Individualized Family Service Plan (IFSP) Background Information

1. Purpose: The background information section records important dates regarding the IFSP process, provides basic demographic and contact information concerning the child and the family referred for EI services, and lists the service coordinator, administrative unit/school district and primary care practice/physician contact information.

2. Process: The service coordinator ensures this page contains accurate information when meeting with the family during initial contacts. Some of the information may have been obtained during the referral/intake process and is verified during first contacts with the family. All sections of this page of the IFSP must be filled out completely.

3. EI Data System: Child information populates from the Client Contact and auto-fills relevant fields on the IFSP form in the EI Data System. Client Family contact information created in EI Data System under the Household Account will also prepopulate into the IFSP. Service coordinators should make sure all contact records, including the Service Coordinator Contact, are completely filled out in the EI Data System. Reference CONTACTS sections above to ensure that all contacts are correctly entered in the data system. Also reference CREATING A RELATIONSHIP (OPTIONAL) section.

Note: The following format follows the outline of the pages in the IFSP document

This information is pulled directly from the EI DATA SYSTEM and populates the top portion of the Print PDF version of the IFSP document.

COLORADO INDIVIDUALIZED FAMILY SERVICE PLAN (IFSP) - #

Child’s Name:

Child’s Age (Days):

IFSP Meeting Date:

Referral Date:

Referred By:

IFSP Type:

Case Number:

1. Information About Your Child

   1. This section of the IFSP documents information about the child, his or her caregivers, and the relationship of each caregiver to the child and the members of the child’s household. This information is pulled from the EI DATA SYSTEM and populates in the IFSP. It is very important that the correct information about the child and family are documented with the correct spelling of the child’s name (no nicknames), including the middle name of the child, date of birth and whether or not the child is enrolled in Medicaid. Update this as needed on the correct contact in EI Data System.

2. Information About Your Family

   1. It is important to document the child’s primary care giver with whom the child resides and relationships. It is also important to provide location, mailing address, and contact information for all who will be working with this family. This information will pull directly from “Related” family Contacts/Household Account information once entered into EI Data System.

3. Important Contact Information

   1. This section of the IFSP documents information about the service coordinator for the family, their supervisor, the administrative unit (AU) where the child resides, the Child Find contact and projected IFSP meeting dates. This information is automatically populated from the service coordinator Contact in EI Data System. If any of these sections are “blank” when you create an IFSP in EI Data System, please ensure each record type is filled out correctly as this is required information to be on an IFSP. This information ensures the family has access to appropriate contact information for all questions as described in the procedural safeguards.

4. Projected IFSP Meeting Date if Eligible

   1. Once a child has been found eligible based on the date and eligibility criteria entered for the Evaluation/Assessment, this section will prepopulate from the EI Data System. Service coordinators will need to manually enter the projected date range for transition planning beginning at the date the child is 2 years 3 months of age and ending at the date the child is 2 years 9 months of age. Reference the TRANSITION INFORMATION section for entering Transition Information in the EI Data System.