HomeMy WebLinkAboutEI-110 Service Delivery1
FRANKLIN/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: Service Delivery
PROCEDURE TOPICS: Parental Consent
Entrance and Exit Data
Child Outcome Data
Referring children to the County IDD program
Teaming
PROCEDURE NUMBER: EI-110
Effective Date: October 26, 2012
Date Revised: October 26, 2022
References:
- IDEA 34 CFR §303.13 and §303.340-345
- Title 55 PA Code §4226.71
- Medical Assistance 837 Handbook
- Announcement: EI-09 #11 Infant/Toddler Early Intervention Service Coordination
- Announcement: EI-12 #02 Updates to Early Intervention Policy Based on Requirements
in IDEA Part C Regulations
- Announcement: EI-12 #07 Collecting and Reporting Child Outcome Data in
Infant/Toddler and Preschool Early Intervention Programs
- Announcement: EI-13 #03 Session Notes
- DHS Bulletin: OCDEL 21-04 Referring Children to the County Intellectual Disability
and Autism Programs
- Memo RE: Teaming Procedures in Early Intervention, FY 2012-13 - Revised
POLICY:
Franklin/Fulton Early Intervention Program follows timelines for service delivery by obtaining
parental consent (attachment) as follows:
The parent shall be fully informed of all information relevant to the activity for which the
consent will be used, in the parent's native language.
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The parent shall be informed and agree in writing to the carrying out of the activity for
which consent is sought, and the consent form shall describe that activity and list the
records (if any) that will be released and to whom.
The parent shall be informed that the granting of consent is voluntary on the part of the
parent and may be revoked at any time.
Written parental consent shall be obtained before:
1) Conducting the initial evaluation and assessment under § 4226.61 (relating to MDE).
2) Referring an at-risk child to the tracking system under § 4226.26 (relating to tracking
system).
3) Determining eligibility for Medicaid waiver services in accordance with § 4226.23
(relating to eligibility for Medicaid waiver services).
4) Initiating or changing Early Intervention services.
Before an Early Intervention service is provided or changed, the contents of the Individual
Family Service Plan (IFSP) shall be fully explained to the parent. If the parent does not consent
to the delivery of a particular Early Intervention service or withdraws consent after first
providing it, that service may not be provided. Those Early Intervention services to which the
parent consented shall be provided. If the parent does not consent to a proposed change that
reduces or terminates Early Intervention services, the requirements of § 4226.103 (relating to
status of a child during proceedings) apply.
Franklin/Fulton Early Intervention Program monitors service delivery to ensure that evidence
based practices are used as follows:
A review of the IFSP for an infant or toddler with a disability and the infant or toddler's family
shall be conducted every six (6) months or more frequently if conditions warrant or if the family
requests such a review. The review may be conducted by a meeting or by another means, such as
conference call or written reports that is acceptable to the parent and other participants. The
purpose of the review is to determine:
1) The degree to which progress toward achieving the outcomes is being made.
2) Whether modification or revision of the outcomes or services is necessary.
Service notes also provide verification of meetings and other contacts a Service Coordinator has
with an infant/toddler and their family/caregiver, evaluation and/or IFSP team. Service notes
need to be written so that others can understand what is being documented. What the Service
Coordinator observes during a meeting or contact is documented. Service notes are written in
people first language, be specific and to the point, including only fact (not opinions). Service
Coordinators should concentrate on creating service notes that give a professional, accurate,
unbiased and objective picture.
Franklin/Fulton Early Intervention follows the Federal guidelines regarding providing services in
natural environments. Part C of the Individuals with Disabilities Education Act (IDEA) requires
that Early Intervention services be provided in “Natural Environments”. Section 303.18 of Part C
defines Natural Environments as “settings that are natural or normal for the child’s age peers
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who have no disabilities”. Therefore, the provision of Early Intervention in natural environments
is not just a guiding principle, but is also required by Federal law.
Franklin/Fulton Early Intervention Program communicates with the family and therapist through
regularly scheduled home visits, telephone calls and review of session notes. Each family has a
phone number that is answered directly by their Service Coordinator and families are encouraged
to call with any questions or concerns. Service Coordinators and Therapists have access to phone
and e-mail on a regular basis in order to provide updates or requests for a team meeting. In
addition, the session note is a record of the service provided to the child and family or caregiver
by the Early Intervention service providers. It includes information related to how the service
assists the child and family or caregiver to achieve the IFSP outcome, the progress being made
and recommendations for the family or caregiver. The information in the session notes may also
be a resource for team members as they work together at achieving the outcome and goals for the
child and family.
A session note must be completed by an Early Intervention professional when IFSP services are
delivered to the child and signed by the caregiver/family. A copy of the session note must be
given to the family or caregiver at the end of the session. When a planned service delivery does
not occur (i.e. child or Early Intervention professional is absent; cancellation without notice or an
act of nature) the Early Intervention professional should document this occurrence, including the
reason, in the child’s record.
Early Intervention regulations clearly state that each child and the child's family shall be
provided with one service coordinator who is responsible for serving as the single point of
contact in helping the parent to obtain the services and assistance needed and for the activities
specified in § 4226.52 (relating to service coordination activities).
Franklin/Fulton Early Intervention program makes referrals to therapists who will be providing
IFSP services, including how to address scheduled and unscheduled breaks in service, as
follows:
Procedures are in place to document on a session note the date any cancellation or no show
occurs. All session notes are then reviewed by the Service Coordinator. Every infant/toddler is
authorized for a certain amount of units of service based on the Individual Family Support Plan
that is created initially when eligibility is determined. Service frequency and duration, outcomes,
can be increased or decreased at any time as long as all team members are in agreement with the
change and the parent’s sign the Parents Rights Agreement. When a break in service occurs, it
will be noted on the session note along with what efforts the provider agency has made to
provide any make-up sessions if requested by the parent or caregiver. It will also indicate the
projected dates of the break in service delivery and when the parent/caregiver speculates that
services may resume.
The Franklin/Fulton Early Intervention Program ensures that progress is monitored as follows:
Each Service Coordinator schedules a face-to-face visit with each infant/toddler family on a
quarterly basis. Service Coordinators also schedule home visits in collaboration with the service
provider so they can monitor progress on current goals. In addition, the Service Coordinators
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read all the session notes to review progress and follow-up with families if there seems to be a
pattern of no-shows or prolonged illness. The Service Coordinators also review any progress
monitorings for the infant/toddler on their caseload.
During the referral process, families are provided with a list of state wide providers and the
Service Coordinator explains that families have choice of providers. If a family has a provider in
mind, they will be immediately contacted to see if they can provide the services outlined in the
IFSP within the 14 day deadline.
If a family has no provider preference, the following will occur:
Service Coordinators will email ALL providers regarding the referral. They will indicate
the need in the subject line (ex. PT NEED, ST NEED, etc.). In the body of the email they
will indicate IFSP date, 14-day deadline date, Initials of child, DOB, Location of
services, Service needed, Frequency/Duration, and any notes regarding the referral (ex.
special day/time request of family, special skills to meet the need of the child, etc.)
Providers will have 24 hours from the time that the referral was sent to
respond. Providers will indicate name of therapist(s), days/times they are available and
any pertinent information that would be beneficial regarding the referral (ex. special
skills, familiarity with treatment of the diagnosis, etc.).
Providers who do not provide a specific service do not need to respond to every
request. Ex: if your agency only provides ST services, you do not need to respond to PT,
OT, SI, etc. requests.
Providers who do provide the specific services requested but do not have a therapist
available, please respond "no therapist available at this time".
If all providers respond prior to the 24 hour deadline, the Service Coordinator will
proceed with contacting the family to see which provider they choose.
If a Provider does not respond within the 24-hour deadline, the Service Coordinator will
proceed without that agency's availability.
After receiving the availability information, the Service Coordinators will contact the
family and give them their options. The family can then choose a provider based on the
information given.
All these activities will be part of the case note.
The role of the Service Coordinator in the Franklin/Fulton Early Intervention Program is an
active, ongoing process. Service Coordinators are responsible for assisting infants/toddlers and
their families in accessing needed Early Intervention services, as well as coordinating and
monitoring the provision of such services.
The Early Intervention program assigns a Service Coordinator to each child and family, as soon
as possible after referral. The Service Coordinator is responsible for serving as the single point of
contact in assisting the family to obtain the services and other possible supports that may be
needed.
All infants/toddlers and preschoolers who are determined eligible for the Early Intervention
Program have child outcome data collected at their entry and exit from the Early Intervention
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Program. Children who participate only in the Infant/Toddler Early Intervention tracking
program will not be included in the measurement of child outcomes.
One IFSP team member is assigned to be responsible for collecting a child’s entry and/or exit
data and that team member will be entered in PELICAN on the IFSP. The designated team
member will coordinate the collection of child outcome data with the family and other team
members. The collection of child outcome data will be considered as part of the normal service
delivery activities and discussions. The collection of child outcome data shall be integrated into
the normal service delivery activities and discussions with the family and any other members of
the team.
Each child's entry and/or exit ratings are based on information collected using an authentic
assessment tool selected by the Franklin/Fulton Early Intervention Program and aligned with the
Pennsylvania Early Learning Standards. An authentic assessment tool relies on natural
observations of a child’s functional skills and abilities with familiar adults in everyday settings
and routines with the use of the decision tree.
The Ounce is identified as the authentic assessment tool used for determining entrance and exit
ratings for infant/toddlers Early Childhood Outcomes ratings.
Franklin/Fulton Early Intervention Program identifies the following timelines for the collection
of entry and exit data for documentation in the PELICAN data collection web based system:
Entry data gathered on all children found eligible for the Early Intervention Program and
entered into PELICAN within 60 calendar days of the development of the child’s IFSP.
Exit data shall be gathered for those children who have received at least six (6) months of
consecutive Early Intervention services and exit data shall be collected and reported in
the BEISFS information management system within 60 calendar days prior to the child’s
anticipated exit from the Infant/Toddler Program.
Franklin/Fulton Early Intervention Program identifies the following children as needing exit data
that includes:
No longer eligible for Early Intervention because the child no longer meets eligibility
criteria;
Anticipated move out-of-state;
Parent withdrawal of their child from the Early Intervention Program; or
Transition from the Infant/Toddler EI Program at age three years.
Children found eligible for the Early Intervention Program will be documented in the BEISFS
information management system within 60 calendar days of the development of the child’s
IFSP/IEP.
The progress of all children shall be measured on the following three (3) outcome indicators
even if the outcome indicator is not an area of concern for the child:
Positive Social Emotional Skills (including social relationships);
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Acquisition and Use of Knowledge and Skills (including early language/communication
for all children and early literacy for Preschoolers); and
Use of Appropriate Behaviors to Meet Needs.
The requirements for entering both entry and exit Early Childhood Outcome (ECO) data do not
include those children who are considered to be in-tracking.
The Franklin/Fulton Early Intervention Program Coordinates the collection of child outcome
data for those children transitioning at age three (3) between the infant/toddler and preschool
programs. Exit data from the Infant/Toddler Early Intervention Program shall be used as entry
data for the Preschool Early Intervention Program if the data was gathered within six (6) months
of the child’s entry in the Preschool Early Intervention Program.
Referring children to the county Intellectual and Developmental Disabilities program:
When an infant/toddler who is eligible to receive EI services will be assigned a service
coordinator, the service coordinator is responsible for coordinating and monitoring needed
services and supports for the child and the child’s family. If the child has a diagnosis of
Intellectual Disability/Developmental Delay/Autism (ID/DD/A) or is suspected of having a
diagnosis of ID/DD/A, the EI service coordinator should discuss with the family the potential
services and supports available through the county Intellectual and Developmental Disabilities
(IDD) program and the benefit of registering the child with the county IDD program. With the
family’s consent, the EI service coordinator will refer the child to the county IDD program by
contacting the IDD program and following the referral process. When a child does not have a
diagnosis of ID/DD/A, but a diagnosis of ID/DD/A is suspected, the EI service coordinator
should refer the child to the county IDD program, which will provide a list of resources that can
assist the child and family with obtaining the necessary test and/or assessment to determine
whether the child has a diagnosis of ID/DD/A.
Children may receive Targeted Support Management (TSM) through the Office of
Developmental Programs (ODP) to complete the following activities listed below, even if the
child is receiving service coordination services through OCDEL:
Completion of the Prioritization of Urgency of Need for Services (PUNS) instrument;
and
Planning for transitions from congregate settings.
Teaming:
Generally, Early Intervention Services for Infants and Toddlers is provided on an individual
basis, with one (1) service provider working with one (1) child and one (1) or more members of
the child’s family. There are occasions when multiple individuals providing Early Intervention
must provide early intervention services to a child and family simultaneously (in other words, on
the same date and at the same time). Services provided simultaneously, or on a teamed basis are
billable to medical assistance when:
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The services provided are consistent with documentation on the IFSP.
The services are fully documented and clearly provided on a direct basis.
There may be occasions when a member of the IFSP team is called upon to provide a service
which is indirect in nature, but required to insure appropriate implementation of the IFSP. For
example, if a member of the team may be authorized to observe Early Intervention services being
provided by other members of the IFSP team. Such activities are not MA billable, but if properly
authorized, may be appropriate elements of the IFSP and can be billed against maintenance
funds. On those occasions the indirect service may be billed using the teaming code.
All occasions when two (2) service providers are providing Early Intervention services to a child
and family at the same time, the services must be discussed with the child’s Service Coordinator
and obtain prior approval. The Service Coordinator will then discuss the situation with the
Service Coordinator Supervisor, and it will be decided whether the services will be billable to
MA, or whether the teaming code needs to be used.
If it is determined that teaming code will be used, the Service Coordinator will provide the
Service Provider with the teaming code, date of service, and number of units that will be used for
the service provided.
All Early Intervention staff and providers will review the information included in this policy and
procedure regarding Service Delivery annually. Training resources related to the collection of
child outcome data, rating child outcomes, frequently asked questions, and data process guides
can be found on the HCSIS Learning Management System (https://www.hcsis.state.pa.us/hcsis-
ssd/). There is also information regarding Service Delivery on the EITA Portal.
ATTACHMENT:
Parent Rights Agreement
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______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Parent Rights Agreement
Event/Reason for Agreement: _________________________________________________________
Name of Child: ______________________________ Date of Birth: ________________________
Yes N/A
I/we have been informed that information gathered is confidential (Family Educational Rights and Privacy Act).
I/we received information explaining Early Intervention, our rights, and Procedural Safeguards.
I/we understand that parents have the right to accept or decline any or all of the proposed services and
activities.
I/we have been informed of the screening process and the right to request a Multidisciplinary Evaluation (MDE)
anytime during the screening process.
I/we give permission for a screening for my child (if a current screening is not available) to determine the need
and focus of an MDE.
I/we give permission for a MDE for my child (if a current evaluation is not available) to determine eligibility for
Early Intervention.
I/we have been informed that an Individualized Family Service Plan (IFSP) meeting shall be held within 45 days
from the date of referral to the Infant/Toddler Early Intervention Program, if my child is found eligible during
the MDE.
I/we participated in the MDE and IFSP meetings to discuss, plan, and implement Early Intervention services or
tracking services.
I/we agree our child no longer needs Early Intervention services because s/he has met exit criteria and all
current Early Intervention services will be discontinued.
I/We request
All activities and services listed on the IFSP.
Another meeting to continue to discuss the issues presented today.
All tracking activities.
All recommended activities and services to be delayed.
Only the following IFSP listed activities or services to start:
The Screening results indicate
Your child is meeting age appropriate developmental milestone for the following reason:
Your child is not meeting age appropriate developmental milestones for the following reasons:
I/we authorize the following team members/agencies to be provided copies of the Evaluation Report(ER)/IFSP:
Name/Agency Address Its entirety or certain sections?
I/we are dissatisfied with the proposed services and activities and request:
A discussion with the county administrator responsible for the Early Intervention program
A mediation session conducted by the Office for Dispute Resolution.
A due process hearing conducted by the Office for Dispute Resolution.
Filing a complaint with the Bureau of Early Intervention Services and Family Supports.
Parent Signatures(s): _______________________________________ Date: _____________________
05/16/18