Local MTP-Education Partner IA FAQs

Yes. As stated in the Local Medical Therapy Program-Education Partner Interagency Agreement released on August 1, 2024, all California Children's Services (CCS) County offices and their collaborating education entities shall send a copy of the most current agreements to both MTPCentral@dhcs.ca.gov and SEDINFO@cde.ca.gov. This agreement may be one of the following:

1. A signed copy of newly released Medical Therapy Program-Education Partner Interagency Agreement template; or
2. An established MTP agreement document that has been reviewed by all parties annually, includes all elements from the Medical Therapy Program-Education Partner Interagency Agreement template, and has defined intervals for re-signature.

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.)

This agreement is required to be reviewed at least annually for clarification and to set forth clear expectations.

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.

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.

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.

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.

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.

In the event of disagreements or challenges, it is recommended that both parties utilize their legal counsel for resolutions.

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.

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.

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.

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.

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.

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.

The CCS program application is a state level standard form (How To Apply ). The ROI is a locally created form, as this will need to be edited to meet the specific programmatic and educational structure needs for each county/region.

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.

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.

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.

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.

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.