guidance materials on: infant & toddler online tracking system

Guidance Materials On:

Infant & Toddler Online Tracking System (ITOTS 1.9)

&

Virginia's Part C Individual Child Data Form

October 2011

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Table of Contents

Keeping Personal Health Information (PHI) Secure ..................................................... 1 ITOTS – What and How ............................................................................................ 1 User Roles ................................................................................................................ 2 Names of the Parts of the ITOTS Screen .................................................................... 3 ITOTS Screen Shots .................................................................................................. 5

Home Screen ......................................................................................................... 5 Child Data Screen .................................................................................................. 6 Individual Child Data Pages .................................................................................... 7 Reports ............................................................................................................... 10 Administrator ...................................................................................................... 13

Report Specifications ............................................................................................... 14 Just the FAQs ......................................................................................................... 27

How do I enter a new referral? ............................................................................. 27 What is entered into ITOTS after a referral? .......................................................... 30 When can I enter Third Party Health Coverage information? .................................. 33 What does the Child Header tell me? .................................................................... 34 How do I change a child‘s status to inactive and back to active? ............................. 35 Can I change or remove incorrect information in a child‘s record? .......................... 36 How do you transfer a child from one system to another? ...................................... 37 How can I remove a child‘s record from the ITOTS system? ................................... 38 Why do such a variety of names come up when I search for a child in ITOTS? ........ 38 Where can I find the definition of how children can be found eligible? .................... 38 How are services defined? .................................................................................... 39

Individual Child Data Form ...................................................................................... 39 General Instructions ............................................................................................ 39 Section by Section Instructions ............................................................................. 39 Referral/Intake .................................................................................................... 39 Eligibility ............................................................................................................. 42 IFSP Eligibility ...................................................................................................... 44 Primary Service Setting ........................................................................................ 45 Diagnosed Disabling Condition .............................................................................. 49 Risk Factors......................................................................................................... 50 Entitled Part C Services ........................................................................................ 51 Status (Active/Inactive) ........................................................................................ 52 Transition/Child Discharge .................................................................................... 53 Third Party Health Coverage ................................................................................. 56 Indicator Assessment ........................................................................................... 57 Missing Exit Data Justification ............................................................................... 57

ATTACHMENT #1 – Interpretation of Risk Factors ..................................................... 58

GUIDANCE MATERIALS ON: VIRGINIA'S PART C ICDF & ITOTS

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Keeping Personal Health Information Secure Personal health information (PHI) is protected under the Health Insurance Portability and Accountability Act (HIPAA). You are responsible for protecting the PHI of the families receiving supports and services through your local system. Please protect the forms that you use to enter the information into ITOTS as well as the information on the computer from viewing by unauthorized persons. Remember:

Secure any forms or papers containing PHI when you leave your work area. Lock, log off or power off your computer (desktop, laptop or other workstation)

when you leave your work area.

Do not change settings on your computer to disable security features. Keep all passwords for access to computing resources confidential. Do not load (or download) or create any software on your computer that has not

been authorized by your agency.

Immediately remove any unauthorized software from your computer. Follow all guidelines regarding transmission of PHI via electronic mail. Report any security problems encountered or observed to your immediate

supervisor. ITOTS – What and How ITOTS, the Infant & Toddler Online Tracking System is the data system used by the Infant & Toddler Connection of Virginia. Access to ITOTS must be requested by your system manager. Prior to gaining access to ITOTS users must:

View these HEALTH Insurance Portability and Accountability Act (HIPAA) training slides: (http://www.dbhds.virginia.gov/documents/adm-HIPAASecurityAwareness.pdf),

Complete the HIPAA Training Acknowledgement Form: (http://www.dbhds.virginia.gov/documents/forms/3024iITS.pdf), and

Complete the ITOTS Account Request Form. These forms must be submitted to the attention of David Mills via:

Email: ([email protected]), Fax: (804) 371-7959 Mail: Attn: David Mills, DBHDS, 1220 Bank Street, Richmond, VA 23219

Once you have been given your username and password, you will be able to log on. This is the home screen: The left of the banner gives you links to the Virginia web page, the Department of Behavioral Health and Developmental Services (DBHDS) web page and the ITOTS Home page. The right side of the banner tells you who is logged onto which system.

http://www.dbhds.virginia.gov/documents/adm-HIPAASecurityAwareness.pdf

http://www.dbhds.virginia.gov/documents/adm-HIPAASecurityAwareness.pdf

http://www.dbhds.virginia.gov/documents/forms/3024iITS.pdf

mailto:[email protected]


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The left side of the page gives you access to Child Data, Reports and Administrator functions. Below that is the logout button. For security, remember to close your browser after each ITOTS session. Clicking on either of the Infant & Toddler Connection of Virginia logos will take you to the website, www.infantva.org. User Roles An individual‘s user level determines the tasks they may perform. The following table designates the differing user levels.

Tasks Supervising User User

Create data X X

Change data X X

View reports X X

Delete referrals or complete records X

Transfer clients X

Maintain council contact and agency information X

Local system managers may request and must authorize individual users for their locality based on one of the user roles illustrated above: User or Supervising User. Multiple users can be assigned to each category at the discretion of the local system. It is recommended that systems include more than one ITOTS user, so required data entry is not missed when the primary person responsible for data entry is absent. For local systems with only one ITOTS user, the user should be assigned the user role of ―Supervising User‖.


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Each local system will designate one ITOTS user to be the primary ITOTS contact person. This person will be the contact when a ‗likely match‘ situation occurs. The following information will be entered locally into the ITOTS system for the primary contact: first name, last name, phone number, fax number and e-mail address. The primary contact information can be changed locally as needed. The local ITOTS user identified as the primary contact should be assigned to the user role of ―Supervising User‖.

Names of the Parts of the ITOTS Screen This screenshot is of the home screen when you first log on. The banner is the top set of lines. On the left it has links to the Virginia.gov web portal, DBHDS‘s web site, below that is the ‗breadcrumbs‘ trail that tells you where in the site you are. On the right at the top is the name of the user and, in the black bar below that, the name of the local system for which you are entering data. Below the banner on the left of the screen with the light yellow background is the navigation panel. Sections of ITOTS can be navigated to from there. To the right of the navigation panel is the logo. This logo is also a link to www.infantva.org. The logo in the navigation panel links to the same site.

Once you have clicked on an item in the navigation panel, the logo will disappear and the data entry panel is shown. Under Child Data you may add a new referral or search the system for a child.

http://www.infantva.org/


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The reports section in the navigation panel will lead you to most of the reports available in ITOTS.

When you are in the child record section there are links to the different pages of the child record. Many of these pages have different tabs for the individual sections within that page.


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On the Administrator section, only available to a Supervising user, you can edit and add information about the local system, its contacts and related agencies.

In the administrative section one can also enter and edit agency information, delete a child record, delete an individual referral and transfer a case load or individual child records from one service coordinator to another.

ITOTS Screen Shots Home Screen From this page you can navigate to the different sections of ITOTS.


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Note: To save space the banner has been cropped from the rest of the screen shots that follow. Child Data Screen Add New Referral: Search for child by details

Add New Referral: Search for child by ITOTS ID

Child Search: Open Child Search: All This search will look through all open, closed and referred children Child Search: ITOTS ID

When this page is displayed, all open children in the system will be listed here.


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Individual Child Data Pages by Tabs: Referral/Intake-Demographic

Referral Intake – Referral

Referral Intake – Intake


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Eligibility – Eligibility Determination

Eligibility – Health and Development

Eligibility – Risk Factors


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Coverage

Initial IFSP – Initial IFSP

Initial IFSP Initial Planned Services


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Child Progress

Status

Transition

Reports


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Report Details: Child Specific Reports

Report Details: Aggregate Reports

Report Details: OSEP Reports

Report Details: OSEP Verification/Monitoring Reports


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Report Details: Child Progress

Report Details: System Administration

Report Details: Practitioner Reports


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Administrator – Local System

Administrator – Contacts Administrator - Agencies

Administrator – Delete Child

Administrator – Delete Referral

Actual names title etc. will be shown here.


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Administrator – Transfer Case Load

Report Specifications General Specifications

A local system may run reports with PHI only for their own locality. All reports are available for download to Excel, users will need to manually adjust

columns in Excel reports. The following items will be included on all reports as appropriate:

Data Source (ITOTS Reporting)

Sort criteria Date range of report Area(s) included in report (Reports that include all systems should reference

―All Systems‖)

Total number of children included in the report Date and time report was run Pagination

All reports that contain PHI are to be protected. Although each report in ITOTS was designed for a specific purpose, you will find that many reports may have more than one use. The reports page in ITOTS has seven sections. Click on the section name to expand. Clicking on another section will collapse the previous section and open the new section. The following tables detail the reports available in each section; the purpose of the report and whether the report covers a time range (R) or point in time (P). Some reports use neither criterion. Those are marked N/A.


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Child Specific Reports

Name Purpose

Specifications

R/P

Open By Age To list all children open on the date selected with their age in months on that date.

IFSP date must be on or before the report date.

Discharge date must be blank OR be on or after the report date.

Date of Birth plus 3 years must be greater than the report date.

Calculation for Age in Months: difference in days between the child‟s date of birth and the report date, divided by 365.25, multiplied by 12, rounded to two decimal places.

P

Other Primary Service Setting

To list all children who are open for whom the primary service setting is listed as other. To assure that the „other‟ primary service settings are appropriate.

The IFSP Date must be on or before the end date.

The discharge date is blank or be on or after the begin date.

Initial Primary Service Setting must be “Other”.

R

Third Party Health Coverage

To list all open children on the user selected date with all types of third party reimbursement sources and the ID number where applicable.

The IFSP Date must be on or before the report date.

The date of discharge must be blank or be on or after the report date.

Date of Birth plus 3 years must be after the report date.

The child must have at least one third party coverage listed.

P

Child Status - List To list all children and their status where they have been referred and have not left the system.

Date of referral must be blank or be on or before the report date.

Discharge date must be blank OR be after the report date.

Referral outcome must be blank or “Eligible/Will Receive Services”.

Calculation of 45-Day Timeline Date: date of referral plus 44 days.

Calculation of Transition Scheduling Deadline Date: add three years to the date of birth and subtract 90 days.

Calculation of Annual IFSP Due Date: If the IFSP

P


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Name Purpose

Specifications

R/P

date plus one year is greater than the report date, use this date. Otherwise use IFSP date plus two years.

Calculation of Third Birthday: Date of Birth plus 3 years.

Calculation of Status: o “Missing Birth Date”: Birth Date is blank. o “Missing Referral Date”: Referral Date is

blank. o “Child is no longer age eligible, please

discharge”: Date of Birth plus 3 years is on or before the report date.

o “Needs Evaluation and IFSP development by <45-Day Timeline Date>”: date of evaluation is blank or after the report date.

o “Needs IFSP development by <45-Day Timeline Date>”: date of evaluation is on or before the report date and IFSP date is blank or after the report date. “Inactive, please discharge by <Date IFSP Services End>”: IFSP date is on or before the report date and inactive date is on or before the report date.

o “Schedule transition conference by <Transition Scheduling Deadline Date>”: IFSP date is on or before the report date and the difference in days between Third Birthday and the report date is between 90 and 180, inclusive.

o “Annual IFSP due by <Annual IFSP Due Date>”: IFSP Date plus one year is after the report date and before the Third Birthday or IFSP date plus two years is after the report date and before the Third Birthday; and it is not time to schedule the transition conference.

o “Receiving Services”: IFSP date is on or before the report date, the difference in days between the Third Birthday and the report date is greater than 180, it is not time for a transition conference to be scheduled, and there is no annual IFSP due.

o “Discharge by <Third Birthday>”: all other situations not handled with other statuses.


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Name Purpose

Specifications

R/P

Children Open Time Range

To list all children open at any time within the selected date range.

IFSP date must be on or before the end date.

Discharge date must be blank OR be on or after the begin date.

R

Current Service Setting

To list all children open on the user specified date, comparing their initial service setting to their current service setting.



Date of Birth plus 3 years must be after the begin date.

P

Other Current Service Setting

To list all children who are open for whom the current service setting is listed as other. To assure that the „other‟ current service settings are appropriate.


The discharge date must be blank or be on or after the begin date.

Current Service Setting must be “Other”.

R

Early Intervention Eligible Children

To list all children open at any time within the selected date range to help DMAS match early intervention eligible children with children who may be eligible to be enrolled in the Medicaid early intervention program.

The evaluation date must be between the begin date and end date, inclusive.

The discharge date must be blank or after the begin date.

EI Eligible must be Yes.

R


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Name Purpose

Specifications

R/P

Children to be Enrolled or Discharged for Medicaid-FAMIS EI

To list all children who need to be enrolled or discharged from Medicaid/FAMIS Early Intervention.

The child must have third party coverage of “Medicaid/FAMIS”.


If enrolled for Medicaid EI is No, Discharge Date and Inactive Date

If enrolled for Medicaid EI is Yes, o If discharged from Medicaid EI is No, Discharge Date must not be blank and must

not be equal to Birth Date plus 3 years and must be on or before the current date; or

Inactive Date must not be blank and must not be equal to Birth Date plus 3 years and must be on or before the current date

o If discharged from Medicaid EI is Yes,

Discharge Date must be blank or must be after the current date; and must both either be blank or be after the current date.

Inactive Date must be blank or must be after the current date

N/A

Open Older than Three

To list all children no longer age eligible open on the date selected with their age in months on that date. This report will be run as needed for the localities to determine age eligibility and ineligibility.

Age in Months is calculated as the difference between the date of birth and the report date in days, divided by 365.25, multiplied by 12, rounded to two decimal places.



P

Inactive To list all children who have a status of inactive during the user specified time period.

Inactive date must be on or before the end date.

Must not have an active date.


R


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Name Purpose

Specifications

R/P

Eligible with no IFSP Date

To list all children who will receive services, but the IFSP date has not been entered. This report is necessary to meet OSEP monitoring requirements.

The date of referral must be between the begin date and end date, inclusive.


The IFSP Date must be blank. Discharge date must be blank.

R

Transition To list all children who have been open, but who left the Part C system during the user specified time period.


The date of discharge must be between the begin date and end date, inclusive.

R

Transition Destination Other

To list all children who have been open, but who left the Part C system during the user specified time period for other reasons. To assure that the „other‟ reasons are appropriate.


The date of discharge must be between the begin date and end date, inclusive.

Discharge Referral must be “Other”.

R

Exceeding 45 Day Timelines

To list all children for whom the length of time since the date of referral exceeds the 45-day timeline for IFSP development. This report is necessary to meet OSEP monitoring requirements.


The difference in days plus one between the date of referral and the IFSP date must be greater than 45.

R

Referred Not Evaluated

To list all children who were referred during the user specified timeframe, but have not been evaluated for eligibility determination.

Date of referral must be between the begin date and end date, inclusive.

Discharge Date must be blank.

“Was Child Evaluated to Determine Eligibility?” is unanswered (blank).

Calculation of the 45-Day Timeline date: date of referral plus 44 days.

R

Referred Not Entering Services

To list all children who were referred but did not reach the development of an IFSP.


R


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Name Purpose

Specifications

R/P

Reason not Entering Services is the Referral Outcome except for the first and fourth situations where it is the Transition Destination/Other.

Child‟s record meets one of the following situations: 1. “Was child evaluated for Eligibility

Determination?” is blank and Date of Discharge is on or before the end date.

2. “Was child evaluated for Eligibility Determination?” is No.

3. “Was child evaluated for Eligibility Determination?” is Yes and referral outcome is not blank and is not “Eligible/Will Receive Services”

“Was child evaluated for Eligibility Determination?” is Yes and referral outcome is “Eligible/Will Receive Services” and IFSP Date is blank and Date of Discharge is on or before the end

Aggregate Reports Referral Outcome by Referral Source

List by referral source the quantities for all possible outcomes of referrals for the time range.

Referral date must be between the begin date and end date, inclusive.

Referral outcome cannot be blank and cannot be “Data cleanup : child lost to system”.

R

Number and Percent Open by Age

List count and percent of open children by age and local system.


Discharge date must be blank or be on or after the report date.

Calculation of %: N (for the category) divided by TOTAL N.

Calculation of Birth to One column: Date of Birth plus 1 year must be after the report date.

Calculation of One to Two column: Date of Birth plus 1 year must be on or before the report date and Date of Birth plus 2 years must be after the report date.

Calculation of Two to Three column: Date of Birth plus 2 years must be on or before the report date.

P


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Name Purpose

Specifications

R/P

Number of Open Three Consecutive Years

To list child counts for three consecutive one year period.

Time period for each year is 12/02 to 12/01 of the year selected.

The two one year periods precede the year selected

R

Child Count By Service

To count all open children by service and local system with a statewide summary.



P

Number and Percent of Open for LBW-Premature

List count and percent of open children who had low birth weight or premature birth.

Include in the Low Birth Weight / Premature Birth column if the child has a risk of “Very Low Birth Weight (<1500g or <3.25 lbs)”, “Preemie - Gestational Age less than 28 weeks”, “Preemie - Gestational Age 28-31 weeks”, “Preemie - Gestational Age 32-37 weeks”, or “Low Birth Weight (1500 g to <2500g or 3.25 lbs to < 5.5 lbs)” or a disabling condition of “Gestational Age Less Than or Equal to 28 Weeks”.

P

OSEP Reports These reports are specifically designed for reporting to Office of Special Education Programs (OSEP) Table 1-A Open By Age Race Ethnicity

To provide a count of all children by age and race/ethnicity who were open on the user specified date.



Count in Birth to One if Date of Birth plus 1 year is after the report date.

Count in One to Two if Date of Birth plus 1 year is on or before the report date and Date of Birth plus 2 years is after the report date.

Count in Two to Three if Date of Birth plus 2 years is on or before the report date.

P

Table 1-B Open By Gender

To provide a count of all children by gender that were open and age eligible on the user specified date.



Each group must display both genders even if the count is zero.

P

Table 2-A Settings To provide a count of all children by age and setting who P


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Name Purpose

Specifications

R/P

By Age were open and age eligible on the user specified date using the child‟s current primary service setting.




Setting is based on the child‟s current primary service setting, not the initial primary service setting and rolled up to OSEP Service Settings.

Count in Birth to One if Date of Birth plus 1 year is

after the report date.

Count in One to Two if Date of Birth plus 1 year is on or before

Table 2-B Settings by Race Ethnicity

To provide a count of all children by setting and race/ethnicity who were open and age eligible on the user specified date using the child‟s current primary service setting.




Setting is based on the child‟s current primary service setting, not the initial primary service setting and rolled up to OSEP Service Settings.

P

Table 3-A Exit by Race Ethnicity

To provide a count of all children by reason for exit and race/ethnicity that have been discharged but not transferred within the Part C system during the user specified time period.


Discharge date must be between the begin date and end date, inclusive.

Each group must display all Reasons for Exit even if all counts are zero but will exclude “Another Part C System in Virginia” and “Data cleanup: actual date and destination unknown”.

R

Table 3-B Exit by Gender

To provide a count of all children by reason for exit and gender that have been discharged but not transferred within the Part C system during the user specified time period.

IFSP date must be before the end date.

R


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Name Purpose

Specifications

R/P


Each group must display all Reasons for Exit even if all counts are zero but will exclude “Another Part C System in Virginia” and “Data cleanup: actual date and destination unknown”

OSEP Verification Monitoring Reports Initial IFSP Dates within the Time Period

To list all children by local system where the initial IFSP date is within the time period selected. This report is necessary to meet the OSEP data verification requirements.

IFSP date must be between the begin date and end date, inclusive.

R

Children Discharged To list all open children discharged within the selected date range, by system. This report is necessary to meet the OSEP data verification requirements.



Exclude discharge referral of “Data cleanup: actual date and destination unknown”.

When discharge referral is Other, display the description of other. When discharge referral is Another Part C System in Virginia, display „Transfer to „ + SystemName.

When discharge referral is Exit with Referrals, display „Exit with Referrals to „ + Preschool/Headstart/Private.

R

Children Active To list all children open within the selected date range, by system. This report is necessary to meet the OSEP data verification requirements.


Discharge date must be blank or be on or after the begin date.

P


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Name Purpose

Specifications

R/P

Timeliness Of Data Entry

To list all children whose eligibility determination dates were entered within the selected date range.

Date eligibility determination entered must be between the begin date and end date, inclusive.

Calculation of Days until Entry: difference in days plus 1 between the evaluation date and the date eligibility determination entered.

Entered By is the first and last name of the user who entered the evaluation date.

R

Initial Progress Assessment Not Entered

To list all children whose initial progress assessments have not been entered.


Age in months at intake must be less than 30.00.

Calculation of age in months at intake: difference in days between date of birth and IFSP date, divided by 365.25, multiplied by 12, rounded to 2 decimal places.

An initial progress assessment must not exist: the first assessment for the child must have been performed on or after the first referral where the outcome was “Eligible, Will Receive Services” and within 14 days of the IFSP Date

P

Timely Initiation Of Service Record Review

To list all children currently open with an initial or annual IFSP date that falls within the time period in the system to select records for monitoring record review for the timely initiation of services indicator.

One of IFSP Date, IFSP Date plus 1 year, or IFSP Date plus 2 years must be between the begin and end dates, inclusive.

Discharge date must be blank or be on or after the begin date.

Date of Birth plus 3 years must be after the begin date.

The first column (#) is a sequential number, beginning with 1 and reset to 1 at the beginning of each grouping.

Calculation of Delay: if at least one of the delay categories is checked, “Y”, otherwise “N”.

Calculation of Condition: if there is at least one disabling condition listed, “Y”, otherwise “N”.

Calculation of Atypical: if at least one of the atypical categories is checked, “Y”, otherwise “N”.

R

Transition Record To list all children discharged within the time period or R


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Name Purpose

Specifications

R/P

Review whose second birthday is before 9/30 of the ending year in the system to select records for monitoring record review for the timely initiation of services indicator.

Discharge date must be between the begin date and end date, inclusive OR (the discharge date must be blank and the child‟s second birthday is before 9/30 of the year for the end date).

Discharge referral must be IFSP Completion (Child less than 3);

Calculation of Delay: if at least one of the delay categories is checked, “Y”, otherwise “N”.

Calculation of Atypical: if at least one of the atypical categories is checked, “Y”, otherwise “N”.

Calculation of Condition: if there is at least one disabling condition listed, “Y”, otherwise “N”.

Child Progress

Child Progress Report (Entry to Exit Comparison)

To provide counts and percentages of children who were eligible during the time range and have both entry and exit data.

There must be <= 6 months between the initial assessment and the exit assessment.

R

Child Interim Progress Report Comparison

To provide counts and percentages of children who have two progress scores.

Last Outcome: assessment date must be the most recent assessment date between the begin and end dates, inclusive.

Prior Outcome: assessment date must be the most recent assessment date that is at least 6 months (inclusive) prior to the last.

R

Child Progress Data Verification

To list assessments by child performed during the user specified time period.

Get all assessments for child that has any assessment for local system.

R

System Administration Active User Accounts

To certify that the individuals listed currently require access to the ITOTS System.

N/A

Practitioner Reports

Practitioner Profile To provide a full profile for a given practitioner for use in provider choice.

List related agencies where the relationships have

N/A


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Name Purpose

Specifications

R/P

not ended and the agency is active. Sort by Agency Name.

List disciplines and qualifications where the qualifications have been validated and have not expired. Sort by discipline, qualification.

List early intervention certifications that have been granted and have not expired. Sort by certification.

List associated local systems where the relationship has not ended, the lead agency is active, and the local system is active. Sort by system name.

Practitioner Listing by Discipline

To list all active agencies with active, certified practitioners by system and discipline.

Agency must have at least one practitioner who has a valid certification, whose relationship with the agency has not ended, and whose relationship with the local system has not ended.

The discipline must have at least one qualification that has been validated and has not expired.

N/A

Practitioner Certification Audit

To determine practitioner certifications to be audited based upon expiration date of their certification/licensure.

Exclude Discipline of “Early Intervention Service Coordinator”.

The practitioners must have a valid EI certification (current status of “granted” and expiration date in the future).

The expiration date for the qualification must be on or before the report date.

P

Certification Count By Discipline

To report total numbers by discipline of early intervention certified practitioners in each system with an unduplicated total of practitioners certified in early intervention.

To be counted, the practitioner must have a valid certification and a valid discipline.

The relationship between the practitioner and local system must be based on the relationship has not ended and the local lead agency is not inactive.

A valid discipline must have at least one qualification that has been validated and has not expired.

N/A


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Just the FAQs

How do I enter a new referral?

There are two situations where you will be adding a new referral for a child. One for a child who does not yet have a record in ITOTS; the second to add a new referral for a child in the system already. First we will discuss a child that does not have a record in the system already. Logged onto the ITOTS system, click on ―Add New

Referral‖ under Client Data. You will have the option of searching by details or ITOTS ID. Use search by details. In the child search dialogue box that opens, enter the child‘s last name, Birth date and gender. Required fields are denoted by a red triangle: . Once you have completed entry, press search. ITOTS will search the database to see if there are any children with the same or similar sounding name and identical birth date and gender.

If this is a unique child, you will get the message that there is no possible match and you will have a button that will allow you to add a new child and referral to ITOTS.


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Click ―Add New Child and Referral‖ and a new Referral/Intake record will open.

This new record will be populated with all of the information entered in the search screen. Also included will be the date of the child‘s third birth date, calculated by ITOTS.

The Referral/Intake page consists of three tabs. They are Demographics, Referral and Intake. The save button above those tabs will save the information on all three tabs at once. If you press save before entering any information, you will get an error message for all ‗required‘ missing fields (see the example to the left). Note that the error message identifies both the tab and the data element required Once required data elements

have been entered, the record may be saved. In order to view the information seen in the child header, you will need to click to another page and come back to the referral intake page populate the child header. ITOTS will then assign an ITOTS ID.


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This will also enable the other pages you have access to for the child. Eligibility Coverage and Child Progress are lavender in the example below which indicates an active link.

This is the Referral Tab which includes required information. Pressing save will save the record. You will receive a confirmation message that the information was saved.

The Intake tab includes the service coordinator‘s name and the intake date,

the first date that a child is eligible for EI Targeted Case Management.


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For a child that is already in the system a second referral may be added to a child‘s record. Select the ITOTS ID as the search criterion and press search.

Child details will open and a message at the bottom of the screen will notify you if all referrals have been closed. Click on the Add New Referral button and the new referral for that child will open. The demographic information will be brought over from the original referral. The city county information will need to be updated. Again the child header will reflect the current status of the child. Until the required Referral Intake information has been entered and saved, none of the other pages can be accessed. In this case the minimum requirement to save is the referral source and date on the referral tab.

What is entered into ITOTS after a referral? Once a referral is saved you will have access to three pages of the child‘s record, Eligibility, Coverage and Child Progress. We will look at Eligibility first.


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The eligibility tab is completed sequentially. Your response to the first question dictates your choice for data entry. If you select No as the answer you will be asked for the reason and exit date.

The exit date must be later than the referral date. A future date is also not allowed.

If the child is not EI eligible, the ITOTS automatically completes the result and exit date. All of the required information for this referral is complete and this child‘s record in ITOTS may be closed.

If the answer to the eligibility determination question is yes, a date is required. Again this date must be after the referral date and cannot be a future date. The question of EI eligibility must be answered yes or no and the result

selected as soon as it is known (e.g., once there is a signed IFSP or the family has declined services). If the choice is anything but ―Eligible will receive services‖, an exit date is required. At that point, all of the required information for this referral is complete and this child‘s record in ITOTS may be closed.


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For those children who are ―Eligible Will Receive Services‖, there is more data to enter. The child development tab has information about the child‘s eligibility. Medically Fragile

must be completed as well as at least one eligibility criteria. Check all known eligibility criteria. To add a diagnosed disabling condition, click the Add New button. A dropdown list will open above for you to select the appropriate condition.

If you select other, a specification is required. Click Add to save the condition.

Multiple conditions may be listed. To remove a diagnosed condition, click the word delete. Edit will allow you to make edits to the specific other diagnosed condition.

Risk factors, the third tab on the eligibility page, are selected in the same way as diagnosed disabling conditions. Multiple risk factors may be added.


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When can I enter Third Party Health Coverage information? Third Party Health Coverage information can be entered as soon as the initial referral has been completed and saved. Click on the word Coverage to get to that page. Click Add New to add a third party health coverage.

The drop down menu lists the choices. If ―None‖ is selected there can be no other selections added. Otherwise, multiple third party coverage types can be added. The case number and policy name are optional fields under Private insurance. Third party coverage selections may be edited or deleted. If you delete the last coverage the record will be considered incomplete and further data entry is not


34

possible. There must always be at least one third party coverage selected (it may be ―none‖). Enter the child‘s recipient ID in Medicaid/FAMIS. It must be 12 numerals to be saved. Do not enter the dashes. What does the Child Header tell me? The Child Header is a snapshot of the child and their current status in ITOTS.

ITOTS ID, Name, Service Coordinator, Local ID, DOB, Referred, and Medicaid are always the same. The two items in the row under Service Coordinator will change based on the status of the child. Given each child status below, the following fields will be listed in the child header:

Child with no Initial IFSP and has not Exited: o Eligibility Completed Date and o 45-Day Deadline.

Child with no Initial IFSP and has Exited: o Eligibility Completed Date and o Exit Date.

Child with an Initial IFSP and 1st or 2nd Annual IFSP Due: o Initial IFSP and o Annual IFSP Due (1st or 2nd annual, the earlier of which is after today‘s

date)

Child with an Initial IFSP and Transition Pending: o Initial IFSP and o 3rd Birthday

Child with an Initial IFSP and Is Inactive: o Inactive Date and o Services Expire Date

Child with an Initial IFSP and has Transitioned: o Initial IFSP and o Discharged Date

The ICDF Report link opens the ICDF Report, but is only accessible after the child and referral information have been entered and saved. Medicaid displays the Medicaid Recipient ID if the child has Medicaid/FAMIS and displays No if the child does not have Medicaid/FAMIS.


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How do I change a child’s status to inactive and back to active? Making a child inactive within the ITOTS system is the method for tracking children who have been given the status "inactive" in accordance with the No Show Policy flow chart. For additional information regarding the No Show Policy, please refer to chapter 8, of the practice manual. http://www.infantva.org/documents/PracManCh8.pdf Only children with a valid IFSP who have been entered into ITOTS can have a status of inactive. Open the child‘s record, click on the Status page. Click Add New to get to the data entry screen.

Enter the inactive date and the date the last IFSP service expires (which can be no later than the child‘s third birthday).

The inactive status will be reflected on the Status page. Note that you can edit or delete the status you added.

The child‘s inactive date and the service expiry date will be reflected in the child header.

If you make contact with the family again and need to make the child active, navigate to the child Status page and click edit. Enter the active date and click update.

http://www.infantva.org/documents/PracManCh8.pdf


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With an active date entered, the child header bar once again changes.

Multiple statuses of inactivity can be entered for a child.

Two reports will assist with managing the inactive children in your system. One is the Child Specific Report ―Inactive‖. The other is the OSEP Verification/Monitoring Report ―Open Cases For Children with an IFSP. Can I change or remove incorrect information in a child’s record? As hard as ITOTS users try to enter accurate information into the ITOTS system, there are times when incorrect information is entered and must be changed. Depending on the scope of the incorrect information there are many choices from logging on and editing a Medicaid number to deleting a service or eligibility criteria to deleting a complete set of dates, settings and services. From a child‘s IFSP record Administrators may delete a referral or entire child‘s record.


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Because when you first enter a child‘s record into ITOTS the search is based on a match of the child‘s last name, gender and date of birth we recommend deleting a child‘s record and starting over if you have initially entered one of those three items in error. If a child‘s name changes during their tenure with you change the name in ITOTS. In such cases, please make a note in the comment section on the demographic tab of the eligibility page of the ITOTS record so that if questions arise during record reviews or processing of Medicaid enrollments or discharges, the child‟s former name is

available. On most all of the other pages and tabs information may be edited and changed. We want the information entered into ITOTS to be accurate. How do you transfer a child from one system to another? As children move from one local system to another, it becomes necessary to transfer them between systems within ITOTS. A child‘s record can be transferred at any point in their tenure with your system. Required is an exit date, a transition destination and the local system you are transferring a record to.

Enter that information and click Save and Transfer. You will be asked to confirm the transfer by selecting the system you are transferring to and then to press Confirm Transfer to complete the transfer.


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How can I remove a child’s record from the ITOTS system? Only a ―Supervising User‖ within the ITOTS system can delete a child‘s record. It is also possible to delete a single referral for a child with multiple referrals. To delete a child‘s entire record. From the home screen, select ―Administrator‖ then ―Delete Child‖. Enter the known search criteria. In this example you see entered the child‘s last name and date of birth. After pressing search you will see all the results that fit your criteria. Click the blue word delete to the right of the child‘s record.

You will receive a confirmation message that the child‘s record was successfully deleted

Why do such a variety of names come up when I search for a child in ITOTS? When you search for a child in ITOTS a search system called soundex is used. This system uses phonetics to match the names. Therefore, a search for Morton will also turn up Martinez and Martin. A search for Johns will yield James, Jang, Jones or Jung. Because of this variety, your searches will yield better results if you search using as many data elements (e.g., date of birth, gender) as are known Where can I find the definition of how children can be found eligible? The definition of eligibility can be found here: http://www.infantva.org/documents/PracManCh5.pdf as chapter five of the practice manual. This includes definitions of diagnosed disabling conditions and Other diagnosed conditions.



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How are services defined? Definitions of services can be found in the glossary of the practice manual here: http://www.infantva.org/documents/PracManChGloss.pdf. The service listed as Family Training, Counseling, and Home Visits is defined under counseling in the practice manual. Individual Child Data Form General Instructions: The Individual Child Data Form has been designed in sections to correspond to pages and/or tabs within the ITOTS system. The first section is ―Referral Demographic.‖ All children referred to your local system must be entered into ITOTS with as much information as is available for that child and family. It is critical that each section of the form be fully completed and the data entered into the ITOTS system within timelines stipulated in the Infant & Toddler Connection of Virginia Practice Manual and the Local Contract for Continuing Participation in the Part C System. For children who have Medicaid or FAMIS coverage, late data entry will impact the ability to receive reimbursement for Service Coordination and other Part C services, including the Assessment for Service Planning, IFSP meetings and delivered services. In all instances where date is requested, please report the date following this format: month month - day day - year year year year Example: 0 2 - 2 1 - 2 0 1 1 Section-by-Section Instructions Referral/Intake

Information entered into this section includes: Child’s Full Name: Federal Part C regulations require a non-duplicated December 1st child count. Enter the child‘s full name, including the child‘s given first name, middle initial and last name. Please do not use nicknames here. However, the child‘s nickname can be listed in the

http://www.infantva.org/documents/PracManChGloss.pdf


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comment section. The child‘s last name will be used to search the system to determine if this child has been entered into ITOTS. Child’s Social Security Number (SSN): Please enter this number if available. This number may be used to help confirm if a child has Medicaid. Date of Birth: Record date of birth using the proper format. City/County Residence: Virginia Legislators have consistently requested specific information on the number and needs of Part C children according to their place of residence. Use the appropriate city/county name that is the child‘s primary place of residence Race Code: To determine minority representation in families receiving Part C services, and to meet federal reporting requirements, users are requested to record the race of the child receiving services according to the following codes: Race Codes: Race Codes: A = Asian B = Black/African American H = Hispanic/Latino P = Pacific Islander or Hawaiian Native N = American Indian/Alaskan Native W = White/Caucasian T = Two or more races U = Unknown In October 1997, the federal office of Management and Budget (OMB) issued standards for the collection and aggregation of data on race and ethnicity (see ―Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity‖). In that announcement, OMB identified a minimum of five racial categories -- American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White -- and one ethnic category -- Hispanic or Latino. Additionally, OMB announced that individuals should be allowed to select as many race/ethnicity categories as were applicable. This data collection allows for the reporting of only one race or ethnicity category per individual and is therefore not in compliance with these standards. OSEP and the Department of Education (ED) are considering changes to the categories used for reporting aggregate data to bring this collection into compliance


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with OMB‘s standards. For the time being, data should be reported using the five racial categories described below. Hispanic/ Latino

A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. Refers to Hispanic and/or Latino.

American Indian or Alaska Native

A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment. (Does not include persons of Hispanic/Latino ethnicity.)

Asian A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent. This includes, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. (Does not include persons of Hispanic/Latino ethnicity.)

Black or African American

A person having origins in any of the Black racial groups of Africa. (Does not include persons of Hispanic/Latino ethnicity.)

Native Hawaiian or Other Pacific Islander

A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. (Does not include persons of Hispanic/Latino ethnicity.)

White A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. (Does not include persons of Hispanic/Latino ethnicity.)

Two or more races A person having origins in two or more of the five race categories listed immediately above. (Does not include persons of Hispanic/Latino ethnicity.)

Unknown You may enter a referral with the race ethnicity of unknown, however, you may not retain that value after the IFSP page has been completed.

Gender of Child: To meet federal reporting requirements on the Part C population please indicate the gender of the child in services. Service Coordinator (Optional): Use this optional field to record/update the name of the person assigned as service coordinator for this child and family.


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Referral Source Code: For state and local planning and evaluation purposes, the referral source is required. Please use the following codes when documenting referral sources: Referral Source Codes: 1. Community Services Board 2. Local Education Agency 3. Department of Health 4. Department of Social Services (Non-CAPTA) 5. Private, Non-profit Organization 6. Hospital 7. Pediatrician/Family Physician Group/Practice

8. Private Therapy 9. Friend/Neighbor/Relative 10. Parent/Guardian 11. DSS CAPTA 12. VISITS 13. Other Referral Source (List____________________)

When a child is referred by an ‗other‘ referral source, specify what that source is. Date of Referral: In order to document compliance with the 45-day timeline, the date of referral to the local Part C system is required. Intake Date: This is the first visit to the family to collect information. This date is required for children who have Medicaid or FAMIS coverage or who have the possibility of obtaining such coverage that is backdated. As long as this date is entered within 10 business days of the intake, this date will be used as the start date for the Medicaid Early Intervention Benefit. Eligibility

ITOTS Id This optional field is for use to make searching for the child‟s record in ITOTS easier.


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Local Case Number This Optional field is for recording other case numbers assigned to the child.

Was Eligibility Determined? Check yes or no as to whether the child received an evaluation. If the child was evaluated and found to be eligible for Part C services, record the date that the evaluation was completed.

The Part C office is tracking the number of children who are referred for services but do not make it into the Part C system. Please check the appropriate box according to the following outcomes: If the child received an evaluation (The question ―Was Child Evaluated to Determine Eligibility?‖ was checked ‗Yes‘): Eval. – Ineligible

On the basis of a multidisciplinary evaluation the child was found ineligible. Eligible/Declined Services

Check this box in instances where the child is evaluated and found eligible but the family declines services. This is to be used for children who have had an ASP or IFSP and decline services.

Eligible/Will Receive Services Check this box when the child is found eligible and the family chooses to receive services through a completed IFSP.

Eligible/Chose Other Svcs: The family was referred to the system, evaluated and found eligible but chose to avail themselves of or be referred to other services. One example of this would be the case for the family with a two year old that is referred but chooses not to enter early intervention but to enter the school system instead.

Eligible/Unable to Contact: The family was referred to the system and evaluated but subsequently the local system was not able to make contact with the family.

Eligible/Ineligible at assessment for service planning The child was referred and found eligible but by the time of the assessment for service planning the child was found to be no longer eligible.

Eligible/Decline assessment for service planning: The child was referred and found eligible but the assessment for service planning was declined by the family.

If the child did not receive an evaluation (The question ―Was Child Evaluated to Determine Eligibility?‖ was checked ‗No‘): Unable to Contact:

The family was referred to the system but the Central Point of Entry was not able to make contact with the family.

Deceased


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The family was referred and contact was made but the child had died. Declined Eligibility Determination

The family declined an evaluation. Exit Date Use this date to note the date of closure following the referral for a child who exits the system before there is a signed IFSP.‖ IFSP Eligibility

IFSP Date: To collect data on the average length of stay in early intervention for evaluation, planning and cost projection purposes, users are requested to record the date that the IFSP is completed i.e., the date the parent/guardian signs. Documentation of mitigating circumstances related to timelines: This section is to be used to document any mitigating circumstances that caused a delay in the 45-day timeline for the development of an IFSP. Please check the appropriate box related to the circumstance following these guidelines: Child Ill: The child‘s illness prevented scheduling to allow for the development

of the IFSP.

Family Ill: The illness of a child‘s family caused a delay in the development of an IFSP.

Family Scheduling Preference:

The family chose to postpone the evaluation or IFSP meeting for the family‘s convenience. Note: This should not take into account the situation where the child‘s family worked during ‗normal business hours‘ but would be available over the weekend or evenings. Situations such as this should be documented as provider unavailability.

Provider unavailability:

Select this option when a provider cannot find time in their schedule for an IFSP meeting because of their workload, no provider is available or other similar situations.

Temporarily lost contact:

This refers to families who have been referred to the system and an initial contact has been made. If a child is referred to the system


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and no subsequent contact has been made, this should be documented in section 3 of the form.

Foster/Surrogate Parent related issues

Check this option when there are difficulties in determining/contacting the person who has the legal right to sign the IFSP

Disaster/Severe Weather

This includes natural or man-made disasters and severe weather situations. Severe weather situations may include, but are not limited to the following: hurricanes, blizzards, severe ice storms, tornadoes, and flooding. Mark Disaster/Severe Weather as the reason for exceeding the 45-day timeline only if the severe weather condition affected the provider‘s ability to keep the appointment with this specific family at the specific time it was scheduled (e.g., the snow was heavy enough that, although the main roads were clear, it was unsafe to travel the heavily snow-covered, hilly, tertiary road leading to the Smith house for their 4:00 IFSP meeting on Wednesday). If the provider fails to keep an appointment for an evaluation and/or IFSP meeting because the agency has a policy to close when the public school system closes (but the provider could have safely reached the family‘s home at the time of their appointment), then the reason for exceeding the 45-day timeline is Provider Unavailability. If the family calls to cancel the appointment due to disaster/severe weather, then the reason for exceeding the 45-day timeline is Family Scheduling Preference.

Primary Service Setting:

Federal reporting requirements indicate that the primary setting in which a child is receiving services must be reported. You are requested to report only the primary setting in which each child and family receive early intervention services. Only one type of setting may be designated. Use the following guidelines to select the appropriate setting. • If a child is receiving services in more than one setting, count the child in the setting

in which he or she receives the most hours of early intervention service, i.e., the primary setting. For example, a toddler who receives one hour of home-based service a month and two hours of service per month in a child care center (a program designed for typically developing children) would be counted under the category "program designed for typically developing children.‖

• If services are delivered to a child and family members, count the child only under the primary setting (as defined above) in which the child is being served.


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• If services are delivered only to family members, i.e., no services are delivered to a child, count the child in Row 7 ("other") and specify ―services to family member only‖.

Settings are defined as follows: 1 Program Designed for Children with Developmental Delays or Disabilities:

Refers to an organized program of at least one hour in duration provided on a regular basis. The program is usually directed toward the facilitation of one or more developmental areas. Examples include early intervention classrooms/centers and developmental day care programs.

2 Program Designed for Typically Developing Children: Services are provided in a facility regularly attended by a group of children. Most of the children in this setting do not have disabilities. For example, this includes children served in regular nursery schools and child care centers.

3 Home: Services are provided in the principal residence of the child's family or care givers. Report children in this category if they are receiving services in the home of their grandparents or another close relative.

4 Hospital (inpatient): Hospital refers to a residential medical facility. The child must be receiving services on an inpatient basis.

5 Residential Facility: Residential program refers to a treatment facility which is not primarily medical in nature, where the infant or toddler currently resides in order to receive early intervention services.

6 Service Provider Location: Provider location services are provided at a center, clinic, or hospital where the infant or toddler comes for short periods of time (e.g., 45 minutes) to receive services. These services may be delivered individually or to a small group of children.

7 Other Setting: Any service setting not included in the settings or programs listed above. For example, if the only component of the infant's early intervention services is parent counseling during which the child is not present and the child receives no direct service, count as "other."

Note that children are to be counted according to the type of program being received at a facility, not the type of facility. For example, children in a program designed for children with developmental delay or disabilities operated at a hospital should be counted under "program designed for children with developmental delay or disabilities." Children who receive physical therapy at a hospital on an outpatient basis should be counted under "service location provider." Children who are inpatients in a hospital should be counted under "hospital."


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Medically Fragile: Indicate whether or not a child meets the following criteria: Children who are medically fragile are those who have a chronic condition and/or who require technology or ongoing support to prevent adverse physical consequences. These children require varying levels of services including: Children with one or more conditions which require continuous, ongoing specialized

health care procedures. These procedures include but are not limited to: mechanical ventilation continuous administration of oxygen continuous cardio-pulmonary monitoring a combination of procedures such as tracheostomy care, gastrostomy feeding

and tube care, administering supply of oxygen and chest and physical therapy and suctioning.

Children who require an intermittent specialized health care procedure or procedures. These procedures include but are not limited to: nasogastric feedings gastrostomy feedings parenteral nutrition oral feedings where a documented risk of aspiration exists oral, nasal and pharyngeal suctioning tracheostomy care urinary catheterization ostomy care medication via injection, inhalation or complex regimens.

Children with identified conditions of unusual severity who require specialized services for the care of acute episodic problems with the potential for the occurrence of a medical crisis. These conditions include but are not limited to: uncontrolled seizure disorders unstable diabetes poorly controlled asthma (reactive airway disease) allergies with history of anaphylaxis.


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Individuals completing this form are requested to document the criteria that are met in determining the child's eligibility as the child enters the program. Documentation of eligibility is critical to assure accurate reporting to the federal government. In order to be determined eligible for services under Part C, the child must meet the specified criteria related to either documented developmental delay, atypical development and/or diagnosed disabling condition. Since a child may meet several criteria, please check all items that apply. Also add any eligibility criteria identified during the ASP. Data collection on eligibility criteria will also assist the state and localities in long term planning for service needs. Developmental Delay: A delay is defined as a 25% or greater deficit in one or more of the developmental areas. Please check all that apply of the categories of Cognitive, Physical: including fine & gross motor, Communication, Social or emotional and Adaptive

Atypical Development: Atypical development includes, but is not limited to, one or more of the following criteria (even when evaluation does not document a 25% developmental delay): Atypical or questionable sensory-motor responses Behavioral disorders that interfere with the acquisition of developmental skills. Identified affective disorders Impairment in social interaction and communication skills along with restricted and

repetitive behaviors Note: With the recent focus on Autism we are requesting that any diagnosis of Autism or autism spectrum disorder be updated in ITOTS after the diagnosis becomes known.


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Diagnosed Disabling Condition

A diagnosed disabling condition is a diagnosed physical or mental condition which has a high probability of resulting in a developmental delay even though a delay may not currently exist. To document that a child has a diagnosed disabling condition, the diagnosis must be made by a qualified professional (under most circumstances this would be a physician). In most instances the diagnosis will be documented in the child's medical records. Please check the category that fits the child's diagnosis for the purposes of determining eligibility. For example, a child with a diagnosis of Down Syndrome would be recorded by checking "Chromosomal abnormalities" and a child with cerebral palsy would be recorded by checking "Significant Central nervous system anomaly". Confusion has arisen regarding when a child would have a diagnosed disabling condition under "Effects of toxic exposure". A child whose parents are known substance abusers but the child has not been diagnosed with "drug withdrawal" symptoms or "fetal alcohol syndrome" would not be recorded as "effects of toxic exposure" but as the risk factor of "severe parenting risk - substance abuse". Please note that medical diagnoses that do not have a high probability of resulting in developmental delay should not be recorded (e.g., "respiratory distress syndrome"). The purpose of collecting diagnosed disabling condition information is to document eligibility determination. Since it is possible that children may have multiple diagnosed disabling conditions, users are requested to identify all disabling conditions that apply.


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Additional information regarding eligibility can be found here: http://www.infantva.org/documents/PracManCh5.pdf as chapter five of the practice manual. This includes definitions of diagnosed disabling conditions and Other diagnosed conditions. Note: With the recent focus on Autism we are requesting that any diagnosis of Autism or autism spectrum disorder be updated in ITOTS after the diagnosis becomes known.

Risk Factors:

In an effort to better understand the relationship of risk factors with developmental delay and disabling conditions, users are requested to report risk factors on each child. Risk factors should be determined from the child's medical records or by report from the child's physician. Indicate all risk factors that apply to the child. Please Note: Possessing any combination of risk factors does not make the child eligible for Part C services. Guidance on definition of risk factors is provided in Attachment 1 of this document.



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Entitled Part C Services:

Federal reporting requirements require states to report the number of Part C eligible children receiving the various entitled early intervention services as reported on the IFSP. Local lead agencies are requested to provide specific information on the frequency, intensity, setting and provider of each entitled service as listed on the IFSP. Local provider(s) may also be entered into the ITOTS system and should prove useful for local oversight and planning. Local systems may use the following examples when completing the Entitled Part C Services matrix: Example 1 A child who has listed on their IFSP that they will receive service

coordination once every six weeks for 30 minutes would be recorded like this:

Entitled Part C

Service

Frequency Intensity

Setting Provider Local

Provider # of

Times

every/

only

# times

During

Week/

Month etc. Minutes

Service Coordination

1 every 6 Week(s) 30 Home Department of Social Services

Rapid River DSS

Example 2 A Child that would receive a 15 minute PT consultation quarterly would be recorded as:

Entitled Part C

Service

Frequency Intensity


Provider # of

Times

every/

only

# times

During

Week/

Month etc. Minutes

Physical Therapy

1 every 3 Month(s) 15 Home Private Therapy Group/Practice

Therapies R Us

Example 3 A child receiving one 35 minute Assistive Technology consultation would be recorded as:

Entitled Part C

Service

Frequency Intensity


Provider # of

Times

every/

only

# times

During

Week/

Month etc. Minutes

Assistive

Technology 1 only 35

Other: Day

Care

Private, Non-profit Organization

AT for You


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Example 4 A child receiving an Assistive Technology device would be recorded as: Entitled

Part C Service

Frequency Intensity


Provider # of

Times every/ only

# times During

Week/ Month etc.

Minutes

Assistive

Technology 1 only Home Other: Retail

Consolidated

Devices

Example 5 A child receiving a 20 minute Music Therapy sessions once every other week would be listed as:

Entitled Part C

Service

Frequency Intensity


Provider # of

Times

every/

only

# times

During

Week/

Month etc. Minutes

Other: Music Therapy

1 every 2 Week(s) 20 Home Extension Agency

Wanderin‘ Minstrel

Use the frequency designation of ―only‖ for services or devices that the IFSP team has determined to be singular occurrences for this particular service plan. Definitions of services are contained in Attachment 3 of these instructions. The following is the list of service providers to be used to populate the ―Provider‖ column: Service Provider Codes: 1. Community Services Board 2. Local Education Agency 3. Department of Health 4. Department of Social Services 5. Department for the Blind and

Visually Impaired 6. Department for the Deaf and Hard of

Hearing

7. Extension Agency 8. Va. School for the Deaf and Blind 9. Private, Non-profit Organization 10. Hospital 11. Child Care Center and Organization 12. Pediatrician/Family Physician 13. Private Therapy Group/Practice 14. Other Service Provider (Specify)

Local Provider is an optional field to be used to designate specific local providers. Status (Active/Inactive):


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Status: Inactive: This checkbox is to be used to assure that all families‘ rights are observed and that no families who are lost to the system are closed to services prior to the last date of planned services as documented in their most recent IFSP. Date Inactive: Once a child has been determined to be ‗lost to the system‘ according to the procedures outlined in the no-show policy page and flowchart, the inactive box is to be checked. The ―Date Inactive‖ should be entered as the date the family was determined to be ‗lost to the system‘. Date Last IFSP Service Expires: Date Last IFSP Service Expires is to be taken from page 6 of the current IFSP and should be the latest date of any services listed on this page and not later than the child‘s third birthday. Status: Active: If a child should be ‗found‘ again after the inactive box has been checked, they may be made active again by editing the status record in ITOTS. Date Active: Enter the date the child was found. Transition/Child Discharge: Date of Closure: For children closed to Part C services or moving to another system, please indicate the date of closure. For those children who remain in the Part C system until their third birthday, please use the day before their third birthday as the date of closure. For all other children please note the date they exit the program as designated on the IFSP. Transition Destination:

General Instructions: 1. Infants and toddlers reported should be those who exited the local Part C system

during the reporting period.


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2. Report only children from birth through age 2 (up to their third birthday) at the time of exiting who had an active IFSP in place at some point in time during the reporting period.

3. Do not enter into ITOTS a child as having exited Part C when services were temporarily suspended (i.e., parent temporarily removed the child for a period of time during which services were not received) and subsequently resumed before the end of the reporting period.

4. Do not enter into ITOTS a child as having exited Part C if the child had an active IFSP in place at the end of the reporting period, even if services were intermittently stopped during the 12-month period.

5. Children entered into ITOTS must be unduplicated. If a child exited more than once during the reporting period, and exited again at the end of the reporting period, enter into ITOTS only the last time the child exited (i.e., enter the child in the category that corresponds to the most recent reason for exit).

6. All children who exited Part C during the reporting period should be enter into ITOTS in one of the categories on this table.

7. For children who are moving to another Part C system within Virginia, please specify which system, if known.

Please use the following codes to indicate transition destination. In order to report this data as required to the federal government, identify the primary transition destination (e.g., only one). Code Term Definition 1 Deceased: The infant has died. Include all children who died during the

reporting year, even if their death occurred at the age of exit.

2 Left Virginia: The infant and family have moved to another state or country. Do not report a child who moves within State (i.e., from one program to another) and services are known to be continuing.

3 Parent/Guardian Withdrew:

The child has been evaluated and an IFSP has been developed. The parent has chosen to withdraw the family from Part C services and provided written or verbal indication of withdrawal from services.

4 Lost Contact With Family

Repeated attempts to contact or provide services to family and child were unsuccessful (attempts must be documented in the child‘s record). Include all children who have not reached the maximum age of service under Part C. Include in this category any child who exited the Part C program before reaching maximum age, and who has not been counted in other categories.


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Code Term Definition 5 IFSP Completion

(Child less than 3):

The infant in question no longer has a developmental delay, atypical development or a diagnosed disabling condition and is no longer eligible for Part C services. They are less than three.

6 Public School/ Part B Eligible

The child has been referred to and is eligible (accepted into) the public school Part B program (use code 10 if the child has been referred to but, has not been determined eligible for Part B).

7 Exit with referrals: 7a Preschool/

Day Care 7b Head Start 7c Private

Therapy

Use one of these codes when the child is no longer age eligible for Part C and has been referred to a preschool, day care, or Head Start facility or program. In addition, include all children who reached maximum age for Part C services, were determined not eligible for Part B, and were referred to another program.

8 Another Part C System in Virginia:

The family is moving within Virginia and will be receiving services within another Part C system. Please specify which system, if known.

9 Exit At Three – No Referrals

The child is no longer eligible for Part C. No further referral is necessary. Include all children who reached maximum age for Part C services, were not eligible for Part B services, successfully completed their IFSP, and no longer required services.

10 Part B Referral, Eligibility Not Yet Determined:

The child has been referred to the public school Part B program but eligibility has not been determined.

11 Other (Specify): Use this category for children who do not fit into any other of the previous categories. Please specify the transition destination.


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Third Party Health Coverage:

Please mark the box for the type of health care coverage for each infant and toddler birth through age two who is eligible for Part C services — regardless of whether or not the insurance covers the service or the family has agreed to have their insurance billed. For this section, please check all that apply. Family Fees: Report families that are participating in Virginia‘s Family Cost

Share system None: This selection is for children who have no third party coverage for

Part C services. Do not use this selection for families who elect not to allow their insurance to be accessed or their insurance does not cover the services listed on their IFSP.

Medicaid/FAMIS: This includes coverage under basic Medicaid and FAMIS. Please NOTE that the Medicaid/FAMIS information must be entered within 10 business days of the intake in order for the intake date to be used as the start date for the Medicaid EI benefit. For children who receive Medicaid or FAMIS coverage at some point after intake, the information must be entered in ITOTS within 30 calendar days of the date the decision was made that the child was eligible for Medicaid or FAMIS in order for services to be reimbursable back to the effective date of Medicaid or FAMIS coverage.

Tricare: The military‘s health insurance program for children with disabilities.

Insurance: This includes coverage through private health care insurers, private (not Medicaid) HMOs and the State Health Benefits Plan.

Please report the ID# for all third party coverage types in the blank on the same row as the coverage type.


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Indicator Assessment:

Complete the appropriate Column with the date of assessment and three indicator ratings as taken from the ―VIRGINIA CHILD INDICATORS SUMMARY FORM‖ for the child‘s entry into the system. At exit (required) and annually between entry and exit (optional), enter the assessment date and the indicator ratings and check the yes or no column for each of the three indicators. Leave the interim columns blank if only and entry and exit assessments are done. Missing Exit Data Justification:

Space has been made available for recording the reason exit data is missing. Please record the code for the missing data in the space provided. ITOTS will not accept discharge information without

either the outcomes data or the justification for why it is not included.


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ATTACHMENT #1

Interpretation of Risk Factors Maternal age 15 years: This age refers to the mother‘s age at time of birth of the infant. Birth weight 1500 grams: This will be the single largest group identified for tracking. These infants will frequently have other diagnoses identified in both the referral and tracking indicators. Prematurity – Gestational Age: Identify each child by their gestational age. a. 28-31 weeks b. 32-37 weeks Apgar 0-3 at 5 minutes: The apgar score is assigned at birth with a maximum of 2 points for each of the following: appearance (color), pulse (heart rate), grimace (reflex irritability, cry), activity (muscle tone), and respiratory effort. A score of 0-3 at 5 minutes indicates problems with establishing normal respiratory and cardiovascular stability and the continued need for resuscitative efforts. Also included in this category would be severe depression at birth which may include a failure to initiate spontaneous respiration at 10 minutes or severe hypotonia persisting to 2 hours of age. Persistent pulmonary hypertension: This diagnosis refers to a condition in which the normal relaxation of the pulmonary vascular bed does not occur. The infants experience profound problems with oxygenation. The treatment frequently includes hyperventilation and metabolic alkalosis. Long term studies have found a higher incidence of developmental difficulties and hearing loss in these infants. Hyperbilirubemia, exchange transfusion: Exchange transfusions are infrequently needed for the control of hyperbilirubemia. They are required when the levels of bilirubin reach a critical level beyond which brain damage is a risk. Periventricular leukomalacia: PVL is an ischemic lesion leading to areas of necrosis in the white matter of the brain. On ultrasound they appear as cysts in the brain. They have a high association with developmental delay. Documented Systemic infection, documented congenital or acquired: This definition covers a whole host of infections including bacterial, viral, and fungal. In each case there should be laboratory proven infection by culture. SGA (10%): The term means small for gestational age and is often referred to as intrauterine growth retardation (IUGR). There are many causes including infections, maternal disease, toxins, and vascular problems affecting the placenta. On the initial


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exam each infant's weight, length and head circumference are plotted. For tracking, weight less than the 10% is an indicator for enrollment. Major congenital anomaly: This refers to any significant abnormality in the anatomical development of the infant with the exception of CNS anomaly (see indicators for direct referral). The abnormality can also include pre-auricular pits and tags. Maternal Conditions During Pregnancy: Include incidences such as accidents, phenylketonuria (PKU, this rare condition can affect the in utero development of the baby and requires that the mother maintain her special diet throughout pregnancy), maternal diabetes or sickle cell Family history of childhood deafness/blindness: The concern in this case is that there is a genetic predisposition for this infant/toddler to develop a visual or hearing problem. Meningitis: This refers to a laboratory proven infection in the cerebrospinal fluid. It includes bacterial, viral and fungal causes. Lead poisoning: Lead poisoning is diagnosed by blood lead levels in the toxic range. Toddlers are most at risk as a result of pica (eating paint chips contaminated with lead). Seizure disorder, excluding febrile: This refers to seizures diagnosed in infants/toddlers beyond the newborn period. Febrile seizures are excluded as they do not have an association with later developmental problems. Lack of well child care: This refers to infants that have been either evaluated only for acute illness or who have had no health care. In the majority of instances, these infants will have had no immunizations. Severe chronic illness: Any illness which significantly affects the infant's/toddler's quality of life or life expectancy. This could include asthma, cystic fibrosis, congenital heart disease, orthopedic problems, etc. Diagnosed genetic disorder: This refers to any number of disorders known to be genetically determined but without an abnormality in chromosome number or length (see direct referral indicators). Founded Child abuse/neglect: The medical staff and/or child protective services prior to enrollment must confirm this diagnosis.


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Severe Parenting Risk Factor: Document incidences of the following: a. Mental illness b. Mental retardation c. Physical disability d. Substance Abuse Environmental or social risk factor:

a. Lack of adequate shelter. This refers to situations where the parent has no permanent housing.

b. Lack of familial support This refers to situations where the mother has minimal or no other support persons available to assist her in the care of the infant/toddler.

c. Domestic violence Following is an example of what could be considered to be ‗other‘ risk factors. Difficulty in providing basic parenting: This indicator refers to any number of difficulties which have the potential to adversely affect the parent(s) ability to effectively care for the infant/toddler. It includes significant life stresses such as death, handicaps (visual, hearing, orthopedic, etc), unemployment, divorce, abandonment, incarceration. It also includes problems such as psychiatric disorders, depression, alcohol and/or other drug use.

guidance materials on: infant & toddler online tracking system

Documents