TYPES OF IFSPs
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Understanding Individualized Family Service Plans (IFSPs)
An IFSP outlines a child’s and family’s unique needs, outcomes, and the early intervention services and supports determined necessary by the IFSP team. When a child is determined eligible and the parents consent to services, the initial IFSP is drafted and implemented. Thereafter, the IFSP team will review the IFSP at least every six months and redetermine eligibility at least annually.
Initial IFSPs
The initial IFSP meeting is the first meeting where the multidisciplinary IFSP team gathers to determine if the child is eligible for Early ACCESS services.
- If the child is eligible, the team will develop an Individualized Family Service Plan (IFSP) for the child/family.
- If the child is reaching the age of 2 years 9 months, a transition plan will be developed to support a smooth and successful transition for the family and child.
- If the child is not eligible, the IFSP team will help the family to find and connect with needed resources.
- If the family declines to hold the initial IFSP meeting, the child’s case must be closed.
Prior to an Initial IFSP meeting
The service coordinator assigned to an IFSP team will arrange the IFSP meeting at a time and location that is convenient for families and use a written meeting notice to inform IFSP team members. The service coordinator will also check that all evaluations and assessments are or will be completed within 45 days of the referral to Early ACCESS.
At an Initial IFSP Meeting
During an initial IFSP meeting, the following will take place:
- Review and share the Procedural Safeguards Manual for Parents. The Early Intervention Procedural Safeguards Discussion Guide may be used to inform parents of their rights, however, parents must be offered a printed copy of the manual by the service coordinator.
- Review and discuss eligibility information. This information includes the family’s resources, priorities, and concerns identified in the initial family assessment, the strength and concerns of the initial evaluation results of the child, and any medical and other records used to determine eligibility.
- Develop the IFSP. The child and family outcomes will be established based on family needs and priorities. The IFSP development process involves:
- Discussing findings from child assessments and the family’s concerns, priorities, and resources.
- Determining and documenting the child and family outcomes that are unique to this child and family.
- Determining and documenting the activities and services needed to achieve the outcomes.
- Choosing appropriate service providers needed to achieve the outcomes.
- Documenting the projected date the provider anticipates will be the first visit in which service is delivered to the child/family. Note: The initial IFSP meeting date cannot serve as the projected start date or first service delivery date for providers unless the service provider’s log note for the delivery of their first service clearly documents a separate visit providing service to the child and/or family occurred following the initial IFSP meeting. The beginning time for the service should correspond to the ending time of the initial IFSP meeting. However, the initial IFSP meeting does serve as the start date for service coordination only.
- Determining where services are to be provided and document the setting.
- To the extent appropriate, identifying medical and other services that the child or family needs or is receiving through sources other than Early ACCESS. If those services are not currently being provided, the service coordinator will describe steps that the service coordinator or family may take to assist the child and family in securing those other services.
- Document Early Childhood Outcomes. Based on evaluation and assessment results, the child’s present level of development will be determined within three Early Childhood Outcome (ECO) areas.
- Develop Transition Plan. For children reaching the age of 2 years 9 months, the team will develop a plan to support the transition from Early ACCESS services which will conclude when the child reaches the age of three. A plan is developed to represent all types of transition pathways. See Transition From Early ACCESS for information.
- Seek parent informed consent for services. The contents of the IFSP must be fully explained to a parent and informed written consent from a parent must be obtained prior to the delivery of early intervention services described in the IFSP.
- Finalize paperwork and communications. Before the initial IFSP meeting is done, the following will be completed:
- Review when each early intervention service is scheduled to begin and address any questions the family may have.
- If the child is insured by Medicaid, seek parent authorization for Medicaid reimbursement to include the IFSP services.
- Provide parents a copy of the IFSP at no cost as soon as possible and no later than 30 days after the IFSP meeting.
- Discuss with the family who else will get copies of the IFSP with appropriate releases.
If determined necessary and/or appropriate, seek consent for the release and exchange of information with community providers.
After an Initial IFSP meeting
Following the initial IFSP meeting, the first delivery of early intervention services will be provided within 30 days of receiving parental consent. For each service, the provider must document the date of the first delivery of service and a log note describing the service that was provided. Additional training tools are available from the Iowa Family Support Network.
When Parents Decline Initial IFSP
When the parents decline to hold an initial IFSP meeting after the evaluation has been completed, the service coordinator will:
- Explores, with the parents, other appropriate community options that might meet the family’s needs. This should include a discussion about making a referral to the local Title V child health agency or Child Health Specialty Clinics for developmental monitoring.
- Provide information so the family can contact Early ACCESS in the future if needed.
- Documents the discussion.
- Complete a Prior Written Notice describing: the initial IFSP meeting was declined by the parent and the parent was informed that eligibility would not be determined and early intervention services would not be provided.
- Close the child’s file by following case closure procedures.
Ongoing Assessments
Once an IFSP has been developed, all IFSP team members communicate and work collaboratively as they implement the services and monitor the progress made toward achieving the child’s and family’s outcomes. Ongoing assessment by service providers occurs as early intervention services are provided. The assessment information is used to identify the child’s unique strengths and needs and the early intervention services appropriate to meet those needs throughout the period of the child’s eligibility.
As providers and service coordinators get to know a child and family better over time, ongoing assessment data may result in identifying new concerns. If additional expertise from a professional is needed by someone not presently on the IFSP team, arrangements must be made in order to have them assess the child or family.
Ongoing Assessment Requirements
Ongoing assessments are conducted by service providers who are responsible for helping the child and family meet their outcomes. Ongoing assessments shall, at a minimum, adhere to the following that are outlined in each IFSP outcome:
- Criteria for accomplishment: How you will know when the outcome is achieved
- Timelines: When you anticipate the outcomes will be achieved
- Strategies/Activities: What will be done and how it will be done
Verbal and written feedback shall be provided to parents regarding the ongoing assessment of their child and progress made towards achieving outcomes. Progress is routinely recorded in the IFSP so decisions can be made about the effectiveness of strategies and services being used to support the child’s development.
Ongoing Assessment Procedures
- Any IFSP team member, including the family, notifies the service coordinator of the need for additional assessment.
- The service coordinator completes a Prior Written Notice (PWN) informing the family that someone outside of the IFSP team will be completing an assessment. This is so the family knows who is coming to see their child. If an IFSP team is requesting an assessment by any provider that is not part of the area education agency, the service coordinator must complete a release and exchange of information form and have it signed by a parent. No other consents are needed.
- The service coordinator makes arrangements to have an assessment done by a qualified professional who has expertise in the developmental area of concern. If the concern was identified by a service provider who is a member of the IFSP team, the service coordinator works with that provider to determine who the best qualified professional would be to do the assessment. The provider also communicates with that individual to share current developmental and progress information.
- Permission to see the child’s IFSP is assigned to the provider doing the assessment by the service coordinator and notifies them when they have access.
- The assessment must be completed within 30 days.
- Results are entered into the IFSP by the person doing the assessment. If that person is someone from outside the area education agency or Child Health Specialty Clinics, the service coordinator must enter the new assessment information into the child’s IFSP. Outside providers do not have access to the IFSP data system.
- Results are shared with other service providers on the IFSP team to do a preliminary analysis in order to determine if an IFSP meeting needs to be held. If assessment results make it clear that no new service is needed, an IFSP meeting is not required. In some cases, newly recommended strategies and activities to support the child’s development can be provided by a current IFSP team member without the need to add new services from an additional service provider. Results and the decision-making process are shared with the family. The team, including the family, must agree on the decision. Decision results are documented in log notes in the IFSP data system.
- When the results are unclear regarding the need for a service change or if the results clearly indicate that a change in service is needed, the IFSP team and the person who did the new assessment, hold an IFSP meeting to review the information. The team determines if new services and outcomes are needed or an adjustment to the amount of current services is needed. Follow all procedures for holding the IFSP meeting.
- When new services are added, you must get parental consent to provide the service. The first delivery of the new service must happen within 30 calendar days from the date the parents gave consent in order to be counted as timely service delivery.
Periodic IFSPs
A periodic review of the IFSP for a child and the child’s family must be conducted every six months, more frequently if conditions warrant, or if the family requests a review. A periodic review may be carried out by a meeting or by other means (phone, video conference, email, providing pertinent records, or during a home visit) that is acceptable to the parents and other participants.
IFSP team completes the periodic review to:
- determine that progress toward achieving the outcomes is being made,
- determine whether modification or revision of the outcomes or services is necessary, and
- discuss new concerns and/or assessment information.
Prior to a Periodic Review
The service coordinator will gather input from the team to determine if a meeting is needed to complete the Periodic Review.
- Meeting will be held:
- If a transition planning meeting is needed (meeting must be held 90 days prior to the child’s third birthday).
- If there is a new concern about the child’s development.
- If different and/or additional support/services are needed to achieve the outcomes in the IFSP.
- If an early intervention service may be ended/discontinued.
- If requested by the family or other team members.
- At a time and location that is convenient to families.
The service coordinator will schedule a Periodic IFSP meeting and provide written meeting notice to the IFSP team.
- Meeting may not be held:
- If there are no new concerns about the child’s development.
- If there are no changes to the early intervention services.
The service coordinator must document who contacted the family to discuss the review, method of contact, and the date of agreement to conduct the periodic review without a meeting.
Completing the Periodic Review
Steps to complete a Periodic Review with a meeting:
- Introductions and roll call: Service coordinator will record who attended the meeting and method of participation.
- Review any new assessment or evaluation information (if applicable).
- Record status and document progress on each child and/or family outcomes.
- Determine needed changes to the IFSP due to the child’s health, development, or family’s priorities. This may involve modifications to outcomes or an increase or decrease in service frequency, duration, intensity, or location.
- Develop Transition Plan. For children reaching the age of 2 years 9 months, the team will develop a plan to support the transition from Early ACCESS services which will conclude when the child reaches the age of three. A plan is developed to represent all types of transition pathways. See Transition From Early ACCESS for information.
- Obtain written parent consent using the Consent for Early ACCESS Services when a new early intervention service is added to the IFSP. The contents of the IFSP must be fully explained to the parent and the Consent for Early ACCESS Services must be completed prior to the delivery of a new service.
- If the child is insured by Medicaid and there was a change in IFSP services, seek parent authorization for Medicaid reimbursement.
- Provide parents Prior Written Notice summarizing decisions.
- Finalize the IFSP modifications and complete periodic review.
- If new early intervention service(s) were consented to, review with the family when it is scheduled to begin.
- Address any questions the family may have.
- Provide parents a copy of the IFSP at no cost as soon as possible and no later than 30 days after the Periodic Review meeting.
- Discuss with the family who else will get copies of the IFSP with appropriate releases.
- If determined necessary and/or appropriate, seek consent for the release and exchange of information with community providers.
Steps to complete a Periodic Review by another means:
- A member of the team reviews child and/or family outcomes and progress with family; this can be done via phone, video conference, email, providing pertinent records or during a home visit.
- Service coordinator documents who contacted the family to discuss review, method of contact, and the date of agreement to conduct the periodic review without a meeting.
- Record status and document progress on each child and/or family outcomes.
- Determine if modifications to the outcomes are needed based on progress and/or family’s priorities.
- Finalize any IFSP modifications and complete periodic review.
- If modifications are made to outcomes, provide parents a copy of outcomes at no cost as soon as possible and no later than 30 days after the review.
After a Periodic IFSP Meeting
Any new service added at the periodic review must begin services within 30 days of signed consent for that new service. The 30 days are calculated from the date of parental consent to the date that the service is delivered as written in the IFSP and accurately recorded in the service provider log notes.
Annual IFSPs
The annual IFSP meeting must be held within one year of the initial IFSP meeting or within one year of the last annual meeting.
The IFSP team completes the annual IFSP to:
- determine if the child continues to be eligible for Early ACCESS.
- discuss evaluation and/or assessment information.
- update the child's present levels of development.
- determine that progress towards achieving the outcomes is being made.
- if the child continues to be eligible, determine whether modification or revision of the outcomes or services is necessary.
Prior to an Annual IFSP meeting
The team must review assessment data and/or annual evaluation and determine eligibility.
The service coordinator assigned to an IFSP team will arrange the IFSP meeting at a time and location that is convenient for families and use a Meeting Notice to inform IFSP team members of the meeting. The service coordinator will also check that all evaluations and assessments are, or will be, completed prior to the annual IFSP meeting.
At an Annual IFSP Meeting
During an annual IFSP meeting, the following will take place:
- Review and share the Procedural Safeguards Manual for Parents. The Early Intervention Procedural Safeguards Discussion Guide may be used to inform parents of their rights, however, parents must be offered a printed copy of the manual by the service coordinator.
- Review and update family information and Family Statements.
- Review evaluation/assessment data to confirm the child continues to be eligible.
- If the child is not eligible, the IFSP team will help the family to find and connect with needed resources.
- If the child is eligible, the team will develop an Individualized Family Service Plan (IFSP) for the child/family.
- Determine the effectiveness of activities and services to achieve the outcomes.
- Determine needed changes to the plan due to the child’s health/development or the family’s capacity to meet their child’s needs. This may involve modifications and/or revisions to outcomes or an increase or decrease in services and/or frequency, duration, intensity, or location.
- Review the IFSP. The child’s present level of development will be determined within three Early Childhood Outcome (ECO) areas.
- Develop Transition Plan. For children reaching the age of 2 years 9 months, the team will develop a plan to support the transition from Early ACCESS services which will conclude when the child reaches the age of three. A plan is developed to represent all types of transition pathways. See Transition From Early ACCESS for information.
- Seek parent informed consent for services. The contents of the IFSP must be fully explained to a parent and informed written consent from a parent must be obtained prior to the delivery of any new early intervention services described in the IFSP.
- Finalize paperwork and communications. Before the annual IFSP meeting is done, the following will be completed;
- Review when each new early intervention service is scheduled to begin and address any questions the family may have.
- If the child is insured by Medicaid, seek parent authorization for Medicaid reimbursement for IFSP services.
- If determined necessary and/or appropriate, seek consent for the release and exchange of information with community providers.
- Discuss with the family who else will get copies of the IFSP with appropriate releases.
After an Annual IFSP meeting
Following the Annual IFSP meeting, the service coordinator will provide parents a copy of the IFSP at no cost as soon as possible and no later than 30 days after the IFSP meeting. If any new services were added to the IFSP, the first delivery of the new early intervention services will be provided within 30 days of receiving parental consent. For each service, the provider must document the date of the first delivery of service and a log note describing the service that was provided.
Modifications
The IFSP may be modified to make changes to child and family outcomes or early intervention services as often as necessary between required reviews.
Modifying IFSPs
- Modifying an IFSP does not change the due date of the Periodic Review or Annual Review.
- If an IFSP Periodic or Annual Review is due within 30 days, it is recommended to revise the IFSP as part of the Review.
- It is necessary to ensure the IFSP team has the opportunity to participate in the modification process.
- An IFSP may be modified with or without a meeting. The IFSP team determines if the modification requires a meeting.
Note: If the only action is to “Change Providers,” then changing the provider is completed without initiating the modification process.
Prior to an IFSP Modification
When an IFSP needs to be modified, the team will consider if the proposed changes require scheduling a meeting.
Meeting will be held:
- If a transition planning meeting is needed (meeting must be held 90 days prior to the child’s third birthday).
- If there is a new concern about the child’s development.
- If different and/or additional support/services are needed to achieve the outcomes in the IFSP.
- If an early intervention service may be ended/discontinued.
- If requested by the family or other team members.
If a meeting is needed, the service coordinator will schedule an IFSP meeting and provide written meeting notice, with the purpose listed as a periodic IFSP.
Meeting may not be held:
- If revising, adding, or ending Child and/or Family Outcomes
- If there are no new concerns about the child’s development.
- If there are no changes to the early intervention services.
If a meeting is not needed, the service coordinator or service provider must document who contacted the family to discuss the modification, method of contact, and the date of agreement to conduct the modification without a meeting.
Completing an IFSP Modification
- Consider and discuss with the family the sections of the IFSP which need to be changed.
- Develop a transition plan to support the transition pathways from Early ACCESS services for children reaching the age of 2 years 9 months. See Transition From Early ACCESS for information.
- Document the agreed-upon changes on the IFSP after confirming changes with IFSP Team Members involved.
- Finalize the IFSP Modification.
- Obtain written parent consent using the Consent for Early ACCESS Services when a new early intervention service is added to the IFSP. The contents of the IFSP must be fully explained to the parent and the Consent for Early ACCESS Services must be completed prior to the delivery of a new service.
After an IFSP Modification
- Implement the IFSP as written.
- Any new service added to an IFSP must be delivered within 30 calendar days from the date of the signed parental consent.
- Provide the family with the modified IFSP within 30 calendar days.
Interim IFSPs
Early ACCESS services may be provided to an eligible child and their family before the completion of the comprehensive multidisciplinary evaluation and assessment.
Prior to an Interim IFSP Meeting
The service coordinator reviews any relevant documents that are available at referral/intake to determine if an interim IFSP is needed. An example of when to use an interim IFSP would be to serve children who move to Iowa with an IFSP from a state where the eligibility criteria are stricter than Iowa’s eligibility criteria and the child needs services immediately. The service coordinator will arrange the IFSP meeting at a time and location that is convenient for families and use a written meeting notice to inform IFSP team members.
At an Interim IFSP Meeting
During the interim IFSP meeting, the following will take place:
- Review and share the Procedural Safeguards Manual for Parents. The Early Intervention Procedural Safeguards Discussion Guide may be used to inform parents of their rights, however, parents must be offered a printed copy of the manual by the service coordinator.
- Review and discuss any information that indicates the child will be eligible for Early ACCESS. This information includes, but is not limited to, any medical records and previous IFSPs that help identify the child’s need for services.
- Develop the IFSP. The child and family outcomes will be established based on family needs and priorities. The IFSP development process involves
- Discussing relevant information used to presume eligibility and the family’s concerns, priorities, and resources.
- Determining and documenting the child and family outcomes that are unique to this child and family.
- Determining and documenting the activities and services needed to achieve the outcomes.
- Choosing appropriate service providers needed to achieve the outcomes.
- Documenting the projected date the provider anticipates will be the first visit in which the service is delivered to the child/family.
- Determining where services are to be provided and document the setting.
- To the extent appropriate, identify medical and other services that the child or family needs or is receiving through sources other than Early ACCESS. If those services are not currently being provided, the service coordinator will describe steps that the service coordinator or family may take to assist the child and family in securing those services.
- Seek parent informed consent for services and evaluation. The contents of the IFSP must be fully explained to a parent and informed written consent from a parent must be obtained prior to the delivery of early intervention services described in the IFSP and before evaluation and assessment can be completed.
- Schedule the comprehensive multidisciplinary child evaluation as well as child and family assessment as soon as possible.
- Finalize paperwork and communications. Before the interim IFSP meeting is done, the following will be completed:
- Review when each early intervention service is scheduled to begin and address any questions the family may have.
- If the child is insured by Medicaid, seek parent authorization for Medicaid reimbursement to include the IFSP services and evaluation.
- Provide parents a copy of the IFSP at no cost as soon as possible and no later than 30 days after the IFSP meeting.
- Discuss with the family who else will get copies of the IFSP with appropriate releases.
- If determined necessary and/or appropriate, seek consent for the release and exchange of information with community providers.
After an Interim IFSP meeting
Following the interim IFSP meeting, the first delivery of early intervention services will be provided within 30 days of receiving parental consent. For each service, the provider must document the date of the first delivery of service and a log note describing the service that was provided. Use the Early ACCESS Guidance on Documenting Timely Delivery of First Services to guide the documentation process. Additional training tools are available from the Iowa Family Support Network. The IFSP team will reconvene after evaluation to develop the initial IFSP within 45 days of the referral to Early ACCESS.
Types of IFSP Resources
To find more information regarding the different types of IFSPs, view downloadable documents on the Early Intervention Resources Page.
Iowa Administrative Rules for Early ACCESS Integration System of Early Intervention Services
- 281—120.11(34CFR303) Early intervention service program
- 281—120.13 (34CFR303) Early intervention services
- 281—120.15(34CFR303) Free appropriate public education
- 281—120.20 (34CFR303) Individualized family service plan
- 281—120.112(34CFR303) Availability of early intervention services
- 281—120.209 (34CFR303) Transition to preschool and other programs