Family Voices urges families to share their thoughts and concerns on this issue:
TO: First Steps’ Families, Providers, and Stakeholders
FROM: Lora Miller, Bureau of Child Development Services Director
RE: First Steps’ Proposed Policy for Past Due Family Co‐Payments
DATE: December 3, 2009
The Bureau of Child Development Services (BCDS) First Steps Program is committed to
providing the widest possible array of early intervention services to Indiana children with
developmental delays and disabilities, and to their families. To accomplish this mission during
these tough economic times, we must maximize existing resources and maintain fiscal
responsibility. Our program partners, and the families we all serve, must do the same.
Because of the large number of families not honoring the co‐pay obligation to which they
agreed when they enrolled in the program, BCDS proposes the following change to First Steps’
family cost participation policy:
Similar to other Indiana Family and Social Services Administration programs,
BCDS will seek permission from the Office of Special Education Programs, U.S.
Department of Education, to suspend co‐pay eligible services to participants
whose accounts are 60 days or more past due, until payment in full is received.
Please note that this change will not affect access to those services for which a co‐pay
cannot be charged (service coordination, and evaluation and assessment).
Under current Indiana law, and First Steps policy and procedure, families are responsible for
doing the following in a timely manner:
1) Paying their co‐pays
2) Informing their service coordinator of changes in income, or of other medical
expenses that may reduce or change the level of income the family has available
to pay co‐pays
3) Requesting a waiver of insurance billing if able to demonstrate financial or
personal hardship would result
Our system allows for timely and reasonable co‐pay adjustments for those families whose
financial status has changed for the worse. Individuals who simply fail to pay put the ongoing
and future stability of the First Steps program at risk.
Families are responsible for their co‐payments when services are rendered. To date, First Steps
has not suspended services to families who fall behind on their payments for any reason.
Considering the state’s current financial limitations, this policy can no longer be supported.
Further details including announcement of the beginning of the mandatory public comment
period, the time and location of the mandatory public hearing, and a draft of the revised state
plan language will be posted soon under the “What’s New” link at www.firststeps.in.gov.
Questions or comments about the proposed policy should be directed to
Our hope is that the proposed changes will help to ensure that First Steps is able to continue to
provide the highest quality early intervention services, now, and in the years to come.