Child and Family Eligibility Factors  

Child and Family Eligibility Factors

DPH would again extend its appreciation to member of the ICC Standards Committee for their very thorough review of the Child and Family Eligibility factors (formerly known as Child and Family Risk Factors).  As discussed on the September webinar, the implementation of the Child and Family Eligibility factors will coincide with the upgrade to the EIIS system.  DPH anticipates a full implementation date of eitherMarch or April 2017.  Jean Shimer and her team will walk programs through the upgrade and it is anticipated that all programs will be upgraded by April.  A formal policy update with an implementation date will be provided once the EIIS upgrade requirements and timelines are more definitive.

In the interim, programs are encouraged to review the EI Child and Family Eligibility grid with staff, consider reflecting upon practices related to engaging families early in the process, discussing sensitive topics, and ensuring consistency that eligibility factors are reviewed will all parents regardless of reason for referral.

DPH has responded to the following questions from providers:

Question #1:  Would it be possible to add “talking points” to the examples/guidance section to help guide discussion with families?

Answer #1: The “Child and Family Eligibility Factors” grid provides guidance related to the procedures/evidence required to determine if the eligibility criteria apply as well as some examples.  “Talking points” are not provided.  The Standards Committee recommends programs reflect on program practice related to interviewing skills and the ability of staff to initiate difficult conversations which include sensitive topics.  If a program determines the need for additional training related to gathering sensitive information or interviewing skills, they should contact their Regional Specialist.

Question #2:  RE: Child Eligibility Factor 6.  Weight for Age and Weight for Height. Please provide clarification on what is considered a major percentiles or centiles for the criteria: “ A child’s weight for age has dropped 2 or more major percentiles in 3 months, if under 12 months of age, or 2 or more major percentiles in 6 months if between 12 and 36 months” .

Answer #2: The terms ‘percentile’ and ‘centile’ tend to be used interchangeably, although percentile seems to be used more often in the United States (‘percentiles’ is the term used in the CDC information about growth charts and their interpretation, whereas the World Health Organization-WHO tends to use ‘centiles’).

The major percentiles are the 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th, and 97th.  These are typically depicted with darker lines on growth charts.  Growth charts (available on the CDC website at: www.cdc.gov/growthcharts/ index.htm are provided in sets that display different major percentile lines to meet the needs of various users.  There is a helpful overview of growth charts on the CDC website at: www.cdc.gov/NCCdphp/dnpa/ growthcharts/training/modules/module2/text/module2print.pdf.  The grid will use the term “percentiles” throughout the document.

Question #3:  Is a phone intake (referral information) provided by a pediatrician’s office or DCF enough to justify a risk factor?

Answer#3: The documentation requirements of each child and family eligibility factor are noted in the grid under the “Procedures for determining presence of eligibility factor/Evidence required” column.

  • A phone referral/intake or fax with information from a DCF worker or supervisor that identifies that the child/family is receiving DCF services case would be sufficient to substantiate Eligibility Factor #18 – Open or Confirmed Protective Services Investigation.
  • A phone referral/intake or fax from DCF that reports information related to other potential Child or Family Eligibility Factors (for example parental disability, substance use or domestic violence) would require the EI team to follow the “Procedures for determining the presence of eligibility factor/Evidence required” associated with those particular eligibility factors (typically, self-identification). Multidisciplinary evaluation teams may not apply these risk factors without informing a parent the information (related to a different eligibility factor) was provided by a referral source and allowing the parent to self-identify the eligibility factor exists.
  • A phone referral/intake or fax from a pediatrician or hospital that includes information related to some of the medically based eligibility criteria (those associated with prematurity, for example) would require documentation from medical records to substantiate the factor would apply.

 

Question #4:  Does the evidence from an outside source (for example, birth records from a hospital) of the eligibility factor need to be received by the EI program in order to apply the eligibility factor (and potentially find the child eligible for services?)  We do not receive a detailed birth record or discharge form quickly enough prior to making the determination.

Answer #4: This procedure and the requirements for the evidence have not changed.  If the “Procedures for determining the presence of eligibility factor/Evidence required” section of the grid requires documentation as confirmation that the eligibility factor applies, the documentation must be available at the time eligibility is determined.  A program may need to develop systems to obtain this information within the 45 day timeline.  These may include asking parents to request the information at the time the referral is made to the program or sending a consent for the disclosure of information form to parents well in advance of when eligibility will be determined.

Question #5:  When will this be implemented and when will the EIIS be updated?  When should we begin training staff?

Answer #5: The DPH Webinar on September 27th, 2016 and dissemination of the DPH Early Intervention Eligibility Factors, Definitions, Criteria and Procedures grid was the notification to the field of the revision to the child and family eligibility factors.  The document was provided so that programs would have sufficient time to train staff.  The implementation date will coincide with updating the EIIS forms and EIIS system.  The anticipated implementation date is March or April 2017.  DPH will continue to provide updates on the progress of the EIIS update and a policy update with a definitive implementation date when known.

Please contact your Regional Specialist with any additional questions.