TYPES OF IFSPs

During an initial IFSP meeting, the following will take place:

1. 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.
2. 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.
3. Develop the IFSP. The child and family outcomes will be established based on family needs and priorities. The IFSP development process involves:
   1. Discussing findings from child assessments and the family’s concerns, priorities, and resources.
   2. Determining and documenting the child and family outcomes that are unique to this child and family.
   3. Determining and documenting the activities and services needed to achieve the outcomes.
   4. Choosing appropriate service providers needed to achieve the outcomes.
   5. 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.
   6.  
   7. Determining where services are to be provided and document the setting.
   8. 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.
4. 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.
5. 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.
6. Finalize paperwork and communications. Before the initial IFSP meeting is done, the following will be completed:
   1. Review when each early intervention service is scheduled to begin and address any questions the family may have.
   2. If the child is insured by Medicaid, seek parent authorization for Medicaid reimbursement to include the IFSP services.
   3. Provide parents a copy of the IFSP at no cost as soon as possible and no later than 30 days after the IFSP meeting.
   4. 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.

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. 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.

When the parents decline to hold an initial IFSP meeting after the evaluation has been completed, the service coordinator will:

1. 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.
2. Provide information so the family can contact Early ACCESS in the future if needed.
3. Documents the discussion.
4. 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.
5. Close the child’s file by following case closure procedures.

1. Any IFSP team member, including the family, notifies the service coordinator of the need for additional assessment. 
2. 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.
3. 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.
4. 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.  
5. The assessment must be completed within 30 days.
6. 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.
7. 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. 
8. 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.  
9. 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.

At times, the service coordinator or EI service providers are unable to contact families whose children have an IFSP and/or unable to provide EI services. 

The following guidelines describe timelines for considerations of “unable to contact.”

Note: The following guidelines may be effective in resolving most cases where IFSP team members are unable to connect with a family. Staff will need to use their professional judgment on the timelines in these procedures.

If the IFSP service provider and/or service coordinator are unable to communicate with families, and thus are unable to provide service(s), then IFSP team members must communicate with the service coordinator and problem-solve, make repeated and varied attempts to schedule another appointment, and document all attempts by providers to contact the family. The Service Coordinator documents in the Log Notes section and all other providers document in the Contacts/Attempts Prior to the First Delivery section of the IFSP. All IFSP team members must record their individual attempts to contact the family.

Notes: The service coordinator, with appropriate consent for release of information, may want to contact the primary medical provider or the referral source (if other than the parent) to ask for assistance in contacting the family. If the family is involved with the Department of Human Services and appropriate consent for release and exchange of information is signed, the service coordinator should contact the child’s DHS worker to obtain current contact information. If the service coordinator is unable to contact the DHS worker, contact the state liaison for DHS Early ACCESS.

If unable to contact the family after one month of the missed appointment, then the service coordinator mails a STOP IFSP SERVICES LETTER letter to the parents indicating attempts to make contact. The letter states request for parents to contact the service coordinator within 2 weeks or services will end and document a summary of attempts to contact the family on the service coordinator logs.

If the family does not contact the service coordinator 14 calendar days from the mailed STOP IFSP SERVICES LETTER or the letter comes back undelivered and there has been no communication with the family, then exit the child from Early ACCESS as Unknown/attempts to contact unsuccessful (UNK) and document a summary of attempts to contact the family on the service coordinator logs.

If the service coordinator receives some type of communication from the family indicating they no longer want EA services, then exit the child from Early ACCESS as Services Declined by Parent (SDP). 

If the family is still interested in Early ACCESS before the Web IFSP exit has been implemented, then schedule the next appointment to provide services as recorded in the ISFP.

If the family contacts the service coordinator/providers after the exit has occurred and is still interested in Early ACCESS, then complete a new referral/intake and indicate that the child was previously in Early ACCESS and follow the referral/intake process. Note: When designing the second multidisciplinary evaluation, the team will need to consider the timeliness of prior evaluations and assessment data

Steps to complete a Periodic Review with a meeting:

1. Introductions and roll call: Service coordinator will record who attended the meeting and method of participation.
2. Review any new assessment or evaluation information (if applicable). 
3. Record status and document progress on each child and/or family outcomes.
4. 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.
5. Consent for Early ACCESS Services must be signed if the team has made any changes in existing services including changes to frequency, intensity, duration, or location, or a service has been added. If there are no changes to services, a new consent for services is not necessary.
6. If the child is insured by Medicaid and there was a change in IFSP services, seek parent authorization for Medicaid reimbursement.
7. Provide parents Prior Written Notice summarizing decisions.
8. Finalize the IFSP modifications and complete periodic review.
9. If new early intervention service(s) were consented to, review with the family when it is scheduled to begin.
10. Address any questions the family may have.
11. 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.
12. Discuss with the family who else will get copies of the IFSP with appropriate releases.
13. 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:

1. 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. 
2. 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.
3. Record status and document progress on each child and/or family outcomes.
4. Determine if modifications to the outcomes are needed based on progress and/or family’s priorities.
5. Finalize any IFSP modifications and complete periodic review.
6. 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.

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.

1. Consider and discuss with the family the sections of the IFSP which need to be changed. 
2. Document the agreed-upon changes on the IFSP after confirming changes with IFSP Team Members involved.
3. Finalize the IFSP Modification.
4. Obtain parental consent for Early ACCESS services and provide Prior Written Notice if Early ACCESS services were modified.
5. Provide the family with the modified IFSP within 30 calendar days.

• 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. 

During the interim IFSP meeting, the following will take place:

1. 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.
2. 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.
3. Develop the IFSP. The child and family outcomes will be established based on family needs and priorities.  The IFSP development process involves
   1. Discussing relevant information used to presume eligibility and the family’s concerns, priorities, and resources.
   2. Determining and documenting the child and family outcomes that are unique to this child and family.
   3. Determining and documenting the activities and services needed to achieve the outcomes.
   4. Choosing appropriate service providers needed to achieve the outcomes.
   5. Documenting the projected date the provider anticipates will be the first visit in which the service is delivered to the child/family.
   6. Determining where services are to be provided and document the setting.
   7. 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.
4. 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.
5. Schedule the comprehensive multidisciplinary child evaluation as well as child and family assessment as soon as possible.
6. Finalize paperwork and communications. Before the interim IFSP meeting is done, the following will be completed:
   1. Review when each early intervention service is scheduled to begin and address any questions the family may have.
   2. If the child is insured by Medicaid, seek parent authorization for Medicaid reimbursement to include the IFSP services and evaluation.
   3. Provide parents a copy of the IFSP at no cost as soon as possible and no later than 30 days after the IFSP meeting.
   4. Discuss with the family who else will get copies of the IFSP with appropriate releases.
   5. If determined necessary and/or appropriate, seek consent for the release and exchange of information with community providers.

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.