EI Services and IFSP Agreement

1) Purpose: The EI Services and IFSP Agreement page of the IFSP document is used to identify specific services that address all of the outcomes developed by the IFSP team, and document that: 1) the parent(s) or legal guardian(s) have been provided a written copy of the procedural safeguards and understand them; 2) the parent(s) or legal guardian(s) participated in the development of the IFSP; and 3) the parent(s) or legal guardian(s) consent to the initiation of the EI service(s) listed on the IFSP.

2) Process: This page is completed as the final step of the written plan by the parent(s) or legal guardian(s), service coordinator and other IFSP team members. The strategies to meet the outcomes on the IFSP are the basis for planning services to meet child and family needs.

3) EI Data System: This information is entered via the IFSP Home Visual Force page under the EI Services tab.

Informal Supports to Meet Your Outcome(s): The IFSP team reviews the family’s informal supports, as discussed and documented under Your Family’s Supports and Resources. The IFSP team then considers if any of these services can address the strategies to meet the outcomes. Informal supports may be people, groups, clubs, associations, programs, and/or organizations the family is involved with (e.g., mom and tot groups, faith communities, recreation programs, neighbors).

Model: Document the model of service provision being implemented for the child and family.

• Primary Service Provider: One primary provider supports the child and family. This provider participates in regularly scheduled team meetings with providers of differing disciplines to discuss and determine strategies appropriate to the child and family. Co-visits with providers of differing disciplines may occur.

• Multidisciplinary Provider: More than one provider of differing disciplines supports the child and family. Providers may participate in team meetings.

• Single Service Provider: One service provider supports the child and family and does not participate in team meetings.

Document the following for each necessary EI service:

• EI Service: List the specific allowable EI service(s) that the IFSP team has identified as necessary in order to implement the strategies to meet the child and family’s IFSP outcome(s).

  • EI services are documented for a maximum duration of twelve months from the date of the Initial IFSP or Annual Review. Services may be documented for a shorter duration to reflect the individual needs of the child and family.

• Service Type: Document if this service is a New, Continued, Continued Revised, End

• Location: Identify the typical location in which the service will be provided. Enter one of the following:

  • Home: Enter this when a service is being provided in the home of a caregiver, such as a parent, grandparent, or relative.

  • Community: Enter this when a service is being provided in a community setting, such as a library program or childcare setting.

  • Other: Enter this when a service is provided in a setting that is not a natural environment. In this instance, the Justification for Services in Settings Other Than the Natural Environment page must be completed. The other instance in which Other is documented is when the method is Teaming.

• Method: Describe how the service will be provided. Multiple methods for a single service may be chosen. Methods include:

  • Individual (with the child and caregiver present):

    • Direct service support to address the functional developmental needs of an infant or toddler

    • Training and education to caregiver(s) and family to understand and support the developmental needs of an infant or toddler which may address, but is not limited to, the following topics:

      • Implementation and development of IFSP strategies

      • Specialized skill building (such as Sign language instruction)

      • Environmental adaptation

      • Use and maintenance of specialized developmental equipment, such as assistive technology devices

      • Participation in the IFSP development and review

• Co-visit (with child and caregiver present):

  • Individual consultation with a parent and provider with another provider that occurs directly within the service delivery setting or through the use of video conferencing.

• Teaming:

  • Provider participation in regularly scheduled team meetings to share expertise across disciplines, and providers to discuss strategies to support progress toward IFSP outcomes. The SC explains the model and use of teaming to the family using the Primary Service Provider Model brochure prior to obtaining parent consent for this methodology.

• Supervision:

  • Observation and support of a paraprofessional within the service delivery setting.

• Frequency:

  • Enter the frequency, to document the number of sessions that a service will be provided over a year.

    • For example, if a service is being provided one time per week, fifty-two (52) should be documented as the frequency.

• Number of Visits:

  • Add additional detail in this column to provide clarification for the family, such as one time per month, three visits in six months, etc. This information should clearly reflect the frequency and distribution of service(s) that the IFSP team, including the family, determines necessary to implement the strategies.

• Intensity in Minutes: Enter the length of each individual service session, such as 45 minutes.

• Individual or Group: Enter whether the service is provided on an individual or group basis. If a service is provided to more than one child with an IFSP during a session, then it is considered a group. This notation is used infrequently.

• Consent Date: Enter the date the parent/legal guardian consents to the EI service.

• Projected Start Date: Enter the projected date for the initiation of each EI service as (mm/dd/yyyy). Start dates of service must be within 28 days of parent consent.

• End Date: Enter the projected date when each service will no longer be provided, such as when the child is expected to achieve the results or outcomes in his or her IFSP, as (mm/dd/yyyy). End dates of service may not be longer than 364 days from the date of the Initial IFSP or Annual Review.

• Funding Source: Enter the individual or agency that is responsible for paying for the service. For more detailed information, see “Fiscal Management and Accountability Procedures” posted on www.eicolorado.org.

• Parent/Guardian Signature: Obtain the signature of parent or legal guardian to document consent for each early intervention service. In order to initiate an EI service included on the IFSP Agreement page of the IFSP, consent shall be obtained from the parent(s) or legal guardian(s). “Consent” means that the parent(s) or legal guardian(s): 1) is fully informed of all information about the activity(ies) for which consent is sought in their native language (unless clearly not feasible to do so) or other mode of communication; 2) understand and agree in writing to the carrying out of the activity(ies) for which consent is sought; and 3) understand the granting of consent is voluntary and may be revoked in writing at any time. Without consent, or if declined*, EI services are not initiated.

• Primary Setting: Choose the primary location where the early intervention service will occur. Choose from Home, Community or Other.

  *Declining Services: All services determined by the IFSP team to be necessary to support a child’s progress toward the IFSP outcomes are documented on the IFSP. A family can decline any EI service without jeopardizing any other EI Service. When a family declines an EI service, the service coordinator notes “declined” in the column for parent consent.

Note: If all services are declined, a family can still receive Service Coordination only. The child must still have an active IFSP that is reviewed at minimum every six months, with updated Annual Assessment documented. Service Coordinator provides monthly contacts. Family can resume services at any time.

Medical and other service(s) necessary to meet the outcome(s), but not required under Part C of IDEA:

• Services included in this section of the EI Services and IFSP Agreement page are defined as medical and other services that the child or family needs or is receiving through other sources to meet the outcome(s) on the IFSP, but that are neither required nor funded by the EI program.

• List the child/family’s other service(s) including time frame, funding source and steps that will be taken to secure any medical or other services. If the child is eligible for Medicaid and Targeted Case Management (TCM) will be provided, document this service in this table.

  • Other Service: List the specific other service.

  • Time Frame: Describe a time frame for when the other service began or will begin.

  • Funding Source: Enter who is responsible for paying for other services, for example, Medicaid, private insurance carrier, community grant, etc.

  • Steps Taken to Secure Service (when applicable): Describe service coordination activities to assist the family in securing these other services. Examples include assisting the family in arranging for medical services, assisting in preparing eligibility or insurance claims, etc.

• Receipt of Procedural Safeguards: Parent initials to indicate that their rights have been explained to them and that they have received a copy of the brochure Notice of Child and Family Rights and Procedural Safeguards in Early Intervention Colorado.

• Signature: Each IFSP team member signs to verify their participation in the development and finalization of the written plan. The IFSP is not valid without the required signatures.

  • IFSP Team Member: Enter the name of each IFSP team member who participated in the development of the written plan in the appropriate row. For IFSPs not completed with the initial evaluation, an EI provider signs as the required person from evaluation/assessment.

  • Discipline or Role: Indicate the role of the IFSP team member.

  • Date: Enter the date of the IFSP team member’s involvement.