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First Steps: Service Coordinator
Unit III Leson 4: Content of the IFSP
Even though there is a FS Module on IFSP development, we want to spend just a little bit of time reviewing what the law says about the content of an IFSP. Spend a few minutes reading what the Part C regulations say regarding the content of an IFSP.
Part C, Section 303.344
Sec. 303.344 Content of an IFSP.
(a) Information about the child’s status.
1. The IFSP must include a statement of the child’s present levels of physical development (including vision, hearing, and health status), cognitive development, communication development, social or emotional development, and adaptive development.
2. The statement in paragraph (a)(1) of this section must be based on professionally acceptable objective criteria.
(b) Family information.
With the concurrence of the family, the IFSP must include a statement of the family’s resources, priorities, and concerns related to enhancing the development of the child.
(c) Outcomes.
The IFSP must include a statement of the major outcomes expected to be achieved for the child and family, and the criteria, procedures, and timeliness used to determine—
1. The degree to which progress toward achieving the outcomes is being made; and
2. Whether modifications or revisions of the outcomes or services are necessary.
(d) Early intervention services.
1. The IFSP must include a statement of the specific early intervention services necessary to meet the unique needs of the child and the family to achieve the outcomes identified in paragraph (c) of this section, including—
i. The frequency, intensity, and method of delivering the services;
ii. The natural environments, as described in Sec. 303.12(b), and Sec. 303.18 in which early intervention services will be provided, and a justification of the extent, if any, to which the services will not be provided in a natural environment;
iii. The location of the services; and
iv. The payment arrangements, if any.
2. As used in paragraph (d)(1)(i) of this section—
i. Frequency and intensity mean the number of days or sessions that a service will be provided, the length of time the service is provided during each session, and whether the service is provided on an individual or group basis; and
ii. Method means how a service is provided.
3. As used in paragraph (d)(1)(iii) of this section, location means the actual place or places where a service will be provided.
(e) Other services.
1. To the extent appropriate, the IFSP must include—
i. Medical and other services that the child needs,but that are not required under this part; and
ii. The funding sources to be used in paying for those services or the steps that will be taken to secure those services through public or private sources.
2. The requirement in paragraph (e)(1) of this section does not apply to routine medical services (e.g., immunizations and “well-baby” care), unless a child needs those services and the services are not otherwise available or being provided.
(f) Dates; duration of services. The IFSP must include—
1. The projected dates for initiation of the services in paragraph (d)(1) of this section as soon as possible after the IFSP meetings described in Sec. 303.342; and
2. The anticipated duration of those services.
(g) Service coordinator.
1. The IFSP must include the name of the service coordinator from the profession most immediately relevant to the child’s or family’s needs (or who is otherwise qualified to carry out all applicable responsibilities under this part), who will be responsible for the implementation of the IFSP and coordination with other agencies and persons.
2. In meeting the requirements in paragraph (g)(1) of this section, the public agency may—
i. Assign the same service coordinator who was appointed at the time that the child was initially referred for evaluation to be responsible for implementing a child’s and family’s IFSP; or
ii. Appoint a new service coordinator.
3. As used in paragraph (g)(1) of this section, the term profession includes “service coordination.”
(h) Transition from Part C services.
1. The IFSP must include the steps to be taken to support the transition of the child, in accordance with Sec. 303.148, to—
i. Preschool services under Part B of the Act, to the extent that those services are appropriate; or
ii. Other services that may be available, if appropriate.
2. The steps required in paragraph (h)(1) of this section include—
i. Discussions with, and training of, parents regarding future placements and other matters related to the child’s transition;
ii. Procedures to prepare the child for changes in service delivery, including steps to help the child adjust to, and function in, a new setting; and
iii. With parental consent, the transmission of information about the child to the local educational agency, to ensure continuity of services, including evaluation and assessment information required in Sec. 303.322, and copies of IFSPs that have been developed and implemented in accordance with Secs. 303.340 through 303.346.
(Approved by the Office of Management and Budget under control number 1820-0550)
(Authority: 20 U.S.C. 1436(d))
Note 1: With respect to the requirements in paragraph (d) of this section, the appropriate location of services for some infants and toddlers might be a hospital setting— during the period in which they require extensive medical intervention. However, for these and other eligible children, early intervention services must be provided in natural environments (e.g., the home, child care centers, or other community settings) to the maximum extent appropriate to the needs of the child.
Note 2: Throughout the process of developing and implementing IFSPs for an eligible child and the child’s family, it is important for agencies to recognize the variety of roles that family members play enhancing the child’s development. It also is important that the degree to which the needs of the family are addressed in the IFSP process is determined in a collaborative manner with the full agreement and participation of the parents of the child. Parents retain the ultimate decision in determining whether they, their child, or other family members will accept or decline services under this part.
Note 3: The early intervention services in paragraph (d) of this section are those services that a State is required to provide to a child in accordance with Sec. 303.12.
The “other services” in paragraph (e) of this section are services that a child or family needs, but that are neither required nor covered under this part. While listing the nonrequired services in the IFSP does not mean that those services must be provided, their identification can be helpful to both the child’s family and the service coordinator, for the following reasons: First, the IFSP would provide a comprehensive picture of the child’s total service needs (including the need for medical and health services, as well as early intervention services). Second, it is appropriate for the service coordinator to assist the family in securing the non-required services (e.g., by
1. determining if there is a public agency that could provide financial assistance, if needed,
2. assisting in the preparation of eligibility claims or insurance claims, if needed, and
3. assisting the family in seeking out and arranging for the child to receive the needed medical-health services).
Thus, to the extent appropriate, it is important for a State’s procedures under this part to provide for ensuring that other needs of the child, and of the family related to enhancing the development of the child, such as medical and health needs, are considered and addressed, including determining
1. who will provide each service, and when, where, and how it will be provided, and
2. how the service will be paid for (e.g., through private insurance, an existing Federal-State funding source, such as Medicaid or EPSDT, or some other funding arrangement).
Note 4: Although the IFSP must include information about each of the items in paragraphs (b) through (h) of this section, this does not mean that the IFSP must be a detailed, lengthy document. It might be a brief outline, with appropriate attachments that address each of the points in the paragraphs under this section. It is important for the IFSP itself to be clear about
a. what services are to be provided,
b. the actions that are to be taken by the service coordinator in initiating those services, and
c. what actions will be taken by the parents.
[58 FR 40959, July 30, 1993, as amended at 63 FR 18295, Apr. 14, 1998; 64 FR12536, Mar. 12, 1999]
As recap of the previous material this narrative from Indiana will put all the elements that have been discussed into perspective.
Material from Indiana’s
First Steps Training
Program
Initial IFSP Meeting
The IFSP team is assembled for a meeting that must occur within 45 calendar days of referral. In addition to reviewing information already collected and documented, this meeting is to determine the outcomes and criteria as well as the strategies, activities, and services designed to achieve them. The location of services is also determined, and the natural environment provisions are applied. An ongoing service coordinator is selected if not already identified. Parental consent to implement the IFSP is obtained as well as permisison to distribute copies of the IFSP form.
Family Perspective
Language used to describe IFSP outcomes, strategies, activities, and services should reflect family preferences and be understandable to all team members. Families must be provided opportunities to direct the team process for the “collaborative” development of outcomes. Any actions that the family or service providers are to engage in must be clearly stated in the plan as “activities or strategies.” Strategies, activities, and services should be compatible with the family’s daily life and occur in natural settings. The family is an active member of the IFSP team and all team members should be accorded the same respect.
Family-Centered Planning
The IFSP process begins at the point of referral for families. Not all families will be eligible for First Steps. For those who are, continue beyond intake and eligibility determination to the next two steps in the process. Of the families who have eligible children, one must consider the current levels of performance for the child in five specified areas. Not all eligible children need services. For those who are in need of service, a team is formed to help the family develop an IFSP unique to that particular family. It is helpful to show families a copy of the IFSP form and to explain that the purpose of the meeting is to address their concerns. With the family’s consent, information is gathered to help the team develop a plan for the family’s unique needs and priorities. Planning includes scheduling meetings at times and locations that are convenient for the family. Thought must be given to the composition of the IFSP team and others the family would like to participate in the process. If the family uses a language other than English, an interpreter or translator is provided for them (unless it is clearly not feasible to do so). It is necessary to explore with the family what their life is like to ensure that early intervention services are provided, in the least intrusive manner possible, in the natural environment of the child. Because the family is entering a new system, transition “into” First Steps should be discussed. One of the ways to ensure an appropriate plan is developed is to meet with the family to discuss the process, the level at which they would like to participate, and their special priorities.
1. Prior written notification
The parents and providers who intend to participate are sent written notification of the meeting including the time and location early enough before the meeting to ensure they will be able to attend. This notification is to allow families time to prepare for the upcoming meeting and to reflect on their options, rights, and responsibilities. It is not possible to “waive” the notification for any reason including parent request.
2. Consents
There are a number of consents that are required within the First Steps system, supported by federal and state law. Families must give permission, called “informed written consent,” in order for certain information to be gathered, shared, and stored or for certain activities to occur.
3. Agenda formation
Families should be encouraged to develop a brief agenda of the things they want to address in the meeting. They should also come with a notebook or folder which serves as the family record, the equivalent of the Early Intervention Record. Medical reports, assessments, therapy schedules, resources, and copies of consents, releases, and IFSPs could be included. It is a good idea to have the family come prepared with paper and pen.
Team Membership and Participation
At the initial IFSP meeting and each annual review thereafter, the IFSP team must include the parent(s) of the child, the service coordinator, a person or persons directly involved in conducting the evaluations and assessments, and representatives from at least two disciplines. Ideally these would include people working directly with the child and/or family. In addition, at the discretion of the family, other family members, an advocate, or family friend may be added to the team. In terms of participation at the IFSP team meeting, those who comprise the team must attend the meeting. If persons directly involved in conducting education and assessment are unable to attend for some reason, arrangements must be made for them to participate some other way including:
- Telephone conference calls
- Sending an authorized, knowledgeable person
- Making relevant reports and/or records available at the meeting
Summary : As a service coordinator you will be responsible for what the IFSP will include, how it is written and how it is carried out. The more planning that is done prior to the meeting the smoother the process will go. It is also the responsibility of the service coordinator to ensure that the needs of the family and child are clearly conveyed to the providers and that the natural environments of the family are understood by the providers. The IFSP should be a document that ALL participants can read and understand; what role they play and all of the other team members responsibilities. Clarity of purpose is a must.