CHILD FIND, REFERRALS, CASE CLOSURES, AND INTAKE

In Iowa, the central point of contact information and state resource directory is located on the Iowa Family Support Network (IFSN) website. This website is a helpful resource for families and other IFSP team members to explore available services and funding sources to meet the identified needs of children and their families.

The IFSN website provides a toll-free number that is available statewide to link callers or interested persons to information about Early ACCESS services.  

Toll free: 1-888-IAKIDS1 (1-888-425-4371)
Email: [email protected]
Website: www.iafamilysupportnetwork.org 

The state resource directory is accessible on the IFSN website. The directory is available for parents and professionals to locate financial resources and services for children in Iowa. The guide presents programs related to education, health, human services, insurance, social security, and other support services.

Each agency responsible for Early ACCESS collaborates with various community partners to ensure that the process for finding potentially eligible children is coordinated with agencies responsible for providing various education, health, social service programs and tribes/tribal organizations, including the following:

• Child Find authorized under Part B of IDEA (Special Education)  
• Maternal and Child Health agencies (MCHB or Title V)  
• Early and Periodic, Screening, Diagnosis and Treatment Program (EPSDT) 
• Developmental Disabilities Assistance and Bill of Rights Act, administered by the Department of Human Services  
• Early Head Start, Head Start  
• Supplemental Security Income (SSI) Program  
• Medicaid  
• Child protection and child welfare programs, including programs administered by the Department of Human Services (CAPTA)  
• Child care programs  
• Programs that provide services under the Family Violence Prevention and Services Act
• Early Hearing Detection and Intervention (EHDI) systems  
• Children’s health insurance program (Hawk-i)

The intake personnel will gather and enter the following information into the Web IFSP System: 

• Date the referral was received. 
• Referral source information. If the referral source is the parent, how they learned about Early ACCESS. 
• Reason for the referral. 
• Child demographic information: name, age, email, family’s address, etc. 
• Prior pre-referral screenings, if available. 
• The language spoken in the home. 
• Other important information(e.g. date of discharge from NICU, the best time to call).

After the child’s information has been entered into the Web IFSP system, the Area Education Agency or Child Health Specialty Clinic staff will assign a service coordinator for each referral.

Parents have the right to decline to have their child participate in a screening and/or evaluation after a referral has been made to Early ACCESS. After following the procedures for First Visit with the Child and Family, a referral may be ended when “contact established and parent(s) not interested in screening or evaluation for Early ACCESS.” 

There are times when a parent consents to have their child screened in order to determine if they would like to consent for a full evaluation. After following the procedures for Post Referral Screening, if a consent for evaluation is not signed, a referral may be ended when “child was screened by Early ACCESS and the parent(s) declined an evaluation for Early ACCESS eligibility.”

Parents have the right to withdraw consent for a screening or an evaluation after the written consent has already been provided, even if the screening or evaluation has been started. At other times contact with the family may be lost after they consent to screening or evaluation. In both of these situations screening or evaluation procedures stop. 

After following the procedures for First Visit with the Child and Family, “consent withdrawn” reasons for ending the referral include:

• Consent signed for post referral screening or Early ACCESS evaluation and assessment; lost contact with parents.
• Consent signed for post referral screening or Early ACCESS evaluation and assessment; parents withdraw/revoke consent.

Parents may decline an IFSP or the child may not be eligible for Early ACCESS. Once an eligibility decision has been reached, if an IFSP will NOT be developed, reasons for ending the referral include:

• Child was determined eligible for Early ACCESS and parent(s) decline IFSP completion; No further action in Early ACCESS.
• Evaluation was completed and the child was determined NOT ELIGIBLE for Early ACCESS services.

When a child passes away prior to finishing the evaluation process or after evaluation and prior to holding the initial IFSP meeting, the reason for ending the referral is “child deceased.”

Once the service coordinator (SC) makes contact with the family, they will set up a time to visit the child and family. Typically, the first visit will happen in the family’s home.  During the first visit, the SC will:

1. Provide an overview of Early ACCESS services. This includes the purpose, a family’s right to a service coordinator, eligibility criteria and information on the evaluation/assessment process, the different types of services available, and that there are no costs to families for service coordination, screening, evaluation/assessment and if eligible, early intervention services.
2. Discuss and listen to the family to begin to identify child and family strengths, interests, concerns, and needs; begin anticipating evaluation needs, and learn of potential needs and priorities of the child and family.
3. Determine if any post-referral screenings are necessary to gather additional data to help the family and team decide if the child should have a comprehensive, multidisciplinary evaluation and assessment. If no pre-referral developmental screening is completed prior to the referral and there is no known condition, a post-referral screening may help the IFSP team decide whether they want to proceed to a full evaluation.
4. Seek consent for evaluation and assessment. If the parent requests only one or two developmental areas to be evaluated, the SC must explain to the family that all areas are required to be evaluated.
5. If the parent consents to evaluation and assessment, the SC will:
   1. Discuss sources of existing records and evaluation/assessment information needed for Early ACCESS processes that have already been obtained and/or obtain Consent to Release & Exchange Information.
   2. If needed, a Consent to Release and Exchange Information form should be completed at the meeting (or prior to) to allow information to be exchanged with providers from outside the network of Early ACCESS service providers
   3. If the child is insured by Medicaid, seek parental consent to release information for Medicaid reimbursement to include evaluation and the IFSP services
   4. Establish how the family and team members will communicate in the future (e.g. provide contact information; establish preferences for when and how to communicate). 
   5. Schedule future times the family can meet with the service coordinator and evaluators. 
6. If the parent declines or refuses evaluation/assessment for their child, the service coordinator will:  provide the family with Prior Written Notice (PWN) that indicates an evaluation will not be conducted due to lack of parent consent, and follow case closure procedures.
7. If the parent withdraws consent for the evaluation after written consent has been provided, all evaluation activities stop. In addition, a parent can complete the evaluation process then decide they do not want to move forward with an initial IFSP meeting. In both of these cases, the service coordinator will:  provide the family with a Prior Written Notice (PWN) that indicates either (1) an evaluation will not continue and eligibility will not be determined or (2) eligibility will not be determined due to parent declining to hold an initial IFSP meeting.  Follow case closure procedures.

NOTE:  If parents have signed consent for evaluation and assessment and cannot be found after (to schedule or complete the evaluation), the SC must follow procedures for “unable to make contact with the family” and sends a Prior Written Notice (PWN) with a letter documenting that the agency will not be conducting an evaluation.  If the PWN comes back undeliverable, file the actual or electronic copy of the returned envelope and PWN in the child’s record.

Post-referral screening is an option if there was no pre-referral developmental screening completed prior to the referral and there is no diagnosed condition.

A pre-referral screening is a developmental screening using a tool that has been completed prior to referral (e.g. Ages and Stages Questionnaire completed at the physician’s office). 

Notes:  

1. At any point in the post-referral screening, a parent may request a full evaluation, regardless of post-referral screening results.
2. Completing a post-referral screening does not alter the 45-day timeline for completing the evaluation, determining eligibility, and holding the initial IFSP meeting, which always begins on the date of referral to Early ACCESS.

Post-referral screenings are carried out by qualified individuals using appropriate screening instruments.

When selecting the screening tool consider the following: 

• Validity and reliability of the tool
• Provides input from families
• Culturally and linguistically sensitive
• Reasonable cost and time to administer

If the team offers the parents a post-referral screening to gather data:  

1. Provide and review current Early ACCESS Procedural Safeguards Manual with parent(s) 
2. Obtain parent signature on Consent for Early ACCESS Post Referral Screening with Prior Written Notice form
3. Complete developmental screening
   1. If post-referral screening information indicates the child is not suspected of having a developmental delay or disability, then the service coordinator will complete the post-referral screening summary, share results using the Prior Written Notice, and inform parents they may request an evaluation.
   2. If post-referral screening information indicates the child is suspected of having a developmental delay or disability, the service coordinator will complete the post-referral screening summary, share results using the Prior Written Notice, and seek consent for evaluation and assessment.