Local MTP-Education Partner IA FAQs
Frequently asked questions (FAQs) and guidance regarding the Local Medical Therapy Program (MTP)-Education Partner Interagency Agreement (IA).-
Do we have to use this template as is or can we modify prior to signing?
While using the original template version is strongly encouraged, you may make minor edits to this template in order to meet the individual needs of your county program and local education partners. All currently drafted sections of the template should be included in the final version. (Should you wish for further state level review prior to signing you may contact the Integrated Systems of Care Division (ISCD) at MTPCentral@dhcs.ca.gov and/or the California Department of Education (CDE) at SEDINFO@cde.ca.gov.)
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How often should this agreement be reviewed and/or renewed?
This agreement is required to be reviewed at least annually for clarification and to set forth clear expectations.
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Can the local Interagency Agreement (IA) be deemed ongoing with the agreement to review annually?
Yes, as long as this is outlined in your agreement; however, re-signature is recommended at defined intervals for clarification and adherence with appropriate representatives.
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What does the amendment process to the IA entail? Are new signatures required upon amendment?
The Interagency Agreement can only be amended by mutual consent. Either party may request an amendment of the Agreement by written request. New signatures would be required for any amendments made to the Agreement.
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We have several special education local plan areas (SELPAs)/local educational agencies (LEAs)/School Districts in our county. Do we need to sign separate local agreements with each of them or can some/all of them sign one agreement?
When possible, one agreement per county public health program is ideal; however, we understand the differences in educational administration in each area and offer that multiple agreements can be signed if needed in order to offer the desired edits.
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How do we schedule a meeting to create/discuss/update the local IA? Is it the responsibility of the Medical Therapy Program (MTP) or SELPA/LEA/School District? How will we know who to communicate with?
It is the responsibility of both the county public health department/California Children's Services (CCS)/MTP as well as local SELPA/LEA/School District to actively collaborate on this local agreement. Best practices would include identifying appropriate point of contact. Ideally, all local IAs will be signed within 6 months of release from the state level departments involved.
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Does the IA require review/approval from County Administration, e.g., the Director of Public Health, the Board of Supervisors, or County Counsel? Do we need our County Office of Education (COE) to review and/or LEA/SELPA/School District Counsel approval?
This will vary county to county, and we encourage each county California Children's Services (CCS) program to have discussions with their public health department leadership to determine who shall meet, review, edit, and sign these documents. Additionally, we encourage SELPAs, LEAs and COEs to collaborate to determine who shall meet, review, edit, and sign these agreements on their behalf as well.
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In the event of disagreements or challenges while creating the IA, who can we use as a resource for mediation and conflict resolution? What is the conflict resolution process when developing the local IA? And when disagreements that cannot be resolved locally crop up during the tenure of the IA?
In the event of disagreements or challenges, it is recommended that both parties utilize their legal counsel for resolutions.
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Who do we contact for interpretation of the State level IA when editing the local IA?
The State level IA is under review currently while the currently posted version remains in effect. Questions may be directed to MTPCentral@dhcs.ca.gov and/or SEDINFO@cde.ca.gov.
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What happens if the Medical Therapy Program (MTP) no longer has staffing or a local paneled vendor to provide Occupational Therapy (OT) services, but the goals are included in the Individualized Education Program (IEP), and the LEA is asked to use their OTs to cover? Can this be billed back to California Children's Services (CCS) for reimbursement?
In such cases, if MTP is unable to provide the medically necessary OT services, and the LEA is using its own OTs to cover the goals included in the IEP, reimbursement can be sought from CCS. The LEA should follow the agreed-upon procedures outlined in the Local Interagency Agreement, including notifying the CCS county MTP liaison in writing of the intent to request reimbursement, providing relevant documentation, and following the dispute resolution process if needed.
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What happens if a goal/client is determined to be no longer medically necessary by CCS, and the IEP team needs to determine the educational need/frequency to meet this need within education?
If CCS determines that a goal/client is no longer medically necessary, the IEP team is responsible for determining the educational need and frequency within the context of the student's education program. The local Interagency Agreement specifies procedures for communication and collaboration between CCS and the LEA in such situations. The IEP team should convene to review assessments, discuss changes in services, and address the educational needs of the student.
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What if there is a frequency dispute or disagreement between CCS and the LEA?
If there is a frequency dispute or disagreement regarding frequency of therapy services, the county CCS will provide what is deemed medically necessary using MTP services. Any decrease in MTP services may result in LEA responsibility to make up if the IEP team determines that the service is educationally necessary for the student to receive a free appropriate public education (FAPE). The agreement provides a framework for resolution through informal discussions and, if necessary, the mediation and complaint process of the Office of Administrative Hearings.
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How does the local Interagency Agreement handle one-way requests for services - medically necessary services by MTP or LEA and educationally necessary services by LEA only?
The agreement recognizes the distinction between medically necessary and educationally necessary therapy services. If there is a one-way request where MTP or LEA is requested to provide either medically necessary or educationally necessary services, the IEP falls under the direct responsibility of the LEA and the Medical Therapy Plan falls under the direct responsibility of the county MTP. The agreement establishes the procedures for communication, coordination, and collaboration between the parties to ensure that the needs of the student are met appropriately and in compliance with legal requirements.
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What if a parent does not consent to the Release of Information (ROI) or Application?
Parental or legal guardian consent is required for the CCS program. A Therapy Assessment by CCS and related services should not be provided without signed consent.
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Are there state CCS applications and ROI forms or are these locally created?
The CCS program application is a state level standard form (How To Apply
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What if timelines don’t align between the CCS and LEA assessment parental consents?
The LEA would need to meet the requirements for both an LEA assessment and CCS Assessment. If timelines are not able to be completed/met during the same meeting, the LEA would need to hold an IEP meeting and then meet for an addendum within the time limit of the additional assessment.
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Is an excused form needed if the MTP therapist is only attending a portion of the IEP meeting? What if the parent doesn’t consent to excusal?
An excusal is needed for all members of the IEP team. However, the MTP therapist should not be considered an IEP Team Member in most cases and is considered to be a meeting participant. This means the MTP therapist/s may attend part or all of the IEP meeting, as relevant to their contributions to the IEP Team. In the cases where the CCS MTP therapist is considered a part of the IEP Team (i.e., MTP goals are written into IEP), they must follow IEP Team guidelines. In this case, if a parent does not consent to their excusal, the meeting would need to be reconvened when all members were present.
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What is meant by efficient and effective manner for providing necessary space and equipment?
Efficient and effective Medical Therapy Unit (MTU) space is more clearly defined through the review of the following:
- Chapter 4, which offers specifics on square footage for specific MTU areas per therapist Full-Time Equivalent (FTE).
- 2 California Code of Regulations (CCR) Section 60310(d), which describes what needs to be included in a local IA regarding MTU space, maintenance and operation of facilities.
- 2 CCR Section 60330(b), which states that the space and equipment is for the exclusive use of the CCS staff when they are on site.
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Are the requirements in the current state level agreement still in effect?
Yes, the state level IA is still in effect. The current version continues to be active and valid, while the Integrated Systems of Care Division (ISCD) and the California Department of Education (CDE) work to update this document.
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Is the LEA responsible for replacement of any broken and consumed items or specific items?
The LEA remains responsible for necessary facility and therapeutic treatment items, including those which may have broken or been consumed. Provision of therapy equipment is the responsibility of the LEA per Government Code Section 7575(d), 2 California Code of Regulations (CCR) Section 60310(d)(2), and the State IA. The State IA does, in Attachment 1: Equipment and Supply List (page 32-36), provide for some equipment and supplies to be provided by CCS. These equipment and supplies are administrative in nature or used by MTU physician and Medical Therapy Conference in the MTU. The LEA is responsible for the large majority of equipment and supplies used for the provision of therapy services to all CCS clients. Additionally, maintenance of the MTU facility is the responsibility of the LEA as per 2 CCR Section 60310(d), and the State IA.