AzEIP Process

1. AzEIP Process From Referral Through Exit

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

5. Initial Visit SC visits within 10 days ; AzEIP SC or ASDB SC Activities Forms Key Principles and Mission Card PWN of eligibility Vision Screen Checklist Hearing Screening Tracking form Child and Family Rights in AzEIP • Explanation of Early Intervention: 7 Key Principles • Discuss Eligibility • Conduct Vision and Hearing Screening • Discuss family rights

6. Initial Visit (cont) Activities 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 • Discussion of all funding sources • Explanation of consents, as appropriate • Explanation of Child and Family Assessment

7. New Path

9. No Yes

10. New Path

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

12. Initial Visit AzEIP SC visits within 10 days Activities 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 • 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

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

14. Evaluation Conducted by 2 (PT, OT, SLP, VI, HI, SW, Psych, DSI) Activities Forms AzEIP approved evaluation instrument AzEIP Developmental Evaluation Report • 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

15. Evaluation (cont.) Activities 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 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.

16. Eligibility

17. 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

18. Initial Assessment AzEIP SC (or in some cases ASDB SC) Activities 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 • Explain Early Intervention: 7 principles • Explain Assessment process • Obtain Consent for Assessment • SC and team members facilitate Assessment discussion • Complete Child Indicators

19. Referral Eligibility 45 days Initial Assessment Initial IFSP

20. Initial IFSP Ongoing SC and at least one team member from eval/assessment Activities 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 • Review Family Priorities from Assessment • Complete IFSP - Discuss all funding sources - Discuss family rights and complete needed Consents and PWN

22. 6 month or other review IFSP SC and all IFSP team members Activities Forms Child’s current IFSP IFSP Addendum pages AzEIP Child Data Forms If needed, Consent to Share information Consent to Obtain Information • Update IFSP pages, as appropriate • Consents, as needed • Address upcoming transition, if appropriate • Update data form • Update data base

24. Annual Assessment SC and at least one IFSP team member Activities 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 • 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

25. Annual IFSP SC and all IFSP team members Activities 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 • Complete new IFSP • Transition Activities, as appropriate • Annual consents as appropriate • Explain and provide Family Survey • Update data

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

29. Exit SC coordinates and documents the child’s exit from AzEIP Activities Forms Child Indicators Exit Summary Family Survey Postage-paid AzEIP envelope AzEIP Child Data Form • 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

30. Resources AzEIP SC Video Team Based EI Overview video PWN Table Eligibility video 7 Key principles of Early Intervention Screening video Procedural Safeguards video Family Guide to Funding Data Form Guidance AzEIP List of Approved Tools Explanation of funding/FCP forms sent to families Hearing Screen Resources Child and Family Rights Eligibility Video Assessment video IFSP video Guidelines for Requesting EPSDT Services Transition video Transition Activities Table

31. Questions