AzEIP ProcessFrom Referral Through Exit

Objectives

• To understand the process of referral through exit within the AzEIP system– Flow Chart– Forms Handout

Initial Visit

Activities• Explanation of Early

Intervention: 7 Key Principles

• Discuss Eligibility • Conduct Vision and Hearing

Screening• Discuss family rights

Forms• Key Principles and Mission

Card

• PWN of eligibility• Vision Screen Checklist • Hearing Screening Tracking

form • Child and Family Rights in

AzEIP

SC visits within 10 days ; AzEIP SC or ASDB SC

Initial Visit (cont)

Activities• Discussion of all funding

sources • Explanation of consents, as

appropriate • Explanation of Child and

Family Assessment

Forms• Family Guide for Funding • Consent for Insurance • Financial Information Form • Percent to Pay Table • Hardship • Rate Sheet • Consent to Obtain Information • Consent to Share Information • Authorization to Disclose

Protected Health Information • Consent for Child Assessment • Child and Family Assessment

Guide for Families

New Path

No

Yes

New Path

Child potentially eligible based on % delay• Family concerns• No records• Records indicate child is not eligible

Initial Visit

Activities• Explanation of Early

Intervention: 7 Key Principles • Conduct Developmental

Screening, if appropriate• Conduct Vision and Hearing

Screening• Discuss Eligibility, need for

evaluation• Provide and explain child and

family rights

Forms• Key Principles and Mission

Card• Consent for Screening/PWN• Screening tool• Vision Screen Checklist • Hearing Screening Tracking

form • Consent to evaluate -PWN• PWN Refuse to Evaluate• Child and Family Rights

AzEIP SC visits within 10 days

Initial Visit (cont)Activities• Discuss all funding sources • Explain consents, as

appropriate

Forms• Family Guide for Funding • Financial Information Form • Percent to Pay Table • Hardship • Rate Sheet • Consent for Insurance • Consent to Obtain Information • Consent to Share Information • Authorization to Disclose

Information

Evaluation

Activities• 2 team members conduct the

evaluation using AzEIP approved test instruments

• DDD and/or ASDB eligibility simultaneously addressed

• All evaluations include the use of Informed Clinical Opinion

• Team members come to consensus regarding eligibility

• Evaluation cannot be combined with Assessment

Forms• AzEIP approved evaluation

instrument • AzEIP Developmental

Evaluation Report

Conducted by 2 (PT, OT, SLP, VI, HI, SW, Psych, DSI)

Evaluation (cont.)Activities

If eligible: •Explain Child and Family Assessment•Address financial matters•Discuss PWN, eligible•Offer copy of family rights

If not eligible: •Discuss community resources •Process for re-referral •Discuss PWN, not eligible•Offer copy of family rights.

Forms

•Consent for Child Assessment •Child and Family Assessment Guide for Families •Financial Information Form •Child and Family Rights in AzEIP •PWN Eligible•PWN Not Eligible

Eligibility

Initial Assessment• SC from AzEIP (or in some cases ASDB) schedules and

participates in the Child and Family Assessment with the family and: – If eligible based on record review: 2 core team members

( PT, OT, SLP, VI, HI, SW, Psych, DSI)– If eligible based on evaluation: 1 team member (PT, OT,

SLP, VI, HI, SW, Psych, DSI)

• If ASDB is conducting the assessment, 2 team members, one of whom may be certified vision or hearing professional with ASDB

• The Initial Assessment must be completed prior to the Initial IFSP Meeting

Initial Assessment

Activities• Explain Early Intervention: 7

principles • Explain Assessment process • Obtain Consent for

Assessment • SC and team members

facilitate Assessment discussion

• Complete Child Indicators

Forms• Consent for Child Assessment • Child and Family Assessment

Guide for Families• IFSP Child and Family

Assessment pages • Child Entry Indicator

Summary• Rating Definitions • Decision Making Tree

AzEIP SC (or in some cases ASDB SC)

Referral

Eligibility

Initial Assessment

Initial IFSP

Initial IFSP

Activities• Review Family Priorities

from Assessment

• Complete IFSP - Discuss all funding sources - Discuss family rights and complete needed Consents and PWN

Forms• IFSP • Consent for Insurance • Consent to Share • Consent to Obtain

Information • Financial Information Form • Rate Sheet • Percent to Pay Table • Hardship Request• Child and Family Rights • AzEIP Child Data Forms

Ongoing SC and at least one team member from eval/assessment

6 month or other review IFSP

Activities• Update IFSP pages, as

appropriate• Consents, as needed • Address upcoming

transition, if appropriate • Update data form• Update data base

Forms• Child’s current IFSP • IFSP Addendum pages• AzEIP Child Data Forms

If needed, • Consent to Share

information • Consent to Obtain

Information

SC and all IFSP team members

Annual Assessment

Activities• Prior to, provide family a copy

of Assessment Guide for Families ; ensure they have a copy at assessment.

• Review 7 Key Principles• Obtain Consent for Child

Assessment• Document Assessment

discussion on NEW IFSP pages • Conduct vision and hearing

screening

Forms• 7 Key Principles card• Child and Family Assessment

Guide for Families• Consent for Child

Assessment • IFSP Child and Family

Assessment pages • Vision Screening Checklist • Hearing Screening Tracking

form

SC and at least one IFSP team member

Annual IFSP

Activities• Complete new IFSP

– Transition Activities, as appropriate

• Annual consents as appropriate

• Explain and provide Family Survey

• Update data

Forms• New IFSP form

– Child and Family Assessment pages

– Transition IFSP pages – PEA Notification/Referral

• Consent to Share Information• Consent to Obtain Information• Consent for Insurance • AzEIP Family Survey • AzEIP Child Data Form

SC and all IFSP team members

Transition

Activities• Transition planning at IFSP

closest to child’s 2nd Birthday• Document transition steps on

IFSP• IFSP Transition Planning

Meeting• Coordinate, schedule and

facilitate Transition Conference prior to age 2.9

• Send PEA Notification/Referral Form

• Attend IEP, if requested by the family

Forms• IFSP Transition Plan Page • IFSP Transition Timeline Page • Invitation to the Transition

Conference• Transition Conference

Summary • PEA Notification/Referral Form • Consent to Share Information

SC, all IFSP service providers, and all persons involved in evaluation or assessment (depending on the child’s age)

Exit

Activities• Coordinate with ASDB and

DDD, as appropriate• Complete Child Indicators

Exit Summary • Provide family with Family

Survey • Offer family copy of record • Update AzEIP Child Data

Form • Update I-TEAMS

Forms• Child Indicators Exit

Summary • Family Survey • Postage-paid AzEIP

envelope • AzEIP Child Data Form

SC coordinates and documents the child’s exit from AzEIP

ResourcesAzEIP SC Video Team Based EI Overview video PWN TableEligibility video7 Key principles of Early InterventionScreening videoProcedural Safeguards videoFamily Guide to Funding Data Form Guidance AzEIP List of Approved ToolsExplanation of funding/FCP forms sent to familiesHearing Screen Resources Child and Family Rights Eligibility VideoAssessment videoIFSP videoGuidelines for Requesting EPSDT ServicesTransition videoTransition Activities Table

Questions