and the facts of the situation.
   
3. The Executive Director or a designee will review the complaint and decide if it is a valid complaint. A complaint will be judged valid if the alleged violation occurred not more than one year before the date the complaint was received, unless:
   1. the alleged violation continues for the child or other children; or
   2. the person making the complaint is requesting reimbursement or corrective action for a violation that occurred not more than three years before the complaint was received.
      
4. If the complaint is judged to be valid, then the Executive Director or a designee will review all the relevant information and will:
   1. conduct an on-site investigation, if necessary; and
   2. give the person making the complaint the opportunity to submit additional information, either orally or in writing.

The Executive Director or a designee will make an independent decision as to whether there has been a violation of IDEA, Part C and send a written copy of the decision to all parties within 60 days of receiving the complaint.

From here

http://takeactioninaz.blogspot.com/2009/03/send-appeal-letter-to-executive.html

For those appealing the DES/DDD letters

I realized that the previous version of this was cut off, so I'm fixing and reposting. Please, please write an appeal letter.

From the AZ Autism Coalition www.azautism.org

IDEA Part C Procedural Safeguards

If your child is between the ages of 0-3 and has been affected by these cuts, you have Federal safeguard rights that are meant to protect your child. Early intervention is partially funded by both State and Federal dollars, thus you must take action and appeal your child’s termination of services. Follow the appeals process (Administrative Review) carefully that is specifically detailed in the DES letter — you have 35 days from the date of the letter to appeal.

Here is a sample letter:

To Whom It May Concern:

My child is _____ years old and has a diagnosis of ___________. He/she has been receiving one hour per week of occupational therapy and speech therapy since __________, along with two hours per week with a developmental specialist. I received a letter from DES dated March 3, 2009, informing me that my child would no longer be receiving any therapies after March 13, 2009, due to the State’s economic hardships.

I respectfully request an Administrative Review and appeal this decision to remove services from my child. My child is entitled to early intervention services based on the Individuals with Disabilities Education Act (IDEA). According to Federal IDEA policy, services can only be stopped if the parents choose to withdraw their consent to participate or the child no longer needs services. Neither of which is the case. Also according to IDEA, services must stay in place while dispute resolution takes place.

Removing services from my child in this manner is a direct violation of IDEA, and I fully intend to dispute this removal of early intervention services.

Sincerely,

Send the letters to:

Division of Developmental Disabilities
Compliance and Review Unit
1789 E. Jefferson St., Fourth Floor
Phoenix, AZ 85007
or fax to: (602) 364-2850

Arizona Center for Disability Law
5025 E Washington St, ste 202
Phoenix, AZ

AzEIP - Dispute
3839 N 3rd St
Suite 304
Phoenix, Az
KTaylor@azdes. gov

I won't say I feel hopeful yet, but this fight isn't over. A majority of my families received their 10 day cancellation letters (including at least one child who shouldn't have received one). There are instructions at the bottom for how to appeal the decision, so we are encouraging parents to write letters of appeal and send them to all interested parties. I posted a sample letter of appeal yesterday, along with instructions for where to send them.
On the legal end, the judge is supposed to rule on the lawsuit Monday. Those present felt that it went well and that we stand a chance. I'm not sure exactly what it would mean for the judge to find in our favor, but it would definitely be a good start.
The magnitude of this situation hits me all over again with every visit that I make. Today I visited a little boy that I've been seeing for almost a year and a half. When we began, he wasn't walking. Now he is walking, climbing, and just about at age level in speech (he has also been receiving speech therapy weekly, and for a short time he also received physical therapy). Its amazing how much good we can do when families can get help EARLY. It is SO much harder to break a bad habit than to just build good habits the first time around. There are countless other kids with a similar story- this is just one.

I'm curious. Has anyone else received a termination letter even though their child qualifies for ALTCS/Long Term Care? I'd be interested to know how many letters were mistakenly sent out.

I suppose I can post this

It will be public knowledge soon enough. I heard from a DDD support coordinator (and my supervisor heard from another source) that 10-day termination letters to families went in the mail today. My understanding is that means most services for children who do not qualify for long term care will end on March 13. We still have not been told when we'll have to stop providing services. It may become clearer when we actually see the letters that go out, but right now it isn't looking good. Families will still have the option of trying to get their insurance to cover therapies (which can be difficult), or paying privately (not cheap). Truly, though, we are in the 11th hour, waiting for a pardon.
I don't know exactly what I thought would happen with all of the protests and everything, but it doesn't appear to have worked. There were ways to avoid these cuts, and they are opting not to take them. What they're doing isn't even legal- an IFSP is a binding document, the same as an IEP, and it can't be changed (including changing services) without the ok of the entire team, which includes the parents. The state could be facing some more pretty serious legal ramifications for all of this.
Honestly, right now I'm sticking to "just the facts m'aam" because I can't bring myself to go any deeper than that. What I'll do job-wise is secondary right now to the thought of probably more than 3000 families of kids ages 0-3 who will be losing services. All of the kids that I WON'T be seeing anymore. All of the kids that I'm just getting to know, and the ones I've been seeing for more than a year. All of the families who have told me that having therapists there has been the difference between being set adrift in a strange land, and having a road map and someone to guide the way.
In a way, though, this doesn't put me much closer to a resolution. We're still providing services, but with an axe over our heads that could drop any minute. And I hate goodbyes. I generally refuse to say them until the last possible minute, and even then I don't do a good job of them.
I've been sitting here with this staring at me since 8:55pm, and I'm stuck. I still don't know what to say. This is still sort of surreal, and it may stay that way until or unless the axe drops and I actually have to say goodbyes.