HomeMy WebLinkAboutEI-101 Procedural SafeguardsFRANKLIN/FULTON COUNTY
MENTAL HEALTH/INTELLECTUAL & DEVELOPMENTAL
DISABILITIES/EARLY INTERVENTION
425 Franklin Farm Lane
Chambersburg, PA 17202
(717) 264-5387
MH/IDD/EI PROCEDURE STATEMENT
PROCEDURE SUBJECT: EI-101 Procedural Safeguards
PROCEDURE TOPICS: Confidentiality/ FERPA
Parental Consent/Access Rights
Surrogate Parents
Conflict Resolution
PROCEDURE NUMBER: EI-101
Effective Date: July 1, 2015
Date Revised: December 5, 2025
References:
34 CFR §300.610 – 300.627, 34 CFR §303.400, 34 CFR Part 99
Announcement: EI-25 #02 Early Intervention Complaint Procedures
Announcement: EI-12 #03 Confidentiality, Parent Consent and Surrogate Parents
Announcement: EI-10 #02 Release of Information
Announcement: EI-25 #03 Mediation, Due Process, and Individualized Family Service
Plan/Individualized Education Program (IFSP/IEP) Facilitation Procedures for Infant
Toddler and Preschool Early Intervention
POLICY:
Confidentiality, including access rights:
The Franklin/Fulton Early Intervention (EI) Program has designated the Early Intervention
Program Specialist for the County and the Early Intervention Service Coordination Supervisor
with Service Access and Management, Inc. (SAM), to manage the confidentiality of personally
identifiable information. Administrative oversight is available when concerns or support may be
required.
The following is a list of the positions within the program that may have access to personally
identifiable information:
1. The MH/IDD/EI Administrator and Deputy Administrator
2. The Early Intervention Program Specialist
3. The Service Coordinator Supervisor
4. The MH/IDD/EI Administrative Assistant and other support staff
5. The Early Intervention Service Coordinators (SC)
6. Fiscal Staff
7. Auditors
All Early Intervention records are in electronic form, including records related to evaluations and
assessments, screening, eligibility determinations, development and implementation of IFSPs,
provision of EI services, individual complaints involving the child, or any part of the child’s EI
record. The confidentiality of these records are assured at the collection, maintenance, storage,
disclosure, and destruction stages of a child’s EI record and applies from the point in time when
the child is referred to the EI program.
A record review form is completed for each child’s file that includes the name of the person
reviewing the file and their position, a date the record was reviewed and the purpose of the
review. The record of access is then electronically scanned and added to the chart every time
someone reviews the record.
A copy of Understanding Early Intervention Data Systems (Attachment- A) is provided and
discussed at the initial meeting with the parents in their home and the Service Coordinator
documents this in the service notes.
The Franklin/Fulton Infant/Toddler EI Programs shall afford the parents of infants or toddlers
who are referred to, or receive EI services, the opportunity to inspect and review all EI records
about the child and the child's family that are collected, maintained, or used both in electronic or
paper form, including records related to evaluations and assessments, screening, eligibility
determinations, development and implementation of IFSPs, provision of EI services, individual
complaints involving the child, or any part of the child’s EI record. The EI Programs shall
comply with a parent’s request to inspect and review records without unnecessary delay and
before any meeting regarding an Individual Family Support Plan (IFSP), or any due process
hearing procedures and in no case more than 10 days after the request has been made. This
includes:
▪ a response from the EI Program to reasonable requests for explanations and
interpretations of the EI records;
▪ a request that the EI Program provide copies of the EI records containing the information
if failure to provide those copies would effectively prevent the parent from exercising the
right to inspect and review the records; and
▪ having a representative of the parent inspect and review the EI records.
If a parent/guardian designates a representative to inspect/review records, they must document in
writing the name of the representative they choose and complete a Release of Information. The
Release of Information will provide confirmation that the parent/guardian allows the agency to
provide the representative with access to personally identifiable information regarding their
child.
Parents will be given any assistance necessary to complete a letter requesting to inspect or
review the records. Parents also need to be informed that if any EI record includes information
on more than one child, the parents of those children have the right to inspect and review only
the information relating to their child.
When a parent requests an amendment to their child’s EI record because they are concerned that
the information is inaccurate, misleading, or violates the privacy or other rights of the child, the
EI Program shall decide within a reasonable period of time of receipt of the request whether to
amend the information. If the EI Program refuses to amend the information, the parent shall be
notified of the refusal and be informed of their right to a due process hearing or a review by the
Bureau of Early Intervention Services and Family Supports (BEISFS) regarding the request for
amending the information in their child’s EI records. If the BEISFS decides that the information
is inaccurate, misleading or in violation of the privacy or other rights of the child or parent,
BEISFS will inform the parent in writing and the local Infant/Toddler EI Program shall amend
the information. The Infant/Toddler EI Program shall inform the parent in writing when the
information is amended.
Parents/caregivers of children receiving Infant /Toddler EI services will not be charged a fee for
the search or retrieval of information from a child’s EI record, a copy of each evaluation,
assessment of the child, family assessment, as soon as possible after each IFSP or after an initial
request for a copy of the child’s entire EI record.
Records will be maintained for four (4) years or until any audit or litigation is resolved.
Parent Notice and Consent
Parental consent must be obtained before personally identifiable information is disclosed to
anyone other than authorized representatives, officials, or employees of the Franklin/Fulton
Early Intervention Program when used for any purpose other than meeting a requirement of
federal and state requirements with the exception of those conditions in FERPA 34 CFR
§99.31and §303.401(d). In addition, the Franklin/Fulton Early Intervention Program must
comply with the requirements of FERPA 34 CFR §99.32, 99.33, 99.34, 99.35, 99.36, 99.38, and
99.39 and also obtain parental consent before administering screening procedures, conducting
evaluations and assessments, the provision of EI services, accessing public benefits or insurance
or private insurance and the disclosure of personally identifiable information.
Prior Written Notice must be written in language understandable to the general public and
provided in the native language of the parent or other mode of communication used by the
parent, unless it is clearly not feasible to do so.
Consent includes;
a) The parent being fully informed of all information relevant to the activity for which
consent is sought, in the parent’s native language, as defined in §303.25;
b) The parent understands and agrees in writing to the carrying out of the activity for which
the parent’s consent is sought, and the consent form describes that activity and lists the
Early Intervention records (if any) that will be released and to whom they will be
released; and
c) The parent understands that the granting of consent is voluntary on the part of the parent
and may be revoked at any time
The parents of an infant or toddler with a disability can determine whether they, their infant or
toddler with a disability, or other family members will accept or decline any EI service at any
time, and may decline a service after first accepting it, without jeopardizing other EI services. In
addition to the language established in Chapter 4226.92, the Infant/Toddler EI Program may not
use due process hearing procedures to challenge a parent’s refusal to provide any consent and
shall ensure that if a parent revokes consent, that revocation is not retroactive (i.e., it does not
apply to an action that occurred before the consent was revoked).
Parents are informed of their rights and procedural safeguards at their initial visit and throughout
the entire time their child receives Early Intervention services. Service Coordinators also obtain
parental consent before administering screening procedures, conducting evaluations and
assessments, for initial provision of EI services or any change in services, accessing public
benefits or insurance or private insurance and the disclosure of personally identifiable
information. If a parent does not give consent for any of the above listed activities, reasonable
efforts are made to ensure that the parent is fully aware of the nature of the activities where
parental consent is sought; and understands that the child may not be able to receive the service
unless consent is provided.
The Service Coordinator is the single point of contact for a family and is responsible for
providing the parent with a copy of their procedural safeguards notice or Parents Rights
Agreement (PRA-Attachment 2). The procedural safeguards are reviewed with families during
the intake and evaluation process, during any IFSP review meetings, or any meeting with the
family at which services could be adjusted, added, or ended. The Service Coordinator provides
the PRA to the parent after reviewing the applicable information with the parent, checking the
appropriate actions to document the outcome of the meeting, and obtaining parent/guardian
signature.
Surrogate Parents
Appointment of a surrogate parent for a child occurs whenever reasonable efforts have been
made to locate the biological parent and in instances when a child is a ward of the state.
A. The Franklin/Fulton Early Intervention Program will adhere to the following when the
child needs a surrogate parent based on the below criteria:
1. A parent cannot be identified.
2. The whereabouts of an identified parent, after reasonable efforts, cannot be
discovered.
a. The Service Coordinator will work with the designated Children and
Youth Program to locate a parent.
b. The Service Coordinator will work with the family’s relatives and friends,
as allowed by confidentiality, to locate the child’s parent.
c. Documentation will be completed in case notes describing the attempts to
locate the parent.
3. The birth parents are deceased and the child has no other parent.
4. The parental rights of the birth parents have been terminated and the child has no
other parent.
Based on criteria 1-4, the EI Supervisor and EI Service Coordinator will determine the need for a
surrogate parent.
Consults will occur as needed with Franklin County Children and Youth or Fulton County
Services for Children concerning the approval of a Surrogate parent for children who are wards
of the state or are in foster care.
The following criteria are used for the selection of a surrogate parent. A surrogate parent as per
Chapter 4226, Early Intervention Services, and Section 4226.96, Surrogate Parents states that:
1. The surrogate has no interests that conflict with the interests of the child.
2. The surrogate has the knowledge and skills that ensure adequate representation of the
child.
3. The surrogate is willing to assume the responsibilities of being a surrogate parent.
4. The surrogate is not an employee of an agency or persons providing Early Intervention
services and other services to the child or to any family members of the child.
5. The surrogate is not an employee of any state agency (because the surrogate is paid by a
public agency to serve as a surrogate).
6. A foster parent of a child in substitute care, who meets the criteria in 1-4, may serve as
surrogate parent for the child, with approval of the County Children and Youth agency
that has legal custody of the child.
Reasonable efforts must be made to ensure the assignment of a surrogate parent not more than
thirty (30) days after the program has determined that the child needs a surrogate parent.
Franklin/Fulton Early Intervention service in collaboration with the Franklin County Children
and Youth Services and the Fulton County Services for Children collaborate so that the delivery
of services is not delayed due to the appointment of a surrogate.
Conflict Resolution
Parents with children receiving EI services must be informed of their procedural safeguards
throughout the entire time they receive EI services. As part of the conflict resolution process,
OCDEL has developed a fact sheet entitled Problem Solving in Early Intervention which
provides information on conflict resolution at the local level. This includes information on
IFSP/IEP facilitation, the EI Complaint Resolution Process (form attached) mediation and due
process. An Early Intervention Complaint Resolution Process (EICRP) has been developed and
is available to assist parents in resolving concerns at the local level before the concern elevates to
the written complaint level. (Attachment- 3) If an Early Intervention Complaint Resolution
Process form has been received by the local EI Program a meeting shall be scheduled within
seven days of receipt of the request.
When contacted, the Program Specialist will provide a family with information about how to
contact the Bureau of Early Intervention Services and Family Supports (BEISFS) for assistance
with a dispute or provide the parent with information about how to file a formal complaint with
BEISFS. The Program Specialist will assist the family with access to, completion of, and proper
submission of any required forms to the appropriate agencies (BEISFS, OCDEL, and ODR)
related to conflict resolution and the complaint process. At any time upon request if families
disagree with or have concerns about any aspect of the services they are receiving through the EI
program, they have the right to problem-solving and conflict resolution activities, including
Individualized Family Service Plan (IFSP) Facilitation, Mediation, Due Process, and filing a
complaint.
Families are informed of their rights to contact the Office for Dispute Resolution for IFSP/IEP
Facilitation, Evaluative Conciliation Conference, Mediation, and Due Process Hearings,
including resolution meetings, if applicable, as part of the procedural safeguards reviewed at the
initial meeting with the family and at any time the Parents Rights Agreement is signed.
The Franklin/Fulton Early Intervention Program will provide and review the fact sheet developed
by the Office of Child Development and Early Learning (OCDEL) entitled, “Problem Solving in
Early Intervention,” during the initial meeting with the family.
When a family requests help with locating the correct forms as well as the contact information
for submittal to BEISFS or ODR, the Program Specialist will make time to assist them as quickly
as possible and also help with filling out and assisting in mailing the forms to the correct
locations.
When a family requests any one method of conflict resolution, it needs to be explained clearly
that a parents/caregiver has the right to file any of the options discussed regarding conflict
resolution and they will be informed of the timelines related to the resolution method they may
choose. They will also be informed that they do not have to pursue conflict resolution in any
particular order or method and can pursue more than one method simultaneously at any time.
Staff new to the Franklin /Fulton Early Intervention Program will receive training regarding the
Procedural Safeguards Checklist (including confidentiality/FERPA, Parental Consent, Access
Rights, Surrogate Parents and Conflict Resolution). All persons collecting or using personally
identifiable information receive training on the requirements in this announcement, 34
CFR§303.401 through 303.417 and 34 CFR part 99 screening procedures. All policy and
procedure statements will be reviewed annually or sooner when changes or updates are released.
Trainings will occur for all staff including administrative, service coordination and fiscal staff as
needed. Any change or update to any policy or procedure statement will be sent upon receipt to
the provider agencies and all changes are reviewed at the next scheduled EI provider meetings
for further review and discussion.
ATTACHMENTS:
Attachment 1: Understanding Early Intervention Data Systems
Attachment 2: Parent Rights Agreement
Attachment 3: Early Intervention Complaint Resolution Process
Attachment 1
Understanding Early Intervention Data Systems
The Office of Child Development and Early Learning (OCDEL), through the Bureau of Early
Intervention Services, serves approximately 79,000 infants, toddlers and preschool children with
developmental delays and/or disabilities from birth until they reach school age. Electronic
information management systems are used to maintain individual child records in the Early
Intervention (EI) program.
What is Early Intervention's Data System?
PELICAN (Pennsylvania’s Enterprise to Link Information for Children Across Networks) is the
name of OCDEL’s information management system. It is used to manage all the records of
children receiving EI services across the Commonwealth. The information that is entered into
PELICAN is based on the information families provide to service coordinators or Early
Intervention service providers about their child through conversation, correspondence and
meetings. The PELICAN system contains:
• Demographic information about children i.e. name, address, contact information, date of
birth etc.
• Evaluation information
• Information about family routines and activities so that OCDEL can match the services to
the child’s natural settings
• Individualized Family Service Plans (IFSP) and Individualized Education Programs (IEP)
• Transition plans
To make sure there is only one identifying number assigned to each child, the EI program will
ask families to provide the child's Social Security Number (SSN). The child's SSN ensures the
proper identification of a child's information, especially if it already exists in other statewide data
systems. This prevents families from providing the same information repeatedly. However,
providing the child's SSN is not required to receive EI services.
Why is information collected in a data system?
Child information is collected to allow for effective program management and accountability
including:
• Assessing the effectiveness of EI programs and services in supporting children and
families both at the state and local level
• Identifying best practices and areas for improvement at the state level
• Completing mandatory state and federal reports
• Making provider payments.
What are the benefits of an electronic data system to families?
Families will not have to give the same information repeatedly as they move through the EI
program. Each child record in the information management system will be assigned one
identifying number. This means that each child receiving services will have only one record in
the statewide data system, regardless of how they entered the system or what services they
receive.
Maintaining child records through an information management system allows the record to be
accessible to his/her IFSP/IEP team. It also allows for a smooth exchange of information when a
child transitions from one program to another, as the child’s record may be shared quickly with a
new program (with parental consent).
Data systems promote and assure:
• Quality services for children
• Program accountability to ensure all resources are used wisely and effectively
• Anticipation of changing needs
• Continuity of data across programs.
Who has access to a child’s information?
Child information contained in the information management system is kept confidential and only
authorized persons will have access to the records, per federal and state confidentiality, privacy,
and security laws. Data in PELICAN is protected by security protocols, which require secure and
encrypted servers, unique user names with strong passwords and user roles that are assigned
specific security roles and access. This means that:
• Only the staff directly involved with a specific child has access to that child’s
information.
• State personnel have limited access to child information for the purposes of monitoring
the delivery of EI services.
• Information about a child will not be shared outside a program, except as permitted by
law and/or with parental consent.
• Families have the right to inspect and review EI records relating to their child and request
an amendment to inaccurate information in a record. A copy of a child’s record is also
available to families upon request and is kept for a period of four years.
• As permitted by law, for transition purposes, a child’s name, date of birth and parent
contact information will be shared with the Preschool Early Intervention Program during
a transition year to assist with planning purposes.
Who should families contact with questions about their child’s record in these data systems?
Families should call their child's Service Coordinator, Teacher/Therapist or Preschool EI
Supervisor should they have any concerns regarding the collection of child information in
PELICAN. If at any time, you feel that confidentiality has been compromised; families may file
a complaint with the OCDEL by call 717-346-9320.
Parent Rights Agreement (PRA)
Prior Written Notice and Written Parental Consent
Name of Child: ______________________________ Date of Birth: ___________________________
Date Sent/Provided to Parent(s): ___________________________
of the Early Intervention activities recommended for a child shall be given to the parent of a child
referred to or eligible for Early Intervention services before an Infant Toddler Early Intervention program proposes, or
declines, to initiate or change any activities.
shall be obtained before conducting any activities such as screening or evaluation. Consent is
voluntary and may be revoked at any time for any reason by verbal or written request.
To be completed by the Infant Toddler Early Intervention program:
The Infant Toddler Early Intervention program is proposing a screening for the child.
To be completed by the parent(s):
I/We am/are providing consent for a screening for my child (if a current screening is not available) to determine
the need and focus of a multidisciplinary evaluation.
I/We decline a screening for my child (if a current screening is not available) to determine the need and focus of
a multidisciplinary evaluation.
Multidisciplinary Evaluation
The Infant Toddler Early Intervention program is proposing a multidisciplinary evaluation of the child.
Initial evaluation
Annual evaluation
To be completed by the parent(s):
I/We am/are providing consent for a multidisciplinary evaluation of my child to determine eligibility for Early
Intervention services.
I/We decline a multidisciplinary evaluation of my child to determine eligibility for Early Intervention services.
Reason the evaluation was declined (optional):_________________________
The child’s eligibility determination based on the evaluation is as follows:
To be completed by the Infant Toddler Early Intervention program:
Your child is not eligible for Early Intervention services, and an Individualized Family Service Plan (IFSP) meeting
will not occur.
Your child is eligible for Early Intervention services and an IFSP meeting will occur.
9/23/2025
Attachment 2
IFSP Meeting and Plan Development
To be completed by the Infant Toddler Early Intervention program:
The Infant Toddler Early Intervention program is proposing to initiate the development or revision of the
Individualized Family Service Plan (IFSP) through an IFSP meeting.
Initial IFSP development
Revisions to the IFSP
To be completed by the parent(s):
I/We am/are providing consent for an IFSP meeting to develop or revise an IFSP.
I/We decline an IFSP meeting for my child who has been determined eligible for Early Intervention services.
Reason the IFSP meeting was declined (optional): ________________________
Initiation of Early Intervention Services
The Infant Toddler Early Intervention program is proposing to initiate Early Intervention services for the child
and family identified on the IFSP.
To be completed by the parent(s):
I/We am/are providing consent for the initiation of Early Intervention services identified on the IFSP
(Select One):
All recommended services identified on the IFSP.
Only the following services identified on the IFSP: _________________________
I/We decline the initiation of all Early Intervention services for my child and family.
o Reason the initiation of services was declined (optional):________________________
Change in the Provision of Early Intervention Services or Eligibility
To be completed by the Infant Toddler Early Intervention program:
The Infant Toddler Early Intervention program is proposing the following:
Change in the Early Intervention services for the child and family on the IFSP.
Change in Eligibility Determination.
To be completed by the parent(s):
I/We am/are providing consent for changes in Early Intervention services for my child and family.
I/We decline the changes in Early Intervention services for my child and family.
I/We agree my child is no longer eligible for Early Intervention services.
I/We disagree my child is no longer eligible for Early Intervention services.
9/23/2025
I/We decline tracking services for my child.
Decline the Provisions of Early Intervention Services or Eligibility
The Infant Toddler Early Intervention program is declining to initiate or change the following:
Identification
Evaluation
Location of services
Provision of Early Intervention services
Tracking Services
To be completed by the Infant Toddler Early Intervention program:
The Infant Toddler Early Intervention program is proposing tracking services for the child.
To be completed by the parent(s):
I/We am/are providing consent for tracking services for my child.
o Reason Tracking services were declined (optional):
Dispute Resolution Options:
I/we request:
A discussion with the County Administrator responsible for the Early Intervention program.
A complaint be filed with the Bureau of Early Intervention Services and Family Supports.
A mediation session conducted by the Office for Dispute Resolution.
A due process hearing conducted by the Office for Dispute Resolution.
I/we have been presented with the Procedural Safeguard Notice and understand that: (1) all information used or
maintained by the Infant Toddler Early Intervention program is confidential; (2) I/we have the right to accept or
decline any or all proposed services and activities; (3) have been informed of the screening process and right to
request an evaluation at any time.
Yes
No
I/we authorize the following team members/agencies to be provided copies of the Evaluation Report (ER) and IFSP
Name/Agency Address Its entirety or certain sections?
Parent/Guardian Signatures(s): _______________________________________ Date: ____________________
9/23/2025
Attachment 3
EARLY INTERVENTION
COMPLAINT RESOLUTION PROCESS
In order to assist parents in resolving concerns at the local level the Office of Child Development
and Early Learning (OCDEL), Bureau of Early Intervention Services and Family Supports (BEISFS), in
order to increase communication and collaboration in attempting to resolve a parent complaint, has
instituted a birth to five Early Intervention Complaint Resolution Process (EICRP).
The purpose of this process is to reduce the number of formal complaints filed with the Bureau of
Early Intervention Services, due to issues with the Infant/Toddler Early Intervention (EI) program or
Preschool Early Intervention program. It also allows complainants and OCDEL EI Advisors to resolve a
concern/problem directly and assist them first in resolving the issue.
Families have the opportunity to phone, fax, or email the Infant/Toddler or Preschool EI Program
and/or the EI Advisor at any time to resolve an issue before elevating it to the complaint level. That
information is:
Departments of Human Services and Education
Office of Child Development and Early Learning
Bureau of Early Intervention Services and Family Supports
607 South Drive, 4th Floor Rotunda
Harrisburg, PA 17120
Email: RA-ocdintervention@pa.gov
Phone: 717-346-9320
Fax: 717-346-9320
If a resolution cannot be reached after a review of the issue by the OCDEL EI Advisor the parents
have the option to pursue the formal complaint process. The EICRP process is OCDEL’s preferred way
to deal proactively with complaint issues and to remain committed in helping families resolve concerns as
early and efficiently as possible.
Departments of Education and Human Services | 607 South Drive | 4th Floor Rotunda | Harrisburg, Pennsylvania 17120 | 717.346.9324 | F 717.346.9330 | www.education.pa.gov | www.dhs.pa.gov
Early Intervention Formal Complaint Form
There are multiple ways that you can file a complaint. You may use this form, send an email, or call 717-346-9320 to file your complaint verbally.
Please note, a complaint must be filed within one year of the date the alleged violation occurred.
This form is available in multiple languages.
An Early Intervention (EI) Advisor will contact you to discuss this complaint. Please check your preferred method of contact below:
☐By phone
Please provide your number: ___________________________
Best time during normal business hours to call: _____________
☐By email
Please provide your email: _____________________________
Are you filing this complaint on behalf of a specific child? ☐ Yes ☐ No
If yes, please provide the name and address of the child:
Child's Name: _________________________________
Address: _________________________________
_________________________________
Date of Birth: (optional) ____________________________
School District: (optional) ____________________________
If the complaint is being filed on behalf of a child or youth experiencing homelessness, please provide
the available contact information:
Please provide the name of the Infant Toddler or Preschool EI program: _______________________
Departments of Education and Human Services | 607 South Drive | 4th Floor Rotunda | Harrisburg, Pennsylvania 17120 | 717.346.9324 | F 717.346.9330 | www.education.pa.gov | www.dhs.pa.gov
Name of Complainant: (optional) ___________________________
Relationship to child: (optional) ☐ Parent/Guardian ☐ Attorney ☐ Advocate ☐ Community Organization ☐ Other
Please provide a statement that describes the violation/issue. Include a description of the nature of the problem (additional pages can be used, as needed):
Please list all of the facts that you would like to share about the problem (additional pages can be used, as needed):
Please suggest a solution to the problem (optional):
Did the violation/issue occur within the past year? If so, on or about what date?
The complaint must be signed for the Bureau of Early Intervention Services and Family Supports (BEISFS) to investigate. You must also send a copy of this complaint to the Infant Toddler or Preschool EI program you included above. By signing below, you are confirming that you have provided a copy of the formal complaint to the EI program.
__________________________________________________ _________________ Signature of Complainant Date Please return the form to: Office of Child Development & Early Learning Bureau of Early Intervention Service & Family Supports 607 South Drive, 4th Floor Harrisburg, PA 17120 E-mail: ra-ocdintervention@pa.gov Fax: 717-346-9330