CHILD FIND, REFERRALS, AND INTAKE
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Child Find Activities
The Iowa Department of Education ensures that all infants and toddlers with disabilities in the state who are eligible for early intervention services are identified, located, and evaluated. Identifying potentially eligible infants and toddlers are year-round commitments by the Area Education Agencies, Iowa Departments of Education, Public Health and Human Services, Child Health Specialty Clinics, and other community partners. The Early ACCESS comprehensive child find system in Iowa is based on public awareness, a central directory of services, and comprehensive identification and referral procedures.
Informing the Public of the Early ACCESS System
Information is provided to agencies and organizations that have a direct interest in early intervention to help locate and refer potentially eligible infants and toddlers from birth to three years of age. Materials are produced by the Iowa Department of Education, in collaboration with the Signatory Agencies (Iowa Department of Education, Iowa Department of Human Services, Iowa Department of Public Health, ad Child Health Speciality Clinics) and AEAs. Materials and information on child development, the referral process, the availability of early intervention services, and Iowa’s central point of contact and central directory are made available and distributed by AEAs, Signatory Agencies, Iowa Family Support Network, and community partners.
Providing a Central Point of Contact and Directory of Services
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.
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
- 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)
Referrals for early intervention services can come from anyone who has any concern about the child’s growth and/or development. An infant or toddler may be referred to Early ACCESS with parent knowledge and approval, however, written parental consent is not required. Referrals are made by phone, email, fax, or online referral form.
The Department of Human Services (DHS) may refer children for multiple reasons, including compliance with the Child Abuse Prevention and Treatment Act (CAPTA). Through CAPTA, children who are the subject of a substantiated case of abuse or neglect, or are identified as being affected by substance abuse or withdrawal symptoms resulting from prenatal drug exposure are referred to Early ACCESS.
If an infant is referred by a hospital prior to being discharged from the NICU, the service coordinator will contact the hospital liaisons or staff following the referral and initiate contact with the family after the child is discharged. If the 45-day timeline cannot be met for the evaluation and initial IFSP due to the child’s hospitalization, the team will not close the intake and will document the delay as a family reason because the child was in the hospital.
If a child and/or family moves into Iowa from another state and currently has an IFSP, this is considered a referral source. The Iowa team will need to determine eligibility in Iowa.
Who Receives Referrals
Referrals are received by the Iowa Family Support Network, Child Health Specialty Clinics (CHSC), and Regional AEA offices.
- Iowa Family Support Network facilitates referrals and is NOT considered a primary referral source.
- If the referral is made to Iowa Family Support Network, their staff will complete the referral form, and then email, fax, and/or call the Early ACCESS regional AEA staff with the referral information.
- AEA and CHSC staff are prepared to take referral information from any referral source and for any region. If a referral call is received for a child who does not live in the region where the call is received, the staff will gather the referral information and send the referral to the appropriate agency.
- Transfer of the referral information to the appropriate region or CHSC is accomplished by one of the following:
- faxes or emails the intake information to the appropriate AEA or CHSC or
- the receiving agency enters the information into the web IFSP as a new intake and assigns the child to the appropriate AEA or CHSC and a courtesy call or email is placed to the appropriate AEA or CHSC to notify them that a new intake has been entered.
- Transfer of the referral information to the appropriate region or CHSC is accomplished by one of the following:
- If the date of referral is fewer than 45-days prior to the child’s third birthday, the child is referred to early childhood special education (IDEA Part B) Child Find rather than Early ACCESS.
Information Gathered from the Referral Source
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.
The Early ACCESS intake process begins with the assignment of a service coordinator. The date the referring source contacts Early ACCESS is the start date of the 45-day timeline for completion of the evaluation and assessment, eligibility determination, and the initial IFSP meeting. During the intake process, the service coordinator will make contact with and visit the family. The family is provided with information on early intervention services and decides if they would like to proceed with an evaluation and assessment process.
Documentation of Missed 45-day Timeline
It is important to use the appropriate codes when documenting the reason for delays in meeting the 45-day timeline. Although there may be acceptable circumstances for not meeting the 45-day timeline, the state is required to report all IFSPs that missed the timeline. The state provides explanations to the Office of Special Education Programs for all IFSPs that did not meet the timeline due to exceptional circumstances. The exceptional circumstances include but are not limited to:
- Child/Family (FA): The child or parent is unavailable to complete the screening or the initial evaluation and assessment; the parent does not provide consent for the screening, initial evaluation or initial assessment, despite documented, repeated attempts by the service coordinator to obtain parental consent; family schedule changes (if the provider’s schedule is causing the conflict, do not use the FA code), a family move or change in residence; family vacation; child hospitalization or illness.
- Other/Outside (OT): significant weather-related events, coordination, or collaboration problems due to an agency outside of the Early ACCESS system such as complications with referrals from the Department of Human Services.
- Agency/System (AG): staff shortage, staff schedule unable to accommodate the family schedule, travel distance to family’s home on the extreme boundary of a region, difficulty managing driving time for distance to family’s home, and schedule of visits.
First Contact with the Family
Once a referral has been assigned to a service coordinator (SC), the SC attempts to contact the family within two business days.
Service coordinators must:
- Make a minimum of three attempts to contact (e.g. phone, drive-by home) family within 14 calendar days from the initial intake/referral.
- Use a variety of attempts to contact at different times of day and days of the week.
- Document all attempts to contact the family.
If the service coordinator needs assistance contacting the family, the SC may contact the referral source to verify the family contact information or obtain alternate or updated contact information.
When the Service Coordinator is UNABLE TO CONTACT THE FAMILY:
- If the SC is unable to contact the family within 14 calendar days, the SC must mail a letter to the parents indicating attempts to make contact and request that the parents contact the SC within 14 days or the referral will be closed.
- If the SC has no contact with the family after 28 calendar days after the referral date, the SC will close the referral. The SC will follow procedures to close the referral.
- If the service coordinator is contacted by the family within 14-28 calendar days from referral and is interested in Early ACCESS, follow procedures above for the First Contact with the Family.
Note: At initial IFSP meetings if the 45- day timeline is not met due to delay in contact with the family, indicate the reason the timeline was not met as a family reason.
If the service coordinator is contacted by the family after the referral is closed, then the service coordinator will open a new intake/referral.
First Visit with the Child and Family
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:
- 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.
- 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.
- 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.
- 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.
- If the parent consents to evaluation and assessment, the SC will:
- 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.
- 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
- If the child is insured by Medicaid, seek parental consent to release information for Medicaid reimbursement to include evaluation and the IFSP services
- 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).
- Schedule future times the family can meet with the service coordinator and evaluators.
- 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.
- 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).
- At any point in the post-referral screening, a parent may request a full evaluation, regardless of post-referral screening results.
- 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:
- Provide and review current Early ACCESS Procedural Safeguards Manual with parent(s)
- Obtain parent signature on Consent for Early ACCESS Post Referral Screening with Prior Written Notice form
- Complete developmental screening
- 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.
- 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.