Table of Contents
Chapter 1: EarlySteps, Louisiana’s Early Intervention System
This chapter introduces EarlySteps Louisiana’s Early Intervention System. Each required component of the
statewide early intervention system is described, highlighting the way in which each component is implemented.
Topics in this chapter include:
Mission and Philosophy For Louisiana’s Early Intervention System
Part C of Public Law 108-446
Introduction
State Lead Agency
Interagency Agreements
Central Directory
Public Awareness
Program Manager
Assistant Program Manager
Training Coordinator
Quality Assurance Coordinator
Provider Relations Specialist
Statewide Parent Liaison
State Interagency Coordinating Council (SICC)
Mission
Goal
Purpose
Membership
Quarterly Meetings
Public Comments
Committees
Organizational Structure
Dissemination of Information
Regional Interagency Coordinating Councils (RICC)
Regional Coordinators
Regional Community Outreach Specialist
Regional Quality Assurance Specialist
Central Finance Office (CFO)
System Point of Entry (SPOE)
Other Personnel in EarlySteps
Family Support Coordination Agency
Service Provider
The following services are provided by EarlySteps
Personnel Standards
Comprehensive System of Personnel Development
Training Requirements
Quality Enhancement (QE)
Technical Assistance
Monitoring
Data Collection and Reporting
Indicator # 9
State Performance Plan (SPP)
Who Do You Call?
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Chapter 2: Parents’ Rights, Opportunities, and Responsibilities
This chapter details the procedural safeguards and rights provided through Part C of the Individuals with
Disabilities Education Act (IDEA). These rights and safeguards must be vigorously enforced throughout the early
intervention process.
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The Rights of a Family in EarlySteps
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Parents’ rights in EarlySteps include
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Family Roles and Responsibilities in EarlySteps
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Some suggestions for making the most of each visit
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Definitions of Procedural Safeguards
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Consent means
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Native language
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Personally identifiable information
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Surrogate Parent
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Prior, Written Notice of Action
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Consent
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Confidentiality
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Opportunity to Examine Records
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Resolution of Disputes: Complaints, Mediation, and Due Process Hearings
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Complaints
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Initiating Formal Complaints
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Timelines
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Complaint Types
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Indicator # 10
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Mediation and Due Process
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What is Medication?
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What is Due Process?
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Requesting Mediation
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Mediator Qualifications
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Due Process/Appeal
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Effect on Due Process Hearing Timelines
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Appointment of an Impartial Person
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Parents Rights in Administrative Proceedings
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Due Process Resolution
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Civil Action
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Status of a Child during Proceedings
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Indicator # 11
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Child’s Right to a Surrogate Parent
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Immunity from Liability
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Children under the Care and Custody of the State
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Other Procedural Safeguards: Accept or Decline Services
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Refuse to Complete/Sign Documents
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Indicator # 4
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Freedom of Choice
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Evaluation and Assessment
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Individualized Family Service Plan
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RECOMMENDED PRACTICE:
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PROVIDING PROCEDURAL SAFEGUARDS INFORMATION TO FAMILIES
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Chapter 3: Child Find and Referral
This chapter describes the child find activities used in EarlySteps to locate those children who may be eligible for
the EarlySteps system of early intervention. Requirements for referral are also detailed.
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Child Find Procedures
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Residency Requirements
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Referral Procedures
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Step 1: Receipt of Referral
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Step 2: Acknowledgement of Referral
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Step 3: Contacting the Family
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Referral Process Chart
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Indicator # 7
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System Point of Entry List
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Chapter 4: Intake
This chapter describes the steps in the process to enroll a child in EarlySteps.
The topics included in this chapter:
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Intake Process
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Step 1: Consent to Proceed
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Step 2: Health History
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Step 3 : Collect existing information from
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Step 4: Vision, Hearing, and Nutrition Screenings
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Step 5: Conduct Developmental Screening Ages and Stages Questionnaire (ASQ)
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Step 6: Completion of DHH Application
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Louisiana Department of Health and Hospitals Application for Services Children 0-3 with Special Needs 6
Medicaid
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Office for Citizens with Developmental Disabilities (OCDD)/Human Service Authority/District (HSA/D)
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Children’s Special Health Services (CSHS)
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Medicaid Waiver Registry
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Dissemination of The Louisiana Department of Health and Hospitals Application for Services Children
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0-3 with Special Needs Procedure
EarlySteps Referral Process for CSHS
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SPOE/FSC Procedures for CSHS Referral
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Medicaid Eligibility Verification
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Referral to Office of Community Services
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Initial Eligibility Refused/Child does not qualify for EarlySteps
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Referral to EPSDT
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For Children Referred to EarlySteps after Age 2 Years, 2 Months
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For Children Re-Referred after Closure
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Early Intervention Records- System Point of Entry
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SPOE Records
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Early Intervention Official Record
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Intake Coordinators “Working File”
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Electronic Early Intervention Record
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Access to Records
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Maintaining the Early Intervention Record
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Transfer of Documentation after Initial IFSP
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Early Intervention Records – Additional Information
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Early Intervention Record Protections
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Opportunity to Examine Records
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Destruction of the Early Intervention Record
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System Point of Entry Personnel
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Intake Coordinator
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Intake Coordinator Caseload
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Intake Coordinator Supervisor
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Supervision Activities
Supervisor Caseload
Documentation of Supervision
Frequently Asked Questions about Intake
Intake Process Chart
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Chapter 5: Initial Eligibility Determination
This chapter describes the steps in the process to determine initial eligibility for a child to enter EarlySteps.
Annual eligibility redetermination is covered in Chapter 7.
The topics included in this chapter:
Eligibility Determination for EarlySteps
EarlySteps Eligibility Determination Overview
Evaluation
Assessment
Step 1. Review of referral information and decision to proceed
Step 2: Selecting Provider for Eligibility Evaluation
Step 3: Conducting the Eligibility Evaluation
Conducting an Eligibility Evaluation at a Child Care Center
Step 4: Reporting Evaluation Results
Providing Evaluation and Assessment Results to Family
Indicator # 7
Timelines
Intake Timelines Exceeding 60 Calendar Days
Step 5: Eligibility Determination
EarlySteps Eligibility Criteria
Definition of Developmental Delay
ICD-9 Codes for Developmental Delay
Use of Informed Clinical Opinion to Determine Eligibility
To establish eligibility using informed clinical opinion the following procedures must be utilized
Initial Eligibility Determination
Re-Determination of Eligibility
ICD-9 Codes for Informed Clinical Opinion
Established Medical Conditions
Diagnosed Conditions List and ICD-9 Codes
Redetermination of Eligibility Using Established Medical Conditions
Indicator # 5 & 6
Step 6: Preparation for the Multidisciplinary Eligibility Team Meeting
Eligibility Determination Process Report and BDI-2 Evaluation Report
Eligibility Determination Team Members
Required Eligibility Determination team members
Intake Coordinator
Family Support Coordinator
FSC Nurse Consultant
Early Intervention Consultant
EarlySteps Providers
Family Members
Non-EarlySteps Providers
Nondiscrimination in Eligibility Determination
Native Language
Family Assessment of Concerns, Priorities, and Resources (CPR)
Indicator
Principles for Identifying Family Concerns, Resources, and Priorities
Team Meeting Notice and Minutes Form
Step 7: Conducting the Team Meeting for Eligibility Determination
Eligibility Determination Process Report and BDI-2 Evaluation Report
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Team Meeting Requirements
Statement of Eligibility Section
Documentation of Evaluation Results
Verification of Informed Clinical Opinion
If Child Meets Eligibility Criteria
If the family of an eligible child declines to move to IFSP development following Eligibility Determination
If Child Does Not Meet Eligibility Criteria
Medicaid Registration
Eligibility Verification
Step 8: Follow-up Documentation
Frequently Asked Questions about Eligibility Determination
Reference and Recommended Reading
Eligibility Determination Process Flowchart: Role of Intake Coordinator
Weight Conversion Chart
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Chapter 6: Individualized Family Service Plan Development
The steps and requirements of the IFSP are detailed in this chapter.
Topics in this chapter include:
IFSP Information: Overview of IFSP Development
Parent’s Role in Choosing Early Intervention Services
IFSP Team
Service Guidelines
Medical Services versus Developmental Services
Nontraditional Services
IFSP Outcomes
Strategies to Achieve IFSP Outcomes
IDEA PL-108-446 for Pre-literacy and Language Skills
Daily Routines and Activities in Typical Settings
Indicator # 2
Justification for Early Intervention Services Delivered Outside of the Child’s Natural Environments
Determining Early Intervention Services
Determining Frequency, Intensity and Length of Early Intervention Services
Determining Method of Service Delivery
Prescriptions
Determining the Need for Assistive Technology
Other Services
Interim IFSP
Selecting Providers
No Provider Available
No FSC Available
IFSP Process
Indicator # 7
Step 1: Preparation for Initial IFSP Meeting
Step 2: IFSP Meeting
Indicator # 3
Indicator # 8
IFSP Team Meeting Minutes
Required components of these minutes
Completing the IFSP Process
Step 1: Provide the family with a Notice of Action
Step 2: Implement the IFSP
Timely Services
Recommended Practice for Writing Quality IFSPs
IFSP Development
Individualized Family Service Plan (IFSP)
IFSP Team Services Process From
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Chapter 7: Ongoing IFSP Implementation, 6 Month-Reviews, and Annual IFSP
Evaluation
Ongoing support coordination (FSC) responsibilities to ensure the provision of appropriate early intervention are
presented in this chapter.
Topics included in this chapter:
Ongoing IFSP Implementation, 6 month Reviews and Annual IFSP Evaluation
Teaming for Success in EarlySteps
Strategies for Fostering Teaming
FSC Role in Ongoing IFSP Implementation
Process for Conducting Review/Revision Team Meetings
EarlySteps Team Meetings
Monthly Contact
Suggested Questions for Monthly FSC Telephone Contacts and Quarterly Reviews
Quarterly Meetings
6 Month Review of the IFSP
Autism Screening
Annual Eligibility Determination and IFSP Meetings
Re-Determination of Eligibility using Informed Clinical Opinion
Re-Determination of Eligibility using Established Medical Condition
Re-Determination of Eligibility using Developmental Delay
IFSP Revisions
Required Documents to be Sent to the SPOE and Family Following a Revision
Justification for Early Intervention Services Delivered Outside of the Child’s Natural Environments
Changing a FSC or Provider
Substituting Early Intervention Providers
Extended Services
References
IFSP Revision
FSC Quarterly Progress Report/6 month review
Optional FSC Case Note
IFSP Team Services Process Form
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Chapter 8: Early Transition, Transition at Age Three and Record Closure
Transition activities out of Part C at age three are presented in this chapter.
Topics included in this chapter:
Transition
Early Transition
Early Transition Process
Early Exit – Record Closure
Transferring from one Region to another Region
FSC Responsibilities
Sending (current or old) SPOE Responsibilities
Receiving or “New” SPOE Responsibilities
Transition at Age Three
Transition Process
Notification of a Child Turning Three
IC/FSC Responsibilities
LEA Responsibilities
OCDD/HSA/D Responsibilities
Family Responsibilities
The Transition Meeting
FSC Responsibilities
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LEA Responsibilities
Other Transition Meeting Attendees
Document and Implement the Transition Plan
Outcomes Measurement
Record Closure
Transition Process for Late Referrals-SPOE Responsibilities
Notification of a Child Turning Three
The Transition Meeting
Document and Implement the Transition Plan
Record Closure
OSEP Reporting
Indicator # 8
Extended Services
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Chapter 9: Support Coordination in EarlySteps
This chapter describes the provision of support coordination for SPOE and FSC.
Topics in this chapter include:
Support Coordination in EarlySteps
Introduction to Support Coordination
Support Coordination in Part C
Family Support Coordination
Family Support Coordinator Responsibilities
Referral to Office of Community Services
FSC Medicaid Eligibility Verification
Billing for FSC Services
FSC Billing Summary Checklist
Maximum Caseload of a FSC
Caseload of a FSC Supervisor
Supervision Activities
Documentation of Supervision
Early Intervention Authorizations
Authorizing Services
Submitting Authorizations to the SPOE
Submission of Claims
Changing a FSC or Provider
Substituting Early Intervention Provider
No Provider Available
Early Intervention Records – Family Support Coordinator
FSC File
FSC Contact Notes
FSC Monthly Contact
FSC Quarterly Progress Report
Early Intervention Records Responsibility
Transfer of Documentation for IFSP’s
Transfer of Records When a FSC Leaves an Agency
Early Intervention Records – Additional Information
Early Intervention Record Protections
Access to Records
Opportunity to Examine Records
Destruction of the Early Intervention Record
FSC Performance Indicators
FSC Quarterly Progress Report
FSC Contact Note Format (Optional)
Family Support Coordination Billing Summary
Targeted Case Management – Support Coordination Billable Service Activities Definitions
Who Do You Call?
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Chapter 10: Service Providers Roles and Responsibilities
The roles and responsibilities of the service providers are detailed in this chapter.
Topics included in this chapter
Introduction
Service Delivery in EarlySteps: Recommended Practices for the Service Provider in Ongoing
Service Delivery
EarlySteps Providers
Qualifications
Roles and Responsibilities
Referral to Office of Community Services
Assessments and Evaluations by Service Providers
Provider Enrollment
Training Requirements
Certification of Enrollment by the CFO
The Service Matrix
Changing a FSC or Provider
Substituting Early Intervention Providers
Service Authorizations
Accessing the Online System for Authorizations
Submission of Claims
Medicaid Services
Documentation Requirements for Service Providers
Provider Contact Note
Provider Monthly Report
Documentation for Assistant Level Providers
Services Provided outside of the Natural Environment
Quality Management
Early Intervention Records – Additional Information
Opportunity to Examine Records
Access to Records
Destruction of the Early Intervention Record
Professional Ethics
Service Provider Performance Indicators
Service Provider Contact Note
Provider Monthly Report
Who Do You Call?
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Chapter 11: Assistive Technology Devices and Services
Purpose
Assistive Technology Definition
Assistive Technology Service
Procedure for Acquisition of Assistive Technology Devices for a Medicaid Eligible Child
Completing Section 7 of the IFSP for an Assistive Technology Device
FSC Responsibilities
SPOE Responsibilities
Provider Responsibilities
Examples of allowable AT Devices
Examples of Items that will not be purchased
Equipment Control
Requirements of the Inventory Control System
Disposition of AT Devices and Equipment
Table 1: Part C Assistive Technology Inventory List (for use by SPOEs and FSCs)
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Chapter 12: Resources
Topics in this chapter include:
Terms You Need To Know
Additional Information
Websites
Website for Language Development and Pre-literacy Skills
Early Childhood Websites
Resources for Transdisciplinary/Primary Service Provider Approach to Service Delivery
Family Survey
Indicator # 4
How EarlySteps Services are Determined
Professional Conduct
Personal Safety Guidelines
Referral to IFSP Process
Universal Precautions
EarlySteps Recommended Practices
Service Guidelines
EarlySteps Services FACT Sheets
Other Fact Sheets
Developmental and Medical Services in Part C
Eligibility Determination
IFSP
Local Education Agencies (LEA) Participation in Part C
Natural Environment
Who Do You Call?
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Chapter 13: Provider Qualifications in EarlySteps
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Chapter 14: Forms
Parents’ Rights: A Family Rights Handbook
Surrogate Parent Determination Form
Referral Form
Acknowledgement of Referral Letter (referral source other than parent)
Acknowledgement of Referral Letter (Parent)
Record Access Log
SPOE 45-day Checklist
Notice of Action
DHH Application for Services 0 – 3 with Special Needs
Health History (IFSP Section 3a: Present Levels of Health Functioning)
Health Summary
Consent to Release and Share Information
Change Form
Early Intervention Services Transition Notification
Freedom of Choice Provider Selection Form
BDI-2 Evaluation Report & IFSP and Program Planning Reports
Eligibility Determination Process Report
Team Meeting Notice and Minutes Form
Request for Authorization/Provider Status Change Form
Worksheet for Audiology Evaluation/Assessment
EarlySteps Eligibility Information for Office for Citizens with Developmental Disabilities (OCDD)/Human
Service Authority (HSA)/District (D) or Medicaid Waiver Registry Referrals
Family Assessment of Concerns, Priorities, and Resources
Individualized Family Service Plan (IFSP)
Service Provider Contact Note (Mandatory)
Provider Monthly Progress Report (Mandatory)
FSC Quarterly Progress Report/6 Month Review
FSC Billing Summary
Parent Activity Checklist (Optional)
IFSP Team Services Process Form
FSC Contact Note Form (Optional)
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