Child and Family Connections permanent case records shall contain at a minimum:

  1. Accurate demographic, referral, financial and Insurance/All Kids information.
  2. Signed releases and consents;
  3. Evaluation/assessment reports, including copies of any reports that have been translated into a family's native language, and documentation of initial and annual eligibility determination;
  4. Current and past IFSPs;
  5. Service coordination case notes unless maintained electronically. NOTE: Case notes must contain accurate documentation and must include a summary of all conversations held between a Service Coordinator and a child's family and/or providers. If the incident was not case noted, the incident did not occur. Service Coordinator documentation must corroborate a service provider's consultation documentation concerning consultation between the service provider and the Service Coordinator;
  6. Any other periodic reviews describing the child's overall progress;
  7. Signed Screening Device for Determining Family Fees and Eligibility for All Kids & DSCC (pdf) which is completed at intake and annual eligibility determinations and documentation of eligibility or ineligibility for All Kids and DSCC, if applicable;
  8. Copies of all correspondence between CFC staff and the child's family, physician, EI service providers and anyone else contacted regarding the child, including copies of any correspondence that has been translated into a family's native language;
  9. HIPAA disclosure log;
  10. If closed, a case closure summary documenting the IFSP functional outcomes, the current EI levels of development as defined by the child outcomes ratings and a new hard copy of the service coordination case notes.
  11. Any other information required per policy, rule or law.

Child and Family Connections Permanent Case Records:

CFC permanent case records are arranged in sections with dividers. As documents are updated, file them in reverse chronological order so the most current document is on top. Hard copy items shall be filed as follows, if applicable for the child and family:

Section 1.0 Referral / Intake / Legal

  1. Consents (hard copy required)
  2. Releases (hard copy required)
  3. Early Intervention - ISBE Surrogate Parent Request Form
  4. Guardianship Information
  5. Other legal status information

Section 2.0 Service Plans

  1. Early Intervention - Evaluation/Assessment Plan/authorizations and attachments (hard copy required)
  2. Early Intervention - Interim IFSP and attachments (hard copy required)
  3. Early Intervention - IFSP and attachments (hard copy required)
  4. Copies of Provisional Provider Authorization Request forms and corresponding decision memos from DHS, if applicable
  5. A hard copy of service coordination case notes printed prior to case closure

Section 3.0 Reports

  1. Medical Reports (Health Summary Forms, Immunization Records, Other Medical Reports)
  2. EI Reports, including copies of reports translated into a family's native language (hard copy required)
  3. All other documentation collected during eligibility determination or Service Plan development, monitoring and update process (i.e., previous outside screenings, assessments, evaluations, etc.)

Section 4.0 Correspondence

  1. Letters, memos, e-mail (except insurance correspondence which is filed in the Financial Section), including letters and memos translated into a family's native language (hard copy required)

Section 5.0 Financial

  1. Financial assessment/documentation of income (hard copy required)
  2. Family Participation Fee Exemption Request and attachments (if applicable/hard copy required)
  3. Insurance Affidavit, Assignment and Release (hard copy required)
  4. Documentation of private insurance coverage
  5. Insurance Exemption Request and attachments (if applicable/hard copy required)
  6. Documentation of public insurance coverage (Copy of All Kids recipient identification card, if applicable. Hard copy required)
  7. Insurance correspondence
  8. Documentation regarding eligibility or ineligibility for other third party payors, including Division of Specialized Care for Children (DSCC)
  9. Screening Device for Determining Family Fees and Eligibility for All Kids & DSCC (hard copy required)

Section 6.0 HIPAA Disclosure Log

  1. A HIPAA disclosure log must be attached to the front inside cover of each file.