Health Information

Purpose: The Health Information/Established Condition section of the EI Referral Case is where information about established condition, prematurity and diagnosis for review are saved.

1. Medical Diagnosis - Free text field and is also displayed on the EI Online Referral Form.

2. Was your child born prematurely? - This is a yes/no question. Any children under age two who were born earlier than 37 weeks gestation are considered premature.

3. If yes, how many weeks? - This field captures how many weeks early a child was delivered. Forty (40) weeks is full gestation; the number of weeks early is counted back from 40.

Established Condition

1. Primary Diagnosis - Lookup menu for the primary diagnosis that includes all diagnoses that have been reviewed. Only a diagnosis that is considered a condition which would automatically establish eligibility can be selected (Established Condition).

2. Does Diagnosis need to be reviewed - Checkbox is checked if the diagnosis is not in the Established Conditions database or if listed as “Needs Review”

   1. In the event the diagnosis needs to be reviewed, a Task is created for the Owner of the EI Referral Case. The task is titled “Established Condition” and is due 10 days after the “Does Diagnosis need to be reviewed” checkbox is checked. Upcoming & Overdue tasks appear in the Tasks & Events section on the far right column of the EI Referral Case and on the Homepage in EI Lightning.

3. Hospital/Practice - Lookup field for the hospital or practice that determined the child’s diagnosis.

4. Qualified Health Professional - Name of the individual who documented the diagnosis in the child’s Medical Record.

5. Credentials - For the qualified health professional who made the diagnosis.

6. Date of Eligibility Determination - the date the Care Navigator/Service Coordinator Enters fields Primary Diagnosis, Hospital/Practice, Qualified Health Professional and Credentials

7. Established Condition Cover Sheet is generated and saved to Files ex.  “Established Condition_mm/dd/yyyy.pdf”

NOTE: When all fields are completed the EI Referral Case updates to indicate the child is “Eligible based on Established Condition,” the Eligible for Services? field updates to Eligible and Date of Eligibility Determination defaults to the date all four fields were completed. This eligibility determination will copy to the EI Screening Record