Chapter 3: Overview of Child and Family Connections - REVISED April 2015

3.1 What Is Child and Family Connections (CFC)

The CFC is the regional intake entity responsible for ensuring that all referrals to the EI Services System receive a timely response in a professional and family-centered manner. Each CFC is responsible for implementation of the EI Services System within their specific geographic region of the state. All staff employed as Service Coordinators or Parent Liaisons by a CFC are required to obtain an EI credential prior to providing services to families.

The CFC functions as the electronic link between the CFC region and the CBO via the state Cornerstone system. Client referral information is stored electronically in Cornerstone and routine updates are made based upon information obtained and decisions made with respect to eligibility, service planning, and service delivery through development and implementation of an Individualized Family Service Plan (IFSP).

3.2 CFC Functions

All CFC activities should be conducted in ways that are consistent with the FERPA and HIPAA. Service coordination is an active, ongoing process that involves assisting parents of infants and toddlers with disabilities in gaining access to, and coordinating the provision of, the EI services required under this part; and coordinating the other services identified in the IFSP under § 303.344(e) that are needed by, or are being provided to, the infant or toddler with a disability and that child's family.

CFCs shall ensure a temporary credentialed service coordinator never enters a child/families home without a fully credentialed service coordinator being present at all times. In addition, the CFC must ensure a Service Coordinator does not provide direct services to any child within the CFC geographic areas which they are employed. The CFC is responsible for ensuring parents are provided provider choice in accordance with Chapter 12-Individualized Family Services Plan (IFSP), see 12.8 & 12.9 - Provider Selection & Provisional Authorization Process.

  • CFC activities include:
    • Receiving referrals;
    • Developing, maintaining, and processing the permanent EI case record;
    • Providing families with information about the EI Services System, including accurate and timely information regarding choices or options and thorough information about rights, procedural safeguards, available advocacy services and opportunities and responsibilities under federal and state law;
    • Facilitating and participating in the IFSP development within 45 days after the initial date of referral also reviewing, monitoring, evaluating and updating;
    • Conducting and completing intake;
    • Coordinating the provision of EI and non-EI services and other services (such as educational, social and medical services that are not provided for diagnostic or evaluative purposes) that the child needs or is being provided for enrolled families;
    • Ensuring completion of initial and annual eligibility determination, including insurance and financial information;
    • Complying with family fee policies;
    • Coordinating evaluations and assessments necessary for development of IFSPs;
    • Completing current EI levels of development/child outcome ratings.
    • Conducting referral and other activities to assist families in identifying available EI providers; * Monitoring that the integrity of the IFSP process is maintained and completed.
    • Assisting the family in monitoring IFSP implementation and obtaining updated documentation from service providers listed on the IFSP; * Determine and ensure implementation of to determine that appropriate EI services are being provided by communicating monthly with the family, using a variety of mechanisms, including: using a variety of
      • face-to-face,
      • telephone,
      • written correspondence, and
      • other methods, including team meetings, to ensure that the family is well informed and functioning as an active participant in the implementation of the IFSP.;
    • Assuring that all IFSPs are reviewed at least every six months and updated annually;
    • Facilitating the development of a transition plan to preschool, school or, if appropriate, to other services
    • Being knowledgeable of and complying with all applicable federal and State laws, guidelines, procedures, rules, regulations, and executive orders applicable to CFC activities;
    • Maintaining accurate documentation in the form of case notes that summarize all conversations held between a Service Coordinator and a child's family and/or providers;
    • Participating in a process to measure family outcomes; and
    • Knowing, understanding, and following the philosophy of EI.
    • Social Emotional Activities (see Chapter 4 - CFC Support Services, 4.2 & 4.3 -Social Emotional Components for details) 
    • Parent Liaison Activities (See Chapter 4 - CFC Support Services, 4.6 & 4.7 - Parent Liaison Activities for details)
    • Pediatric Consultative Services (See Chapter 4 - CFC Support Services, 4.4 & 4.5 - Pediatric Consultative Services section for details).
    • Local system management activities
    • Providing adequate accessible and secure space and facilities to store permanent records, house staff and hold meetings;
    • Selecting, training and supervising qualified staff necessary to carry out the CFCs contractual obligations;
    • Maintaining a directory of non-EI financial resources and support services for use with families;
    • Maintaining permanent records for each child referred for a minimum of six years, in accordance with EI record-keeping requirements; Facilitating Local Interagency Council activities (See Chapter 4 - CFC Support Services, 4.8 - Local Interagency Council Coordination for details);
    • Assisting families in accessing non-EI financial resources and support services by making appropriate referrals while the child is enrolled with the EI Services System and at transition. Children found ineligible should be offered referrals for non-EI community resources prior to case closure;
    • Maintaining administrative and programmatic contact with all EI service providers in the service area;
    • Participating in routine monitoring and technical assistance activities as required by DHS, including on-site monitoring, data collection and reporting obligations, record reviews, financial audits, complaint investigations, and consumer satisfaction surveys;
    • Enrolling as an "All Kids Application Agent" in order to complete the All Kids application for families who may be eligible and choose to enroll in All Kids; and
    • Submitting data and reports as requested by the state and performing other activities as requested by DHS to assist in system implementation.

3.3 Overview of Program Manager Reports

CFC offices are required to submit reports that provide data concerning local system management activities.

3.4 Program Manager Reports Policy

  • 3.4.1 Each CFC Program Manager will report service delays to the DHS EI Program on a monthly basis.
  • 3.4.2 Each CFC Program Manager will report Service Coordination Caseload counts on a monthly basis.
  • 3.4.3 Each CFC Program Manager will report Family Fee Delinquency Activity on a monthly basis.
  • 3.4.4 Each CFC Program Manager will report Transition Referral activity on children referred less than 45 days from third birthday on a monthly basis.
  • 3.4.5 Each CFC Program Manager will work with their Local Interagency Council(s) (LICs) to address delays in services, provider recruitment and gaps in services due to lack of qualified credentialed/enrolled providers on an annual basis.

3.5 Program Manager Reports Procedure

  • The data for the service delays, the Service Coordination Caseload summary, the Transition Referral activity and the LICs information will be completed in a report format provided by the DHS EI Program. The Family Fee Delinquency report is formatted at the discretion of the CFC Program Manager.
  • 3.5.1 The service delays and transition referral activity will be reported monthly using the DHS-created database. The Program Manager must gather and report electronically the required service delay information for children for which the initial IFSP, six-month review, annual IFSP or specific services are delayed beyond the required time lines and will record the service delay information on the most current version of the EI Service Delay/Transition Referral Activity Worksheet.
  • 3.5.2 The Program Manager must gather and report electronically the required transition referral activity, as outlined in Chapter 7 of the manual, for children referred less than 45 days before their third birthday on the most current version of the EI Service Delay/Transition Referral Activity Worksheet. The transition referral activity information must be sent to the EI Program Data Manager via secure CBO webmail no later than the close of business the 15th day of the following month. In the event that the 15th of the month falls on a weekend or holiday the report must be submitted no later than the close of business of the next business day. NOTE: Service Delay reporting does not include medical diagnostic or AT services.
  • 3.5.3 The Service Coordination Caseload summary is automated through the Cornerstone system. The Program Manager, or their designee, must complete the AD22 - Employee Expenses to calculate the number of Full Time Equivalent (FTE) Service Coordination positions for the month. Only those Service Coordinators who are credentialed and carrying a caseload should be counted. Also if a Service Coordinator goes on leave, they should not be counted towards the FTE Count for any month they are on leave. Finally the CFC manager does not count towards the CFC FTE Count. In the event no FTE Count is recorded by the CFC in Cornerstone, the CFC will be reported has having 0 (zero) staff for the reporting month. The individual Service Coordinator staff information must be updated monthly no later than the 8th of the following month.
  • 3.5.4 The Program Manager must use the monthly CBO report of Family Fee delinquency to indicate the actions taken to contact families who are showing on the list as delinquent. Reporting can be any method to identify actions taken to contact families at the 30/60/90 days over-due point of the IFSP and activity taken to discontinue services for failure to comply with Family Fee policy. This information is due by the last day of the month of the receipt of the monthly Family Fee Delinquency report and is to be submitted to the EI Family Fee Specialist via fax or secure webmail.
  • 3.5.5 Six weeks after the end of the fiscal year, each CFC Program Manager will submit an annual report on the work of the LIC(s) to address delays in services, provider recruitment and gaps in services due to lack of qualified credentialed/enrolled providers and to coordinate, design and implement child find activities for the CFC office's geographic region.

3.6 CFC Nepotism Standards

To ensure authorizations are issued in accordance with the Provider Selection Policy found below, all Employees are subject to the following Nepotism policy and procedures.

3.6.1 A CFC employee may not issue authorizations, or influence another CFC employee to issue authorizations, to a) immediate family members and b) individuals who live in his/her household. A CFC employee may issue authorizations to extended family members as long as the CFC employee discloses the relationship in the Nepotism Disclosure Form, enters into an Individualized Nepotism Plan with the CFC Manager, and follows the Provider Selection Policy, all discussed below.

3.6.2 At the time of hire and each July 1 thereafter, each CFC employee must complete a Nepotism Disclosure Form (NDF). The CFC Program Manager is responsible for reviewing the NDF, and the NDF shall be maintained in the employee's employment file. If an employee discloses a provider or provider agency who is an immediate family member or lives in his/her household, the employee may not issue authorizations to that provider or provider agency, or influence another employee to issue authorizations to that provider or provider agency. The CFC Program Manager is responsible for making sure such authorizations do not occur. The CFC Manager shall provide to the CFC's EI Specialist at the Bureau a copy of each NDF where the CFC employee affirmatively answers that they have a familial (immediate or extended) relationship with an EI service provider or agency owner within 30 days of receipt.

3.6.3 If an employee discloses an extended family member, the CFC Program Manager shall develop a written Individualized Nepotism Plan (INP) for that employee to ensure compliance with the Provider Selection Policy. The INP shall be submitted for review to the CFC's EI Specialist at the Bureau within 30 days of the disclosure by the CFC employee. The CFC Program Manager must obtain Bureau approval of the INP. The employee will receive a copy of the final INP, and the INP shall be maintained in the employee's employment file.

3.6.4 On the first day of the annual CFC Compliance Monitoring, the CFC Program Manager shall provide EI Monitoring with a copy of any/all NDFs and INPs. EI Monitoring will review this documentation, and review necessary related documentation to ensure compliance.

3.6.5 An "immediate family member" is defined as any of the following relationships by blood-parent, child, brother, sister-and relationships by marriage-husband, wife, step-parent, stepchild, brother-in-law, son-in law, daughter-in law, half-brother, half-sister and cohabitating couples/significant others.

3.6.6 An "extended family member" is defined as any of the following relationships by blood-grandparent, grandchild, uncle, aunt, nephew, niece, first cousin-and relationships by marriage-aunt, uncle, nephew, and niece.

3.7 Provider Selection Policy and Procedures

The CFC shall ensure that Service Coordinators follow the Provider Selection Policy unless a CFC-specific plan of provider selection that has been submitted and approved by the Bureau with written documentation maintained.

Service Coordinators shall provide families with provider choice to the fullest extent possible. CFCs shall require providers to forward a "resume" or "curriculum vitae" to include in a booklet or electronic format to be presented to each family. The Service Coordinator shall never recommend a provider over another based upon personal preference. The final selection of the provider should be the family's based on the individual circumstances of that child/family. The choice of providers offered to the family may be limited due to the following:

  • 3.7.1 Initial Evaluating Providers
  • Service Coordinators shall consider the developmental needs of the child for determining any expertise or experience of one evaluator provider over another.
  • 3.7.1.1 If a family does not speak English, the Service Coordinator shall check for a bilingual evaluator provider(s). If a bilingual evaluator provider is available, the family shall be given the bilingual evaluator provider(s) to choose from.
  • 3.7.1.2 No single evaluator provider may evaluate a single child as two discipline types.
  • 3.7.1.3 The number of credentialed and enrolled EI evaluator providers in a geographic region may be limited.
  • 3.7.1.4 After these factors are considered, the Service Coordinator shall offer the family all available evaluator providers to perform the initial evaluations/assessments. The CFCs must offer all available evaluator providers and allow the family to choose and rank, in order of preference, 3 to 5 providers (if appropriate) and then contact the evaluator providers in the preference of the family for openings to evaluate/assess the child.
  • 3.7.2 Direct Service Providers
    • 3.7.2.1 Private insurance policies or other payors (i.e. DSCC) may require the use of network providers, except as specified in Chapter 10.0: Public and Private Insurance Use Determination of the CFC Procedure Manual.
    • 3.7.2.2 Service Coordinators shall consider the developmental needs of the child for determining any expertise or experience of one service provider over another.
    • 3.7.2.3 If a family does not speak English, the Service Coordinator shall check for a bilingual service provider(s). If a bilingual service provider is available, the family shall be given the bilingual service provider(s) to choose from.
    • 3.7.2.4 No single service provider may provide EI services to a single child as two discipline types.
    • 3.7.2.5 The number of credentialed and enrolled EI service providers in a geographic region may be limited.
  • After these factors are considered, the Service Coordinator shall offer the family all available service providers. The CFCs must offer all available providers and allow the family to choose and rank, in order of preference, 3 to 5 service providers (if appropriate) and then contact the service providers in the preference of the parent for openings to evaluate/assess the child.