Effective Date: April 1, 1999 CT Birth to Three System Date Revised: July 1, 2012 Title: INTAKE

Purpose: Describes the single point of intake for Birth to Three services and the capacity to track non-eligible children’s development.

Overview

Child Development Infoline (CDI) serves as the single point of entry for families into the Connecticut Birth to Three System via a toll free telephone number (1-800-505-7000) or fax- or website-submission of a completed referral form. Within the United Way/2-1-1 organization, the separate CDI handles all calls coming into the Birth to Three 1-800- 505-7000 line as well as calls for Help Me Grow, Children and Youth with Special Health Care Needs and Early Childhood Special Education. CDI staff members are available Monday through Friday from 8 a.m. to 6 p.m. except on holidays, (New Year’s Day, Martin Luther King Day, Presidents’ Day, Memorial Day, Fourth of July, Labor Day, Columbus Day, Thanksgiving, the day after Thanksgiving day and Christmas). A voicemail system is available 24 hours a day, 365 days a year. Callers hear a brief description of how to make a referral, hours of operation, and have the opportunity to leave their name and number to receive a return call. The message names Birth to Three, Early Childhood Special Education, Help Me Grow and Children and Youth with Special Healthcare Needs programs.

Referrals to programs come only through the toll-free intake number, fax or Birth to Three website at CDI. Only CDI can enroll children in the Birth to Three System and assign a case number. The Department of Developmental Services will only pay invoices for referred or enrolled children.

Processing a Referral

Child Development Infoline (CDI) staff begins the Birth to Three intake process using the following steps: 1. Sort calls across Birth to Three, Help Me Grow, Early Childhood special education, or Children and Youth with Special Health Care Needs, depending on the caller’s needs.

2. When a child who is within 45 calendar days of their third birthday is referred to the Birth to Three System, CDI will re-direct the caller to the responsible local school district to seek an evaluation for preschool special education. CDI will offer to mail or direct the parent to the web site for Form ED621, “Referral for Special Education” and provide the address of the contact for their school district. This is not a Birth to Three referral, therefore the child’s information will not be entered into the Birth to Three database. Intake page 2

3. Confirm the parent’s or legal guardian’s interest in proceeding with the referral when it was made to the Birth to Three System by a third party.

4. Confirm that the child resides in the state of CT. The Connecticut Birth to Three System is not required to provide Part C early intervention services to a child who is also receiving Part C early intervention services in another state if that child and their family are only temporarily visiting in Connecticut. This does not apply to children who are homeless or whose family is highly mobile (e.g. migrant workers) or displaced by a catastrophic event such as a hurricane or flood, who are wards of the state, or who reside on an Indian reservation.

5. Gather information on the child’s current abilities from the referral source and/or parent. Staff may use developmental screening tools or additional tools (such as a screen for autism spectrum disorders) as needed to identify the referral concerns. CDI staff will not give any indication of a referred child’s presumed eligibility regardless of the medical or developmental information provided at intake. Each parent who requests an evaluation whose child meets the age criteria for a referral and for whom a developmental concern is identified will be referred a program.

6. Offer families a choice of program from among those serving their town to perform the initial evaluation of their child. If a family has no preference for a particular program, CDI uses a rotation cycle to identify the program that will perform the initial evaluation. Families are told that all of the programs are comparable in terms of quality of services, types of staff employed, and ability to schedule the evaluation and services in the home or other natural environment. If a family would like some time to think before selecting a program, CDI will give the family the name and contact information for the programs serving their town and they can call before making a decision. In these cases CDI will call the family back if they do not hear from them within two weeks.

If a parent requests a program that does not serve their town, CDI will contact the Birth to Three Child Find Coordinator for approval prior to completing the referral. If the Child Find Coordinator is not available the Birth to Three Director or Assistant Director will be contacted. This will not delay any pending referral beyond one business day.

Once a program has been identified and the referral is complete CDI sends a confirmation letter to the parent along with an information packet that includes a list of the programs serving their town, Family Handbook Guide I, the orientation DVD or directions on where to view the video online, and additional resources as appropriate within one business day of a completed referral.

7. Informs the family that the evaluation is provided at no cost. Families whose children are not covered by Medicaid are told that there is a monthly fee for services for families with incomes of $45,000 or more. They are told that the selected program will contact them within a few days to schedule the initial appointment, and that the Family Handbook Guide I they receive includes more information on the evaluation process and their rights. If a family has additional questions about the process, CDI Intake page 3

addresses them. All families are told they can call CDI back if they have any questions or concerns, if they have not heard from a program as expected, or are unhappy with the selected program.

8. Ensure that sufficient information is obtained so that the early intervention program receiving the referral is able to make contact with the family. If a family has no telephone, CDI will confirm with the referral source that the information is correct, and that the family is aware of the referral. If there is a question about the family’s knowledge of the referral or the address, CDI mails a “request for contact” letter to the family, so that they can call for additional information and can consider having their child evaluated through the Birth to Three System.

9. If CDI determines that the family is homeless, they will enter that information in the notes section of the Child Info Screen of the data system. This will alert the receiving program that the family needs to be contacted as soon as possible before there is a change in their address, and to take extra measures to ensure completion of the evaluation, assessment and IFSP process if the child is found to be eligible.

10.Send a confirmation letter to the referral source if the referral is made by someone other than the family, with the name, address, contact person and phone number of the program that will evaluate the child. If CDI is unable to reach the family or if the family declines services, a letter is sent to the referral source indicating this.

11.Enter intake information into the Birth to Three data system and then transmit to the selected early intervention program. If the family is in the process of moving to Connecticut or the child is hospitalized, CDI staff will note “Referral on Hold” in the notes section of Concerns screen.

12.Offer the family information about the Birth to Three programs that specialize in serving children who are deaf or hard of hearing along with the other programs that serve their town of residence, if the child being referred has a diagnosed hearing loss that meets the Birth to Three eligibility criteria. The family will also be asked if they would like the specialty programs to contact them to discuss their program’s approach. CDI will also offer to mail or direct the parent to the online location of Birth to Three System Service Guideline #5, Young Children who are Hard of Hearing or Deaf, at http://www.birth23.org/providers/SG5-Hearing.pdf for more information.

13.Offer information on the autism-specific programs that serve their town if the parent or referral source has indicated that the child has a diagnosis of an Autism Spectrum Disorder, failed a screen for Autism or identifies specific concerns about whether the child may have an Autism Spectrum Disorder. CDI will also offer to mail or direct the parent to the online location of the Birth to Three Service Guideline #1, Autism Spectrum Disorder at http://www.birth23.org/providers/SG1-Autism.pdf for more information.

14.Contact programs that have indicated they are not in rotation to accept referrals when a parent request for that program is received and that program does serve the town the family resides in. Otherwise CDI will contact the Birth to Three Child Find Intake page 4

Coordinator, Director or Assistant Director for approval. If the program is not able to accept the referral within five calendar days, the referral will be sent to the next available program in the automatic rotation cycle.

15.When a parent makes an unusual request, (e.g. choosing a program that does not serve their town or requests services be provided in both the town of residence and at child care that is located in another town, outside of the program’s catchment area), CDI will contact the Birth to Three Child Find Coordinator, Director or Assistant Director for approval.

Birth to Three Program Responsibilities

The Birth to Three program agrees to the following: 1. Have personnel available to accept referrals on all business days, fifty-two weeks per year. The program agrees to accept referrals only from CDI.

2. Contact referred families within one business day by telephone or by mail if there is no telephone contact number for the family.

3. Indicate, through the Birth to Three Data System, when the program is out of the rotation cycle because it can no longer accept any new referrals or transfers and again when it is able to accept new referrals and transfers.

4. Accept any referrals and transfers from other programs and provide services to any child found eligible while the program is accepting referrals via rotation.

5. A program that accepts the referral or transfer of a child from outside their catchment area, with the approval of the Birth to Three Child Find Coordinator, Director or Assistant Director for approval is responsible to provide all services identified on the IFSP including transition activities without any additional compensation from the CT Birth to Three System or the family.

6. When no contracted Birth to Three programs serving a particular town are accepting new referrals or transfers, CDI will send new referrals to each contractor serving that town on a rotation basis based on program size and the contractor agrees to accept those referrals. The program will be responsible for contacting the family and notifying them when they will be able to complete the eligibility evaluation.

Children Who Return After Being Exited From the Birth to Three System

When an eligible child who has received Birth to Three services is exited by a program due to family choice or “unable to locate” and then the family contacts the program or CDI and wants to resume services the following protocol will be followed by CDI or Birth to Three Administrative staff:  If it has been less than six months since their last service (this includes services provided at no cost to the family) and the child is returning to the same Birth to Three program, Birth to Three staff will change the child’s status in the data system back to eligible and for attendance purposes, they will be “continued”. The program will then Intake page 5

send one of the IFSP team members who is able to do assessments to the first home visit and that visit should mostly be a reassessment of the child’s current functioning level. The service coordinator may then need to revise the IFSP if it is out-of-date or if changes are needed. Once the program has resumed home visits they will receive two service units for that first month because the child is “continued”.

 If it has been more than six months since the last service, including services provided at no cost to the family, the child will be treated as a re-referral. A new eligibility evaluation will be completed to determine eligibility, followed by an assessment if the child is eligible. The program that receives the referral will bill for the evaluation whether it is the program that provided services to the child previously not.

When an eligible child who exited prior to receiving any Birth to Three services returns the following protocol will be followed:  If it has been less than 3 months and the child is returning to the same program that completed the original evaluation, the child will be re-activated by the program or the Birth to Three administration. The program will not bill the Birth to Three System for another evaluation or assessment.

 If it has been less than 3 months since the original evaluation and the parent chooses to work with a different program the child will still be reactivated with the original program and that program will transfer the child to the program selected by the parent. The receiving program will begin with a review of the IFSP as they would with any transfer. The program will not bill the Birth to Three System for another evaluation or assessment.

 If it has been more than three months, the child will be treated as a re-referral and a new eligibility evaluation and assessment will be completed and billed for by the program whether or not it was the child’s original program.

In all of these possible scenarios when the child is reactivated then the timelines specified in the IDEA Part C regulations and Birth to Three procedures for developing or reviewing the IFSP and for parent cost participation will be in effect as if the child had not been exited.

Tracking and Monitoring

For a child found ineligible for the Birth to Three System, tracking and monitoring is available through the Help Me Grow program, using the Ages and Stages Questionnaire (ASQ). The service coordinator should explain the process, give the family a Help Me Grow/ASQ brochure (in English and Spanish) and, obtain the parents’ consent to participate, by asking them to sign the form that is built into the brochure. Signing in either English or Spanish consent portion of the brochure will determine the language in which the family will receive their questionnaires. This should be done within one week of determining the child not eligible. After the consent form is completed, the service coordinator should mail it to CDI. Intake page 6

Once the consent form is received by Child Development Infoline, a welcome letter is mailed to the family to let them know they are enrolled in the ASQ Tracking and Monitoring process and when to expect their first questionnaire. An ASQ questionnaire will be sent to the family at the appropriate age in months (the Ages & Stages Questionnaires®, Third Edition cover the following ages: 4, 8, 12, 16, 20, 24, 27, 30, 33, 36, 42, 48, 54, and 60 months). A self-addressed stamped envelope is included with the questionnaire, so that families can return it to CDI for scoring. If a child’s score falls below the cut-off range, a staff person at CDI contacts the family and offers them the option to request another evaluation from the Birth to Three System if more than 90 days have passed since the prior evaluation. The staff person also contacts the family to discuss any concerns they may have noted on the returned questionnaire. For concerns about speech delays, a re-referral may be initiated even if the scores do not fall below the cut-off, based on Connecticut Birth to Three System Service Guideline #3: Children Referred for Speech Delays. If the ASQ results show that the child may have a significant delay, yet it has been less than three months since the child was evaluated for eligibility, Child Development Infoline staff will contact the Child Find Coordinator, and they will investigate the discrepancy between the eligibility evaluation results and the ASQ parent report. If it has been more than three months since the eligibility evaluation, the family will be offered a new evaluation.

If the family accepts the offer of a new evaluation, they may choose to have their child re-evaluated by the program that did the prior evaluation or they may select another program to perform the evaluation. If the child is determined eligible for services, an IFSP should be developed and participation in the ASQ tracking and monitoring program will end. If the child is again found ineligible for services, another consent form should be sent to CDI, so they can re-activate the file and continue to mail out questionnaires at appropriate intervals.

If the child’s score is found to be above the cut-off score, or if the family decides they are not interested in having another evaluation completed, their child’s questionnaire will be mailed back to them with suggested appropriate activities for the family to try until they receive the next questionnaire.

All Birth to Three programs must retain evaluation information for six years (see Records procedure). If a child is to be evaluated by another provider, the program that did the first evaluation may be asked to send the information, or a copy of it, to the second program with written consent by the parent.

Child Development Infoline’s Other Responsibilities

In addition to processing referrals into the Birth to Three System, CDI staff perform the following activities:  Maintain data on calls that do not result in a Birth to Three referral.  Contact family whose child is not eligible for Birth to Three and who wanted follow up two months after the referral date. Ask if the parent was satisfied with the evaluation, if they have any questions about the evaluation and if they were given the ASQ consent form at the visit. If there are further questions about the evaluation they are referred to the Birth to Three Family Liaison or the program that did the evaluation. Intake page 7

 Conduct a consumer satisfaction survey of the referral sources to the Birth to Three System to get feedback on their experience using CDI.  Access other Infoline departments for information such as childcare and medical coverage for families who need services outside the Birth to Three System.  Participate in Public Awareness activities as requested or appropriate.

______References: Child Development Infoline Confirmation Letter Child Development Infoline Cover Letter 1 (W/Phone) Child Development Infoline Cover Letter 2 (W/O Phone) Child Development Infoline Decline Eval Letter State & National Resource List 34 CFR Section 303.115 and 303.3117 Section 17a-248-2 of the Regulations of the State of CT Service Guideline #1: Children with Autism Spectrum Disorders Service Guideline #3: Children Referred for Speech Delays