EXPAND EARLY INTERVENTION SERVICES, the official text

Enrolled SB 178 
 Relating to early intervention services for certain children; relating to optional services under 
 the medical assistance program; and providing for an effective date. 
 _______________ 
 * Section 1. AS 47.07.030(b) is amended to read: 
 (b) In addition to the mandatory services specified in (a) of this section and the 
 services provided under (d) of this section, the department may offer only the 
 following optional services: case management services for traumatic or acquired brain 
 injury; case management and nutrition services for pregnant women; personal care 
 services in a recipient's home; emergency hospital services; long-term care 
 noninstitutional services; medical supplies and equipment; advanced practice 
 registered nurse services; clinic services; rehabilitative services for children eligible 
 for services under AS 47.07.063, substance abusers, and emotionally disturbed or 
 chronically mentally ill adults; targeted case management services; inpatient 
 psychiatric facility services for individuals 65 years of age or older and individuals

under 21 years of age; psychologists' services; clinical social workers' services; marital 
 and family therapy services; professional counseling services; midwife services; 
 prescribed drugs; physical therapy; occupational therapy; chiropractic services; low- 
 dose mammography screening, as defined in AS 21.42.375(e); hospice care; treatment 
 of speech, hearing, and language disorders; adult dental and dental hygiene services; 
 prosthetic devices and eyeglasses; optometrists' services; intermediate care facility 
 services, including intermediate care facility services for persons with intellectual and 
 developmental disabilities; skilled nursing facility services for individuals under 21 
 years of age; early intervention services for children eligible under AS 47.20.080; 
 and reasonable transportation to and from the point of medical care. 
 * Sec. 2. AS 47.20.060 is amended to read: 
 Sec. 47.20.060. Purpose. It is the purpose of AS 47.20.060 - 47.20.290 to 
 (1) subject to the availability of funding, provide quality learning and 
 related early intervention family support services to eligible children under the age of 
 three who have developmental delays or disabilities [AND, ON A DISCRETIONARY 
 BASIS, TO THOSE CHILDREN UNDER THE AGE OF THREE WHO ARE AT 
 RISK OF DEVELOPMENTAL DELAYS OR DISABILITIES]; 
 (2) bring together and make optimal use of all available federal, state, 
 local, and private resources for the benefit of children under the age of three with 
 developmental delays or disabilities and their families; 
 (3) expand and improve existing learning and early intervention 
 services and to provide and arrange for comprehensive services through local agencies 
 and statewide support programs. 
 * Sec. 3. AS 47.20.070(c) is amended to read: 
 (c) In connection with the system established under (a) of this section, the 
 department shall 
 (1) develop a state plan that identifies the best methods of providing 
 services to children under the age of three with developmental delays or disabilities 
 and their families and report to the governor on the extent to which that plan is being 
 implemented in the state; 
 (2) develop and implement an educational program concerning the

nature and effects of developmental delays and disabilities; 
 (3) serve as a clearinghouse for educational materials and information 
 about developmental delays and disabilities; 
 (4) organize and encourage training programs for persons who provide 
 services to children under the age of three with developmental delays and disabilities 
 and their families; 
 (5) [ESTABLISH A TRAINING PROGRAM FOR 
 PARAPROFESSIONALS WHO PROVIDE SERVICES TO CHILDREN UNDER 
 THE AGE OF THREE WITH DEVELOPMENTAL DELAYS AND DISABILITIES 
 AND THEIR FAMILIES; 
 (6)] cooperate with other public and private agencies and individuals to 
 facilitate the transition of children served in the early intervention system to the formal 
 education system; 
 (6) [(7)] identify and use all public and private resources available to 
 the state; 
 (7) [AND (8)] monitor and evaluate the services provided to ensure the 
 demonstrable effectiveness of the services and compliance with state and federal law 
 and department policy regarding the provision of early intervention services; and 
 (8) at least every five years, in consultation with medical 
 professionals and the state entity that satisfies the requirement for a state 
 interagency coordinating council as provided under 20 U.S.C. 1441, review the 
 conditions that qualify as a disability under AS 47.20.060 - 47.20.290 and, as 
 appropriate, make recommendations to the legislature on updating those 
 conditions. 
 * Sec. 4. AS 47.20.080(a) is amended to read: 
 (a) A child and the child's family are eligible for [CORE] early intervention 
 services [AND ADDITIONAL EARLY INTERVENTION SERVICES] under 
 AS 47.20.060 - 47.20.290 if the child is under the age of three and 
 [(1)] experiencing developmental delay or disability [; OR 
 (2) AT RISK OF EXPERIENCING DEVELOPMENTAL DELAY 
 OR DISABILITY IF EARLY INTERVENTION SERVICES ARE NOT

PROVIDED]. 
 * Sec. 5. AS 47.20.100 is amended to read: 
 Sec. 47.20.100. Individualized family service plan. The individualized 
 family service plan developed under AS 47.20.090(b)(2) shall be based on the 
 evaluation conducted under AS 47.20.090(b)(1) and must include [, SUBJECT TO 
 AS 47.20.080(b),] 
 (1) provisions for case management services to implement the plan, 
 including the name of the case manager from the profession most immediately 
 relevant to the child's or family's needs who will be responsible for the implementation 
 of the plan and coordination with other agencies and persons; 
 (2) a statement of the child's present levels of physical development, 
 cognitive development, language and speech development, psychosocial development, 
 and self-help skills, based on appropriate objective criteria; 
 (3) a description of the family's concerns, priorities, and resources as 
 they relate to the future enhancement of the child's development; 
 (4) a description of the specific early intervention services that will 
 help meet the unique needs of the child and the family, including the frequency, 
 intensity, and method with which the services should be delivered; 
 (5) the projected dates for initiation of services and the anticipated 
 duration of the services; 
 (6) an outline of the major outcomes expected to be achieved for the 
 child and the family along with the criteria, procedures, and timelines that will be used 
 to determine the degree to which progress toward achieving the outcomes are being 
 made and whether modifications or revisions of the outcomes or services are 
 necessary; and 
 (7) a statement of the steps that will be taken to support the transition 
 of the child and the family to the use of services available under other appropriate 
 programs, including programs for children who are three years of age or older. 
 * Sec. 6. AS 47.20.290(4) is amended to read: 
 (4) "developmentally delayed" means 
 (A) for services not provided under 20 U.S.C. 1431 - 1445

(Individuals with Disabilities Education Act), as amended, functioning at 
 least 15 percent below a chronological or corrected age or the equivalent [1.5] 
 standard deviation [DEVIATIONS] below age appropriate norms in one or 
 more of the following areas: cognitive development, gross motor development, 
 sensory development, speech or language development, or psychosocial 
 development, including self-help skills and behavior, as measured and verified 
 by appropriate diagnostic instruments and procedures or through systematic 
 observation of functional abilities in a daily routine by two professionals and a 
 parent, developmental history, and appropriate assessment procedures; or 
 (B) for services provided under 20 U.S.C. 1431 - 1445 
 (Individuals with Disabilities Education Act), as amended, functioning at 
 least 25 percent below a chronological or corrected age or the equivalent 
 standard deviation below age appropriate norms in one of the areas listed 
 in (A) of this paragraph or at least 20 percent below a chronological or 
 corrected age or the equivalent standard deviation below age appropriate 
 norms in two or more of the areas listed in (A) of this paragraph; 
 * Sec. 7. AS 47.20.290(6) is repealed and reenacted to read: 
 (6) "early intervention services" means the following services designed 
 to help meet the developmental needs of a child under the age of three who is 
 developmentally delayed or disabled: 
 (A) assistive technology devices and services; 
 (B) early identification, screening, and assessment; 
 (C) family training, counseling, and home visits; 
 (D) health services for the child that are necessary to enable the 
 child to benefit from the other services described in this paragraph; 
 (E) medical services only for diagnostic or evaluation purposes; 
 (F) occupational therapy; 
 (G) physical therapy; 
 (H) psychological services; 
 (I) service coordination services; 
 (J) sign language and cued language services;

(K) special instruction (developmental therapy); 
 (L) speech-language pathology and audiology services; 
 (M) social work services; 
 (N) transportation and related costs that are necessary to enable 
 the child and the child's family to receive a service described in this paragraph; 
 (O) vision services; and 
 (P) other services identified by the department in regulation. 
 * Sec. 8. AS 47.20.080(b), 47.20.290(1), and 47.20.290(2) are repealed. 
 * Sec. 9. The uncodified law of the State of Alaska is amended by adding a new section to 
 read: 
 REPORT TO THE LEGISLATURE. By July 1, 2029, the Department of Health shall 
 submit a report to the senate secretary and chief clerk of the house of representatives and 
 notify the legislature that the report is available. The report must include the number of 
 children in the state who need early intervention services, the number of children in the state 
 being provided early intervention services, the types of early intervention services provided in 
 the state, the cost of early intervention services provided in the state, the amount of federal 
 funding received by the state for early intervention services, and recommendations for any 
 additional statutory changes that may be needed to improve and expand early intervention 
 services for eligible children under the age of three who have developmental delays or 
 disabilities. 
 * Sec. 10. The uncodified law of the State of Alaska is amended by adding a new section to 
 read: 
 MEDICAID STATE PLAN FEDERAL APPROVAL. To the extent necessary to 
 implement this Act, the Department of Health shall amend and submit for federal approval the 
 state plan for medical assistance coverage consistent with AS 47.07.030(b), as amended by 
 sec. 1 of this Act. 
 * Sec. 11. The uncodified law of the State of Alaska is amended by adding a new section to 
 read: 
 CONDITIONAL EFFECT. (a) Section 1 of this Act takes effect only if, on or before 
 July 1, 2028, the United States Department of Health and Human Services 
 (1) approves the amendments to the state plan for medical assistance coverage

under AS 47.07.030; or 
 (2) determines that approval of the amendments to the state plan for medical 
 assistance coverage under AS 47.07.030 is not necessary. 
 (b) The commissioner of health shall notify the revisor of statutes in writing within 30 
 days after the United States Department of Health and Human Services approves the 
 amendments to the state plan or determines that approval is not necessary under this section. 
 * Sec. 12. If sec. 1 of this Act takes effect, it takes effect on the day after the United States 
 Department of Health and Human Services approves the amendments to the state plan for 
 medical assistance coverage submitted under sec. 10 of this Act or determines that approval of 
 the amendments is not necessary. 
 * Sec. 13. Except as provided in sec. 12 of this Act, this Act takes effect July 1, 2026.