Early Intervention Services for Lead Poisoned Children

EARLY INTERVENTION SERVICES FOR LEAD POISONED CHILDREN WHO ARE LESS THAN  3  YEARS OF AGE – HERE IS WHAT YOU SHOULD KNOW

For the parents of recently diagnosed lead poisoned children facing the prospect that their precious and perfectly normal child has been the victim of toxic levels of lead and transformed into a child with a likelihood of suffering from cognitive delays, getting immediate help is essential for the future of your child. Aggressive early interventional services are available – and you are entitled to a comprehensive multidisciplinary evaluation in order to determine eligibility for your lead poisoned child.

SCIENTIFIC AND MEDICAL BASIS FOR EARLY INTERVENTION

Is there a scientific basis as to why is early intervention important? Yes. Studies have found that the earlier a child receives appropriate therapies the better the chances for the ultimate outcome. Children who have been diagnosed with elevated lead levels have a demonstrated increase in likelihood to develop developmental and learning delays. It is imperative that parents be proactive and that they protect their children by intervening early.

CAN EARLY INTERVENTION SERVICES PREVENT PERMANENT DAMAGE FROM LEAD POISONING?

Unfortunately not, as studies have shown that the damage from lead is permanent  – yet despite the permanency of the damage from lead intoxication, a child will likely do better and the negative effects of the lead poisoning mitigated by early intervention and the administration of appropriate therapies.

After the referral for early intervention services is made, the task of obtaining a timely and complete evaluation is of key importance. In recognition of the urgency of the intervention, Federal regulations require that the evaluation be expedited and completed within a very short period of time.

DOES A REFERRAL FOR EARLY INTERVENTION SERVICES HAVE TO BE MADE BY A PHYSICIAN?

We were recently asked by a father of a recently diagnosed with an elevated lead level of 6 mg/dl. if a referral for an early evaluation must be made by the pediatrician. His experience was that he called 311 as directed by the NYC Department of Health website and requested that he be evaluated.  He stated that he was brushed off and told that the referral must come from a physician.

While his experience may not be surprising given the recent track record of the City of New York in the area of lead poisoning control in NYC Housing Authority buildings, in point of fact what he was told by 311 was inaccurate. If a child has been diagnosed with a condition which is likely to result in a delay in development, a parent is empowered by law to make the referral for the evaluation in order to determine eligibility for such services. You do not need a physician, health care provider or any other entity to make this referral for the evaluation. As noted, it is scientifically well settled that lead poisoned children have a vastly increased risk of developmental delays. You are entitled by law to such an evaluation for early intervention services.

WHO DO I CONTACT TO GET EARLY INTERVENTION SERVICES FOR MY CHILD?

As noted, in the City of New York, the Department of Health is charged with the responsibility to administer early intervention services. They use the 311 telephone portal and a referral form as the starting point for a referral. You can download the form from https://www1.nyc.gov/assets/doh/downloads/pdf/earlyint/ei-referral-form.pdf

Federal Law mandates that in exchange for federal funding that there must be a referral process in place in order that infants and toddlers be identified for early intervention services. The convenient 311 contact point as well as the form which can be accessed on-line should in theory be both user friendly and efficient. As demonstrated by the experience of our client, this may not be the case in practice. When you call, it is advisable to obtain the name of the person to whom you are speaking and/or a reference number for your request. Of course, involving your child’s pediatrician in making the referral may indeed smooth the process and is a logical approach to take.

WHAT IS THE TIMELINE FOR COMPLETION OF THE EVALUATION FOR EARLY INTERVENTION SERVICES?

The law requires that the complete multi-disciplinary evaluation of the child and family as well as the conduct of a meeting to determine the child’s eligibility for early intervention be completed no less than 45 days after receiving the referral. (See 34 C.F.R. Section 303.321 (e)) As with all rules, there are exceptions as in the case when a child may be too ill to be tested and in such case the timeline may be extended.

WHO PERFORMS THE EVALUATION FOR ELIGIBILITY FOR EARLY INTERVENTION SERVICES?

The evaluation must be multidisciplinary in nature. In the case of a lead poisoned child, an assessment by a neuro-psychologist, social worker, speech therapist, and/or an occupational therapist may be required. They must evaluate five developmental domains: physical health; cognitive status; social skills/emotional health; speech and language; as well as adaptive behavior such as how they deal with daily living routines and demands of life compared to other children of similar age.

WHAT HAPPENS IF YOU DO NOT AGREE WITH THE FINAL RECOMMENDATION OF THE EVALUATION FOR EARLY INTERVENTION SERVICES?

Parents may file a challenge to the report and request that the matter be mediated. If that fails, you may file for an impartial hearing. A complaint may be filed if you believe that any provider is not doing their job properly.

New York City has previously published a very helpful policy and procedure manual which may be found online at https://www1.nyc.gov/assets/doh/downloads/pdf/earlyint/earlyint-policy-manual.pdf

A shorter list of rights and procedures may be accessed at https://www1.nyc.gov/assets/doh/downloads/pdf/earlyint/ei-family-rights.pdf

WHAT SHOULD I DO IF I HAVE A PROBLEM WITH OBTAINING A REFERRAL FOR EARLY INTERVENTION IN NEW YORK CITY?

If the referral is coming from the parent of a lead poisoned child and you encounter resistance from 311 and/or the Department of Health in setting up a referral for the evaluation of a lead poisoned child –you may have an attorney intervene. You have legal rights in this domain. Act to enforce them. Time may be of the essence in obtaining help for your young child. 

CAN I HAVE AN ATTORNEY ASSIST IN THE PROCESS OF OBTAINING EARLY INTERVENTION SERVICES FOR MY LEAD POISONED CHILD IF HE OR SHE IS DENIED SERVICES?

In the event that you have a child who has been lead poisoned and feel that you wish to have an attorney assist you in the process of obtaining a fair hearing due to a denial of services you may retain an attorney for such purpose.

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