IFSP

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					Effective Date: July 1, 1996                                         CT Birth to Three System
Date Revised: July 1, 2011

Title:                 INDIVIDUALIZED FAMILY SERVICE PLAN (IFSP)

Purpose: Insure that each eligible child and family has an Individualized Family
         Service Plan that meets federal requirements.

                                         Overview

The individualized family service planning process is used to develop and deliver
appropriate early intervention services to an infant or toddler with disabilities and his or
her family. Throughout the IFSP process, family members and service providers work
as a team. The family’s concerns and priorities guide the entire process. After all
evaluation and assessment information has been gathered, the team develops IFSP
outcome statements. Outcomes reflect what family members see as important for their
child and themselves. The team then determines objectives, strategies, supports, and
services necessary to meet those IFSP outcomes. The team must take into
consideration the child’s and family’s natural environment in which they live, learn and
play and the capacity of the family to meet their own child’s unique needs. The
objectives, strategies, supports, and services are committed to the document called the
IFSP. The IFSP is an agreement between the family and the program providing
supports and services.

                               IFSP Timelines and Procedures

Procedures for IFSP development, review, and evaluation (34 CFR sec. 303.342) are:

   A meeting to develop the initial IFSP must be held within 45 calendar days of the
    child’s referral to the Birth to Three System (i.e. from the call to Child Development
    Infoline).

   This meeting must be conducted in settings and at times that are convenient to the
    family. It most often occurs in the family’s home.

   For families that are not proficient in English, the meeting must be in their native
    language or other mode of communication of the family unless it is clearly not
    feasible to do so. This may involve use of an interpreter.

   Parents must be provided with written prior notice of the time and place of the
    meeting a reasonable time before the meeting to ensure that they will be able to
    attend. Form 1-6 (Written Prior Notice) should be used for this purpose

   The IFSP must be reviewed at least every six months or more frequently if changes
    are needed or if the family requests a review. The purpose is to determine the
    degree of progress made toward achieving the outcomes and whether revision of
    the outcomes or services is necessary.
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   According to IDEA Part C regulations, a meeting must be conducted at least
    annually to evaluate the IFSP for a child and family, and, as appropriate, to revise its
    provisions. This means anytime within the 12 months after the initial or previous
    evaluation of the IFSP. The results of any current evaluations (completed within the
    past three months) conducted under § 303.322(c) and other information available
    from the ongoing assessment of the child’s development in all five domains and the
    family concerns must be used in determining what services are needed and will be
    provided. This information does not need to be the result of a multidisciplinary
    assessment.

   For each child who may be eligible for preschool special education services (IDEA
    Part B), a conference must be convened with the approval of the family at least 90
    days or, at the discretion of the parties, up to nine months before the child’s third
    birthday to ensure adequate time to determine whether the child is eligible, to plan a
    program, and to carry out activities to help the child and family prepare for the
    change in services.

   For each child who is not being referred for preschool special education services
    (IDEA Part B), the service coordinator must convene a transition conference at least
    90 days prior to the child’s exit from the Birth to Three System (and as early as nine
    months prior to the third birthday) to develop a plan as part of the IFSP to support
    the child’s transition to other appropriate services. Reasonable efforts should be
    made, with the approval of the family, to invite participation from any community
    agency from whom the family is seeking services.

   An IFSP is completed only when a child is eligible for Birth to Three services.

   If a family chooses to receive only those services available at no cost, an IFSP is
    written to reflect this decision (see Page 7 “Completing the IFSP Form for a Child
    Receiving Services at No Cost”). If, at a later date, a family chooses to begin
    receiving direct services, the IFSP must be revised to reflect this decision.

   Once a child is found to be eligible for Birth to Three services he or she remains
    eligible while enrolled in the Birth to Three System until they meet the exit criteria.
    Children moving from an IFSP with services at no cost to an IFSP with services do
    not require another eligibility determination.

                                     IFSP Participants

At the initial IFSP meeting and the meeting to evaluate the IFSP that must be held at
least annually, the following participants must be present (34 CFR sec 303.343):

   The parent or parents of the child.
   Other family members, as requested by the parent, if feasible to do so;
   An advocate or person outside of the family. If the parent requests that the person
    participate.
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    The service coordinator that has been designated to be responsible for
     implementation of the IFSP;
    A person or persons directly involved in conducting the evaluation and assessment;
    Service providers as appropriate. This may include providers from the early
     intervention program, the child’s physician, representatives from the child’s local
     public school, other agencies, or child care providers;

At a minimum, the initial IFSP and the meeting held annually to evaluate the IFSP must
include the parent, service coordinator, and one person directly involved in conducting
the most recent evaluation or assessment of the child. For periodic reviews the
minimum participants must include the parent and service coordinator.

It is possible that the primary interventionist may fulfill both the roles of service
coordinator and evaluator or assessor if they are a licensed or certified early
interventionist who can perform evaluations and assessments.

                     Including the Primary Health Care Provider
           (Physician or Advanced Practice Registered Nurse) in the IFSP

Connecticut General Statute 17a-248e(c) requires that the IFSP be developed in
consultation with the child’s primary health care provider who is licensed in Connecticut
or a contiguous state. To meet this requirement, the service coordinator should obtain
parental permission to contact the primary health care provider indicating that his or her
input is requested for a patient’s IFSP. The primary health care provider’s input should
be sought regarding services that will be recommended and whether there are any
contra-indications warranted by the child’s medical status. Following the IFSP meeting,
the IFSP form must be sent to the primary health care provider (physician or advanced
practice registered nurse) for review and signature before implementation of services
can begin. Use Form 3-6, the cover letter to the primary health care provider requesting
his or her signature on the IFSP that indicates confirmation of the appropriateness of
the diagnosis(es) as stated by the diagnostic (ICD-9) code and the recommendations
for the treatment services as they are written. This signature serves as a prescription for
physical therapy and authorization for insurance billing. Since the IFSP is used to bill
commercial insurance, the primary health care provider signing the IFSP must meet the
insurance plan’s definition of primary health care provider. A faxed signature from the
primary health care provider on the service page of the IFSP is acceptable.

                                        Interim IFSP

Early intervention services may begin for a child who is eligible for Birth to Three
services and the child’s family prior to the completion of the multidisciplinary
assessment under the following conditions:

A.      Parental consent is obtained.

B.      An interim IFSP is developed that includes:
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      1. the name of the service coordinator who will be responsible for the
         implementation of the interim IFSP and coordination with other agencies and
         persons, and
      2. the early intervention services that have been determined to be needed
         immediately by the child and the child’s family.

C.    The interim IFSP must be signed by the child's primary health care provider
      (faxed copy is permissible) before services may begin.

D.    The multidisciplinary assessment (and review of the interim IFSP which then
      becomes the initial IFSP) still must be completed within 45 days from the child’s
      date of referral to CDI.

                              Completing the IFSP Form

The Connecticut IFSP was designed to be in compliance with IDEA 2004 and Sec.
303.344 of the IDEA regulations as amended in 1999. The Connecticut Birth to Three
System’s IFSP form was created to support the concept that the development of this
plan is a process that begins with the first phone call to the system. Each section of the
form helps to document the process. For more detailed information on the IFSP form
page by page, see the IFSP Handbook at Birth23.org/providers/IFSPhandbook.pdf.

Cover Sheet
Purpose: Includes information about the child, family, health care provider, school
district and service coordinator. This page must be completed as part of the initial and
annual IFSP meetings and is also used to update information at reviews if there are
changes; otherwise it is optional to use this page for the IFSP reviews

Section I.
Summary of Child's Present Abilities, Strengths, and Needs
Purpose: serves as a summary of information that has been gathered regarding the
child's present abilities, strengths, and needs. The information must be based on
current (no more than three months old) evaluation and assessment results,
observations and parent report. This section must also include a statement of the
child's present level of physical development, (including vision, hearing, and health
status), cognitive development, communication, social and emotional development, and
adaptive development.
                                                                                IFSP page 5


Sections II.
Summary of Family's Concerns, Priorities and Resources as They Relate to
Enhancing Their Child's Development - Family Outcomes
Purpose: Provides an opportunity for the family members to think about and share
their hopes, dreams, and concerns for their child as well as family strength needs and
priorities, and to develop and write family outcomes. Family Concerns are the areas
identified by the family as needs, issues, or problems they want to address. Family
Priorities are the things or accomplishments important to the family. Family Resources
are formal and informal means that can help the family. Family Outcomes are the
changes the family wants for themselves.

What information the family chooses to share is voluntary on their part. The service
coordinator must check with the family about the content and wording of information
before writing it down.

Sections III.
Other Services That Are In Place or Needed
Purpose: Birth to Three is only a piece of the larger support network for the child and
family. This section identifies services that are in place or desired by the family. These
support or services are not required early intervention services under Part C of IDEA,
yet they will be considered as part of the overall plan. The service coordinator is
responsible for assisting the family to obtain and coordinate these services with the
Birth to Three services.

Section IV.
Plan for Transition from the Birth to Three System
Purpose: It provides an opportunity to record the discussion of the child and family
needs regarding the child’s eventual transition from the Birth to Three System. The plan
must include the steps to be taken to support the transition of the child including
discussion with, and training of, parents regarding future placements and other matters
related to the child’s transition; procedures to prepare the child for changes in service
delivery, including steps to help the child adjust to, and function in, a new setting. This
plan must be completed during the initial and annual IFSP and revised as needed
during periodic IFSP reviews.

Section V.
Outcome
Purpose: Indicates the changes the family wants for themselves or for their child and
relates to developmental information. This section must contain child outcomes and
may include family outcomes if not already written in Section III. Outcomes should be
functional and make sense to the family in the context of their everyday routines,
activities, and environments. Outcomes should be based on a one year basis unless
the child will be turning three sooner. Per IDEA 2004 the IFSP shall be in writing and
contain “… a statement of the measurable results and or outcomes expected to be
achieved for the infant and toddler and the family, including pre-literacy and language
skills as developmentally appropriate for the child.
                                                                                IFSP page 6




Section VI.
Early Intervention Services and Supports
Purpose: Indicates the early intervention services and supports necessary to meet the
unique needs of the child and family to achieve the desired outcomes as previously
written. The decisions regarding what services and supports will be provided, including
type, frequency, location, intensity, and duration, can only be made after the
development of outcomes and strategies. Family members and professionals are
encouraged to talk about services and supports openly and to make joint decisions
based upon the outcomes chosen and the strategies developed by the team. The
decision to provide a service or support can not be based solely upon factors such as:
nature or severity of disability, age of child, availability of services, administrative
convenience, family preference, payment methodology, or service provider preference.

The early intervention services under Part C of IDEA are: assistive technology devices
and services; audiology; family training; counseling and home visits; health services
necessary to enable the child to benefit from other EI services; medical services only for
diagnostic or evaluation purposes; nutrition services; occupational therapy services;
physical therapy services; psychological services; service coordination; social work
services; special instruction; speech-language pathology, sign language and cued
language services; transportation and related costs; and vision services

It is important to be very clear with the family what services they can expect to be
delivered by whom and how often and whether visits are separate or joint. Since EI
Associates and Assistants must work under the supervision of a licensed or certified
professional who must also co-sign all progress notes, no IFSP should have an EI
Associate or Assistant listed as the sole service provider. The person providing
supervision and co-signing progress notes should also be listed as periodically seeing
the child and family. See the IFSP Handbook for more detailed information.

There are instances when services must be phased in, particularly for a child who
needs intensive services. If all services cannot begin immediately, the IFSP service
section should indicate which services are beginning when, with a staggered phase-in
up to the agreed-upon maximum frequency/intensity and type. If services are written
into the IFSP that are not delivered, then the family has the right to expect those hours
and types of service to be made up.

The service coordinator should have discussions with the family about events that affect
service delivery such as the program’s schedule, holidays, staff vacation, staff illnesses,
inclement weather, or other emergency situations. This should be documented either in
the meeting notes (just below section VII) or on an additional IFSP page or on some
other piece of paper that the parent signs and receives a copy of and is filed in the
child’s record. Without the signature, there is no documentation that the parent agreed,
at least at the time, to the plan. There are no hard and fast rules about the best way to
negotiate this with each family because the IDEA describes early intervention as a
“year-round” program without setting any reasonable parameters. The IFSP meeting is
                                                                                   IFSP page 7


the time to negotiate those parameters with each family. Family may change their
minds, however, and the parameters may need to be re-negotiated at future IFSP
reviews or annual meetings.

Federal law requires that parents understand their rights. It is the obligation of the
service coordinator to do this by giving the parents a written documentation of their
rights at least annually and taking the time to review those rights with them (see
Procedural Safeguards procedure). Parents then document this by checking line 1.

Parents must be given written prior notice at an IFSP meeting after the family and their
team has determined the services being proposed and start dates that are a reasonable
amount of time before they begin. Parents indicate that they have been given this
notice and agree to the complete plan as written by checking 2a. If they don't agree
with the complete plan they can indicate that by checking 2b. As an example, there
may be an instance when a parent may want more services or different services to be
delivered than the team is recommending or they may wish to refuse a recommended
service. They can decline that service or state their request here without jeopardizing
the other early intervention services listed.

If a parent indicates that they do not accept the full plan as written, the provider must
take steps to resolve the issue. The parent can exercise their rights under the Birth to
Three System (see Procedural Safeguards and Complaint procedures).

The parent, the appointed surrogate parent, or someone who is acting in the parental
role must sign and date the IFSP. DCF staff members or contractors such as safe
home staff may not sign the IFSP since they are employees of the agency caring for the
child and, as such, prohibited as acting in the parental role by the IDEA Part C.

If the program chooses to use a laptop computer on-site to produce the IFSP or
chooses to enter the information and produce a typed version at the office, the parent
must review and sign the typed version for it to be considered valid.

Section Vll.
IFSP Team Members
Purpose: serves as a record of the persons who participated at the IFSP meeting
either by being present or by providing information via a report or some other means.
This helps the team identify those team members who are not present but who are
going to assist in the implementation of the IFSP and with whom there may be ongoing
verbal communication.

       Completing the IFSP Form for a Child Receiving Services at No Cost

If a family of an eligible child meets the criteria for the Family Cost Participation fee (see
Family Cost Participation Procedure) they may request to receive only those services
that are available at no cost. By IDEA Part C regulations, the following services must be
provided at no cost to the family: evaluation, assessment (initial and annually), IFSP
                                                                                 IFSP page 8


development and review, service coordination (including transition planning) and
procedural safeguards.

When a family of a child eligible for Birth to Three services chooses to only receive
those services available at no cost to the family the following sections of the IFSP form
should be completed:

The Cover page, Section I, Section II, Section III, Section IV and Section VII should be
completed as they would be for any IFSP, reflecting information about the child and the
family concerns as well as transition plans and the team members who participated in
the development of the plan. Section V, the outcome page should also be completed
with strategies that reflect family and community resources since Birth to Three services
will not be provided.

The service grid on Section VI can be left blank or annual assessment can be listed on
the grid. Service coordination is already identified on the page and can be highlighted
making sure the correct name and contact information is listed.

To help the family understand what will be happening as a result of this plan, it is
recommended that the service coordinator check the box indicating other pages are
attached to clarify services and then on an additional blank page or in the meeting notes
section on the signature page, the service coordinator should write a brief description of
what will be happen.

The parent still signs this page indicating they have received their rights and are in
agreement with the plan. If they give written permission to send a copy of the plan to
the primary health care provider, the completed IFSP is sent, however the primary
health care provider's signature is not required since no services are being provided.

The same procedures should be used when doing a periodic review or annual review of
the IFSP for a family that will be receiving only those services provided at no cost.

                              Periodic Review of the IFSP

To stay current with the child’s and family’s needs, the IFSP is reviewed at least every
six months and more frequently if conditions warrant or the family requests such a
review. Each time an IFSP is reviewed the clock starts again on the requirement that
IFSPs be reviewed at least every six-months. The IFSP must be fully evaluated at least
annually.
The purpose of a periodic review is to determine the degree to which progress toward
achieving the outcomes is being made and whether revisions to those outcomes, or
services, or transition plan, or other information is necessary.

The review may be carried out at a meeting or by another means, such as a phone call,
that is acceptable to the parents and other participants. (However, even if the review is
by telephone, it does not eliminate the need for prior written notice.) Participants at this
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review must include the parent or surrogate parent, the service coordinator, other family
members as requested by the parent if feasible to do so, and an advocate or person
outside of the family if the parent requests. The minimum participants at a periodic
review are the parent and service coordinator.

Prior to the meeting or scheduled phone call, written prior notice must be provided to
the family within a reasonable time to ensure that they will be able to attend. Use Form
1-6 (Written Prior Notice) for this purpose. An IFSP review may only be held without
written prior notice if it is initiated by the parent rather than by the program.

Section R-1. Individualized Family Service Plan Review: Outcomes
Purpose: states the reason for reviewing the IFSP. Records the status and progress
of outcomes identified for the child and family and states the progress made towards the
“Next Steps” identified on section IV, the transition plan. Additional pages can be added
as needed to record this information and outcome pages or a new section IV may be
attached to reflect new outcomes or plans developed as a result of the review or to
show how an ongoing need will be addressed.

Section R-2.
Individualized Family Service Plan Periodic Review: Supports and Services
Purpose: indicates all services the child and family will be receiving from this review
date forth. The start dates for existing services from the previous IFSP that do not
change at the periodic review remain the same. The start date for a new or changed
service is the date of the review unless otherwise noted. If, following a required review
of the IFSP, there are no changes to the services as listed in the previous IFSP, “No
Change” can be written across the grid. The IFSP will require a new signature from the
child’s primary health care provider if, as a result of the review, there are increases in
the frequency or intensity of existing services or additional services are added to the
plan. Form 3-7 is the cover letter to the primary health care provider to accompany the
revised IFSP. Services previously written on the plan and approved by the primary
health care provider may continue while waiting for authorization of the new or
increased services.

                         Annual Meeting to Evaluate the IFSP

According to IDEA Part C regulations, a meeting must be conducted at least annually to
evaluate the IFSP for a child and family, and, as appropriate, to revise its provisions.
The service coordinator should give the family written prior notice (Form 1-6) of this
meeting. The results of any current evaluations (within the past three months)
conducted under § 303.322(c) and other information available from the ongoing
assessment of the child and family must be used in determining what services are
needed and will be provided. Therefore, there must be current information available on
the child’s development in all five domains. This information does not need to be the
result of a multidisciplinary assessment. The child’s primary interventionist (if that
person is an E.I. professional) can provide all of the assessment information, although if
there are others serving the child and family, their information must be included.
                                                                              IFSP page 10




To evaluate the IFSP, the service coordinator should ensure that proper notice of the
meeting is sent to the participants. The IFSP meeting arrangements must be made and
written prior notice provided to the family use Form 1-6 (Written Prior Notice) for this
purpose.

To document the evaluation of the IFSP, the service coordinator should first complete
an IFSP cover page using information from the original or last annual review of the
IFSP. Check to be sure that the information is still current including having permission
to notify the child’s school district.

Following this page should be the page entitled “Section R-1. Individualized Family
Service Plan Review: Outcomes” indicating the status of the child’s and family’s
outcomes as well as the Transition Plan page. After this, the rest of the IFSP document
(Sections I through VII.) should be completed. This IFSP must be sent to the primary
health care provider for his review and signature.

                                       Implementation of the IFSP

As soon as possible following the IFSP meeting, the service coordinator should send a
full copy of the IFSP (with all referenced reports attached) to the parent and copies to
anyone else for whom the parent has listed on a signed release.

Programs must provide, arrange, or ensure access to the services described in the
IFSP Section VI following the meeting and after obtaining the required primary health
care provider signature. Programs cannot provide or arrange for a service for which the
parent has not given consent or for which consent has been withdrawn. All services
scheduled to be provided at least monthly must begin no later than 45 days from the
day that the parent signs the IFSP. The service coordinator should ensure
uninterrupted implementation of an IFSP that involves multiple service providers or
agencies.




_____________________________
References:
Form 1-4, Consent for Evaluation/Assessment
Form 1-6, Written Prior Notice
Form 3-1, Individualized Family Service Plan (IFSP)
Form 3-6, Physician IFSP Cover Letter
Form 3-7, Physician IFSP Review Cover Letter
Section 17a-248c and 248(e)c of the C.G.S.
Exit Procedure
Procedural Safeguards Procedure
Section 17a-248-1 (7) and (8) of the Regulations of the State of CT
Part C of IDEA Sec. 1436
34 CFR Sections 303.340
IFSP Handbook
Online Data System Manual

				
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